KR101703564B1 - Appratus and method for displaying medical images including information of vascular structure - Google Patents

Abstract

An apparatus and method for displaying a pre-operative CT (Computed Tomography) image before an intra-operative real-time X-ray image is displayed. The disclosed display device matches an X-ray image of a patient who has received a contrast agent with a CT image taken before the operation, and displays the registered image again by matching with the real time X-ray image. According to the disclosed apparatus and method, it is possible to display three-dimensional blood vessel information on a real-time X-ray image, thereby improving convenience and stability of the procedure.

Description

[0001] APPARATUS AND METHOD FOR DISPLAYING MEDICAL IMAGES [0002] BACKGROUND OF THE INVENTION [0003]

TECHNICAL FIELD The present invention relates to a technique for displaying a medical image, and more particularly, to a medical image display apparatus and a method thereof that can assist in finding an accurate position and direction of a blood vessel during angiography or stenting.

The present invention was derived from research conducted as part of the industry convergence technology development project of the Ministry of Commerce, Industry and Energy and the Korea Industrial Technology Evaluation & Management Service [assignment number: 10044910, title: 3-D Ultra Precision Simulation Diagnosis of Vascular Disease - Development of integrated software system for treatment support].

Recently, coronary artery disease is rapidly increasing due to western diet, longevity, and lack of exercise. Coronary artery disease is a disease that occurs when the coronary artery becomes narrowed or closed due to stenosis and fails to meet the metabolic demand in the myocardium. Stent implantation / implantation is used to relieve stenosis by implanting / deploying a metal mesh stent into the lesion as a typical treatment method. Stent implantation / implantation is a non-surgical treatment method that uses minimal incision, anesthesia, and invasive manipulation, so it has the advantage of less physical, mental, and economic burden on the patient. However, since the medical staff depends on the 2D XA (X-ray Angiogram) image during the procedure, the 3D structure of the blood vessel to be operated depends on the medical staff's intuition and tactile feedback, so it is difficult to guarantee the accuracy of the high- . In order to compensate for these drawbacks, research has been conducted actively on a technique for displaying a 2D XA image acquired during a procedure and a 3D CTA (Computed Tomography) image obtained before the operation to display the image in real time during the procedure.

For example, US Pat. No. 8,831,303 entitled " DETECTION AND TRACKING OF INTERVENTIONAL TOOLS "introduces an assistive technology through intra-operative 2D XA imaging and pre-operative 3D CT imaging. The prior art attempts to improve the accuracy of the matching between the 2D projected image of the 3D CT image in 2D and the discrepancy map of the 2D real-time moving image (fluoroscopic image).

However, according to the prior art, there is a problem that depth information is lost in an image of a 3D CT image projected in 2D, which causes the visibility of a practitioner to be greatly reduced.

US Patent No. 8,831,303 entitled " DETECTION AND TRACKING OF INTERVENTIONAL TOOLS "(Registered on April 09, 2014)

"High-speed Rigid Body Matching Technique of 2D XA Imaging and Pre-operative 3D CTA Imaging during Surgery", Journal of Korea Multimedia Society Vol. 16, No.12, Taeyong Park et al. (Release date: December 2013)

Existing prior art research has focused primarily on algorithm refinement to accelerate rigid or non-rigid matching processes in 2D-3D matching processes. However, due to the recent rapid development of computing power, the 2D-3D matching time has been dramatically shortened.

In the course of the procedure, the practitioner must perform the procedure while viewing only the 2D real-time moving image (fluoroscopic image) without confirming the 3D information of the blood vessel information obtained from the 3D image, that is, the depth information. Therefore, It was not easy.

An object of the present invention is to provide minimally invasive procedures for blood vessels by providing 3D vascular structure information obtained from a 3D image on a 2D real time video to a practitioner during a procedure.

An object of the present invention is to provide an overlay of depth information of 3D vascular structure information on a 2D real-time moving image so that the operator can easily identify the depth information.

SUMMARY OF THE INVENTION An object of the present invention is to improve the safety of vascular stenting by providing 3D vascular structure information on a 2D real-time video.

SUMMARY OF THE INVENTION An object of the present invention is to provide a visualization of 3D vascular structure information on a 2D real-time video, thereby shortening the time required for vascular stenting and reducing the radiation dose of the patient.

The object of the present invention is to shorten the procedure time by minimizing the automatic / manual adjustment of the C-arm equipped with the 2D real-time moving image photographing apparatus during the vascular stent procedure.

An object of the present invention is to provide an overlay of a vascular stent plan based on three-dimensional structure information of a blood vessel so as to be easily identifiable by a practitioner on a 2D real-time video.

The purpose of the following embodiments is to virtually display the position of a blood vessel in a real-time image in which a contrast agent is not input.

The purpose of the following embodiments is to display the position and orientation of the stent planned in the planning stage on a real-time image with no contrast injected.

According to an exemplary embodiment, an image matching between a first medical image including three-dimensional anatomical information of a patient and a second medical image obtained after a contrast agent is administered to the blood vessel of the patient is executed A first image processing unit for generating first anatomical information including three-dimensional blood vessel information of the patient; An obtaining unit for receiving the third medical image obtained for the patient; And a second image processor for matching the first anatomical information with the third medical image and generating a fourth medical image overlaid with the first anatomical information on the third medical image, An image display device is provided.

The first medical image may be a pre-operative 3D medical image, and may include a CT image and an MR image. The second medical image is a fluoroscopic image obtained for a certain period of time after administration of the contrast agent, and may be called a standard moving image or a reference moving image.

The third medical image means a moving image that is obtained in real time while the contrast agent is not being administered and the fourth medical image means a medical image to be displayed during the procedure according to the embodiment of the present invention.

At this time, the second image processing unit may generate the fourth medical image including the depth information of the first anatomical information.

Here, the second image processing unit may generate and display a fourth medical image including information on the position or direction of the stent to be implanted in the blood vessel.

The second image processing unit may further include a simulation unit for simulating a blood flow velocity or a pressure inside a blood vessel according to a position or a direction of the stent to be placed in the blood vessel, The fourth medical image including the second medical image can be overlaid on the real time X-ray video.

In addition, the standard X-ray moving image obtained after administration of the contrast agent may include information on the variation of the blood vessel over time. The first image processing unit may generate the first anatomical information including information on the variation of the blood vessel over time.

The apparatus may further include a modeling unit that transforms the first anatomical information including the 3D vessel information into a model matched with a standard X-ray video using information on the variation of the blood vessel, It is possible to perform image matching using a model matched to a standard X-ray moving picture.

The modeling unit transforms the first anatomical information including the three-dimensional vessel information into a model matched with the real-time X-ray moving image of the patient, and the second image processing unit transforms the first anatomical information including the three- The model can be used to match real-time X-ray videos with the first anatomical information.

In addition, the second image processor may determine a display attribute of the blood vessel based on depth information of the blood vessel among the first anatomical information.

According to yet another exemplary embodiment, there is provided a method comprising: obtaining a first medical image comprising three-dimensional anatomical information of a patient; Obtaining a second medical image obtained after the contrast agent is administered to the blood vessel of the patient; Performing image matching between the first medical image and the second medical image to generate first anatomical information including three-dimensional blood vessel information of the patient; Receiving a third medical image obtained for the patient; And matching the first anatomical information with the third medical image and generating a fourth medical image overlaid on the third medical image with the first anatomical information overlaid on the third medical image, .

At this time, the step of generating the fourth medical image may generate the fourth medical image including the depth information of the first anatomical information.

Here, the method may further include acquiring a plan to place the stent into the blood vessel based on the three-dimensional blood vessel information. At this time, the step of generating the fourth medical image may generate the fourth medical image including information on at least one of the position or direction of the stent to be implanted in the blood vessel according to the plan.

And simulating the blood flow velocity or the pressure inside the blood vessel according to the position or direction of the stent and overlaying the simulated blood flow velocity or pressure inside the blood vessel on the real time X-ray movie to generate a fourth medical image, And displaying it.

In addition, the standard X-ray moving image may include information on the variation of the blood vessel over time. The step of generating the first anatomical information may generate the first anatomical information including information on the variation of the vessel over time.

Extracting information on a variation of a blood vessel from the standard X-ray video; And transforming the first anatomical information including the three-dimensional vessel information into a model matched with the standard X-ray moving image by using information on the variation of the extracted blood vessel, wherein the first anatomical information The step of generating information may perform image matching using a model matched to the standard X-ray moving image. The first anatomical information may be generated to include information about variations in blood vessels.

The method may further include transforming the 3D vessel information into a model matched with a real time X-ray moving image of the patient, wherein the generating the fourth medical image includes: The first anatomical information and the real-time X-ray video can be matched.

The generating of the fourth medical image may include determining a display property of the blood vessel based on depth information of the blood vessel among the first anatomical information; And generating the fourth medical image including a blood vessel image reflecting the determined display property.

According to the present invention, it is possible to provide the 3D vessel structure information obtained from the 3D image on the 2D real-time video to the practitioner in the procedure to support the minimally invasive procedure for the blood vessel.

According to the present invention, depth information of 3D vascular structure information can be overlaid on the 2D real-time moving image so that the practitioner can easily identify the depth information.

According to the present invention, 3D vessel structure information is provided on a 2D real-time moving image, thereby enhancing the safety of vessel stenting.

According to the present invention, 3D vessel structure information is visualized and provided on a 2D real-time video, thereby shortening the time required for vessel stenting and reducing the radiation dose of the patient.

According to the present invention, it is possible to shorten the procedure time by minimizing the automatic / manual adjustment of the C-arm equipped with the 2D real-time moving image photographing apparatus during the vessel stenting operation.

According to the present invention, a vessel stent plan based on three-dimensional structure information of a blood vessel can be overlaid on a 2D real-time moving image so that the operator can easily identify the vessel.

According to the embodiments described below, it is possible to virtually display the position of a blood vessel in a non-contrasted real-time image.

According to the embodiments described below, the position and orientation of the stent planned in the planning stage can be displayed on the non-contrasted real-time image.

1 is a view illustrating an image display apparatus according to an exemplary embodiment.
2 is a view for explaining a stent insertion procedure according to an exemplary embodiment.
FIG. 3 is a view showing that a CT image is matched with a real-time X-ray image, and blood vessel information is overlaid on a real-time X-ray image according to an exemplary embodiment.
4 is a view showing a medical image display apparatus according to an exemplary embodiment.
5 is a view showing a medical image display apparatus according to another exemplary embodiment.
6 is a view showing a medical image display apparatus according to another exemplary embodiment.
7 is a diagram illustrating a medical image display method according to an exemplary embodiment.
8 is a diagram illustrating a medical image display method according to another exemplary embodiment.
9 is a diagram illustrating a medical image display method according to another exemplary embodiment.
10 is a diagram illustrating a medical image display method according to another exemplary embodiment.
FIG. 11 is a view illustrating a display of overlaying and displaying blood vessel information on a real-time X-ray image by matching a CT image with a real-time X-ray image according to another exemplary embodiment.

Other objects and features of the present invention will become apparent from the following description of embodiments with reference to the accompanying drawings.

Preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the following description of the present invention, a detailed description of known functions and configurations incorporated herein will be omitted when it may make the subject matter of the present invention rather unclear.

However, the present invention is not limited to or limited by the embodiments. Like reference symbols in the drawings denote like elements.

Hereinafter, embodiments will be described in detail with reference to the accompanying drawings.

1 is a view illustrating an image display apparatus according to an exemplary embodiment.

The C-arm 110 is a mobile X-ray fluoroscopic device used in a limited narrow space, such as an operating room. The C-arm 110 is a semi-circular arm 130 and the X-ray imaging apparatus 121 and 122 are provided at the ends of the semicircular arm 130.

The C-arm 110 is preferred to both patients and practitioners because it can transmit extremely small amounts of X-rays compared to other X-ray inspection equipment.

The C-arm 110 can transmit a very small amount of X-ray, so that the patient can be photographed in a real-time X-ray image, and the photographed real-time X-ray image is displayed through the medical image display device 140 . Although the CT (Computed Tomography) and the MRI (Magnetic Resonance Imaging) can not photograph the patient's condition in real time, the C-arm 110 shown in FIG. 1 can photograph the patient's condition in a real time X-ray image. Accordingly, the physician can refer to the real-time X-ray image displayed through the medical image display device 140 in order to grasp the state of the patient during the operation, the progress status of the operation, and the like.

However, since the general real-time X-ray image does not include the blood vessel information of the patient, in order to refer to the patient's blood vessel information in order to perform the stent insertion, etc., X-ray imaging of patients with imaging or contrast agents should be used. However, the X-ray image of the patient who received the CT image or the contrast agent is not the image captured during the procedure but the image of the patient before the operation. Therefore, it is difficult to determine the success or failure of the operation through the real-time X-ray image because the result of the procedure or procedure is not reflected.

2 is a view for explaining a stent insertion procedure according to an exemplary embodiment.

2 (a) is a view showing normal blood vessels 211 and 212 which are not narrowed. In FIG. 2 (a), the blood vessels 211 and 212 are spaced apart from each other by a predetermined distance to maintain a space through which blood can flow.

FIG. 2 (b) is a diagram showing abnormal blood vessels 221 and 222 having narrowed blood vessels. According to one aspect, when the endothelial cells inside the artery are damaged or arteriosclerosis progresses, the blood vessels 221 and 222 become narrow as shown in FIG. 2 (b). When the blood vessels 221 and 222 are narrowed, blood does not easily flow and the pressure inside the blood vessel increases. 2 (b), if the blood vessels 221 and 222 are narrowed, they may develop into a myocardial infarction, and treatment is required.

2 (c) is a view showing blood vessels 231 and 232 into which the stent 240 is inserted.

When the blood vessels 221 and 222 are narrowed as shown in FIG. 2 (b), the blood vessels 231 and 232 can be widened by inserting the stent. According to one side, the vessel can be inserted into the vessel after the vessel is stenosed using cardiovascular techniques. The stent 240 can be inserted as shown in FIG. 2 (c) using the inserted conduit. The stent 240 is a kind of metal mesh, and is inserted in a region where stenosis has occurred to prevent restenosis.

When the stent 240 is inserted as shown in FIG. 2 (c), the blood vessels 231 and 232 are again widened and the pressure inside the blood vessel is lowered.

FIG. 3 is a view showing that a CT image is matched with a real-time X-ray image, and blood vessel information is overlaid on a real-time X-ray image according to an exemplary embodiment.

3 (a) shows that the blood vessel information 320 is overlaid and displayed on the real-time X-ray image 310. FIG. Here, the real-time X-ray image 310 is a real-time video shot using a C-arm intra-operatively during a doctor's procedure such as stent insertion. In addition, the blood vessel information 320 is information on blood vessels extracted from a pre-operatively captured CT image, and can indicate the direction and thickness of the blood vessel. Particularly, in FIG. 3 (a), the thickness of the blood vessel is overlaid on the real-time X-ray image 310 such that the shape of the blood vessel is exposed.

According to one aspect, information (stent procedure plan information) about the planned stent 330 before the operation can be displayed overlaid on the real-time X-ray image. Here, the information on the stent 330 may include information on the position, direction, and type of the stent.

3B shows that the blood vessel information 350 is overlaid and displayed on the real-time X-ray image 340. FIG. In FIG. 3 (b), information on the thickness of the blood vessel is deleted, and only the centerline 350 of the blood vessel is extracted and overlaid on the real-time X-ray image 340.

Also in FIG. 3 (b), information about the stent 360 planned before the operation is overlaid.

As shown in FIG. 3, if the patient's blood vessel information and stent information are overlaid and displayed on the real-time moving image, the physician can obtain sufficient information for the operation with only the real-time X-ray image displayed on the medical image display device. Therefore, it is possible to concentrate more on the procedure, and it is possible to easily grasp the success or failure of the procedure, thereby improving convenience and stability of the procedure.

In FIGS. 1 to 3, a CT image is presented as an example of a 3D image before the procedure, but any modality capable of providing 3D anatomical structure information can be applied without limitation, and a magnetic resonance (MR) As shown in FIG.

1 to 3 illustrate an embodiment in which a stent is implanted in a blood vessel, the spirit of the present invention is not limited to this. It will be understood by those skilled in the art that the concept of the present invention can be applied not only to blood vessels but also to tubular structures such as lymph vessels, esophagus, colon, and the like. In the following embodiments, the concept of the present invention will be described focusing on blood vessels for convenience of explanation.

4 is a view showing a medical image display apparatus according to an exemplary embodiment. The medical image display device 400 according to the exemplary embodiment may include a processor (not shown). The processor may include a first obtaining unit 410, a matching unit 420, a second obtaining unit 430, and an image processing unit 440.

The first acquiring unit 410 acquires an X-ray image of a patient who has administered a contrast agent, that is, a standard X-ray movie. Contrast agents are artificially introduced into the stomach, intestines, blood vessels, cerebrospinal fluid, joints, and so on, so that the X-ray absorption of each tissue can be artificially enlarged so that the tissues and blood vessels can be seen during radiographic examinations such as MRI, CT, and X- Thereby enhancing the contrast of the image. Therefore, the X-ray image of the patient receiving the contrast agent is contrasted with the area where the contrast agent is not administered.

According to one aspect, the first acquiring unit 410 may acquire an X-ray image of a patient who has administered contrast agent to a blood vessel. In this case, the X-ray image clearly shows the blood vessel shape of the patient in contrast to the other parts.

According to one aspect, the first acquiring unit 410 may acquire an X-ray movie of a patient who has administered contrast agent to a blood vessel. In this case, the X-ray moving image acquired by the first acquiring unit 410 may include an image in which the contrast agent spreads to the blood vessel along the shape of the blood vessel.

The X-ray video of the patient receiving the contrast agent is taken for a predetermined time. During the shooting time, the patient's blood vessel position may be changed due to respiration, pulse, or movement. Here, fluctuations due to respiration and pulse are periodic fluctuations, and fluctuations due to patient movement can be classified into non-periodic fluctuations.

Therefore, the X-ray image to which the contrast agent is administered may include information on the variation of the blood vessel over time. Here, the information on the variation of the blood vessel may include information on the range of the variation, the period of the variation, the center position of the variation, and the like. That is, information on the position of the blood vessels in the maximal respiratory tract and the minimum respiratory tract, the shape of the blood vessels, and the like may be included. In addition, since blood vessels are not always constant in the maximal respiratory and minimal respiration, information on the position, movement, shape range of the blood vessels in the maximal respiratory, and the position, movement, and range of the blood vessels in the minimum respiratory May be included. Preliminary signals for changes in blood vessels can be obtained through additional sensors such as electrocardiogram (ECG) or electromyogram (EMG).

In addition, the first acquiring unit 410 may acquire a CT image including three-dimensional blood vessel information of a patient. Here, the CT image is an image photographed using a computer tomography technique. Unlike general X-ray images, when a computer tomography technique is used, a cross-sectional image of a patient is obtained, which can be obtained by synthesizing using a computer. In particular, the CT image acquired by the first acquiring unit 410 may include three-dimensional blood vessel information of the patient.

The first acquiring unit 410 may acquire the stent plan plan information generated based on the CT image including the three-dimensional vessel information of the patient. The stenting plan may include information such as the type, size, material, and flexibility of the stent. The stenting plan may further include information about the location of the stent in the blood vessel, and may include information about the pressure to inflate the stent.

The matching unit 420 matches the CT image including the three-dimensional vessel information of the patient with the standard X-ray image to which the contrast agent is administered. At this time, matching with the standard X-ray image may be the CT image itself, but it may be a rendered model of the 3D vessel structure obtained from the CT image. Also, matching with a standard X-ray image may further include anatomical information about an organ such as heart, lung, or the like around the blood vessel, as needed, according to need.

The second acquiring unit 430 acquires a real-time X-ray image of the patient. The X-ray image and the CT image of the patient who received the contrast agent acquired by the first acquiring unit 410 and the real-time X-ray image acquired by the second acquiring unit 430, And C-arm equipment at the time of diagnosis, and it is an image obtained by photographing the patient during the procedure.

Because the X-ray can not be projected for a long time, the resolution of the real-time X-ray image is lower than the resolution of the X-ray or CT image of the patient receiving the contrast agent and does not include the patient's blood vessel information.

The image processing unit 440 aligns the matching image of the matching unit 420 with the real-time X-ray image, and displays the overlay on the real-time X-ray image. According to one aspect, the overlaid image may be displayed through a display device located around the C-arm as shown in FIG. At this time, the generated (overlaid) image to be displayed on the display device includes the anatomical information about the blood vessel and the organ of the patient appearing in the real-time X-ray moving image, and the 3D vascular structure information obtained from the CT or MR image Which may include more precise anatomical information.

According to one aspect, the image processing unit 440 can overlay the real-time X-ray image with information on the position or direction of the stent to be inserted into the patient's blood vessel. The physician can compare the position of the stent to be inserted into the blood vessel with the position of the actually inserted stent in the real-time X-ray image, and thus, the success of the stent insertion can be grasped at a glance.

The doctor who performs the operation can grasp the current state of the patient and the blood vessel information of the patient at a glance through the display device. Therefore, additional manipulation of the C-arm can be avoided, and trial-and-error can be reduced. The doctor can concentrate on the procedure, shortening the total procedure time and reducing the patient's radiation exposure dose.

According to the embodiment shown in FIG. 4, 3D vessel information is overlaid and displayed on a two-dimensional real-time X-ray image. Accordingly, the image processing unit 440 can additionally display the depth information of the blood vessel among the three-dimensional blood vessel information.

According to the related art, depth information of three-dimensional blood vessel information is lost in the process of matching three-dimensional blood vessel information obtained through a CT image or an MR image to a two-dimensional real-time X-ray moving image (fluoroscopic image). According to this, the practitioner can only distinguish the contour of the blood vessel on the 2D projection plane, and it is difficult to know the three-dimensional path, shape and direction of the blood vessel. Therefore, the practitioner needs to check the three-dimensional path, shape, and direction of the blood vessel and to confirm whether or not the catheter being operated on is in accordance with the stenting plan. As an example of such a confirmation process, the stereoscopic path, shape, and direction of the blood vessel can be confirmed while changing the shooting angle and view point of the real-time X-ray movie through automatic or manual rotation and angle adjustment of the C-arm.

In particular, at the point where the blood vessel branches, the catheter must be accurately guided to the target branch among the various branches of the blood vessel. To this end, adjustment of the photographing angle and the like through adjustment of the C-arm frequently occurs.

As the practitioner adjusts the C-arm several times during the procedure, the procedure time becomes longer and the patient's exposure dose increases. According to the embodiments of the present invention, the practitioner can confirm the depth information at the branch point of the blood vessel, thereby avoiding additional operations such as adjustment of the C-arm. For example, if a blood vessel branch approaching an operator at a branch point of the blood vessel and a blood vessel branch approaching the operator are overlaid on a real-time X-ray image by image processing using different colors, patterns, or contours, the operator can select a desired vessel branch Since it is easy to check whether it is matched, the procedure can be carried out without additional manipulation of the C-arm.

Thus, the practitioner can reduce trial and error, shorten the total procedure time, and reduce the overall radiation exposure dose. It is very important to reduce the radiation exposure dose. It is very important that the development of the vascular stenting method that can reduce the radiation exposure dose is very important because the radiation is exposed not only to the patient but also the staff and the staff around it. I have.

According to one aspect, the image processing unit 440 can determine a display attribute for the blood vessel based on the depth information of the blood vessel. Here, the display attribute may include at least one of color, pattern, number, contrast, and thickness of the blood vessel. The image processor 440 may display depth information of a blood vessel by varying at least one of color, pattern, number, contrast, and thickness of the blood vessel according to the determined display property.

The image processing unit 440 may overlay the information on the stent included in the stent plan on the real-time X-ray image to generate an image to be displayed. In particular, displaying the position of the stent in association with the blood vessel can be very important to the practitioner, which may be interpreted as providing the operator with the navigation to accurately guide the catheter to the target vessel position.

When the color of each part of the virtual blood vessel image to be overlaid on the real time X-ray moving image is differently displayed based on the depth information, a certain length of the virtual blood vessel image may be divided into segments. Or a color corresponding to the depth value along the center line of the virtual blood vessel.

FIG. 11 is a flowchart illustrating a method of matching anatomical information including three-dimensional structure information of a blood vessel with a real-time X-ray image according to another exemplary embodiment of the present invention, FIG. 2 is a view showing an overlay display.

Referring to FIG. 11, the 3D structure information 1120 of a blood vessel is overlaid on a real-time X-ray moving image 1110.

At this time, the three-dimensional structure information 1120 of the blood vessel can be displayed including depth information expressed in color. For example, since the first branch 1121 and the second branch 1122 of the three-dimensional structure information 1120 have different depth information, they may be displayed in different colors, shades or patterns. At this time, the blood vessels can be divided into segment units of a predetermined length, and display attributes such as color, contrast, or pattern can be determined for each segment according to the representative depth value. Or the display attribute may be expressed according to the depth value of each voxel of the three-dimensional structure information of the blood vessel. At this time, the blood vessel may have a continuously changing display property.

FIG. 11 shows an embodiment in which depth information is reflected in a display attribute. However, according to another embodiment of the present invention, a medical image display based on a display attribute reflecting a result of a blood vessel simulation according to a stenting plan can be also performed. That is, the blood flow rate in the blood vessel, the pressure on the outer wall of the blood vessel, and the like can be displayed in color, contrast, pattern, or symbol.

5 is a view showing a medical image display apparatus according to another exemplary embodiment. The medical image display apparatus 500 according to the exemplary embodiment may include a processor including a first obtaining unit 510, a matching unit 520, a second obtaining unit 530, an image processing unit 540, And a simulation unit 550.

The first obtaining unit 510, the matching unit 520, the second obtaining unit 530, and the image processing unit 540 in FIG. 5 correspond to the first obtaining unit 410, the matching unit 420, The second acquiring unit 430, and the image processing unit 440, detailed description thereof will be omitted.

The simulation unit 550 simulates the blood flow velocity or the pressure inside the blood vessel according to the position or orientation of the stent planned before the operation. The image processor 540 may display the simulated blood flow velocity or pressure inside the blood vessel overlaying the real-time X-ray image.

According to one aspect, the image processing unit 540 may determine a display attribute for the blood vessel according to the simulated blood flow velocity or the pressure inside the blood vessel. Here, the display attribute may include at least one of color, pattern, number, contrast, and thickness of the blood vessel. The image processor 540 may display at least one of the color, pattern, number, contrast, and thickness of the blood vessel according to the determined display property to express the simulated blood flow velocity or the pressure inside the blood vessel.

5, an embodiment in which the simulation unit 550 simulates the blood flow velocity or the pressure inside the blood vessel according to the position or direction of the stent planned before the operation is shown. According to another embodiment of the present invention, a simulation of the blood flow velocity or the pressure inside the blood vessel due to the placement of the stent in the planning process can be performed by an external planning system or a simulation system. At this time, the medical image display apparatus of the present invention can obtain the result of the simulation executed by the external planning system or the simulation system, and the image processing unit can display the result of the simulation overlaying the real time X-ray movie .

6 is a view showing a medical image display apparatus according to another exemplary embodiment. The medical image display apparatus 600 according to the exemplary embodiment may include a processor including a first obtaining unit 610, a matching unit 620, a second obtaining unit 630, an image processing unit 640, A simulation unit 650, and a modeling unit 660. The first obtaining unit 610, the matching unit 620, the second obtaining unit 630 and the image processing unit 640 shown in FIG. 6 correspond to the first obtaining unit 410, the matching unit 420, The second acquiring unit 430, and the image processing unit 440, detailed description thereof will be omitted.

As described above, the X-ray image of the patient who administered the contrast agent acquired by the first acquiring unit 610 may include information on the variation of the blood vessel over time.

The modeling unit 660 transforms the three-dimensional blood vessel information of the CT image into a model matched with the X-ray image of the patient using the information of the blood vessel variation. In this case, the matching unit 620 matches the CT image to the X-ray image of the patient who received the contrast agent using a model matched to the X-ray image of the patient who administered the contrast agent.

According to one aspect, the modeling unit 660 transforms the 3D vessel information of the CT image into a model matched with the real-time X-ray image acquired by the second acquiring unit 630. In this case, the image processing unit 640 may overlay the matched image with a real-time X-ray image using a model matched to the real-time X-ray image.

The image processor 640 can display the depth information of the stent to the operator in detail by overlaying and displaying the shape and position of the stent, which is included in the stent plan planning information, after being placed in the blood vessel. Especially, it is very important to grasp the information such as the direction in which the stent emerges in the z-axis direction and the direction in which the stent is moved along the blood vessel. Given the depth direction information of the blood vessel branch that diverges from the divergent point of the blood vessel, the practitioner will be able to significantly reduce the number and time of rotating the C-arm angle or changing the shooting conditions.

The image processing unit 640 may display the depth direction information of the stent and the depth direction information of the blood vessel together or may display a predetermined marker so that the operator can pay attention to the branch point of the blood vessel. It is also possible to add and display information that guides the orientation of the wire or catheter that is preloaded to inject the stent on the z-axis in the plan.

The simulation unit 650 can simulate information such as the fractional flow reserve (FFR) of the virtual blood vessel, and the modeling unit 660 can obtain the anatomical information of the 3D vessel structure through the simulated computation information You can update to a richer state. Particularly, FFR in the blood vessels is inconvenient because the pressure sensor is inserted into the body during the procedure to measure the pressure in the blood vessel. Therefore, the cooperative operation of the simulation unit 650 and the modeling unit 660 can reduce the FFR , It is possible to minimize the intra-vascular pressure measurement process by inserting the pressure sensor into the body.

7 is a diagram illustrating a medical image display method according to an exemplary embodiment.

In step 710, the medical image display device acquires the CT image of the patient. Here, a CT image is a computer-generated image of a cross-sectional image of a patient photographed using a computer tomography technique, and may include three-dimensional blood vessel information of a patient.

In step 720, the medical image display device acquires an X-ray image of the patient who administered the contrast agent. An X-ray image of the patient receiving the contrast agent is taken for a predetermined time and may include information on the variation of the blood vessel over time.

In step 730, the medical image display device matches the CT image containing the patient's three-dimensional vessel information to the X-ray image of the patient receiving the contrast agent. Here, both the X-ray image of the patient receiving the contrast agent and the CT image containing the 3D vessel information may be images taken before the operation.

In step 740, the medical imaging display device acquires a real-time X-ray image of the patient. Here, a real-time X-ray image of a patient is an image of a patient during the procedure.

In step 750, the medical image display device aligns the matched image with the real-time X-ray image in step 720, and displays the overlay on the real-time X-ray image.

According to one aspect, in step 750, the medical image display device may display information on the position or orientation of the stent to be inserted into the patient's blood vessel, overlaying the real-time X-ray image. If information about the position or orientation of the stent is displayed at the planning stage, the doctor compares it with information about the position or orientation of the inserted stent in the real-time X-ray image. .

8 is a diagram illustrating a medical image display method according to another exemplary embodiment.

8 (a) is a diagram showing a specific configuration for matching a CT image to an X-ray image of a patient to which contrast agent is administered.

In step 810, the medical image display apparatus transforms the three-dimensional blood vessel information of the CT image into a model matched with the X-ray image of the patient using the contrast agent, using information on the variation of the blood vessel.

In this case, in step 730, the medical image display device can match the CT image to the X-ray image of the patient who received the contrast agent using a model matched to the X-ray image of the patient who administered the contrast agent.

FIG. 8 (b) is a diagram showing a specific configuration for displaying a matched image by matching with a real-time X-ray image.

In step 820, the medical image display device transforms the three-dimensional vessel information into a model that matches the real-time X-ray image of the patient.

In this case, the medical image display device can overlay the matched image on the real-time X-ray image using the model matched to the real-time X-ray image in step 750.

9 is a diagram illustrating a medical image display method according to another exemplary embodiment.

9 (a), the medical image display device can display information on a stent to be inserted into a blood vessel by overlaying the real-time X-ray image. For example, in step 910, the medical image display device may display information about the position or orientation of the stent determined in the planning step prior to the procedure.

If information about the position or orientation of the stent is displayed at the planning stage, the doctor compares it with information about the position or orientation of the inserted stent in the real-time X-ray image. .

In (b) of FIG. 9, the medical image display device can display the effect after the stent insertion operation on a real-time X-ray image.

In step 920, the medical image display device may simulate blood flow velocity or pressure inside the vessel depending on the position or orientation of the stent to be inserted into the blood vessel. Here, the position or direction of the stent to be inserted into the blood vessel may be determined in the planning step before the procedure.

In step 930, the medical imaging display device may display simulated blood flow velocity or intra-vessel pressure overlay on real-time X-ray images. According to one aspect, the medical image display device determines a display attribute for the blood vessel in accordance with the simulated blood flow velocity or the pressure inside the blood vessel, and displays the blood vessel according to the determined display property to indicate the simulated blood flow velocity or the pressure inside the blood vessel .

10 is a diagram illustrating a medical image display method according to another exemplary embodiment.

In FIG. 10, the medical image display apparatus can display the depth information of the blood vessel among the three-dimensional vessel information on a two-dimensional real-time X-ray image.

In step 1010, the medical image display device may determine a display attribute for a blood vessel based on depth information of the blood vessel. Here, the display attribute may include at least one of color, pattern, number, contrast, and thickness of the blood vessel.

In step 1010, the medical image display device may display at least one of the color, pattern, number, contrast, and thickness of the blood vessel in accordance with the determined display property to overlay the depth information of the blood vessel on the real time X-ray image .

The method according to an embodiment may be implemented in the form of a program command that can be executed through various computer means and recorded in a computer-readable medium. The computer-readable medium may include program instructions, program instructions, data files, data structures, and the like, alone or in combination. The program instructions to be recorded on the medium may be those specially designed and configured for the embodiments or may be available to those skilled in the art of computer software. Examples of computer-readable media include magnetic media such as hard disks, floppy disks and magnetic tape; optical media such as CD-ROMs and DVDs; magnetic media such as floppy disks; Magneto-optical media, and hardware devices specifically configured to store and execute program instructions such as ROM, RAM, flash memory, and the like. Examples of program instructions include machine language code such as those produced by a compiler, as well as high-level language code that can be executed by a computer using an interpreter or the like. The hardware devices described above may be configured to operate as one or more software modules to perform the operations of the embodiments, and vice versa.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. For example, it is to be understood that the techniques described may be performed in a different order than the described methods, and / or that components of the described systems, structures, devices, circuits, Lt; / RTI > or equivalents, even if it is replaced or replaced.

Therefore, other implementations, other embodiments, and equivalents to the claims are also within the scope of the following claims.

110: C-arm device
121, 122: X-ray photographing apparatus
130: C-arm
140: medical image display device

Claims (17)

A matching unit for generating a matching image by performing image matching between a first medical image including three-dimensional anatomical information of a patient and a second medical image obtained after administration of a contrast agent to a tubular structure in the body of the patient, ;
An obtaining unit for receiving the third medical image obtained for the patient; And
An image processing unit for matching the matching image with the third medical image and generating a fourth medical image overlaid on the third medical image with first anatomical information included in the matching image;
And a medical image display device. The apparatus of claim 1, wherein the image processing unit
And generates the fourth medical image including depth information of the first anatomical information. The apparatus of claim 1, wherein the image processing unit
Wherein the fourth medical image includes information on at least one of a position and a direction of a stent to be implanted in the tubular tissue. The method according to claim 1,
A simulation unit for simulating the velocity of the fluid in the tubular tissue or the pressure inside the tubular tissue according to the position or direction of the stent to be placed in the tubular tissue;
Further comprising:
Wherein the image processing unit generates the fourth medical image including information on the velocity of the simulated fluid or the pressure inside the tubular tissue. The method according to claim 1,
Wherein the first anatomical information includes information on a variation of the tubular tissue with the passage of time obtained from the second medical image. 6. The method of claim 5,
A modeling unit that transforms the first anatomical information into a model matched with the second medical image using information on the variation of the tubular tissue obtained from the second medical image,
Further comprising:
Wherein the matching unit executes the image matching using a model matched with the second medical image. The method according to claim 6,
Wherein the modeling unit transforms the first anatomical information into a model matched with the third medical image,
Wherein the image processing unit matches the first anatomical information with the third medical image using a model matched with the third medical image. The method according to claim 1,
Wherein the image processing unit determines a display attribute for the tubular tissue based on depth information of the tubular tissue among the first anatomical information. Acquiring a first medical image including a three-dimensional anatomical information of a tubular tissue of a patient;
Acquiring a second medical image obtained after the medical image display apparatus has administered the contrast agent to the tubular tissue of the patient;
The medical image display apparatus performing image matching between the first medical image and the second medical image to generate a matching image;
The medical image display device receiving a third medical image obtained for the patient; And
The medical image display device matching the matching image with the third medical image and generating a fourth medical image overlaid on the third medical image with the first anatomical information included in the matching image;
And displaying the medical image. 10. The method of claim 9,
The step of generating the fourth medical image
And generating the fourth medical image including depth information of the first anatomical information. 10. The method of claim 9,
The medical image display device acquiring a plan to place the stent into the tubular tissue based on the 3D tubular tissue information;
Further comprising:
The step of generating the fourth medical image
Wherein the fourth medical image includes information on at least one of a position or a direction of a stent to be implanted in the tubular tissue according to the plan. 10. The method of claim 9,
Simulating the velocity of the fluid within the tubular tissue or the pressure inside the tubular tissue according to the position or orientation of the stent to be placed in the tubular tissue; And
Wherein the medical image display device generates the fourth medical image including information on the velocity of the simulated fluid or the pressure inside the tubular tissue
And displaying the medical image. 10. The method of claim 9,
The first anatomical information includes
And information on the variation of the tubular tissue with the passage of time obtained from the second medical image. 14. The method of claim 13,
Transforming the first anatomical information into a model matched with the second medical image using the information on the variation of the tubular tissue obtained from the second medical image,
Further comprising:
The step of generating the matching image
And the image matching is performed using a model matched to the second medical image. 15. The method of claim 14,
Transforming the 3D tubular tissue information into a model matched with the third medical image
Further comprising:
The step of generating the fourth medical image
And matching the first anatomical information with the third medical image using a model matched to the third medical image. 10. The method of claim 9,
The step of generating the fourth medical image
Determining a display attribute for the tubular tissue based on depth information of the tubular tissue among the first anatomical information; And
Generating the fourth medical image including the image of the tubular tissue reflecting the determined display attribute
And displaying the medical image. A computer-readable recording medium on which a program for executing the method according to any one of claims 9 to 16 is recorded.

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