CN104780833B - Blood flow function inspection device and radiographic apparatus - Google Patents
Blood flow function inspection device and radiographic apparatus Download PDFInfo
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- CN104780833B CN104780833B CN201380056596.0A CN201380056596A CN104780833B CN 104780833 B CN104780833 B CN 104780833B CN 201380056596 A CN201380056596 A CN 201380056596A CN 104780833 B CN104780833 B CN 104780833B
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
- A61B5/02154—Measuring pressure in heart or blood vessels by means inserted into the body by optical transmission
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0263—Measuring blood flow using NMR
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0265—Measuring blood flow using electromagnetic means, e.g. electromagnetic flowmeter
- A61B5/027—Measuring blood flow using electromagnetic means, e.g. electromagnetic flowmeter using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B6/03—Computerised tomographs
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- A—HUMAN NECESSITIES
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- A61B6/12—Devices for detecting or locating foreign bodies
Abstract
A kind of blood flow function inspection device and radiographic apparatus for realizing in the inspection of blood flow function such as FFR measurement, measurement operating procedure simplification and the shortening of working time is provided.Radiographic apparatus possesses：X-ray generation unit, to subject X-ray irradiation；X-ray detection unit, detect and irradiated by above-mentioned X-ray generation unit, and through the X ray of above-mentioned subject；Image generation unit, radioscopic image is generated according to the X ray detected by above-mentioned X-ray detection unit；Recording unit, record use and are arranged at the pressure data that the pressure sensor of seal wire is collected into；Measurement position setup unit, using above-mentioned radioscopic image, set the measurement position of the pressure based on above-mentioned pressure sensor；And display unit, near real-time show above-mentioned radioscopic image, and the measurement position that overlapping display is set by measurement position setup unit.
Description
Technical field
Embodiments of the present invention are related to the blood flow function inspection device for checking blood flow function etc. and possess the blood
Flow the radiographic apparatus of function inspection device.
Background technology
In recent years, for example, when hemadostewnosis occurs etc., without the treatment of surgery, and use the pipe for being referred to as conduit
The example that shape part carries out the treatment of internal medicine increases.Inserted in the treatment using conduit, such as by conduit from pars inguinalis
Enter subject, the conduit is advanced to narrow along blood vessel, expand air bag in the narrow, thus treated.
In addition, in order to prevent ISR, it is also cancellous sometimes through will be made up of the metal for being referred to as support
Cylinder is inserted into narrow, so as to prevent stricturization again from the interior side bearing vascular wall of blood vessel.
However, the medical treatment based on above-mentioned conduit surely not ensures 100% improvement symptom.
For example, when multiple narrows be present in a blood vessel, actually also take into full account with implementing the narrow for the treatment of
The different narrow in portion is more related to the possibility of blood flow reduction.In this case, if not to being related to blood flow reduction
Other narrows treated, then symptom will not improve.
In addition, in the case of worse situation, it is also contemplated that the possibility of the sophisticated tissue necrosis of blood vessel.At this
In the case of sample, narrow is whether treated, because tissue is downright bad in itself, therefore symptom will not also improve.
In addition, in the presence of the financial burden caused by being treated to narrow and along with treatment in reality
Risk, therefore, as described above, it may be said that treatment should be avoided to be unprofitable to the treatment of narrow as symptom improves.
Situation from the description above, in order to predict the therapeutic effect of narrow in advance, stored up using coronary blood flow is referred to as
Back-up number (FFR；Fractional Flow Reserve) index.FFR is calculated by following formulas.
FFR=(Pd/Pp) ... (formula 1)
Here, Pd and Pp are that the seal wire with pressure sensor is inserted into the pressure that narrow is measured
Value, the pressure close to the position of heart side from narrow is set to Pp, by from narrow at the position of tip side
The pressure at place is set to Pd.That is, the ratio between the pressure (blood pressure) of FFR value by calculating the front and rear part of narrow obtains.According to this
FFR value, judge necessity of various treatments etc..In other words, index quilts of the FFR as the functional assessment of coronary artery pathological changes
Assessed for coronary artery pathological changes.In addition, in the past, various skills are itself proposes for the above-mentioned seal wire with pressure sensor
Art (for example, referring to patent document 1 to patent document 3).
Prior art literature
Patent document
Patent document 1:Japanese Unexamined Patent Publication 2003-265617 publications
Patent document 2:Japanese Unexamined Patent Publication 11-76183 publications
Patent document 3:Japanese Unexamined Patent Publication 11-33004 publications
The content of the invention
In addition, in order to calculate FFR, it is desirable to following complicated operation：Seal wire with pressure sensor is configured to be located at
Narrow it is front and rear, and while to be operable so that seal wire stable, all manually carries out being used to record on one side being based on pressure
Operation (pressing of record button) and amendment operation of the measurement result (pressure data) of sensor etc..It is in addition, more existing
In the case of individual lesion, it is necessary to repeat above-mentioned operation to each lesion each.In addition, for not injured blood vessel
Inwall etc. must control seal wire all the time, and therefore, measuring the operation of FFR device will be carried out by other people.
Therefore, the possibility that record measurement result etc. is measured or forgotten in inappropriate position is also taken into full account, i.e.,
Make rightly to have carried out all operations, can also be taken a considerable amount of time as the activity duration.
The present invention in view of above-mentioned situation and complete, and it is an object of the present invention to provide a kind of blood flow work(such as the measurement for realizing FFR
The blood flow function inspection device and X ray of in the inspection of energy, measurement operating procedure simplification and the shortening of working time
Diagnostic device.
Radiographic apparatus involved by present embodiment possesses：X-ray generation unit, to subject X-ray irradiation；X
Ray detector units, detection are irradiated by above-mentioned X-ray generation unit and pass through the X ray of above-mentioned subject；Image generation is single
Member, radioscopic image is generated according to the X ray detected by above-mentioned X-ray detection unit；Recording unit, record use are arranged at
The pressure sensor of seal wire and the pressure data being collected into；Measurement position setup unit, using above-mentioned radioscopic image, set by
The measurement position of above-mentioned pressure sensor detection pressure；Display unit, above-mentioned radioscopic image is shown near real-time, and again
The measurement position that folded display is set by measurement position setup unit.
Brief description of the drawings
Fig. 1 is the block diagram for the configuration example for representing the blood flow function inspection device involved by the 1st embodiment of the present invention.
Fig. 2 is the figure of the measurement position of narrow when representing to calculate FFR.
Fig. 3 is the block diagram for the configuration example for representing the blood flow function inspection device involved by the 2nd embodiment of the present invention.
Fig. 4 is the figure of the measurement position of narrow when representing to calculate FFR.
(symbol description)
10 ... X-ray mechanisms, 12 ... X-ray tube balls, 14 ... detecting systems, 16 ... top plates, 20 ... image procossings dress
Put, 24 ... video memories, 31 ... subtract shadow portion, 32 ... filtering part, 36 ... affine transformation portions, 37 ... control units, 38 ... A/D conversion
Device, 41 ... display parts, 45 ... look-up tables, 47,103 ... optical channel cards, 50 ... radiographic apparatus, 90 ... pass with pressure
The seal wire of sensor, 100 ... blood flow function inspection devices, 101 ... pressure measxurement portions, 105 ... seal wire leading section test sections, 107 ...
Target location configuration part, 109 ... record timing control parts, 111 ... record portions, 113 ... FFR calculating parts, the identification of 121 ... positions
Portion, 123 ... position correction units, 125 ... network interfaces, 127 ... target location configuration parts, 129 ... record timing control parts,
141 ... display parts, 151 ... PACS, 161 ... CT devices, 171 ... MRI devices, 160 ... C-arms.
Embodiment
Hereinafter, referring to the drawings, examined for the blood flow function inspection device involved by embodiments of the present invention and X ray
Disconnected device illustrates.
[the 1st embodiment]
Fig. 1 is the block diagram for the configuration example for representing the blood flow function inspection device involved by the 1st embodiment of the present invention.
As shown in the drawing, the blood flow function inspection device 100 involved by this 1st embodiment has been communicatively coupled radiodiagnosis dress
Put the 50, seal wire 90 with pressure sensor, electrocardiograph (not shown).In addition, in the following description, with by independently of
Radiographic apparatus 50 and the blood flow function inspection device 100 that forms realize that FFR described later calculates the feelings of involved processing
Condition is example.However, and be not limited to the example, the X ray of the function of built-in blood flow function inspection device 100 can also be passed through
Diagnostic device 50 realizes that FFR calculates involved processing.
Radiographic apparatus 50 is the device for providing X-ray diagnostic images to blood flow function inspection device 100, is had
Standby X-ray mechanism 10 and image processing apparatus 20.
Above-mentioned X-ray mechanism 10 has X-ray tube ball 12, detecting system 14, the top plate 16 and C of bed (not shown)
Shape arm 160.
Above-mentioned X-ray tube ball 12 is installed in C-arm 160 together with detecting system 14.Said detecting system 14 is usually
FPD (Flat Panel Detector, flat panel detector).However, detecting system 14 can also possess image intensifier and TV takes the photograph
Camera.The pillar supporting that C-arm 160 is hung down from ceiling.C-arm 160 can rotate on three orthogonal axles.It is positioned in
Subject P on the top plate 16 of bed (not shown) is configured between X-ray tube ball 12 and detecting system 14.
Image processing apparatus 20 has control unit 37, A/D converters 38, video memory 24, subtracts shadow portion 31, affine transformation
Portion 36, display part 41, look-up table (after, referred to as LUT) 45, filtering part 32 and optical channel card 47.
Above-mentioned control unit 37 synthetically controls each portion of image processing apparatus 20.Above-mentioned A/D converters 38 and X-ray
Mechanism 10 connects, to being digitized processing from X-ray mechanism 10 as analog information come the data for projection supplied.It is above-mentioned
Video memory 24 stores the throwing after processing is supplied and be digitized by A/D converters 38 from X-ray mechanism 10
Shadow data.It is above-mentioned subtract shadow portion 31 and perform view data subtract shadow (DSA；Digital Subtraction Angiography).On
State the filtering process such as carrying out high frequency emphasis processing of filtering part 32.Above-mentioned affine transformation portion 36 is amplified place to view data
Reason, mobile processing.Above-mentioned LUT45 carries out greyscale transformation to view data.Above-mentioned optical channel card 47 is that optical-fibre channel transfers
I/F。
Above-mentioned blood flow function inspection device 100 has pressure measxurement portion 101, optical channel card 103, the detection of seal wire leading section
Portion 105, target location configuration part 107, record timing control part 109, record portion 111, FFR calculating parts 113 and display part
141。
Above-mentioned pressure measxurement portion 101 is received to come with the output signal of the pressure sensor of the seal wire 90 of pressure sensor
(pressure data), according to signal of change (measurement) pressure.
Above-mentioned optical channel card 103 is the I/F that optical-fibre channel transfers.Here, image processing apparatus 20 and the inspection of blood flow function
Device 100 is looked into connect by fibre channel cables via optical channel card 47,103.It is configured to by using optical-fibre channel
The high-speed data communication of cable, transfer to blood flow function inspection device 100 near real-time and be collected into by X-ray mechanism 10
Data.
Above-mentioned seal wire leading section test section 105 is according to the X-ray diagnostic images detection band transferred from image processing apparatus 20
There is the leading section of the seal wire 90 of pressure sensor.Specifically, for example set in the leading section of the seal wire 90 with pressure sensor
It is equipped with radioactive ray impermeability mark (for example, the mark being made up of tungsten etc.).In addition, before the seal wire 90 with pressure sensor
End, which has, improves visual construction.Above-mentioned seal wire leading section test section 105 from X-ray diagnostic images by detecting the mark
Note, to detect the leading section of the seal wire 90 with pressure sensor.In addition, seal wire leading section test section 105 for example passes through correlation
The image processing techniques such as computing follow the trail of the leading section of the seal wire 90 with pressure sensor.
Above-mentioned target location configuration part 107 according to from image processing apparatus 20 transfer come X-ray diagnostic images, setting in advance
First measure the target location (measurement position described later) of (record) pressure.
Above-mentioned record timing control part 109 carries pressure sensor according to what is detected by seal wire leading section test section 105
Seal wire 90 leading section position and the measurement position that is set by target location configuration part 107, will be above-mentioned in defined timing
Pressure data is recorded in record portion 111.In other words, above-mentioned record timing control part 109 is according to pressure sensor
The position of the leading section of seal wire 90 and measurement position, control timing (generation record pressure data being recorded in record portion 111
Timing signal).
Specifically, when the leading section for detecting the seal wire 90 with pressure sensor reaches measurement position set in advance
Put and when the measurement position static stipulated time is static, record timing control part 109 will be passed in the measurement position by pressure
The pressure data that sensor is collected into is recorded in record portion 111.In addition, being set to measurement position set in advance has certain model
Enclose.
Above-mentioned record portion 111 is recorded in what each measurement position was collected under the control that record timing control part 109 is carried out
Pressure data.
Above-mentioned FFR calculating parts 113 calculate Coronary Blood Flow Reserve fraction according to the pressure data recorded in record portion 111
(after, referred to as FFR).FFR is the index for predicting the therapeutic effect of narrow in advance.Here, Pd and Pp are set to
Seal wire with pressure sensor is inserted into the value for the pressure that narrow is measured, when will from narrow it is close
It is above-mentioned when the pressure at the position of heart side is set to Pp, the pressure at the position of tip side from narrow is set into Pd
FFR is calculated by following formulas.
FFR=(Pd/Pp) ... (formula 2)
That is, the ratio between pressure of front and rear part that FFR value can be by calculating narrow obtains.
Hereinafter, illustrate that the FFR of the blood flow function inspection device 100 involved by the 1st embodiment based on the present invention is calculated
One example of involved a series of processing.
In addition, it is necessary to calibration under atmospheric pressure when actually using the seal wire 90 with pressure sensor to calculate FFR
Etc. various calibrations.However, these calibrations are not the specific places of blood flow function inspection device involved by this 1st embodiment
Reason, therefore, is omitted the description.
First, conduit is directed to the heart side for the blood vessel for producing narrow by user, injects contrast agent one therefrom on one side
While by X-ray mechanism 10 and image processing apparatus 20 collect X-ray diagnostic images dynamic image (after, referred to as
For X ray dynamic image).Now, in the case that the blood vessel of check object is cardiovascular, except X ray dynamic image it
Outside, also electrocardiogram is collected by the way that electrocardiograph is (not shown) simultaneously.Pass through X-ray mechanism 10 and image processing apparatus 20
Sent to blood flow function inspection device 100 to the image near real-time being collected into.
User, can be clear with reference to the X ray dynamic image for the display part 141 for being shown in blood flow function inspection device 100
Ground identifies narrow, and the image that selection activity (for example, activity of heart) is few, presses " target location setting button ".
Fig. 2 is the figure of the measurement position in narrow when representing to calculate FFR.As shown in Fig. 2 target location configuration part
107 is substantially vertical relative to the blood vessel of measurement object according to describing from the order closest to the lateral tip side of heart of narrow
Line and setting measurement position.Now, in the case where the blood vessel of check object is cardiovascular, when specified heart is generally stationary
Electrocardio phase, the setting measurement position on radioscopic image corresponding with the electrocardio phase.For example, as shown in Figure 2 as example,
Set measurement position clearly displays on the x-ray image.
Here, for the lesion with multiple narrows, the operation is correspondingly repeated with narrow number.Shown in Fig. 2
Example in narrow (1) S1 and narrow (2) S2 be present, therefore, respectively to the heart side and tip side of narrow at two
It is each to describe straight line.Here, to narrow according to setting measurement position order-assigned numbering (in the present example, (1),
(2))。
In fig. 2, the line of narrow (1) S1 heart side represents Pp1 (blood pressure of narrow (1) S1 heart side) survey
Position is measured, the line of tip side represents Pd1 (blood pressure of narrow (1) S1 tip side) measurement position.Similarly, in fig. 2,
The line of narrow (2) S2 heart side represents Pp2 (blood pressure of narrow (2) S2 heart side) measurement position, tip side
Line represents Pd2 (blood pressure of narrow (2) S2 tip side) measurement position.
When being judged to rightly setting measurement position by target location configuration part 107, user's pressing " complete by setting
Button ".Thus, measurement position information and electrocardiogram phase information (how much % positions of R-R signals) are sent to record timing
Control unit 109.In addition, set measurement position can also be according to the phase information of electrocardiogram, by overlapping display measurement position
State and the state that does not show distinguish.In addition it is possible to according to the phase information of electrocardiogram, overlapping display is updated successively and is surveyed
Measure the realtime graphic of position.Then, user is while with reference to the X ray dynamic image of display part 141 is shown in, while making with pressure
The seal wire 90 of force snesor in the defined opening position of narrow (2) S2 end side in the catheter by making to pass with pressure
The seal wire 90 of sensor exposes from the leading section of conduit.In addition, at least in the operation of conduit, seal wire 90 with pressure sensor
In, seal wire leading section test section 105 obtains X ray from radiographic apparatus 50 via fibre channel cables and moved in real time at any time
State image, carry out subtracting shadow to the image being collected at certain moment and in the image being collected into immediately before, generation passes with pressure
The subtraction image that the movement of the seal wire 90 of sensor is extracted.Now, it is right in the case where the blood vessel of check object is cardiovascular
The image being collected into the electrocardio phase used in the setting of measurement position and the image being collected into before its 1 cycle are subtracted
Shadow, generation carry the subtraction image that the movement of the seal wire 90 of pressure sensor is extracted.
In addition, seal wire leading section test section 105 carries the two of the seal wire 90 of pressure sensor from the extraction of above-mentioned subtraction image
Edge, the two edges extracted according to this, this is detected using the characteristic quantity of the leading section of the seal wire 90 with pressure sensor
Leading section.
User one side guiding catheter, the seal wire 90 with pressure sensor is set gently to move in the blood vessels on one side.Record
Timing control part 109 enters to the leading section of the above-mentioned seal wire 90 with pressure sensor detected and above-mentioned measurement position information
Row compares, and it is in the range of predetermined distance and quiet to judge whether the leading section for carrying the seal wire 90 of pressure sensor enters from measurement position
The stipulated time is stopped.Now, in the case where the blood vessel of check object is cardiovascular, to from in the setting of measurement position
The leading section for the seal wire 90 with pressure sensor that the image detection that the electrocardio phase used is collected into arrives and above-mentioned measurement position
Confidence breath is compared, and judges whether the leading section of the seal wire 90 with pressure sensor from measurement position enters predetermined distance model
Enclose interior and static the stipulated time.Here, when the leading section for being judged as the seal wire 90 with pressure sensor is entered from measurement position
Enter in the range of predetermined distance and during the static stipulated time, record timing control part 109 for example makes blood flow function inspection device 100
Display part 141 show " start narrow (2) heart side position at blood pressure recording.Please seal wire fixation not moved "
The message of the meaning.
In addition, record timing control part 109 is in the leading section and measurement position for confirming the seal wire 90 with pressure sensor
After the distance put does not change, such as " blood pressure recording at the heart side position of narrow (2) will be carried out.It will please lead
Silk fixation not move " the message of the meaning be shown in display part 141, the pressure data of the measurement position is recorded in record portion
In 111 (generation record timing signal).That is, record portion 111 record timing control part 109 carry out control under (according to record
Timing signal), it is recorded in the pressure data collected by the measurement position pressure sensor.
When the record of stipulated time is completed, record timing control part 109 will be " at the heart side position of narrow (2)
Blood pressure recording has been completed.Seal wire is please moved to next measurement position." the message of the meaning be shown in display part 141.Work as note
When record is completed, by the curve of the recorded pressure data of expression, (blood pressure of measurement position changes record timing control part 109
Curve) it is shown in display part 141.
Then, user's visual confirmation is shown in the curve of the display part 141, judges whether normally to measure blood pressure.
This, for example, when blood pressure changes and significantly changed in each cycle, may correctly not carry out the measurement, therefore, user presses
Press " remeasuring button ", perform measurement again.
For remaining measurement position (that is, in the case of this example, narrow (2) S1 tip side position, narrow
(1) S2 heart side position, tip side position) above-mentioned a series of operation processing is performed respectively.
Then, when Pp1, Pd1, Pp2, Pd2 all calculating, which record, to be completed, timing control part 109 is recorded from note
Record portion 111 reads these pressure datas and is output to FFR calculating parts 113.Then, FFR calculating parts 113 record these in record
Pressure data (in the present example, Pp1, Pd1, Pp2, Pd2) in portion 111 substitutes into above-mentioned (formula 2), all narrow so as to calculate
The value of FFR involved by narrow portion (in the present example, narrow (1) S1 and narrow (2) S2).
In addition, in the present embodiment, radiographic apparatus 50 and blood flow function inspection device 100 are set to absolute construction,
But blood flow function inspection device 100 can also be embedded into inside radiographic apparatus 50.Alternatively, it is also possible to only by blood flow work(
The function of a part for energy check device 100 is embedded into inside radiographic apparatus 50.Specifically, can also be configured to by
Seal wire leading section test section 105, target location configuration part 107, record timing control part 109 are embedded into radiographic apparatus 50
Inside, the instruction record timing from radiographic apparatus 50 to blood flow function inspection device 100.
In addition, this 1st embodiment is in addition to FFR calculating, additionally it is possible to suitable for passing through the step meter identical with FFR
In the calculating of the Coronary Blood Flow Reserve (CFR) of calculation.
As described above, according to this 1st embodiment, using the teaching of the invention it is possible to provide a kind of to realize such as FFR measurement
It is in the inspection of blood flow function, measurement operating procedure simplification and the shortening of working time blood flow function inspection device and
Radiographic apparatus.
Blood flow function inspection device and radiographic apparatus involved by the 1st above-mentioned embodiment for example can be as
It is following to deform and implement like that.
《Variation 1》
For example, in above-mentioned example, FFR calculating parts 113 calculate record all narrows (narrow (1) with
And narrow (2)) involved by pressure data at the time of calculate FFR.However, it is also possible to record a narrow institute calculating
FFR is calculated successively at the time of Pp and Pd being related to.
Alternatively, it is also possible to be configured to when the value of the FFR involved by a certain narrow is less than " empty blood threshold value " (for example, will
0.75 is set to " empty blood threshold value ", and FFR value is calculated when being recorded as 0.63 etc.), in order that user is confirmed, make this narrow
The curve of pressure data involved by portion is shown in display part 141.
Alternatively, it is also possible to be configured to when the value of the FFR involved by a certain narrow is less than " empty blood threshold value " (for example, will
0.75 is set to " empty blood threshold value ", and FFR value is calculated when being recorded as 0.63 etc.), the survey involved by the narrow is collected again
The pressure data of opening position is measured, calculates FFR again.
《Variation 2》
In the above description, it is configured to when the leading section for being judged as the seal wire 90 with pressure sensor is entered from measurement position
Enter in the range of predetermined distance and during the static stipulated time, the pressure data of measurement position is automatically recorded in record portion
In 111.However, and be not limited to the example, such as measurement position can also be indicated by the manually operated of user itself
The record of pressure data starts.Now, preferably with the leading section of the seal wire 90 with pressure sensor reach measurement position (or
Into in the range of predetermined distance) for triggering, such as show the display part 141 of blood flow function inspection device 100 " please to press narrow
Blood pressure recording start button at the heart side position in portion (2).Please seal wire fixation not moved " etc. supervise record to start to indicate
Message (or being exported by sound etc.).Notify just in above-mentioned measurement and measure to have completed in addition it is possible to show
Message.Additionally, it is preferred that assume when the leading section that no input record starts to indicate and carry the seal wire 90 of pressure sensor leads to
When having crossed measurement position, such as display part 141 is set to show that " not recording the blood pressure at the heart side position of narrow (2) " etc. is alert
Accuse message (or being exported by sound etc.).
《Variation 3》
On the x-ray image, can also by from it is around different in the form of (for example, different colors, different concentration, bright
Reversion, flicker or the combinations thereof of degree) come it is overlapping display with pressure sensor seal wire 90 leading section position
(that is, the position of pressure sensor).
[the 2nd embodiment]
Hereinafter, for the present invention the 2nd embodiment involved by blood flow function inspection device and radiographic apparatus
Illustrate.In order to avoid repeat specification, illustrate and the difference of the 1st above-mentioned embodiment.In addition, in present embodiment
In, also in a same manner as in the first embodiment, with by independently of radiographic apparatus 50 and the blood flow function inspection device that is formed
100 realize that FFR described later is example when calculating involved processing.However, and be not limited to the example, can also be by interior
The radiographic apparatus 50 of the function of blood flow function inspection device 100 is equipped with to realize that FFR calculates involved processing.
In this 2nd embodiment, position sensor (example is set in the leading section of the seal wire 90 with pressure sensor
Such as, GPS sensor).
Fig. 3 is the block diagram for the configuration example for representing the blood flow function inspection device involved by the 2nd embodiment of the present invention.
As the inscape different from the blood flow function inspection device 100 involved by the 1st embodiment, can mainly arrange
Enumerate：As for carrying out the network interface with the I/F of the communication of Ethernet (Ethernet, registration mark) etc. outside
Signal (for example, gps signal) detection of (Network I/F) 125, basis from above-mentioned position sensor carries pressure sensor
Seal wire 90 leading section position identification portion 121, above-mentioned for being preset according to 3-D views such as CT images or MRI images
The target location configuration part 127 of measurement position, the calibration for carrying out the 3-D view such as CT images or MRI image and position sensor
Position correction unit 123 and according to the output information from position identification portion 121 and from the defeated of target location configuration part 127
Go out information to judge the record timing control part 129 of control record timing.
Blood flow function inspection device 100 involved by this 2nd embodiment is communicatively coupled via network interface 125
There are CT devices 161, MRI device 171 and PACS151.
Hereinafter, illustrate involved by the FFR calculating of the blood flow function inspection device involved by the 2nd embodiment based on the present invention
And a series of processing an example.
In addition, actually, it is necessary to calibration under atmospheric pressure when using the seal wire 90 with pressure sensor to calculate FFR
Etc. various calibrations.However, these calibrations are not the specific places of blood flow function inspection device involved by this 2nd embodiment
Reason, therefore, is omitted the description.
First, user obtains inspection from CT devices 161, MRI device 171 and PACS151 etc. via network interface 125
The 3-D view of the blood vessel of object.The 3-D view is to go out the doctor in the region comprising narrow for the vessel delineation of check object
Use image.
User presses " target location setting button ", and target location configuration part 127 is on 3-D view according to from narrow
(detection) measurement position is recognized as shown in Figure 4 to the order of tip side in immediate heart side.Fig. 4 is to represent to calculate FFR
When narrow at measurement position figure.
Here, for the lesion with multiple narrows, the operation is correspondingly repeated with the number of narrow.In Fig. 4 institutes
In the example shown, due to narrow (1) S1 and narrow (2) S2 be present, therefore, respectively the heart side to narrow at two and
Respectively draw a mark in tip side.Here, numbering is matched somebody with somebody to narrow according to the order for being set by the user measurement position.
In Fig. 4, the mark of narrow (1) S1 heart side represents Pp1's (blood pressure of narrow (1) S1 heart side)
Measurement position, the mark of tip side represent Pd1 (blood pressure of narrow (1) S1 tip side) measurement position.Similarly, it is narrow
The mark of portion (2) S2 heart side represents Pp2 (blood pressure of narrow (2) S2 heart side) measurement position, the mark of tip side
Note represents Pd2 (blood pressure of narrow (2) S2 tip side) measurement position.
When being judged to rightly setting measurement position by target location configuration part 107, user's pressing " press by setting completion
Button ".Thus, measurement position information and electrocardiogram phase information (how much % positions of the R-R signals) quilt for being collected into 3-D view
It is sent to record timing control part 109.
Then, user makes the seal wire 90 with pressure sensor in the catheter by advancing, pressing " calibration
(Calibration) button ".Examined according to the signal (for example, gps signal) from above-mentioned position sensor in position identification portion 121
Measuring tape has the leading section of the seal wire 90 of pressure sensor, and the spy of blood vessel is reached in the leading section of the seal wire 90 with pressure sensor
At the time of sign construction, it is determined that the 3-D view with the position correspondence of the leading section of the seal wire 90 with pressure sensor at the moment
On position.This series of operation processing performs three times.
Then, coordinate on the 3-D view of the blood vessel of the check object determined by above-mentioned processing and according to carrying out self-alignment
Put the three-dimensional coordinate that the signal (for example, gps signal) of sensor detects and be sent to position correction unit 123.Position correction unit
123 information sent according to these, carry out the calibration of 3-D view and position sensor.Thus, complete to be carried by being arranged at
The three-dimensional coordinate and the three-dimensional of the blood vessel of check object that the position sensor of the leading section of the seal wire 90 of pressure sensor detects
The correspondence (position correction processing) of three-dimensional coordinate on image.
After position correction processing is completed by above-mentioned processing, user with reference to the X for being shown in display part 141 while penetrate
Line dynamic image, while making the seal wire 90 with pressure sensor in the catheter by the rule of narrow (2) S2 end side
Fixed opening position makes the seal wire 90 with pressure sensor expose from the leading section of conduit.
The signal of position sensor from the leading section for being arranged at the seal wire 90 with pressure sensor is (for example, GPS believes
Number) three-dimensional coordinate is transformed into by position identification portion 121, and three-dimensional that (amendment) is blood vessel is converted by position correction unit 123
Three-dimensional coordinate on image.Three-dimensional coordinate after the conversion is shown as on the 3-D view of blood vessel for being shown in display part 141
The position of seal wire 90 with pressure sensor, near real-time it is sent to record timing control part 109.
Then, record timing control part 109 to the leading section of the above-mentioned seal wire 90 with pressure sensor detected with
Above-mentioned measurement position information is compared, and judges whether the leading section of the seal wire 90 with pressure sensor enters from measurement position
In the range of predetermined distance and the static stipulated time.
Here, when the leading section for being judged as the seal wire 90 with pressure sensor enters predetermined distance scope from measurement position
During the interior and static stipulated time, record timing control part 109 for example makes the display part 141 of blood flow function inspection device 100 aobvious
Show and " start the blood pressure recording at the heart side position of narrow (1).Please seal wire fixation not moved " the meaning message.
In addition, record timing control part 109 confirms leading section and the measurement position of the seal wire 90 with pressure sensor
After distance does not change, such as make " to carry out the blood pressure recording at the heart side position of narrow (1).Please seal wire is consolidated
Surely not move " etc. the message of the meaning be shown in display part 141, the pressure data of the measurement position is recorded in record portion
In 111 (generation record timing signal).That is, record portion 111 record timing control part 109 carry out control under (according to record
Timing signal), it is recorded in the pressure data that the measurement position is collected into by pressure sensor.
When the record of stipulated time is completed, record timing control part 109 for example makes " the heart side position of narrow (1)
The blood pressure recording at place is completed.Seal wire is please moved to next measurement position." the message of the meaning be shown in display part 141.Work as note
When record is completed, record timing control part 109 makes the curve of the pressure data that expression recorded, and (blood pressure of measurement position changes
Curve) it is shown in display part 141.
Then, user's visual confirmation is shown in the curve of the display part 141, determines whether normally to measure blood pressure.
This, such as when blood pressure changes and significantly changed in each cycle, the measurement may not be carried out exactly, therefore press " again
Secondary measurement button ", performs measurement again.
For remaining measurement position (in the present example, narrow (1) S1 tip side position, narrow (2) S2 heart
Dirty side position, tip side position) above-mentioned a series of operation processing is performed respectively.Then, as Pp1, Pd1, Pp2, Pd2
When all calculating records are completed, record timing control part 109 reads these pressure datas from record portion 111 and is output to
FFR calculating parts 113.Then, the pressure data that FFR calculating parts 113 are recorded these in record portion 111 is (in the present example,
Pp1, Pd1, Pp2, Pd2) substitute into above-mentioned (formula 2), so as to calculate all narrows (in the present example, narrow (1) S1 with
And narrow (2) S2) involved by FFR value.
《Variation》
Certainly, the calculating timing (variation 1) for the FFR that illustrates in the 1st embodiment, based on manually operated pressure
The record of force data starts to control (variation 2), the display form (variation 3) of position of pressure sensor to be also applied to
This 2nd embodiment.
As described above, according to this 2nd embodiment, using the teaching of the invention it is possible to provide one kind play with the 1st embodiment involved by
And blood flow function inspection device and the blood flow function inspection device and X ray of radiographic apparatus identical effect examine
Disconnected device., can also be to be used in the setting of measurement position in addition, when the blood vessel of check object is cardiovascular
The leading section for the seal wire 90 with pressure sensor that the image detection that electrocardio phase is collected into arrives and above-mentioned measurement position information
Be compared, judge with pressure sensor seal wire 90 leading section whether from measurement position enter predetermined distance in the range of and
The static stipulated time.
Several embodiments of the invention is illustrated, but these embodiments are prompted as an example, it is not intended to
Limit the scope of invention.
For example, in the respective embodiments described above, example goes out utilizes radiographic apparatus as medical diagnostic imaging apparatus
Situation.However, and be not limited to the example, for example, it is also possible to use X ray computer tomographic, magnetic resonance imaging
Other medical diagnostic imaging apparatus such as device, diagnostic ultrasound equipment realize described blood flow functional check.
In addition, these new embodiments can be implemented in a manner of others are various, the main idea of invention is not being departed from
In the range of, various omissions, displacement, change can be carried out.The scope of these embodiments or its deformation with being contained in invention
Or in main idea, and be also contained in the invention of claims record and its scope of equalization.
Claims (23)
1. a kind of radiographic apparatus, possesses：
X-ray generation unit, to the predetermined region X-ray irradiation of subject；
X-ray detection unit, detect the X ray for being irradiated by above-mentioned X-ray generation unit and having been passed through above-mentioned subject；
Image generation unit, radioscopic image is generated according to the X ray detected by above-mentioned X-ray detection unit；
Recording unit, record use and are arranged at the pressure data that the pressure sensor of seal wire is collected into；
Measurement position setup unit, using the radioscopic image relevant with above-mentioned predetermined region, preset by above-mentioned pressure sensing
Device measures the measurement position of pressure；And
Display unit, by the overlapping above-mentioned radioscopic image that updates successively of being shown in of above-mentioned measurement position set in advance.
2. radiographic apparatus according to claim 1, it is characterised in that
State and not overlapping display of the above-mentioned display unit according to the overlapping display measurement position of the phase information of electrocardiogram control
State.
3. radiographic apparatus according to claim 1, it is characterised in that
Above-mentioned display unit is carried out more according to the phase information of electrocardiogram to control to the realtime graphic of overlapping display measurement position
New timing.
4. radiographic apparatus according to claim 1, it is characterised in that
Above-mentioned radiographic apparatus is also equipped with position detection unit, and the position detection unit detects the pressure in above-mentioned subject
The position of sensor.
5. radiographic apparatus according to claim 1, it is characterised in that
Above-mentioned display unit overlapping position for showing the pressure sensor detected by position detection unit also in the form of different.
6. radiographic apparatus according to claim 5, it is characterised in that
Above-mentioned different form is one of different colors, different concentration, the reversion of brightness or flicker or combination.
7. radiographic apparatus according to claim 4, it is characterised in that
Above-mentioned radiographic apparatus is also equipped with control unit, and the control unit is according to set above-mentioned measurement position and detection
The position relationship of the position of the above-mentioned pressure sensor arrived, control to the above-mentioned pressure data of above-mentioned recording unit records.
8. radiographic apparatus according to claim 7, it is characterised in that
Above-mentioned control unit judges whether above-mentioned pressure sensor reaches above-mentioned measurement position set in advance, is being judged to reaching
And in the case of the measurement position static stipulated time, output supervises above-mentioned pressure data to the record of above-mentioned recording unit
Indicate the message of input.
9. radiographic apparatus according to claim 8, it is characterised in that
Above-mentioned control unit is designated as triggering with the record inputted by user, starts to the above-mentioned number pressure of above-mentioned recording unit records
According to.
10. radiographic apparatus according to claim 9, it is characterised in that
When above-mentioned instruction is not carried out recording input and above-mentioned pressure sensor passed through above-mentioned measurement position when, above-mentioned control
Unit prompts the user with defined message.
11. radiographic apparatus according to claim 7, it is characterised in that
Above-mentioned control unit using above-mentioned pressure sensor in the above-mentioned measurement position static stipulated time as triggering, by above-mentioned pressure
Force data is to above-mentioned recording unit records.
12. radiographic apparatus according to claim 7, it is characterised in that
The location information signal and above-mentioned X that above-mentioned position detection unit is exported according to the position sensor for being arranged at above-mentioned seal wire
The coordinate system of ray image, the position of the above-mentioned pressure sensor detected is corrected,
Above-mentioned control unit judges above-mentioned pressure sensor in above-mentioned measurement according to the position of revised above-mentioned pressure sensor
Opening position whether static stipulated time.
13. radiographic apparatus according to claim 7, it is characterised in that
Above-mentioned control unit determines above-mentioned pressure sensing by using the above-mentioned radioscopic image being collected into same electrocardio phase
Changing over time for device and the position changed, so as to judge above-mentioned pressure sensor in the whether static rule of above-mentioned measurement position
Fix time.
14. radiographic apparatus according to claim 12, it is characterised in that
Above-mentioned control unit determines above-mentioned pressure sensing by using the above-mentioned radioscopic image being collected into same electrocardio phase
Changing over time for device and the position changed, so as to judge above-mentioned pressure sensor in the whether static rule of above-mentioned measurement position
Fix time.
15. radiographic apparatus according to claim 7, it is characterised in that
Above-mentioned control unit prompts the user with the 1st message when starting above-mentioned pressure data to above-mentioned recording unit records,
The 2nd message is prompted the user with record processing.
16. radiographic apparatus according to claim 15, it is characterised in that
Above-mentioned 1st message is to include the position reported the message of the meaning of start recording in a short time and supervise above-mentioned seal wire
Put at least message of some in fixed message.
17. radiographic apparatus according to claim 15, it is characterised in that
Above-mentioned 2nd message is that the message of above-mentioned seal wire is not moved comprising the message for representing the meaning in record and requirement
In at least message of some.
18. radiographic apparatus according to claim 7, it is characterised in that
When above-mentioned pressure change is completed to the record of above-mentioned recording unit, above-mentioned control unit prompts the user with expression record
It is at least one in the message for the meaning that the message and notification of the meaning completed can move above-mentioned seal wire.
19. radiographic apparatus according to claim 7, it is characterised in that
When above-mentioned pressure data is completed to the record of above-mentioned recording unit, above-mentioned control unit makes involved by the expression record
The curve of pressure data is shown in above-mentioned display unit.
20. radiographic apparatus according to claim 7, it is characterised in that
When above-mentioned pressure data is completed to the record of above-mentioned recording unit, above-mentioned control unit calculates coronary blood according to the record
The value of stream deposit fraction, when the value is below defined threshold value, again by the above-mentioned number pressure of same above-mentioned measurement position
According to being recorded in above-mentioned recording unit.
21. radiographic apparatus according to claim 7, it is characterised in that
When the record of the above-mentioned pressure data involved by above-mentioned measurement position is completed, above-mentioned control unit makes to be shown in above-mentioned show
Show the display form generation change at the position corresponding with the measurement position on the above-mentioned radioscopic image of unit.
22. radiographic apparatus according to claim 7, it is characterised in that
When the above-mentioned pressure data involved by above-mentioned measurement position record do not complete when, above-mentioned control unit be shown in it is above-mentioned
On the above-mentioned radioscopic image of display unit, supervise above-mentioned involved by user record position corresponding with the measurement position
The warning of pressure data is shown.
23. a kind of blood flow function inspection device, possesses：
Measurement position setup unit, using the 1X ray image relevant with predetermined region, preset by being arranged at seal wire
Pressure sensor measures the measurement position of pressure；
Recording unit, record are received using the pressure sensor for being arranged at above-mentioned seal wire in above-mentioned measurement position set in advance
The pressure data collected；With
Control unit, according to above-mentioned measurement position set in advance and the position relationship of the position of above-mentioned pressure sensor, control
To the above-mentioned pressure data of above-mentioned recording unit records.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2012261261 | 2012-11-29 | ||
| JP2012-261261 | 2012-11-29 | ||
| PCT/JP2013/082271 WO2014084377A1 (en) | 2012-11-29 | 2013-11-29 | Circulatory function examination device and x-ray diagnostic device |
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| CN104780833A CN104780833A (en) | 2015-07-15 |
| CN104780833B true CN104780833B (en) | 2018-03-02 |
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| CN105662387B (en) * | 2016-01-06 | 2017-09-29 | 博动医学影像科技（上海）有限公司 | The system of acquisition blood flow reserve fractional value with double working modes |
| CN112426142B (en) * | 2019-12-31 | 2021-09-21 | 深圳北芯生命科技股份有限公司 | Intravascular pressure measurement system |
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| CN101028194A (en) * | 2006-02-28 | 2007-09-05 | 东芝医疗系统株式会社 | X-ray diagnostic apparatus |
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| CN101028194A (en) * | 2006-02-28 | 2007-09-05 | 东芝医疗系统株式会社 | X-ray diagnostic apparatus |
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