CN106780720B - Medical image display method and device - Google Patents
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Abstract
The invention provides a medical image display method and a device, wherein the medical image display method comprises the steps of obtaining scanning data of a plurality of phases in a cardiac cycle of a detected person; reconstructing a first image of a plurality of phases based on the scan data; receiving a first display parameter set by a user based on a first image; segmenting the first image based on the first display parameter and displaying the segmented first segmented image; receiving a second display parameter set by a user based on the first segmentation image; reconstructing a second image of the plurality of time phases based on the second display parameters and segmenting the second image to obtain a segmented second segmented image; and counting the image characteristics based on the second segmentation image, and highlighting the corresponding time phase position of the image which is in line with the specific characteristics. The medical image display method based on the invention can automatically reconstruct the data of a plurality of time phases and the three-dimensional MPR image of the examined person according to the evaluation requirement of a doctor, thereby avoiding the complex workload of manually reconstructing and adjusting the images of the plurality of time phases by a user.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a medical image display method and device.
Background
Transcatheter Arterial Valve Implantation (TAVI) is a completely new minimally invasive valve replacement procedure that has been developed in recent years. Accurate pre-operative assessment of the patient's aortic annulus and valve condition, as well as other cardiovascular structures, is required prior to TAVI, after which replacement prosthetic valves and surgical protocols are selected according to the results of the assessment.
Multi-row spiral CT (MDCT) is an important imaging means for TAVI preoperative evaluation, and mainly utilizes the characteristics that MDCT imaging has high temporal resolution and spatial resolution, can clearly display the aorta and other cardiovascular structures, and can reconstruct a three-dimensional multi-planar reconstruction (MPR) image.
The evaluation result of the size evaluation object based on the image after MDCT imaging is used as a selection basis for selecting the size of the replaced prosthesis, and if the size of the prosthesis is not properly selected, the prosthesis is not matched with the original ecological organ or tissue size of a patient, so that the smooth operation is hindered, and postoperative complications can be caused. For example, when the evaluation object is the aortic valve annulus, since the aortic valve annulus changes with the pulsation of the heart of the patient, the evaluation index for evaluating the valve annulus size has different trend with the variation of the cardiac cycle, which requires that the valve annulus size of the patient is evaluated at different phases of the cardiac cycle to know the variation of the valve annulus size, and finally, the valve annulus size is evaluated.
The existing valve annulus size evaluation is mainly carried out by staff aiming at images of the systole in the cardiac cycle, but due to individual difference between different patients, no clear reference is provided for specific patients according to which phase of the images should be adopted. In addition, the evaluation of the size of the valve ring comprises a plurality of different evaluation indexes, the variation trend of the different evaluation indexes along with the cardiac cycle is different, and different indexes cannot be evaluated perfectly by selecting a single time phase for evaluation. Therefore, the method requires a worker to manually reconstruct the volume data and MPR images of different time phases and measure the corresponding evaluation indexes to determine the size of the valve annulus, which undoubtedly greatly increases the workload of the worker and prolongs the time required for TAVI preoperative evaluation.
Disclosure of Invention
The invention aims to provide a medical image display method and a medical image display device, which are used for solving the problems that the reconstruction of volume data and MPR images of each time phase by using the conventional medical image display method and device depends on workers, so that the workload of the workers is increased, and the time required by TAVI pre-operation evaluation is prolonged.
In order to solve the above technical problem, the present invention provides a medical image display method, including:
obtaining scan data for a plurality of phases within a cardiac cycle of a subject;
reconstructing a first image of the plurality of phases based on the scan data;
receiving a first display parameter set by a user based on a first image;
segmenting the first image based on the first display parameter and displaying the segmented first segmented image;
receiving a second display parameter set by a user based on the first segmentation image;
reconstructing a second image of the plurality of time phases based on the second display parameters and segmenting the second image to obtain a segmented second segmented image;
and counting image features based on the second segmentation image, and highlighting the corresponding time phase position of the image which accords with the specific features.
Optionally, in the medical image display method, the first display parameter includes: the volume data range required by the size evaluation object and the reconstruction angle of the three-dimensional multi-plane reconstruction image required by the size evaluation object.
Optionally, in the medical image display method, the size evaluation object is an annulus and/or an aortic root.
Optionally, in the medical image display method, when the size evaluation object is an annulus or an aortic root, a volume data range required by the size evaluation object includes: ascending aorta, sinotubular junction, aortic and coronary ostia, annulus plane and left ventricular outflow tract.
Optionally, in the medical image display method, when the size evaluation object is an annulus and an aortic root, a reconstruction angle of a three-dimensional multi-planar reconstructed image required by the size evaluation object is as follows: an oblique axial plane parallel to the annulus plane, and an oblique sagittal plane and an oblique coronary plane containing the left and right coronary ostia.
Optionally, in the medical image display method, the size evaluation indicator of the valve annulus includes: annular minor diameter, annular major diameter, annular mean diameter, annular area based area mean diameter, annular perimeter based perimeter mean diameter.
Optionally, in the medical image display method, the evaluation index of the size of the aortic root includes: mean diameter of aortic sinus, mean diameter at sinotubular junction, mean diameter at ascending aorta, distance of left and right coronary sinus ostia to the plane of the annulus.
Optionally, in the medical image display method, the second display parameter includes: time phase range and reconstruction angle of three-dimensional multi-plane reconstruction image.
Optionally, in the medical image display method, MDCT is used to obtain scan data of a plurality of phases in a cardiac cycle of a subject.
The present invention also provides a medical image display apparatus including:
the scanning data acquisition module is used for acquiring scanning data of a plurality of phases in the cardiac cycle of the examinee;
a first image reconstruction module to reconstruct a first image of the plurality of phases based on the scan data;
the first segmentation image acquisition module is used for receiving a first display parameter set by a user based on the first image, segmenting the first image based on the first display parameter and displaying the segmented first segmentation image;
the second segmentation image acquisition module is used for receiving a second display parameter set by a user based on the first segmentation image, reconstructing second images of the multiple time phases based on the second display parameter, and segmenting the second images to acquire segmented second segmentation images;
and the time phase position display module is used for counting the image characteristics based on the second segmentation image and highlighting the time phase position corresponding to the image which accords with the specific characteristics.
In the medical image display method and the medical image display device provided by the invention, the medical image display method comprises the steps of obtaining scanning data of a plurality of phases in a cardiac cycle of a detected person; reconstructing a first image of the plurality of phases based on the scan data; receiving a first display parameter set by a user based on a first image; segmenting the first image based on the first display parameter and displaying the segmented first segmented image; receiving a second display parameter set by a user based on the first segmentation image; reconstructing a second image of the plurality of time phases based on the second display parameters and segmenting the second image to obtain a segmented second segmented image; and counting image features based on the second segmentation image, and highlighting the corresponding time phase position of the image which accords with the specific features. The medical image display method based on the invention can automatically reconstruct the data of a plurality of time phases and the three-dimensional MPR image of the examined person according to the evaluation requirement of a doctor, provides richer information for a user, and simultaneously avoids the complex workload of manually reconstructing and adjusting the images of the plurality of time phases by the user.
Drawings
FIG. 1 is a flow chart of a medical image display method according to an embodiment of the invention;
fig. 2 is a schematic structural diagram of a medical image display apparatus according to another embodiment of the present invention.
Detailed Description
The medical image display method and apparatus proposed by the present invention will be further described in detail with reference to the accompanying drawings and specific embodiments. Advantages and features of the present invention will become apparent from the following description and from the claims. It is to be noted that the drawings are in a very simplified form and are not to precise scale, which is merely for the purpose of facilitating and distinctly claiming the embodiments of the present invention.
Example one
Please refer to fig. 1, which is a flowchart illustrating a medical image display method according to the present embodiment, wherein the medical image display method and apparatus mainly include the following steps:
firstly, step S10 is executed to obtain scan data of a plurality of phases in the cardiac cycle of the subject;
preferably, the MDCT is used to perform a scan to obtain scan data for a plurality of phases within the subject's cardiac cycle. Specifically, the data acquisition method by using MDCT includes, but is not limited to, the following two methods: the MDCT acquires data by adopting an Electrocardiogram (EGC) gated retrospective spiral acquisition mode or acquires data by adopting an electrocardiogram triggered gated acquisition mode.
Next, step S11 is executed to reconstruct a first image of the plurality of phases based on the scan data;
next, step S12 is executed to receive a first display parameter set by the user based on the first image; wherein the first display parameter comprises: a volume data range required for a size evaluation object, and a reconstruction angle of a three-dimensional multi-planar reconstruction (MPR) image required for the size evaluation object.
Next, step S13 is executed to segment the first image based on the first display parameter and display a segmented first segmented image;
next, step S14 is executed to receive a second display parameter set by the user based on the first divided image;
next, step S15 is executed to reconstruct a second image of the plurality of time phases based on the second display parameters, and segment the second image to obtain a segmented second segmented image;
next, step S16 is executed to count image features based on the second segmentation image and highlight the time phase position corresponding to the image that matches the specific feature.
The size evaluation object includes, but is not limited to, the annulus and/or the aortic root, which is determined according to the user's requirement, and the following describes the medical image display method by taking the size evaluation object as the annulus and the aortic root as an example.
The volume data in the volume data range is the data of the anatomical structure required by the aortic valve implantation, and generally, the CT scan before TAVI needs to cover a larger anatomical structure range, which generally includes: aortic root, aorta, iliac arteries and common femoral artery for the complete assessment of the patient's aortic and peripheral vascular condition by the physician, wherein the assessment of size-related parameters for the annulus and aortic root only requires the use of CT image data in a small range containing the aortic root in order to narrow the scope of image processing. In this embodiment, when the size evaluation object is an annulus or an aortic root, the volume data range includes: ascending aorta, sinotubular junction, aortic and coronary ostia, annulus plane and left ventricular outflow tract.
Setting the principle of the reconstruction angle of the three-dimensional multi-plane reconstruction image: the measurement and evaluation of the parameters related to the size of the annulus and the size of the aortic root need to be performed on multi-planar reconstructed images at different angles, and in general, the physician needs to evaluate the annulus size parameters on the oblique axial plane of the aortic annulus, i.e. the annulus plane, and size parameters at the aortic sinus, sinotubular junction and ascending aorta on other oblique axial planes parallel to the annulus plane, and the distance of the left and right coronary ostia from the annulus plane on the oblique sagittal and oblique coronary planes. In this embodiment, the set reconstruction angle of the required three-dimensional multi-plane reconstructed image is as follows: an oblique axial plane parallel to the annulus plane, and an oblique sagittal plane and an oblique coronary plane containing the left and right coronary ostia.
The trend of the phase change of each evaluation index at any time is counted in a chart form, and the phase position with the largest valve ring size is marked according to different evaluation indexes, so that comprehensive information is provided for size selection of the artificial valve. The size evaluation index of the valve annulus includes: minor diameter of valve annulus DSMajor diameter of valve ring DLThe average diameter D of the valve ring is (D)L+DS) Area of annulus A, area mean diameter D based on annulus areaA2 × sqrt (a/pi), annulus circumference C, and circumference average diameter D based on the annulus circumferenceC＝C/π。
In this embodiment, the size evaluation index of the aortic root includes: mean diameter of aortic sinus, mean diameter at sinotubular junction, mean diameter at ascending aorta, distance of left and right coronary sinus ostia to the plane of the annulus.
The segmentation specifically comprises the following steps:
step 1: smoothing filtering
Performing smooth filtering on the tomographic images within the volume data range of the plurality of time phases to suppress image noise;
step 2: edge detection
Performing edge detection on the cross-sectional image subjected to the smoothing filtering processing in the step 1 by using an edge detection operator (for example, a Sobel operator);
and step 3: ascending aorta segmentation
An ascending aorta segmentation result for each tomographic image of the tomographic images subjected to the edge detection; and mapping the ascending aorta segmentation results of all the tomographic images into the three-dimensional multi-plane reconstructed image according to the set reconstruction angle of the three-dimensional multi-plane reconstructed image.
Specifically, since a contrast medium is injected into a vein of a patient during a scanning process, and an aorta shows a high-contrast object close to a circle in a tomographic image in the volume data range, a circle object detection algorithm based on hough transform can be used to obtain a center coordinate and a diameter of the circle object in the image.
Therefore, first, hough transform-based circular object detection is performed on the first layer image within the volume data range. Since other circular-like structures (such as atria, ventricles, etc.) may exist in the image, it is necessary to determine the central coordinates and the diameter of the ascending aorta from the detection result of the hough transform based on the detection result of the hough transform circular object in combination with the diameter range (usually 20mm-35mm) of the ascending aorta and the position relationship in the image (the ascending aorta is usually located at the left side of the whole heart region), and obtain a circular region approximately covering the ascending aorta in the image of the layer.
Performing morphological expansion on the obtained circular area to obtain a background area seed point; performing morphological corrosion on the obtained circular area to obtain a target area seed point; and taking the background region seed points and the target region seed points as input, and obtaining the ascending aorta segmentation result in the first layer image in the volume data range by using a random walk algorithm.
Although the ascending aorta is oriented in the axial direction of the human body, the position and shape of the ascending aorta in different tomographic images vary in the CT image. Therefore, in the process of segmenting the ascending aorta in the tomographic image by using the random walk algorithm, the background and the target region seed points need to be updated layer by layer, that is, after the segmentation of the ascending aorta in the current layer of image is completed, morphological expansion and erosion operations are performed on the segmentation result, and the segmentation result is used as the background and the target region seed points for the segmentation of the ascending aorta in the next layer of image, and then the segmentation result of the ascending aorta in the next layer of image is obtained by using the random walk algorithm. And repeating the steps until the segmentation results of the ascending aorta in all the tomographic images in the volume data range are obtained, and finally mapping the segmentation results of the tomographic images into a three-dimensional multi-planar reconstructed image (MPR image) according to the set reconstruction angle of the MPR image.
And 4, step 4: coronary sinus ostial identification
In a three-dimensional multi-planar reconstructed image including oblique sagittal and oblique coronal positions of left and right coronary ostia, the position of the coronary ostia is identified from the segmentation result of the ascending aorta and the CT value range. Since the coronary sinus ostium is the opening of the coronary arteries above the aortic sinus, which are also filled with contrast agent, the CT values of the coronary arteries are close to those of the aorta. Therefore, in the oblique sagittal MPR image and the oblique coronal MPR image including the left and right coronary ostia, region growing is performed with the segmentation result and the CT value range of the ascending aorta as the seed point and the threshold range, respectively, and the first growing positions on both sides of the ascending aorta are the coronary ostia positions.
Example two
Please refer to fig. 2, which is a schematic structural diagram of the medical image display device according to the embodiment. As shown in fig. 2, the medical image display apparatus includes: the device comprises a scanning data acquisition module, a first image reconstruction module, a first segmentation image acquisition module, a second segmentation image acquisition module and a time phase position display module; the scanning data acquisition module is used for acquiring scanning data of a plurality of phases in the cardiac cycle of the examinee; the first image reconstruction module is to reconstruct a first image of the plurality of phases based on the scan data; the first segmentation image acquisition module is used for receiving a first display parameter set by a user based on the first image, segmenting the first image based on the first display parameter and displaying the segmented first segmentation image; the second segmentation image acquisition module is used for receiving a second display parameter set by a user based on the first segmentation image, reconstructing second images of the multiple time phases based on the second display parameter, and segmenting the second images to acquire segmented second segmentation images; and the time phase position display module is used for counting the image characteristics based on the second segmentation image and highlighting the time phase position corresponding to the image which accords with the specific characteristics.
The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other.
In summary, in the medical image display method and apparatus provided by the present invention, the medical image display method includes obtaining scan data of a plurality of phases in a cardiac cycle of a subject; reconstructing a first image of the plurality of phases based on the scan data; receiving a first display parameter set by a user based on a first image; segmenting the first image based on the first display parameter and displaying the segmented first segmented image; receiving a second display parameter set by a user based on the first segmentation image; reconstructing a second image of the plurality of time phases based on the second display parameters and segmenting the second image to obtain a segmented second segmented image; and counting image features based on the second segmentation image, and highlighting the corresponding time phase position of the image which accords with the specific features. The medical image display method based on the invention can automatically reconstruct the data of a plurality of time phases and the three-dimensional MPR image of the examined person according to the evaluation requirement of the doctor, avoid the complex workload of manually reconstructing and adjusting the images of the plurality of time phases by a user, and simultaneously provide more comprehensive and rich information for evaluation, for example, the doctor can refer to the data of the complete cardiac cycle to know the change condition of the concerned anatomical structure in the whole cardiac cycle. In addition, in practical application, a plurality of parameters need to be evaluated by a user (doctor), different parameters may correspond to different optimal evaluation time phases, and the scheme provided by the invention can be conveniently suitable for the user to evaluate various types of parameters.
The above description is only for the purpose of describing the preferred embodiments of the present invention, and is not intended to limit the scope of the present invention, and any variations and modifications made by those skilled in the art based on the above disclosure are within the scope of the appended claims.
Claims (10)
1. A medical image display method, comprising:
obtaining scan data for a plurality of phases within a cardiac cycle of a subject;
reconstructing a first image of the plurality of phases based on the scan data, the first image being a three-dimensional multi-planar reconstructed image and including a plurality of tomographic images of the object under different reconstruction angles with respect to the size evaluation;
receiving a first display parameter set by a user based on a first image, wherein the first display parameter comprises a volume data range required by the size evaluation object;
dividing each of the tomographic images in the first image based on the first display parameter, retaining the tomographic image in the volume data range to obtain a divided first divided image, and displaying the divided first divided image;
receiving a second display parameter set by a user based on the first segmentation image, wherein the second display parameter comprises a reconstruction angle of a three-dimensional multi-plane reconstruction image;
reconstructing a second image of the plurality of time phases based on the second display parameter, wherein the second image is the first segmentation image under a set reconstruction angle, performing segmentation related to a size evaluation index on the second image, and mapping a segmentation result to a three-dimensional multi-plane reconstruction image to obtain a segmented second segmentation image;
and counting image features related to the size evaluation index based on the second segmentation image, and highlighting the corresponding time phase position of the image conforming to the specific features.
2. The medical image display method according to claim 1, wherein the first display parameter further includes: the size evaluates a reconstruction angle of a three-dimensional multi-planar reconstructed image required by the object.
3. A medical image display method according to claim 1, wherein the size evaluation object is an annulus and/or an aortic root.
4. The medical image display method according to claim 3, wherein when the size evaluation object is an annulus or an aortic root, a volume data range required for the size evaluation object includes: ascending aorta, sinotubular junction, aortic and coronary ostia, annulus plane and left ventricular outflow tract.
5. The medical image display method according to claim 3, wherein when the size evaluation object is an annulus and an aortic root, the reconstruction angle of the three-dimensional multi-planar reconstructed image required for the size evaluation object is: an oblique axial plane parallel to the annulus plane, and an oblique sagittal plane and an oblique coronary plane containing the left and right coronary ostia.
6. The medical image display method according to claim 3, wherein the size evaluation index of the valve annulus includes: annular minor diameter, annular major diameter, annular mean diameter, annular area based area mean diameter, annular perimeter based perimeter mean diameter.
7. A medical image display method according to claim 3, wherein the evaluation index of the size of the aortic root comprises: mean diameter of aortic sinus, mean diameter at sinotubular junction, mean diameter at ascending aorta, distance of left and right coronary sinus ostia to the plane of the annulus.
8. A medical image display method according to claim 1, wherein the second display parameter further includes a phase range.
9. A medical image display method as set forth in claim 1, wherein MDCT is employed to obtain scan data of a plurality of phases within a cardiac cycle of a subject.
10. A medical image display apparatus, characterized by comprising:
the scanning data acquisition module is used for acquiring scanning data of a plurality of phases in the cardiac cycle of the examinee;
a first image reconstruction module for reconstructing a first image of the plurality of phases based on the scan data, the first image being a three-dimensional multi-planar reconstructed image and including a plurality of tomographic images of a size-assessment-related object at different reconstruction angles;
a first segmentation image acquisition module, configured to receive a first display parameter set by a user based on the first image, segment the first image based on the first display parameter, and display a segmented first segmentation image, where the first display parameter includes a volume data range required by the size evaluation object, and the first segmentation image is the tomographic image within the reserved volume data range;
a second segmentation image obtaining module, configured to receive a second display parameter set by a user based on the first segmentation image, reconstruct a second image of the multiple time phases based on the second display parameter, where the second display parameter includes a reconstruction angle of a three-dimensional multi-planar reconstruction image, and the second image is the first segmentation image at the set reconstruction angle, perform segmentation related to a size evaluation index on the second image, and map a segmentation result to the three-dimensional multi-planar reconstruction image, so as to obtain a segmented second segmentation image;
and the time phase position display module is used for counting the image characteristics related to the size evaluation index based on the second segmentation image and highlighting the time phase position corresponding to the image which accords with the specific characteristics.
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