EP1617763A1 - Appareil d'imagerie angiographique radiographique - Google Patents

Appareil d'imagerie angiographique radiographique

Info

Publication number
EP1617763A1
EP1617763A1 EP04728619A EP04728619A EP1617763A1 EP 1617763 A1 EP1617763 A1 EP 1617763A1 EP 04728619 A EP04728619 A EP 04728619A EP 04728619 A EP04728619 A EP 04728619A EP 1617763 A1 EP1617763 A1 EP 1617763A1
Authority
EP
European Patent Office
Prior art keywords
projection images
ray
vascular tree
ray projection
vascular
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP04728619A
Other languages
German (de)
English (en)
Inventor
Holger c/o Philips Int. Pty. & St. GmbH SCHMITT
Michael c/o Philips Int. Pty. & St. GmbH GRASS
Volker c/o Philips Int. Pty. & St. GmbH RASCHE
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Philips Intellectual Property and Standards GmbH
Koninklijke Philips NV
Original Assignee
Philips Intellectual Property and Standards GmbH
Koninklijke Philips Electronics NV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Philips Intellectual Property and Standards GmbH, Koninklijke Philips Electronics NV filed Critical Philips Intellectual Property and Standards GmbH
Priority to EP04728619A priority Critical patent/EP1617763A1/fr
Publication of EP1617763A1 publication Critical patent/EP1617763A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/481—Diagnostic techniques involving the use of contrast agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/504—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of blood vessels, e.g. by angiography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4429—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units
    • A61B6/4435—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being coupled by a rigid structure
    • A61B6/4441—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being coupled by a rigid structure the rigid structure being a C-arm or U-arm

Definitions

  • the invention relates to an X-ray imaging device with computer means which are set up to visualize the blood flow in a coronary vascular tree of a patient.
  • the invention relates to a corresponding computer program and an X-ray imaging method that can be carried out on the device according to the invention.
  • three-dimensional medical imaging methods such as B. three-dimensional rotary X-ray imaging (3D-RX) is becoming increasingly important.
  • the image data obtained with such methods contain interesting information for the diagnosis of vascular diseases, such as. B. stenoses.
  • the visualization of the vascular structures is crucial so that a treating doctor can quickly and reliably identify potential sources of danger.
  • the flow behavior and in particular the flow rate of the blood can provide important information for the examining doctor, for example in relation to the severity of an existing stenosis.
  • the doctor can only assess the condition of a stenosis on the basis of the reconstructed geometry of the vessels.
  • the known methods which can only provide static images of the vascular tree, it is not possible to assess the threat of a stenosis on the basis of the effects of the stenosis on the blood flow, ie the flow velocity of the blood in the area of the stenosis.
  • the object of the invention is therefore to provide an X-ray imaging device which enables the flow behavior of the blood in the coronary vascular tree to be examined.
  • the invention solves this problem by a device according to claim
  • the invention is based on the use of a suitable computer of an X-ray imaging device for visualizing the blood flow in a coronary vascular tree.
  • the claimed X-ray imaging device can be a complete X-ray device with corresponding
  • the invention proposes to start with a visualization of a data set consisting of x-ray projection images and EKG data (electrocardiogram) of the examined patient obtained in parallel therewith. These data can be recorded in advance of the visualization and then fed to the computer via a corresponding data input or via temporary storage in a database. This procedure is appropriate if the technology according to the invention is used on a medical workstation separate from the device used for the actual image recording. Alternatively, the data can already are processed during the image recording according to the invention if the computer means used for this purpose are directly assigned to the X-ray device equipped with corresponding image recording means.
  • a first set of x-ray projection images of the vascular tree is recorded in different phases of the cardiac cycle, preferably from different projection directions.
  • a suitable contrast medium is administered to the patient to make the vascular tree visible in the X-ray projection images.
  • the patient's EKG is also continuously recorded so that each of the images acquired can be assigned to a specific phase of the cardiac cycle.
  • the three-dimensional structure of the vascular tree is reconstructed in the various phases of the cardiac cycle by a suitable program control of the computer means in accordance with a method known per se.
  • the reconstructed structure is then divided into a plurality of vessel segments, for each of which the flow behavior of the blood is to be examined individually.
  • a second set of x-ray projection images of the vascular tree is taken - again with the patient's ECG being recorded at the same time.
  • the second set of x-ray projection images is expediently given only a short contrast medium bolus, which is advantageous for the examination of the flow behavior of the blood in accordance with the further method steps described below.
  • the first set of x-ray projection images is preferably recorded with a longer contrast agent bolus so that the three-dimensional structure of the vascular tree can be examined as precisely as possible.
  • the flow behavior of the blood in the vascular tree can be examined on the basis of the two sets of x-ray projection images by determining the time-dependent contrast agent concentration within the reconstructed three-dimensional structure of the vascular tree. This is done according to the Invention first assigning the x-ray projection images of the second set to a phase of the cardiac cycle on the basis of the recorded EKG.
  • Local image areas within the x-ray projection images of the second set are then found for the vascular segments of the reconstructed structure of the vascular tree, specifically according to the spatial positions of these vascular segments in the relevant phase of the cardiac cycle.
  • the image areas on which the respective vessel segments are imaged in the respective projection images can be calculated, for example, according to the projection angles at which the x-ray projection images of the second set were taken.
  • Image areas are then determined as to how the contrast medium concentration within the individual vascular segments changes over time, thus how the vascular tree fills with contrast medium. This allows direct conclusions to be drawn about the flow behavior of the blood within the vascular tree.
  • the contrast medium flow determined with the device according to the invention must be visualized in a suitable manner for the examining doctor. For this purpose, it is conceivable, for example, that the time-dependent contrast agent concentration is displayed as a brightness or color value in a three-dimensional view of the reconstructed three-dimensional structure of the vascular tree.
  • the basic idea of the invention is, on the one hand, to take into account the movements of the blood vessels during the heartbeat when reconstructing the three-dimensional structure of the vascular tree. Not only is the structure itself reconstructed, but also its temporal change caused by the movement of the heart.
  • the individual stages of movement of the vascular tree are assigned to the respective phases of the cardiac cycle on the basis of the ECG recorded parallel to the image recording.
  • the idea of the invention is also to record the patient's EKG when the second set of x-ray projection images is recorded, so that the reconstructed three-dimensional structure of the vascular tree with the image features of the patient is related to the respective phase of the cardiac cycle X-ray projection images of the second set can be matched. This results in comprehensive three-dimensional data about how the blood flows through the vascular tree.
  • the second set of x-ray projection images is first recorded while the vascular tree is filled with contrast medium, and only then is the first set of x-ray projection images recorded after the vascular tree has been completely filled with contrast media is filled. In this way, only a single dose of contrast medium is required.
  • the evaluation of the x-ray projection images outlined above for determining and visualizing the time-dependent contrast agent concentration within the vascular tree then takes place with the computer means of the x-ray imaging device only after the image acquisition of the first and second set of x-ray projection images has been completed.
  • first and / or second set of x-ray projection images be recorded by means of continuous rotary x-ray imaging at a plurality of projection angles.
  • the first set of x-ray projection images should be recorded from as many projection directions as possible so that the three-dimensional spatial structure of the vascular tree can be reconstructed as precisely as possible.
  • the reconstruction can in particular also take place on the basis of a large number of projection images, which are recorded during several successive cardiac cycles.
  • special attention must be paid to the temporal resolution so that the inflow of the contrast agent into the vascular tree can be precisely tracked in time. It therefore makes sense that the The second set of x-ray projection images is recorded under only a few different or even under a fixed projection angle.
  • the first set of x-ray projection images is expediently taken with continuous rotary x-ray imaging during several successive cardiac cycles, and the second set is recorded with only a few, possibly fixed projection angles with the highest possible temporal resolution while the vascular tree fills with contrast agent.
  • the reconstructed three-dimensional image derived from the first set of x-ray projection images also shows anatomical structures, for example bones, which can represent a disruptive factor in the further evaluation. It therefore makes sense for the three-dimensional structure of the vascular tree to be reconstructed using computer-aided modeling of the vascular tree while eliminating the other anatomical structures contained in the first set of x-ray projection images.
  • a computer program according to claim 7 is suitable for implementing the visualization technology according to the invention on an X-ray imaging device equipped with a suitable computer means.
  • the corresponding software can advantageously be used by users of suitable imaging devices on a data medium, such as a floppy disk or CD-Rom, or for downloading a data network (Internet) is made available.
  • FIG. 1 flow diagram of the visualization technology according to the invention
  • Figure 2 X-ray imaging device according to the invention.
  • the method shown schematically in FIG. 1 serves to visualize the blood flow in a patient's coronary vascular tree.
  • the method begins with the acquisition of a first set 1 of x-ray projection images in different phases of the cardiac cycle.
  • a first EKG 2 of the patient is recorded parallel to the recording of the x-ray projection images.
  • the three-dimensional structure of the vascular tree is then reconstructed from the first set 1 of x-ray projection images, specifically in the different phases of the cardiac cycle, so that a set 3 of three-dimensional data sets of the coronary vascular structure is then available for the different heartbeat phases.
  • Computer-aided modeling of the vascular tree is carried out, anatomical structures contained in the x-ray projection images that do not belong to the examined vascular tree being eliminated.
  • a data set 4 the three-dimensional structure of the vascular tree is divided into a plurality of vascular segments 5.
  • the data record 4 contains information about the spatial position of each vascular segment 5 in every phase of the cardiac cycle, so that the structure and movement of the vascular tree is completely modeled by the data record 4.
  • a second set 6 of X-ray projection images of the vascular tree are recorded during or after the administration of a contrast agent.
  • a second EKG 7 of the patient is also recorded here.
  • the X-ray projection images of the second set 6 are each assigned to a phase of the cardiac cycle on the basis of the EKG 7.
  • vascular segment 8 for which the time dependence of the contrast agent concentration is to be determined, local image areas within the x-ray projection images of the second set 6 are found in accordance with the spatial position of the vascular segment 8 in a specific phase of the cardiac cycle.
  • the time-dependent position data of data record 4 are used for this.
  • the contrast medium concentration within the vascular segment 8 is then determined by evaluating the X-ray absorption within the local image areas found.
  • the time course of the contrast agent concentration in the range of Vessel segment 8 can be shown as diagram 9 for the purpose of visualization. Such diagrams can be generated for all vascular segments, so that overall there is a comprehensive picture of the blood flow within the vascular tree.
  • the imaging device shown in FIG. 2 is a
  • C-arm X-ray device which has a C-arm 10 which is suspended from a ceiling (not shown in more detail) by means of a holder 11.
  • An X-ray radiation source 12 and an X-ray image converter 13 are movably guided on the C-arm 10, so that a plurality of X-ray projection images of a patient 15 lying in the center of the C-arm 10 on a patient table 14 can be recorded at different projection angles.
  • the synchronous movement of the x-ray radiation source 12 and the x-ray image converter 13 are controlled by a control unit 16.
  • the x-ray radiation source 12 and the x-ray image converter 13 run synchronously around the patient 15.
  • the image signals generated by the X-ray image converter 13 are transmitted to a computer-controlled image processing unit 17.
  • the heartbeat of the patient is monitored by means of an EKG device 18, and the EKG is transmitted to the image processing unit 17.
  • the image processing unit 17 has a program control, by means of which the x-ray projection images are processed in accordance with the previously described method.
  • a monitor 19 connected to the image processing unit 17 is used for visualization.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Radiology & Medical Imaging (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

L'invention concerne un appareil d'imagerie angiographique radiographique pour visionner la circulation du sang dans l'arbre coronaire d'un patient. Selon l'invention, une première série (1) d'images radiographiques de l'arbre coronaire est prise pendant différentes phases du cycle cardiaque, en même temps que l'ECG (2) du patient est enregistré. La structure tridimensionnelle de l'arbre coronaire pendant les différentes phases du cycle cardiaque est ensuite reconstruite au moyen de moyens de programmation appropriés d'éléments informatiques (17) de l'appareil décrit. Une deuxième série (6) d'images radiographiques est prise pendant qu'un agent de contraste est administré, à nouveau en même temps que l'ECG (7) est enregistré. Afin de déterminer la concentration d'agent de contraste en fonction du temps à l'intérieur de la structure tridimensionnelle reconstruite de l'arbre coronarien, l'invention propose de localiser des zones locales de l'image associées aux segments individuels (5, 8) des vaisseaux à l'intérieur des images radiographiques de la deuxième série (6) d'images, en fonction des positions dans l'espace des segments (5, 8) des vaisseaux pendant la phase en question du cycle cardiaque. La concentration d'agent de contraste dans la zone des segments (5, 8) des vaisseaux est ensuite déterminée par évaluation de l'absorption des rayons X dans les zones locales de l'image ainsi localisées.
EP04728619A 2003-04-22 2004-04-21 Appareil d'imagerie angiographique radiographique Withdrawn EP1617763A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP04728619A EP1617763A1 (fr) 2003-04-22 2004-04-21 Appareil d'imagerie angiographique radiographique

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
EP03101103 2003-04-22
PCT/IB2004/050476 WO2004093684A1 (fr) 2003-04-22 2004-04-21 Appareil d'imagerie angiographique radiographique
EP04728619A EP1617763A1 (fr) 2003-04-22 2004-04-21 Appareil d'imagerie angiographique radiographique

Publications (1)

Publication Number Publication Date
EP1617763A1 true EP1617763A1 (fr) 2006-01-25

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP04728619A Withdrawn EP1617763A1 (fr) 2003-04-22 2004-04-21 Appareil d'imagerie angiographique radiographique

Country Status (4)

Country Link
US (1) US7539529B2 (fr)
EP (1) EP1617763A1 (fr)
JP (1) JP2006524087A (fr)
WO (1) WO2004093684A1 (fr)

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Also Published As

Publication number Publication date
WO2004093684A1 (fr) 2004-11-04
US20060293579A1 (en) 2006-12-28
WO2004093684A8 (fr) 2006-03-02
JP2006524087A (ja) 2006-10-26
US7539529B2 (en) 2009-05-26

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