JP2000210289A - Three-dimensional ultrasonic diagnostic system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To three-dimensionally and understandably display information of the coronary blood flow of a heart or the perfusion separating from the intracardiac blood flow to provide information of the three-dimensional cardiac muscle blood flow useful for clinical diagnosis even when a three-dimensional ultrasonic image is used. SOLUTION: This three-dimensional ultrasonic diagnostic system is provided with a means (two-dimensional array 1, pulser/preamplification unit 4) to three- dimensionally transmit an ultrasonic beam to a diagnostic position including the left ventricle in a subject body and to receive its ultrasonic echo, a means (transmission delay circuit 5, echo processor 6, doppler processor 7) to generate three-dimensional data of the diagnostic location based on the ultrasonic echo received thereby, a means (heat chamber detecting part 8) to obtain the heart chamber area in the three-dimensional data generated thereby, and a means (monitor 3, 3D processor 9, display unit 11) to generate a display image which is made to easily discriminate information at the cardiac muscle part of the heart.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a three-dimensional ultrasonic diagnostic apparatus for providing information useful for clinical diagnosis of myocardial ischemia, and more particularly to an image for detecting and displaying a blood flow in a myocardium from a three-dimensional image. Concerning the device of processing.

[0002]

2. Description of the Related Art In clinical diagnosis of the heart, improvement of a technique for evaluating myocardial ischemia is one of the important issues. As a technique for evaluating such myocardial ischemia, the coronary artery (coronary blood flow) of the heart and myocardial perfusion have been conventionally subjected to color Doppler imaging by a color Doppler method using an ultrasonic diagnostic imaging apparatus or a contrast imaging method using a contrast agent. 2. Description of the Related Art A technique for diagnosing an ischemic part of a heart, which is a three-dimensional structure, by rendering a two-dimensional ultrasonic image such as an image, a power Doppler image, and a contrast image is known.

On the other hand, in recent years, a three-dimensional ultrasonic diagnostic apparatus configured to form a three-dimensional image by scanning an ultrasonic beam in a three-dimensional area has been spotlighted, and a CFM image, a power Doppler image, a 3D contrast image, etc. Is expected to be put to practical use in clinical diagnosis using three-dimensional ultrasonic images.

[0004]

However, considering that the above-described three-dimensional ultrasonic diagnostic apparatus is applied to clinical diagnosis of the heart, a three-dimensional image obtained by three-dimensionally scanning the heart to be diagnosed is: Since the intracardiac blood flow, the coronary blood flow, and the myocardial perfusion are displayed so as to overlap each other, it is difficult to distinguish between them, and there is a problem that it is difficult to diagnose myocardial ischemia three-dimensionally as it is. This problem has not been observed in the case of a conventional ultrasonic diagnostic apparatus that displays a two-dimensional image.

The present invention has been made in consideration of such a conventional problem, and even when a three-dimensional ultrasonic image is used, the information of the coronary blood flow or perfusion of the heart is obtained in the heart chamber. It is displayed in a three-dimensionally easy-to-understand manner in distinction from the blood flow,
It is intended to provide three-dimensional myocardial blood flow information useful for clinical diagnosis.

[0006]

In order to achieve the above object, the present inventor has proposed a means for masking a blood flow image in a heart chamber, for example, 1) automatically extracting an endocardium from an ultrasonic black and white image. Means for masking the inside thereof, 2) means for automatically extracting and masking the blood flow in the heart chamber from a color Doppler or power Doppler image, 3) blood flow in the heart chamber from a contrast image based on a contrast imaging method using a contrast agent. Means for automatically extracting and masking, and after masking by these masking means or after extracting the heart chamber boundary, the coronary blood flow and perfusion of the entire heart chamber (between the intima and the adventitia) are determined by MIP (Maximum or Min).
Imum Intensity Projection
: Maximum value or minimum value projection), integral value projection, volume rendering, and the like.

[0007] A three-dimensional ultrasonic diagnostic apparatus according to the present invention comprises:
It is completed based on such a point of interest.

That is, according to the first aspect of the present invention, a transmitting / receiving means for transmitting an ultrasonic beam three-dimensionally to a diagnostic site including the left ventricle of the heart in a subject and receiving the ultrasonic echo, Generating three-dimensional data of the diagnostic site based on the ultrasonic echo received by the transmitting / receiving means; 3
Dimensional data generating means, heart chamber area determining means for obtaining a heart chamber area in the three-dimensional data generated by the three-dimensional data generating means, and converting a value in the heart chamber area in the three-dimensional data into a different value And a display image generating means for generating a display image in which information in the myocardial portion of the heart is easily identified.

According to a second aspect of the present invention, in the first aspect of the invention, the three-dimensional data generating means generates at least one of morphological information and blood flow information of the diagnosis site. Features.

[0010] According to a third aspect of the present invention, in the first aspect of the present invention, the heart chamber region determining means determines the diagnostic region of the diagnostic site generated by the three-dimensional data generating means. It is characterized in that an endocardium is extracted from morphological information, and a heart chamber region is obtained based on the extracted endocardium.

[0011] According to a fourth aspect of the present invention, in the first aspect of the present invention, the heart chamber region determining means includes the diagnostic region of the diagnostic region generated by the three-dimensional data generating means. The heart cavity region is obtained based on blood flow information.

According to a fifth aspect of the present invention, in the first aspect of the present invention, the heart chamber region determining means is obtained in a state where a contrast agent is injected into the subject. It is characterized in that a heart chamber region is obtained based on three-dimensional data obtained based on an ultrasonic echo.

According to a sixth aspect of the present invention, in the first aspect of the present invention, the display image generating means excludes data in the heart chamber region in the three-dimensional data. A display image is generated based on data.

According to a seventh aspect of the present invention, in the sixth aspect, the display image is a two-dimensional image obtained by projecting the three-dimensional data.

According to an eighth aspect of the present invention, in the seventh aspect, the two-dimensional image is set at an arbitrary distance from the boundary surface of the heart chamber and the boundary surface in the three-dimensional data. It is characterized in that luminance information of data included in a region between the reference plane and the reference plane is projected from the reference plane side onto a boundary surface of the heart chamber by a predetermined projection method.

According to a ninth aspect of the present invention, in the invention of the eighth aspect, the projection method is a MIP method.

According to a tenth aspect of the present invention, in the eighth aspect, the projection method is an integral value projection method.

According to an eleventh aspect of the present invention, in the seventh aspect, the two-dimensional image is a partial image of the three-dimensional data.

According to a twelfth aspect of the present invention, in the eleventh aspect, the partial image is included in a partial area obtained by dividing the left ventricle of the heart by a plane including a major axis thereof. I do.

According to a thirteenth aspect of the present invention, in accordance with the twelfth aspect of the present invention, there is further provided a means for detecting a long axis of the left ventricle of the heart based on the heart chamber region determined by the heart chamber region determining means. It is characterized by the following.

According to a fourteenth aspect of the present invention, in the thirteenth aspect, the means for detecting the major axis of the left ventricle of the heart includes one of a plurality of principal axes of inertia determined by the form of the heart chamber. It is a means for detecting as the long axis of the left ventricle of the heart.

According to a fifteenth aspect of the present invention, the three-dimensional ultrasonic diagnostic apparatus transmits an ultrasonic beam three-dimensionally to a diagnostic site including the left ventricle of the heart in the subject and receives the ultrasonic echo. Transmitting and receiving means for generating three-dimensional blood flow information data of the diagnostic site based on the ultrasonic echo received by the transmitting and receiving means, and a heart region for obtaining a heart chamber region in the blood flow information data Determining means, and means for generating a display image from which the blood flow information of the heart chamber region has been removed.

A three-dimensional ultrasonic diagnostic apparatus according to a sixteenth aspect of the present invention transmits an ultrasonic beam three-dimensionally to a diagnostic site including the left ventricle of the heart in a subject and receives the ultrasonic echo. Transmitting and receiving means, and three-dimensional data generating means for generating three-dimensional blood flow information data of the diagnostic site based on the ultrasonic echo received by the transmitting and receiving means,
Means for generating a display image so that the image processing method is different between the myocardial region and the heart cavity region of the heart, and a region having a small blood flow in the myocardium is easily identified, and a unit for displaying the display image. It is characterized by having.

[0024]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of a three-dimensional ultrasonic diagnostic apparatus according to the present invention will be described with reference to the drawings.

The ultrasonic diagnostic apparatus shown in FIG. 1 is applied as a real-time three-dimensional system for obtaining real-time ultrasonic three-dimensional images that can be used for clinical diagnosis of myocardial ischemia and the like. That is, the ultrasonic diagnostic apparatus includes a two-dimensional array probe 1 having a configuration in which a plurality of ultrasonic transducers are arranged in a two-dimensional array, an apparatus main body 2 connected to the probe 1, and a main body 2 connected to the main body 2. Monitor 3.

The two-dimensional array probe 1 drives a plurality of ultrasonic transducers under the control of the apparatus main body 2 so that an ultrasonic beam can be diagnosed in a subject in accordance with preset transmission beam forming conditions. A three-dimensional scan is performed toward a part, and an ultrasonic echo signal reflected or back-scattered by a small scatterer at an acoustic impedance boundary in a body tissue in the subject with respect to the ultrasonic beam is applied with a weak voltage. The signal is converted into an echo signal and received, and the received signal is sent to the apparatus main body 2.

The apparatus main body 2 includes a pulser / preamplifier unit 4 connected to the probe 1, a reception delay circuit 5 connected to the preamplifier output side of the unit 4, and a first bus BU1 connected to the reception delay circuit 5. , A plurality of processors connected via a computer, ie, an echo processor 6, a Doppler processor 7, a heart chamber detector 8, and a 3D processor 9
And a host CPU 10 and a display unit 11 connected to each of these processors via a second bus BU2.

The pulsar / preamplifier unit 4 generates a transmission pulse for generating a pulse voltage for controlling the direction and convergence of the ultrasonic beam by the probe 1 based on a preset three-dimensional transmission beam forming condition. The probe 13 includes a T / R 12 that supplies a drive signal to the probe 1 based on a pulse voltage from the generator 13, and a preamplifier 14 that receives a signal received by the probe 1.

The reception delay circuit 5 controls the direction and convergence of the ultrasonic beam based on a preset three-dimensional reception beam forming condition, and performs plural simultaneous receptions of a plurality of ultrasonic beams in parallel. (N) circuit sets, that is, BFs (beamformers) 1 to BFn are provided.

The echo processor 6 performs three-dimensional detection on the reception signal from the reception delay circuit 5 using a predetermined reference frequency, and performs three-dimensional morphological information (in the case where a contrast agent is used) in the subject according to the signal amplitude. Generates three-dimensional spatial distribution image data indicating a contrast image including the information of the contrast agent, and outputs this image data to the heart chamber detecting unit 8.
Send to

The Doppler processor 7 measures the time change of the phase of the reception signal from the reception delay circuit 5 to
For example, at least one of three-dimensional spatial distribution image data of speed, power, and variance indicating blood flow information of the subject's heart and its peripheral part is generated, and this image data is used as the heart cavity detector 8.
Send to

The heart chamber detecting section 8 is constituted by, for example, a processor for executing a preset heart chamber detecting algorithm.
By the processing of this processor, data on the heart chamber of the left ventricle of the heart is detected based on the three-dimensional spatial distribution data from the echo processor 6 or the Doppler processor 7.

Here, the concept of the algorithm executed by the heart chamber detector 8 is as follows: 1): 3 from the echo processor 6
When using dimensional information, 2): Doppler processor 7
3): a case where a contrast image based on a contrast imaging method using a contrast agent is used.

First, 1): when three-dimensional morphological information is used, a boundary detection method using a luminance difference of image data, for example, a method of binarizing an image or differentiating a pixel value, An algorithm such as ACT, which has been put to practical use, is used by improving it for a three-dimensional image, for example, and is obtained from the three-dimensional morphological information of the range including the left ventricle LV in the heart HE as shown in FIG. The endocardium M1 corresponding to the boundary position of the heart chamber OB of the chamber LV is extracted and set. This endocardium M1
Can be manually extracted by the operator while looking at the screen. Alternatively, if the epicardium (including the boundary position on the right ventricle RV side in the septum IS in FIG. 2) is easier to extract than the endocardium M1 of the left ventricle LV, after extracting the epicardium, It is also possible to set a position inward from the position by a certain distance, as the virtual endocardium M1.
Based on the endocardium M1 (cardiac cavity boundary surface) automatically and manually extracted and set from the three-dimensional morphological information, the inside is detected as cardiac cavity data. In this case, it can be performed without using a contrast agent.

2): When three-dimensional blood flow information is used, the left ventricle LV shown in FIG. 4 is applied by applying the same algorithm using the luminance difference as in 1) to the Doppler signal (image).
A boundary surface between the heart chamber blood flow BL1 and the coronary blood flow BL2 in the inside is automatically extracted, and the internal position is detected as heart chamber data.
In this case, the boundary surface can be manually set by the operator while viewing the screen in the same manner as described above. Also, as shown in FIG. 5, by specifying a part of the heart chamber blood flow BL1 using the marker M displayed on the screen, all the blood flow parts connected to the part can be set in the heart chamber OB. Is also possible. In this case, the coronary blood flow BL2 is three-dimensionally inseparable from the heart chamber blood flow BL1 because it is not in contact with it.

3): When using a contrast image,
As shown in FIG. 6, for example, when a contrast agent mainly containing microbubbles injected from a vein is used, the echo of the blood flow BL2 in the heart chamber is changed to a perfusion BL3 (coronary blood flow BL2) around it.
) Is more intense than the echo of
A heart cavity boundary is extracted using the difference in luminance between the two, and the inside thereof is detected as a heart chamber OB. This effect becomes more remarkable when a contrast image obtained by harmonic imaging (HM) is employed.

The heart chamber OB detected in any one of the above 1) to 3) may be slightly smaller than the actual one, or may be larger than the actual one. For example, the heart chamber OB detected from the morphological information 1) may be smaller than the actual one due to the influence of the trabecula in the heart, and conversely, the blood flow information 2) or the blood flow information 3). The heart chambers OB detected from the contrast images are expected to be larger than the actual ones due to the effects of low resolution, blooming, and the like.

As a countermeasure, if the heart chamber OB is expected to be smaller than the actual one, FIG.
As shown in the figure, the outer surface S2 of the heart chamber OB that is separated from the boundary surface S1 of the heart chamber OB by an arbitrary distance D1 is set as the heart chamber OB. When the heart chamber OB is expected to be larger than that of the heart chamber OB, the heart chamber OB is separated from the boundary surface S1 of the heart chamber OB by an arbitrary distance D2 as shown in FIG. The inner surface S3 is set as the heart chamber OB.

The 3D processor 9 converts the image data of the heart chamber OB detected by the heart chamber detector 8 into an echo processor 6
The mask is masked from the three-dimensional spatial distribution image data from the Doppler processor 7 and the blood flow image is displayed on the monitor 11 via the display unit 11. As a method of displaying the blood flow image, any of MIP, integral value projection, surface rendering, volume rendering, and the like may be adopted.

Here, the concept of the mask processing by the 3D processor 9 will be described with reference to FIGS.

First, a case where an image is displayed without masking the heart chamber OB will be described. FIG. 8 shows an example in which three-dimensional blood flow information obtained by three-dimensional CFM is displayed by MIP. In this case, since the intracardiac blood flow BL1 and the coronary blood flow BL2 are displayed in an overlapping manner, it is difficult to identify the coronary blood flow BL2, and myocardial ischemia cannot be diagnosed as it is.

Therefore, the myocardial OB detected as described above is masked from the three-dimensional blood flow information to obtain a MIP display image, thereby rendering only the coronary blood flow BL2 as shown in FIG. However, since the coronary blood flow BL2 includes information on the entire left ventricular myocardium, in this state, the coronary blood flow BL2a on the near side and the coronary blood flow BL2b on the back side of the coronary blood flow overlap and are displayed. Diagnosis of myocardial ischemia is difficult.

As a countermeasure, as shown in FIG. 10, the left ventricle LV is divided into two into a front left chamber LV1 and a rear left chamber LV2 at a division plane PL passing through the long axis AX. MIP and masking the back left chamber LV2, as shown in FIG. 11, the front left chamber LV1
Monitor, that is, only the near coronary blood flow BL2a
Can be displayed above. At this time, as shown in FIGS. 11A and 11B, the morphological image (normal two-dimensional ultrasonic image representing the morphology of the heart) IM of the left ventricle LV on the division plane PL is superimposed on the MIP image. May be displayed so that the positional relationship with the blood vessel can be easily understood.
FIG. 11A shows an image without a stenosis site, and FIG.
1 (b) shows an image when there is a stenosis site. When there is a stenosis site as shown in FIG. 11B, a state is obtained in which a hole is formed in the image, and the image becomes one in which the stenosis site can be easily identified.

Although the above-described mask processing is an example using three-dimensional blood flow information, the same applies to a contrast image. This is shown in FIGS.

That is, when an image is displayed without masking the heart chamber OB, in the three-dimensional display of the myocardial perfusion by the contrast imaging method, the echo of the blood flow BL1 in the heart chamber and the myocardial perfusion as shown in FIG. The echo of BL3 overlaps, making it difficult to distinguish between them.

Therefore, as shown in FIG.
By masking the echo of L1, only the perfusion BL3 can be drawn. However, since the perfusion BL3 contains information on the entire left ventricular myocardium, the perfusion BL3 on the near side in this state is left as it is.
a and the perfusion BL3b on the back side are overlapped and displayed, and even in this case, it is difficult to diagnose myocardial ischemia.

Therefore, as shown in FIG.
Is divided into a front left chamber LV1 and a rear left chamber LV2 by a division plane PL passing through the long axis AX, for example, the front left chamber LV
By masking the rear left chamber LV2 as well as the front left chamber LV1 as shown in FIG. 15, only the front perfusion BL3a is monitored 3 as shown in FIG.
Can be displayed above. At this time, a perfusion image obtained by dividing the morphological image (normal two-dimensional ultrasonic image representing the morphology of the heart) IM of the left ventricle LV on the division plane PL into two as shown in FIGS. The position may be displayed in such a manner that the positional relationship with the blood vessel can be easily understood. 15A shows an image when there is no ischemic site, and FIG. 15B shows an image when there is an ischemic site. When there is an ischemic site as shown in FIG. 15 (b), a state is obtained in which an image has a hole, and an image in which the ischemic site can be easily identified is obtained.

Therefore, according to this embodiment, even in the case of a three-dimensional image, the local cardiac function of the entire left ventricle of the heart can be easily and objectively and quantitatively evaluated, and information useful for clinical diagnosis can be provided. .

In the above-described embodiment, the 2D array probe 1 and the pulsar / preamplifier unit 4 serve as transmitting / receiving means, and the reception delay circuit 5, echo processor 6, and Doppler processor 7 serve as three-dimensional data generating means. The cavity detector 8 constitutes the heart cavity region determining means, and the 3D processor 9, the display unit, and the monitor 3 constitute the display image generating means. However, the present invention is not limited to this, and does not depart from the gist. Needless to say, the present invention can be modified and implemented within the range.

That is, the display image generating means converts the values in the heart chamber region in the three-dimensional data into different values so that the information in the myocardial portion of the heart can be easily identified. 2) 3) Display image from which blood flow information in the heart chamber region has been removed. 3) Display in which the region with low blood flow in the myocardium can be easily identified by using different image processing methods for the myocardial region and the heart chamber region of the heart. One of the images
One or a combination thereof may be generated.

As for the image display method, for example, the front left chamber LV1 and the rear left chamber LV2 divided into two by the division plane PL as shown in FIG. 16 are displayed side by side on the monitor 3 at the same time, or as shown in FIG. Left side L on the monitor 3
V1 may be a red system, and the rear left chamber LV2 may be a blue system, and may be displayed in a different color. In this case,
It is possible to make a diagnosis of the entire left ventricle at a glance. In the three-dimensional display of myocardial perfusion,
The color is purple if there is no ischemia, blue if there is ischemia in the front left ventricle, and red if there is ischemia in the back left ventricle.

When only one side of the left chamber LV1 or LV2 divided into two is displayed, the position of the division plane can be moved to cover the entire left chamber and updated at any time. For example, as shown in FIG. 18, it is preferable to rotate the division plane PL about the long axis AX. This allows a diagnosis of the entire left ventricle of the heart.

Regarding the above MIP display, FIG.
As shown in (a) and (b), the operation is performed in the direction perpendicular to the heart chamber boundary surface S1 to map onto the heart chamber boundary surface S1, and the MI
The target range is defined as a fixed distance D between the heart chamber boundary surface S1 and the outside thereof.
The distance may be limited to the virtual outer surface S3 separated by three. In this case, the meaning of the image can be made clearer, and the image can be generated mainly using information of only the myocardial portion.
There is also an advantage that the calculation time is further reduced. This effect is particularly remarkable in the case of perfusion display using the contrast imaging method. Similarly, in the case of integral value projection, surface rendering, and volume rendering other than MIP, it is also possible to project by limiting an area used as data.

With respect to the image mapped on the heart chamber boundary surface S1, as shown in FIG. 20A, a two-dimensional image IM is obtained by a simple geometric projection on a predetermined divided section PL. Can be mapped. Regarding the setting method of the divided section PL in this case, the left ventricle L is manually set while viewing the three-dimensional image, or as shown in FIG.
The plane passing through the major axis AX of V can be automatically set. In the latter case, it can be automatically detected as one of the principal axes of inertia of the heart chamber or the interface of the heart chamber, or by using another algorithm.

FIGS. 21A and 21B show other display examples. In this case, the data between the left ventricle boundary surface S1 and the outer surface S3 outside of the boundary surface S3 by a certain distance D3 is subjected to projection processing such as MIP along a direction parallel to the long axis AX. It is. This allows the bullseye (bul
(1's-eye) display image can be obtained.

The above-described processes such as detection of a heart cavity, masking of a blood flow image in a heart cavity, and display of coronary blood flow or perfusion are useful for diagnosis. Is preferably performed in real time, but is not limited to this.
For example, the same can be applied to a three-dimensional image reconstructed from a two-dimensional tomographic image.

Therefore, the above-described ultrasonic diagnostic apparatus is applied to a real-time three-dimensional system. However, the present invention is not necessarily limited to this, and is sufficiently applicable as long as it can generate three-dimensional data. It is possible.

The schematic flowcharts shown in FIGS. 22 and 23 summarize the processing procedure by the above-described three-dimensional ultrasonic apparatus. Hereinafter, this processing procedure will be described.

First, in FIG. 22, in step S1, the three-dimensional ultrasonic apparatus includes the left heart of the subject in the subject by transmitting / receiving means (including the 2D array probe and the pulsar / preamplifier unit in the example of FIG. 1). An ultrasonic beam is transmitted to the diagnosis site, and the ultrasonic echo is received.

Then, in step 2, three-dimensional data generating means (a receiving delay circuit, an echo processor,
3D data (3D morphological information, 3D blood flow information such as velocity information and power value, contrast image by contrast imaging using a contrast agent) from ultrasonic echoes (Step S2).

Next, in step S3, the above-described algorithm (for example, see FIGS. 2 to 7 and the description thereof) is executed by the heart chamber detecting means (including the heart chamber detecting unit in the example of FIG. 1). The heart chamber is detected from the three-dimensional data.

Accordingly, in step S4, the above-described algorithm (for example, FIGS. 8 to 15 and its description) is obtained from the three-dimensional data by the display image generating means (including the 3D processor, the display unit, and the monitor in the above example). ) To remove or convert the intracardiac data (step S41), and display the three-dimensional image with the removed or converted intracardiac data on a monitor (step S42).
(For example, see FIGS. 16 to 21 and the description thereof).

As a specific example of this case, for example, the case where MIP processing and volume rendering processing described below are used is considered.

(1) When MIP Processing is Used In this case, first, the three-dimensional image data in the heart chamber region is converted into a value indicating that there is little or no blood flow (step S41). Then, the converted three-dimensional image data is MIP-processed along the projection direction and projected on a two-dimensional plane,
Thereby, a display image is generated (step S42).

(2) When Volume Rendering is Used In this case, first, the three-dimensional image data in the heart chamber region is converted into a value having high transparency (step S41). And
The converted three-dimensional image data is volume-rendered along the projection direction and projected on a two-dimensional plane.
A dimensional display image is generated (step S42). In addition,
In the volume rendering process, usually, the transparency of the pixel is set to be higher according to the value of the image. For this reason, the transparency can be increased by converting the value of the three-dimensional image data into a value indicating that there is little or no blood flow. Further, as a method of increasing the transparency, a method of increasing a set value of the transparency provided corresponding to the position of the three-dimensional image data may be adopted.

(3) When Another Example of Volume Rendering Process is Used In this case, the three-dimensional image data in the heart chamber region is converted into color data having low transparency and which can easily identify a color representing a blood flow. Conversion is performed (step S41). And 3 after this conversion
The two-dimensional image data is volume-rendered along the projection direction and projected on a two-dimensional plane to generate a two-dimensional display image (step S42). Thus, the portion of the myocardium where the blood flow is small shows the color assigned to the heart chamber region, so that the ischemic region of the myocardium can be easily identified.

In the processing procedure of steps S1 to S4 shown in FIG. 22, the processing of step S4 can be performed independently or in parallel instead of the processing of step S5 shown in FIG. That is, in the example in this case, after each of the processes in steps S1 to S3 similar to the above, in step S5, the boundary of the heart chamber region is set as the boundary of the three-dimensional image by the display image generation unit (step S51).
Based on the heart cavity region boundary set here, a two-dimensional display image is generated from the three-dimensional image data so that the data of the heart cavity region does not contribute to the display image (step S52).

As a specific example of this case, for example, the case where MIP processing and volume rendering processing described below are used is conceivable.

That is, when the MIP process is used, the heart chamber boundary region set along the direction traversing the myocardium is M
IP processing is performed, and the obtained value is assigned to the heart chamber region boundary. Then, a value assigned to the heart chamber region boundary is projected on a two-dimensional plane to generate a two-dimensional display image. Thus, since the data in the heart chamber region is limited to the processing range of the image data at the boundary of the heart chamber region so as not to be included in the processing range of the image data, the data of the heart chamber region does not contribute to the display image. A two-dimensional display image can be generated from the three-dimensional image data.

When volume rendering is used, three-dimensional image data is projected onto a two-dimensional plane along the projection direction to generate a two-dimensional display image. In the projection at this time, the region from the set boundary of the heart chamber region to the region on the myocardium side is subjected to volume rendering processing, and the region on the side of the heart cavity from the boundary of the heart chamber region is not subjected to volume rendering processing. Thus, a two-dimensional display image can be generated from the three-dimensional image data so that the data of the heart chamber region does not contribute to the display image.

[0071]

As described above, according to the present invention,
The three-dimensional ultrasonic diagnostic apparatus can easily and objectively and quantitatively evaluate the local myocardial blood flow in the entire left ventricle of the heart and provide useful information for clinical diagnosis.

[Brief description of the drawings]

FIG. 1 is a schematic block diagram showing an embodiment of a three-dimensional ultrasonic diagnostic apparatus according to the present invention.

FIG. 2 is a schematic diagram showing the entire heart of a diagnostic site.

FIG. 3 is a schematic diagram showing the left ventricle of the heart.

FIG. 4 is a schematic diagram illustrating superimposed display of blood flow information when the inside of the heart chamber is not masked.

FIG. 5 is a schematic diagram illustrating a case where a heart cavity is set using a marker.

FIG. 6 is a schematic diagram illustrating a luminance difference of blood flow information in a contrast image.

FIGS. 7A and 7B are schematic diagrams illustrating a setting example of a detected heart chamber. FIGS.

FIG. 8 is a schematic diagram illustrating an example of MIP display of three-dimensional blood flow information (color Doppler) when the inside of the heart chamber is not masked.

FIG. 9 is a schematic diagram illustrating superimposed display of the front side and the back side of coronary blood flow after a myocardial mask.

FIG. 10 is a conceptual diagram illustrating an example of division of a left ventricle.

FIG. 11 is a conceptual diagram showing a display example of a divided image of the left ventricle.
(A) is a diagram showing an image when there is no stenosis site, and (b) is a diagram showing an image when there is a stenosis site.

FIG. 12 is a schematic diagram showing a display example of a contrast image when the inside of the heart chamber is not masked.

FIG. 13 is a schematic diagram illustrating superimposed display of the front side and the back side of coronary blood flow after a myocardial mask in the case of a contrast image.

FIG. 14 is a conceptual diagram illustrating an example of division of a left ventricle in the case of a contrast image.

15A and 15B are conceptual diagrams illustrating a display example of a divided image of a left ventricle in the case of a contrast image, in which FIG. 15A is a diagram illustrating an image when there is no stenosis site, and FIG. FIG.

FIG. 16 is a conceptual diagram showing an example of displaying divided images of the left ventricle in parallel.

FIG. 17 is a conceptual diagram showing a watermark display example of a divided image of the left ventricle.

FIG. 18 is a conceptual diagram illustrating a case where a division surface of a left ventricle is rotated.

FIGS. 19 (a) and (b) show MI on the heart chamber interface.
The conceptual diagram explaining P.

FIG. 20A is a conceptual diagram illustrating an example of projection from the boundary surface of the heart chamber, and FIG. 20B is a conceptual diagram illustrating an example of setting the long axis of the left ventricle.

FIGS. 21A and 21B are conceptual diagrams showing a case where a bullseye-like display image is obtained in another display example.

FIG. 22 is a schematic flowchart showing a processing procedure of the three-dimensional ultrasonic apparatus.

FIG. 23 is a schematic flowchart showing another processing procedure of the three-dimensional ultrasonic apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Two-dimensional array probe 2 Main body 3 Monitor 4 Pulser / preamplifier unit 5 Transmission delay circuit 6 Echo processor 7 Doppler processor 8 Heart chamber detection part 9 3D processor 10 Host CPU 11 Display unit HE heart OB Heart chamber LV Left ventricle (left LV1 Divided left ventricle on the near side LV2 Divided left ventricle on the back side RV Right ventricle (right ventricle) IS Ventricular septum MM myocardium M1 Left ventricular endocardium BL1 Coronary blood flow BL2 Intracardiac blood flow BL2a Frontal coronary blood Flow BL2b Coronary blood flow on the back side BL3 Myocardial perfusion BL2a Myocardial perfusion on the near side BL2b Myocardial perfusion on the back side S1 Cardiac cavity boundary surface S2 External cardiac cavity surface S3 Internal cardiac cavity surface S4 Imaging reference plane D1, D2, D3 Constant distance PL Divided section (plane passing through the long axis) AX Long axis of the left ventricle

Claims (16)

[Claims] 1. A transmitting / receiving means for transmitting an ultrasonic beam three-dimensionally to a diagnostic site including a left ventricle of a heart in a subject and receiving the ultrasonic echo, and an ultrasonic wave received by the transmitting / receiving means Three-dimensional data generating means for generating three-dimensional data of the diagnostic site based on an echo; heart chamber area determining means for obtaining a heart chamber area in the three-dimensional data generated by the three-dimensional data generating means; Display image generating means for converting a value in the heart chamber region in the dimensional data into a different value, and generating a display image in which information in the myocardial portion of the heart is easily identified. Three-dimensional ultrasonic diagnostic equipment. 2. The three-dimensional data generating means according to claim 1, wherein said three-dimensional data generating means generates at least one of morphological information and blood flow information of said diagnosis site.
Dimensional ultrasonic diagnostic equipment. 3. The cardiac cavity region determining means extracts an endocardium from the morphological information of the diagnostic site generated by the three-dimensional data generating means, and obtains a cardiac cavity region based on the extracted endocardium. The three-dimensional ultrasonic diagnostic apparatus according to claim 1, wherein: 4. The heart cavity region determination unit according to claim 1, wherein the heart cavity region is determined based on blood flow information of the diagnosis site generated by the three-dimensional data generation unit. The three-dimensional ultrasonic diagnostic apparatus according to claim 2. 5. The heart cavity region determining means obtains a heart cavity region based on three-dimensional data obtained based on an ultrasonic echo obtained in a state where a contrast agent is injected into the subject. The three-dimensional ultrasonic diagnostic apparatus according to claim 3, wherein: 6. The display image generating means according to claim 1, wherein the display image generating means generates a display image based on data in the three-dimensional data excluding data in the heart chamber region. The three-dimensional ultrasonic diagnostic apparatus according to any one of claims 5 to 10. 7. The three-dimensional ultrasonic diagnostic apparatus according to claim 6, wherein the display image is a two-dimensional image obtained by projecting the three-dimensional data. 8. The luminance information of data included in an area between a boundary surface of the heart chamber and a reference plane set at an arbitrary distance from the boundary surface in the three-dimensional data. 8. The three-dimensional ultrasonic diagnostic apparatus according to claim 7, wherein the image is projected from the reference plane side onto the boundary surface of the heart chamber by a predetermined projection method. 9. The ultrasonic diagnostic apparatus according to claim 8, wherein said projection method is a MIP method. 10. The three-dimensional ultrasonic diagnostic apparatus according to claim 8, wherein said projection method is an integral value projection method. 11. The three-dimensional ultrasonic diagnostic apparatus according to claim 7, wherein the two-dimensional image is a partial image of the three-dimensional data. 12. The three-dimensional ultrasonic diagnostic apparatus according to claim 11, wherein the partial image is included in a partial region obtained by dividing the left ventricle of the heart by a plane including a major axis thereof. 13. The apparatus according to claim 12, further comprising: means for detecting the long axis of the left ventricle of the heart based on the heart chamber region determined by the heart chamber region determining means.
Dimensional ultrasonic diagnostic equipment. 14. The means for detecting the major axis of the left ventricle is a means for detecting one of a plurality of principal axes of inertia determined by the form of the heart chamber as the major axis of the left ventricle. The three-dimensional ultrasonic diagnostic apparatus according to claim 13, wherein: 15. A transmitting / receiving means for transmitting an ultrasonic beam three-dimensionally to a diagnostic site including a left ventricle of the heart in a subject and receiving the ultrasonic echo, and an ultrasonic wave received by the transmitting / receiving means. Means for generating three-dimensional blood flow information data of the diagnostic site based on the echo; heart area determining means for obtaining a heart chamber area in the blood flow information data; removing blood flow information of the heart chamber area A three-dimensional ultrasonic diagnostic apparatus, comprising: means for generating a displayed image. 16. A transmitting / receiving means for transmitting an ultrasonic beam three-dimensionally to a diagnostic site including a left ventricle of the heart in a subject and receiving the ultrasonic echo, and an ultrasonic wave received by the transmitting / receiving means. A three-dimensional data generating means for generating three-dimensional blood flow information data of the diagnosis site based on an echo; and an image processing method differing between a myocardial region and a heart cavity region of the heart, and a blood flow in the myocardium. A three-dimensional ultrasonic diagnostic apparatus, comprising: means for generating a display image so that an area having a small number of images is easily identified; and means for displaying the display image.