JP2001224577A - Medical x-ray apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a three-dimensional image and two-dimensional image capable of varying the fluoroscopic angle to the axial direction of a subject with the same device. SOLUTION: This apparatus comprises a support frame having an opening part for inserting a table for placing the subject, a rotating member rotated around the opening part, a rotation control means, at least one C-shaped member having a curvature radius about an isocentre, a slide control means for controlling the slide position of the C-shaped member, an X-ray tube device supported on one end of the C-shaped member to emit X-ray to the subject, an X-ray detector supported on the other end of the C-shaped member and arranged in opposition to the X-ray tube device with the subject between to detect the transmitted X-ray of the subject, an image processing device for controlling the rotation of the rotating member by the rotation control means, sliding the C-shaped member to an optional position by the slide control means, and processing the output signal from the detector to generate the two-dimensional image and three-dimensional image, and a display device.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical X-ray apparatus, and more particularly, to an IVR using an angiographic examination or an X-ray diagnostic apparatus.
(Interventional Radiology, catheter surgery under fluoroscopy)
The present invention relates to a medical X-ray apparatus having a function of obtaining a line image and a three-dimensional X-ray image.

[0002]

2. Description of the Related Art Medical X-ray fluoroscopy such as an X-ray fluoroscopy table and a circulatory organ X-ray examination apparatus has become indispensable in the field of diagnosis. It is being used. This treatment is performed by inserting a catheter with various instruments attached to the tip under fluoroscopy into the blood vessels and organs of the subject. Therefore, it has a great merit that the pain given to the subject can be reduced and the treatment can be performed at a low cost, so that it is rapidly spreading.
Such a method of treatment is called IVR.

In this IVR, it is desirable to be able to three-dimensionally grasp the position and shape of the target part. For this purpose, a three-dimensional image is acquired by an X-ray CT apparatus, the position and shape of the target part are grasped based on the three-dimensional image, and an X-ray generation system and X-ray detection are performed on the grasped target part. Various methods using a circulatory organ X-ray diagnostic apparatus with the system supported by a C-shaped arm (“Medical Dental Publishing Co., Ltd .: Medical Radiation Science Course 13, Radiation Diagnostic Equipment Engineering, page 156, FIG. 4-7”) X-rays are radiated from various angles, treatment is performed with reference to a two-dimensional fluoroscopic image of the target site acquired by the circulatory organ X-ray diagnostic apparatus, and the result of the treatment is confirmed again using the X-ray CT apparatus. I was doing it.

The circulatory organ X-ray diagnostic apparatus using the C-shaped arm is configured to perform various rotation and movement operations such as rotation of the arm and slide movement so that fluoroscopy and imaging can be performed from various directions. Prior to the surgery, as described above, the position and shape of the treatment target site are confirmed based on the three-dimensional image generated by the X-ray CT apparatus, and the position and shape obtained from the three-dimensional image and the circulation are determined. Diagnosis and treatment are performed on the basis of the two-dimensional image which is seen through the X-ray diagnostic apparatus.

[0005] Such a circulatory organ X-ray diagnostic apparatus and X-ray C
In the method using the T apparatus together, the information obtained during the IVR is only two-dimensional information obtained by the circulatory organ X-ray diagnostic apparatus. However, it is not possible to intuitively grasp the positional relationship between the treatment target site and the treatment instrument attached to the distal end of the catheter.

To obtain a three-dimensional image by X-ray CT, a three-dimensional image of the subject is reconstructed from the transmitted X-ray detection data of the subject while moving the subject in the body axis direction. A technique called volume scan or helical scan is used. However, this volume scan type X-ray CT apparatus has a problem that the resolution in the body axis direction of the subject is low.

[0007] If the resolution is low, it may be difficult to accurately grasp the position and shape of the treatment target site.
Further improvement in resolution is desired.

As a method of improving the resolution, a method of taking an image while lowering the moving speed of the subject with respect to the rotation speed of the imaging system can be considered. In this case, the responsiveness required by the IVR can be obtained. Can not. The X-ray CT
In the method of using the apparatus and the circulatory organ X-ray diagnostic apparatus together, two apparatuses, an X-ray CT apparatus and a circulatory organ X-ray diagnostic apparatus, which require an expensive and large installation space, are provided.
There are also problems in terms of economy and installation space.

On the other hand, an X-ray source for irradiating X-rays in the form of a cone beam, an imaging system comprising an imaging intensifier (hereinafter referred to as “X-ray II”) and a television camera are used. X called the three-dimensional X-ray CT device
Using a three-dimensional X-ray CT system
A method of acquiring a line image and a three-dimensional X-ray image is conceivable. In a normal X-ray CT apparatus including a three-dimensional X-ray CT apparatus, a subject is placed in a cavity provided in a gantry. There is a problem that it is not possible to secure a sufficient working space for the operator to perform a smooth treatment.
Furthermore, in the case of the IVR, it is necessary to constantly observe the state of the expression of the subject in order to quickly respond to sudden changes in the condition of the subject during the operation. In a state where the subject is placed in the cavity thus obtained, it is difficult to observe the state of the facial expression and the like of the subject, and there is a problem that it is not possible to quickly respond to a sudden change of the body. Therefore, as a solution to the problem of the method of using the X-ray CT apparatus and the circulatory organ X-ray diagnostic apparatus together, a three-dimensional image of the subject and a two-dimensional image obtained by X-ray fluoroscopy are generated by the same apparatus. And X that can perform treatment
A wire apparatus has been proposed in Japanese Patent Application No. 10-306238. This apparatus has an X-ray tube as an X-ray source at one end of a support member, an image receiving means at the other end, and a means for rotating these elements. The transmission X-ray data can be obtained from the entire circumferential direction of the object, and not only a two-dimensional fluoroscopic image of the subject but also a three-dimensional image (a three-dimensional image of an arbitrary tomographic plane.
X-ray image generating means for generating a T image).

In this apparatus, a space for relatively moving the subject is formed at the center of rotation of the rotating means for supporting the imaging system, and the subject is horizontally moved in parallel with the center axis of rotation of the rotating means. By simply moving the rotating means horizontally, the imaging area of the imaging system can be moved from the head to the foot. As a result, transmitted X-ray data from the entire circumferential direction at an arbitrary position is collected, and the transmitted X-ray data is input to the X-ray image generating means, and a three-dimensional image of the imaging region is obtained by a well-known reconstruction operation. Things. Further, in the two-dimensional image, when the fluoroscopic direction of the treatment site is determined based on the three-dimensional image, the rotation position of the support member is fixed at the position in the fluoroscopic direction, and the two-dimensional image is viewed through the direction determined by the rotational position. Get a two-dimensional image.

With such an apparatus, the position and shape of the treatment site of the subject are grasped from the three-dimensional image, and the treatment is performed while referring to the two-dimensional image based on the grasp. A three-dimensional image is generated and confirmed by the above method without moving the subject.

[0012]

Problems to be Solved by the Invention
In the X-ray apparatus proposed in -306238, the following points were not considered. That is, IVR
In this method, the position and shape of a treatment site of a subject are grasped from a three-dimensional image, and the grasped treatment region is treated while viewing a two-dimensional fluoroscopic image from multiple directions.
However, the X-ray apparatus proposed in Japanese Patent Application No. 10-306238 can see through an arbitrary angle direction (direction perpendicular to the body axis of the subject) on the center of rotation, but can be viewed horizontally from the support member. Sliding movement is not possible in the direction (body axis direction of the subject).

[0013] Therefore, since the patient is inclined with respect to the body axis direction of the subject and cannot be seen through the inclined direction, it is impossible to observe the treatment site from these directions.
The problem remains that the range of treatment with IVR is limited. That is, since there is no function of tilting the X-ray source and the X-ray image receiving device in the body axis direction of the subject and arranging the X-ray source and the X-ray receiving device so as to face each other, it may be impossible to depict blood vessels and the like from the fluoroscopic direction.

In view of the above-mentioned problems, it is an object of the present invention to provide a medical X-ray system suitable for IVR in which a three-dimensional image and a two-dimensional image in which the perspective angle with respect to the body axis direction of the subject can be varied by the same apparatus. It is to provide a device.

[0015]

The object of the present invention is to provide a supporting frame having an opening for inserting a table on which a subject is placed, a rotating member supported by the supporting frame and rotating around the opening, Rotation control means for controlling the rotation of a rotating member, and at least one C-shaped member which is slidably supported by the rotating member in the body axis direction of the subject and has a C-shape having a radius of curvature about an isocenter. A sliding control means for controlling a sliding position of the C-shaped member; and an X supported by one end of the C-shaped member for irradiating the subject with X-rays.
A X-ray tube apparatus, an X-ray detection apparatus supported by the other end of the C-shaped member, disposed opposite to the X-ray tube apparatus across the subject, and detecting transmitted X-rays of the subject; The control unit controls the rotation of the rotating member, the sliding control unit slides the C-shaped member to an arbitrary position, processes an output signal from the detection device, and outputs a two-dimensional image and a three-dimensional image. This is achieved by including an image processing device that generates the image and a display device that displays the image generated by the image processing device.

With this configuration, during fluoroscopy, the X-ray tube device and the X-ray detector are set at an arbitrary angle around the subject by rotating the rotating member by the rotation control means, and the slide control means is provided. By setting the rotating member perpendicular or at an arbitrary angle to the body axis of the subject, the transmitted X-rays of the subject are detected by the X-ray detection device by seeing through from these set directions, and this detection signal is The image is processed by the image processing device to generate a two-dimensional image. At the time of cone beam CT imaging, the rotation member by the slide control means is set to be perpendicular or at an arbitrary tilt angle to the body axis of the subject, and rotated at the set vertical or arbitrary tilt angle by the rotation control means. The member is rotated around the subject, X-rays transmitted through the subject are detected by an X-ray detector, and the detection signal is processed by an image processing device to generate a three-dimensional image. The two-dimensional image and / or the three-dimensional image generated by these can be displayed on a display device, and IVR or the like can be performed with reference to the displayed image.

For use in IVR, it is desirable that the opening for inserting the subject is as wide as possible in terms of securing a working space during the operation. Also in this regard, in the present invention, the function of rotating the X-ray tube device and the X-ray detection device around the subject and the function of inclining the subject with respect to the body axis of the subject are provided by the rotating member and the C-shaped member. Since the openings are separately provided, the opening can be made wider than that of a conventional X-ray CT apparatus, and a working space necessary for performing IVR can be secured.

[0018] This makes it easy to constantly observe the facial expression of the subject in order to quickly respond to sudden changes in the condition of the subject during the operation, and quickly responds to sudden changes in the condition of the subject. Be able to respond. Further, according to the present invention, by providing a means for moving the subject in the body axis direction of the subject, the subject can be imaged while the subject is stationary.

Further, the two-dimensional image and the three-dimensional image formed by the image processing device are simultaneously displayed on the same display device or different display devices, and by referring to these images, the position of the target part, Shape information is abundant and I
A medical X-ray apparatus suitable for VR can be provided.

[0020]

DESCRIPTION OF THE PREFERRED EMBODIMENTS [1] Description of Configuration FIG. 1 is a sectional view showing the configuration of a medical X-ray apparatus according to the present invention, and FIG.
1 is a front view of FIG. 1, and FIG. 3 is a perspective view showing a configuration of the C-shaped arm of FIG. The configuration of the present invention will be described below with reference to FIGS.

In FIG. 1, reference numeral 1 denotes a C-shaped arm having a radius of curvature centered on an isocenter and having a C-shape, 2 denotes a support frame provided with an opening 12 into which a subject's body can be inserted,
3 is a rotating plate rotatably supported on the support frame,
A drive unit 20 for sliding the C-arm 1 is supported on the rotating plate. Therefore, C-arm 1
Are slidably supported by the drive unit 20 supported by the rotating plate 3 and rotatably supported by the rotating plate 3.

The C-arm 1 has two arms, a C-arm 4 and a C-arm 5 as shown in FIG. 2, and has a substantially Y-shaped Y-arm 6 from both ends of the C-arms 4 and 5. , 7 are connected and fixed, and the C-arm 4 and the C-arm 5 are connected.

Numeral 8 denotes an image receiving device fixed at an arbitrary position on the Y-type arm 6. This image receiving device may be composed of an image intensifier and a television camera or a CCD (charge coupled device) camera, or may be a semiconductor. A flat panel type two-dimensional sensor using a detector may be used.

An X-ray tube device 9 (hereinafter simply referred to as an X-ray tube) fixed to the Y-arm 7 is disposed at a position facing the image receiving device 8.

The sliding means for the C-arm 1 includes a plurality of roller pairs 21 for slidably supporting the C-arm and the C-arm inside a driving unit 20, and a slide motor 23 having a pulley 22. And the idler pulley 24 drives and slides the belt 25 wound around the outer periphery of the C-arm. Therefore, the image receiving device 8 and the X-ray tube 9 can operate along the body axis of the subject while facing each other around the isocenter Z. The sliding means may be provided on either the C-arm 4 or the C-arm 5 or on both the C-arms 4 and 5.

The rotating means of the C-arm 1 can be rotated by a drive unit 30. The drive unit 30 is composed of a bearing 10 rotatably supported on the support frame 2 and a support frame 2
, A pulley 33 fixed to a motor shaft 32, a detector 34 for detecting rotation of the motor,
The pulley 33 fixed to the motor shaft 32 and the rotary plate 3 are connected by a belt 36,
The rotational force of the motor 31 is transmitted to the rotating plate 3 and can rotate with respect to the support frame 2.

Accordingly, the C-shaped arm 1 fixed to the rotating plate 3 can rotate about a horizontal axis including the isocenter Z, and the image receiving device 8 and the X-ray tube 9 can rotate facing each other.

[2] Description of Operation Next, the operation of the embodiment of the present invention will be described with reference to FIGS.
A detailed description will be given with reference to FIG.

The operator instructs the operating device 40 to select a fluoroscopic image or a cone beam CT image.
According to this instruction, when the function of acquiring a fluoroscopic image is selected, the output of the image receiving device 8 is input to the image processing means 50 by the switch 45, and when the function of acquiring a cone beam CT image is selected, the switching is performed. The output of the image receiving device 8 is input to the image processing means 60 by the image sensor 45.

(1) When a Function to Obtain a Perspective Image is Selected When the operator selects a function to acquire a fluoroscopic image, the system controller 41 causes the switch 45 to send the image receiving device 8
Is transmitted to the image processing means 50 for processing the fluoroscopic image data, and the control commands for positioning the X-ray tube 9 and the image receiving device 8 in the desired direction through the system controller 41 are transmitted to the respective control means. Send to This will be described in detail below.

A command to slide the X-ray tube 9 and the image receiving means 8 to a position perpendicular to the body axis of the subject is sent from the operating device 40 to the sliding control means 42 via the system controller 41. The driving unit 2 that slides the C-arm 1 on which the X-ray tube 9 and the image receiving device 8 are mounted, based on the instruction to perform the sliding movement.
The motor 23 rotates the pulley 22 provided at the shaft end of the motor, and the belt 2 meshes with the pulley.
5. The force is transmitted to the C-arm 1 via the idler pulley 24, and the image receiving means 8 and the X-ray tube 9 face each other along a plurality of roller pairs 21 which support the guide rail provided on the C-arm 1 therebetween. Make it work.

In order to confirm the running direction of the blood vessel, X
It is necessary to operate the wire tube 9 and the image receiving device 8 at arbitrary rotation positions. In this case, similarly, a command is issued from the system controller 41 to the rotating plate rotation control means 43 based on a command of the operating device 40 operated by the operator. The motor 31 of the drive unit 30 is driven based on the command, and the pulley 33 fixed to the motor shaft 32 is rotated.
The rotational force is transmitted through a belt 36 connected to the support frame 2, the rotating plate 3 is rotated through a bearing 10 rotatably supported on the support frame 2, and a brake 35 is operated to a desired angle. , And see through from this held angle.

Then, at the rotation angle of the rotary plate 3 and the sliding position of the C-arm 1, X-rays corresponding to the X-ray conditions from the system controller 41 are generated based on a command from the operating unit 40 by the operator. The X-ray control means 44 generates an X-ray control amount for causing the X-ray based on the control amount to be converted into an X-ray.
The light is emitted from the tube 9 and irradiates the subject. The X-ray transmitted through the subject is input to the image receiving device 8, converted into an electric signal, and the analog signal converted into the electric signal is input to the A / D converter 51 of the image processing means 50. This analog signal is converted into a digital signal by the A / D converter 51, sent to the image processing unit 52 and stored in the frame memory 53. The image processing unit 52 applies contrast and contrast to the transmitted digital image signal in a display gradation processing unit 54.
Image processing such as gamma characteristic conversion is performed, and the digital image signal that has been subjected to the gradation processing is converted into an analog signal by the D / A converter 55, and a fluoroscopic image is displayed on the display 70.

(2) When the Function of Acquiring a Cone Beam CT Image is Selected When the operator selects the function of acquiring a cone beam CT image, the system controller 41 sends the output of the image receiving device 8 to the switching unit 45 by the cone. A command to be input to the image processing means 60 for processing the beam CT image data is sent, and a command for setting the X-ray tube 9 and the image receiving device 8 to a position perpendicular to the body axis of the subject is sent to the sliding control means 42. A command for controlling the rotation of the rotary plate is sent to the rotary plate rotation control means 43, and a cone beam CT image is captured according to these control commands. Hereinafter, this operation will be described.

When the operator selects the cone beam CT function, the system controller 41 operates the switch 45 so that the processing of the image processing means 60 can be performed. At the same time, a command is output from the system controller 41 so that the image receiving device 8 and the X-ray tube 9 are located at positions that coincide with the vertical axis including the isocenter Z. Based on the command, the respective drive units 20 and 30 motors 2
The rotating plates 3 and 31 are driven to operate the rotating plate 3 and the C-arm 1, and are stopped in a state where the focal point of the X-ray tube 9 and the center of the image receiving device 8 are aligned on the vertical axis including the isocenter Z.

At the stage where preparations such as positioning of the subject have been completed, the operator performs imaging of the cone beam CT.
The operation device 40 is operated. A command is output from the system controller 41 to the rotating plate rotation control means 43, and the motor 31 of the drive unit 30 is driven based on the command, and the rotating plate 3 is rotated in the same manner as described above.

When the rotation of the rotating plate 3 has reached a constant speed, the system controller 41
X-rays are output from the tube 9 and the X-rays transmitted through the subject are detected by the image receiving device 8.

The signal detected by the image receiving device 8 is converted into a digital signal by an A / D converter and stored in a data collector 61. The data collector 61 receives the X-ray absorption data from the data collector 61, and receives the data. On the other hand, a preprocessor 62 that performs preprocessing such as logarithmic conversion, gain correction, and offset correction, a convolver 63 that receives data from the preprocessor and performs a product-sum operation on X-ray absorption data in a pre-projection direction, and a convolver 63 A back projector 64 that reconstructs a superimposed tomographic image by back-projecting the data after the product-sum operation to an image memory 65 described later, and an image that stores the tomographic image reconstructed by the back projector 64 A memory 65 and an image converter 66 for setting CT values in a desired range with respect to data relating to the reconstructed tomographic image on the image memory 65. It is displayed on the display 70.

As described above, according to the embodiment of the present invention, the position and the shape of the target part are grasped from the three-dimensional image, and the perspective from multiple directions, in particular, the perspective angle in the body axis direction is determined based on the result. Can be set arbitrarily, so that diagnostic information of blood vessels, organs, and the like, which are complicated and complicated, is abundant, and the diagnosis and treatment can be improved.

[0040]

As described above, according to the present invention, a three-dimensional image and a two-dimensional image are generated by the same apparatus, and the information on the position and shape of the subject to be diagnosed and treated based on the three-dimensional image is obtained. Based on the perspective at an arbitrary angle with respect to the body axis direction of the subject, a reference is made to a two-dimensional perspective image from multiple directions.
VR can be performed. As a result, the position and shape information of complicated and complicated blood vessels and organs will be abundant,
It is possible to provide a medical X-ray apparatus that contributes to improvement of treatment, is economical, and requires a small installation space.

[Brief description of the drawings]

FIG. 1 is a sectional view showing a configuration of a medical X-ray apparatus according to the present invention.

FIG. 2 is a front view of the medical X-ray apparatus of the present invention.

FIG. 3 is a perspective view showing a configuration of a C-arm according to the present invention.

FIG. 4 is a configuration diagram of a control device of the medical X-ray apparatus of the present invention.

[Explanation of symbols]

Reference Signs List 1 C-arm, 2 support frame, 3 rotating plate, 8 image receiving device, 9 X-ray tube device, 10 bearing, 20, 30 drive unit, 23, 31 motor, 22, 33 pulley, 25,
36 belt, 21 roller pair, 24 idler pulley, 34 detector, 35 brake, 41 operating device, 4
2 slide control means, 43 rotating plate rotation control means, 45
Switcher, 50, 60 Image processing means, 70 Display

Claims (1)

[Claims] 1. A supporting frame having an opening for inserting a table on which a subject is placed, a rotating member supported by the supporting frame and rotating around the opening, and a rotation control for controlling the rotation of the rotating member. Means and at least one C-shaped member which is slidably supported by the rotating member in the body axis direction of the subject and has a C-shape having a radius of curvature centered on an isocenter.
A C-shaped member, sliding control means for controlling a sliding position of the C-shaped member, an X-ray tube device supported at one end of the C-shaped member and irradiating the subject with X-rays, X, which is supported at the other end of the letter-shaped member and is disposed opposite to the X-ray tube device with the subject interposed therebetween, and detects transmitted X-rays of the subject.
A line detection device, the rotation control means controlling the rotation of the rotating member, the sliding control means sliding the C-shaped member to an arbitrary position, and processing an output signal from the detection device to obtain a second signal. A medical X-ray apparatus comprising: an image processing device that generates a three-dimensional image and a three-dimensional image; and a display device that displays the image generated by the image processing device.