JP2004180940A - Endoscope - Google Patents

Endoscope Download PDF

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Publication number
JP2004180940A
JP2004180940A JP2002351629A JP2002351629A JP2004180940A JP 2004180940 A JP2004180940 A JP 2004180940A JP 2002351629 A JP2002351629 A JP 2002351629A JP 2002351629 A JP2002351629 A JP 2002351629A JP 2004180940 A JP2004180940 A JP 2004180940A
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Japan
Prior art keywords
image
vbs
branch
endoscope
route
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Granted
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JP2002351629A
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Japanese (ja)
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JP3930423B2 (en
Inventor
Toshiya Akimoto
Junichi Onishi
順一 大西
俊也 秋本
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Olympus Corp
オリンパス株式会社
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Priority to JP2002351629A priority Critical patent/JP3930423B2/en
Publication of JP2004180940A publication Critical patent/JP2004180940A/en
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Abstract

<P>PROBLEM TO BE SOLVED: To ensure the navigation of an endoscope to an object site by a guiding image corresponding to an actual branching position. <P>SOLUTION: When the endoscope reaches a branch thumbnail VBS image 54(h), the VBS image is rotated, based on the data on the amount of rotation of a first rotary operation. A moving image with the amount of rotation specified by the first rotary operation is reproduced between the VBS image 54(h) and a branch thumb nail VBS image 54(i). When the endoscope reaches the image 54(i), the VBS image is rotated, based on the data on the amount of rotation of a second rotary operation. A moving image with the amount of rotation specified by the second rotary operation is reproduced between the VBS image 54(i) and a branch thumbnail VBS image 54(j). <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an endoscope apparatus, and particularly to an endoscope apparatus for navigating insertion of an endoscope into a duct in a body such as a bronchus.
[0002]
[Prior art]
2. Description of the Related Art In recent years, diagnosis based on images has been widely performed. For example, three-dimensional image data is obtained in a subject by capturing a tomographic image of the subject using an X-ray CT (Computed Tomography) apparatus or the like. Diagnosis of affected parts has been performed using dimensional image data.
[0003]
The CT apparatus continuously performs a spiral continuous scan (helical scan) on a three-dimensional region of the subject by continuously feeding the subject in the body axis direction while continuously rotating the X-ray irradiation / detection. A three-dimensional image is created from tomographic images of successive slices in a three-dimensional region.
[0004]
One such three-dimensional image is a three-dimensional image of the bronchi of the lungs. The three-dimensional image of the bronchus is used for three-dimensionally grasping the position of an abnormal part suspected of, for example, lung cancer. Then, in order to confirm the abnormal part by biopsy, a bronchial endoscope is inserted, an image of the abnormal part is approached, and a tissue sample is collected with a biopsy forceps inserted through a forceps opening of the endoscope. Is done.
[0005]
As in the bronchus 500 shown in FIG. 22, when the location of the abnormal part is near the end of the branch, the tip of the endoscope can correctly reach the target site in a short time when the location of the abnormal part is near the end of the branch. Is difficult, for example, in Japanese Patent Application Laid-Open No. 2000-135215, etc., a three-dimensional image of a pipe in the subject is created based on image data of a three-dimensional region of the subject, and the three-dimensional image is formed on the three-dimensional image. By obtaining a route to a destination point along a pipeline, creating a virtual endoscope image of the pipeline along the route based on the image data, and displaying the virtual endoscope image. An apparatus for navigating a bronchoscope to a target site has been proposed.
[0006]
[Patent Document 1]
JP 2000-135215 A
[0007]
[Problems to be solved by the invention]
However, in the navigation to the target site by the apparatus disclosed in Japanese Patent Application Laid-Open No. 2000-135215, a live endoscopic image captured by a bronchial endoscope is displayed, and a virtual endoscopic image at a branch of the bronchi is displayed. Although it guides the insertion destination, as described above, not only does the bronchus have multi-stage branches, but each image at the branch is a similar image with multiple branch destination paths, so By simply displaying the virtual endoscope image, even if a virtual endoscope image at a branch position different from the actual branch position of the live endoscopic image is displayed, the operator can perform virtual endoscope at the correct branch position. There is a possibility that this may be mistaken for an image, and such misidentification has a problem in that navigation to a target part of the bronchoscope is seriously hindered.
[0008]
The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide an endoscope apparatus capable of reliably navigating an endoscope to a target portion by a guide image corresponding to an actual branch position. And
[0009]
[Means for Solving the Problems]
An endoscope apparatus according to the present invention includes: a three-dimensional image generating unit configured to generate a three-dimensional image of a body cavity path in the subject based on image data of a three-dimensional region of the subject; and an image of the body cavity path in the subject An endoscope that performs navigation, and a navigation image generating unit that generates a navigation image including an endoscope image of a body cavity passage in the subject captured by the endoscope and the three-dimensional image. In an endoscope apparatus for observing and treating the inside of the subject while guiding an insertion path of the endoscope into a body cavity in the subject, the endoscope apparatus may be configured to perform the above-described operation at all branch points where the body cavity in the subject branches. Reduced image generating means for generating a plurality of reduced images of a three-dimensional image, image rotating means for rotating the three-dimensional image of the reduced image generated by the reduced image generating means, and the image rotating means for converting the three-dimensional image The rotation amount data Constituted by and a rotation amount data storage means for storing in association with serial three dimensional images.
[0010]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0011]
1 to 21 relate to an embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of an endoscope apparatus, FIG. 2 is a configuration diagram showing a configuration of an input unit in FIG. 1, and FIG. Is a flowchart showing a flow of a navigation data generation process by the bronchoscope navigation apparatus of FIG. 1, FIG. 4 is a first diagram showing a route setting screen developed in the process of FIG. 3, and FIG. 5 is a route developed in the process of FIG. FIG. 6 is a second diagram showing the setting screen, FIG. 6 is a flowchart showing the flow of the route setting process of FIG. 3, FIG. 7 is a first diagram showing the route setting screen developed in the process of FIG. 6, and FIG. FIG. 9 is a third diagram showing a route setting screen developed in the process of FIG. 6, and FIG. 10 is a route search by the bronchoscope navigation device of FIG. FIG. 11 is a first diagram illustrating a modified example of FIG. FIG. 12 is a second diagram illustrating a modified example of the route search by the bronchoscope navigation device. FIG. 12 is a flowchart showing a flow of a navigation process by the bronchoscope navigation device of FIG. 1. FIG. 13 is an operation of the bronchoscope navigation device of FIG. FIG. 14 is a second diagram illustrating the operation of the bronchoscope navigation device of FIG. 1, FIG. 15 is a third diagram illustrating the operation of the bronchoscope navigation device of FIG. 1, and FIG. 4 is a fourth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1, FIG. 17 is a fifth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1, and FIG. 18 is the operation of the bronchoscope navigation device of FIG. FIG. 19 is a seventh diagram for explaining the operation of the bronchoscope navigation device of FIG. 1, and FIG. 20 is a diagram of the bronchoscope navigation device of FIG. Eighth diagram illustrating the use, FIG. 21 is a ninth diagram illustrating the operation of the bronchoscope navigation device shown in FIG.
[0012]
As shown in FIG. 1, an endoscope apparatus 1 according to the present embodiment includes a bronchoscope 2 that is inserted into a bronchus in a patient and images the inside of the bronchi to biopsy a diseased tissue at the end of the bronchus. An input unit 4 formed of a flexible sheet in which a plurality of switches provided on the side are formed in a film shape, and a virtual endoscopic image (hereinafter referred to as a VBS image) inside the bronchi based on CT image data and a bronchoscope. An endoscopic image (hereinafter, referred to as a live image) obtained by the bronchoscope 2 and a VBS image are synthesized and displayed on a monitor 5 based on the imaging signal from the input unit 2 and the input signal from the input unit 4, and displayed on the monitor 5. And a bronchoscope navigation device 6 for performing navigation to the bronchi.
[0013]
Although the input unit 4 is provided on the hand side of the bronchoscope 2, it may be configured by a foot switch.
[0014]
The bronchoscope navigation device 6 can output three-dimensional image data generated by a known CT device (not shown) that captures an X-ray tomographic image of a patient, for example, an MO (Magnetic Optical Disk) device, a DVD (Digital Versatile Disk) device, or the like. CT image data capturing unit 11 for capturing via a portable storage medium, CT image data storing unit 12 for storing three-dimensional image data captured by CT image data capturing unit 11, and CT image data storing unit 12 An MPR image generation unit 13 that generates an MPR image based on the three-dimensional image data, and a navigation route to the bronchus of the bronchoscope 2 (hereinafter, referred to as a route setting screen that generates a later-described route setting screen having the MPR image generated by the MPR image generation unit) , Simply write the route) A VBS image generating unit 15 that generates a continuous VBS image of a route set by the route setting unit 14 on a frame basis based on the three-dimensional image data stored in the CT image data storage unit 12; A VBS image storage unit 16 that stores the VBS image generated by the VBS image generation unit 15 and an imaging signal from the bronchoscope 2 and an input signal from the input unit 4 are input, and a live image, a VBS image, and a plurality of thumbnail VBS images are input. An image processing unit 17 for generating a navigation screen described later, an image display control unit 18 for displaying the route setting screen generated by the route setting unit 14 and the navigation screen generated by the image processing unit 17 on the monitor 5, A keyboard and a pointing device (mouse or monitor) for inputting setting information to the unit 14 Composed of the setting information input unit 19 for consisting a touch panel) that is provided on. Note that the setting information input unit 19 can also input information to the image processing unit 17.
[0015]
The CT image data storage unit 12 and the VBS image storage unit 16 may be configured by one hard disk, and the MPR image generation unit 13, the route setting unit 14, the VBS image generation unit 15, and the image processing unit 17 It can be composed of one arithmetic processing circuit. Further, the CT image data capturing unit 11 captures CT image data via a portable storage medium such as an MO or a DVD. However, a CT device or an in-hospital server storing CT image data is connected to an in-hospital LAN. If so, the CT image data capturing unit 11 may be configured with an interface circuit connectable to the in-hospital LAN, and the CT image data may be captured via the in-hospital LAN.
[0016]
As shown in FIG. 2, the input unit 4 includes a next VBS switch SW1 for instructing an update of a VBS image for each bronchi branch point displayed on the navigation screen, and a previous VBS for instructing movement to a preceding VBS image. The switch SW2 is a switch that switches the VBS image to correspond to the direction of the live image. The switch SW3 is a freeze switch that instructs to capture a still image of the live image.
[0017]
The operation of the present embodiment thus configured will be described.
[0018]
As shown in FIG. 3, prior to observation / treatment with the bronchoscope 2, the bronchoscope navigation device 6 captures the three-dimensional image data of the patient generated by the CT device by the CT image data capturing unit 11 in step S1. The three-dimensional image data acquired in S2 is stored in the CT image data storage unit 12.
[0019]
In step S3, the route setting unit 14 displays a route setting screen 21 as shown in FIG. 4 on the monitor 5, and selects patient information on the patient information tag screen 22 on the route setting screen 21. By this selection, an MPR image composed of, for example, three different multi-section images of the patient selected in step S4 is generated, and this MPR image 23 is displayed on the route setting screen 21 in step S5.
[0020]
The selection of patient information on the patient information tag screen 22 is performed by inputting a patient ID for identifying a patient through the setting information input unit 19.
[0021]
Next, when the route setting tag 24 (see FIG. 4) on the route setting screen 21 is selected by the setting information input unit 19 in step S6, a route setting tag screen 25 as shown in FIG. 5 is displayed on the route setting screen 21. Then, a route setting process described later is performed to set a route for insertion navigation of the bronchoscope 2 in the bronchi.
[0022]
When the route of the insertion navigation is set, a continuous VBS image of all the routes set by the VBS image generating unit 15 is generated for each frame in step S7, and the VBS image generated in step S8 is stored in the VBS image storage unit 16. I do.
[0023]
In the bronchoscope navigation device 6 according to the present embodiment, for example, the insertion of the bronchoscope 2 in the bronchus can be navigated by two navigation methods as described later. Then, the mode (navigation mode) is set in the route setting unit 14 by the setting information input unit 19. The information on the navigation mode is also transmitted to the image processing unit 17 via the route setting unit 14, and the mode information is stored therein.
[0024]
Through the processing in steps S <b> 1 to S <b> 9, preparation for navigation by the bronchoscope navigation device 6 at the time of observation and treatment by the bronchoscope 2 is completed.
[0025]
Here, the route setting processing in step S6 will be described with reference to FIG.
[0026]
As shown in FIG. 6, in the route setting process of step S6, by operating the setting information input unit 19, a route search button on the route setting tag screen 25 shown in FIG. 5 is clicked. A start point input instruction window 31 for prompting the input of the start point of the route as shown in FIG. 5 is displayed on the route setting screen 21, and the start point is displayed on one of the tomographic images of the MPR image 23 using the cursor 30 on the route setting screen 21. Set. When the start point is set, the start point is set at the corresponding position on the two tomographic images of the other MPR images 23, and the end point input instruction window 32 for prompting the input of the end point of the route as shown in FIG. 21.
[0027]
Therefore, similarly to the setting of the start point in step S12, the end point is set on one tomographic image of the MPR images 23 using the cursor 30 on the route setting screen 21. When the end point is set, the end point is set at a corresponding position on the two tomographic images of the other MPR images 23.
[0028]
When the start point and the end point are set, the route setting unit 14 searches for a route in the bronchus from the start point to the end point in step S13. Since the bronchus have a complicated route, the route in the bronchus from the start point to the end point is not always determined uniquely. Therefore, the route setting unit 14 determines in step S13 that the route in the bronchus from the start point to the end point. Is searched for a first candidate.
[0029]
Then, the route setting unit 14 superimposes and displays the route searched in step S14 on the MPR image 23 on the route setting screen 21 as shown in FIG. A window 33 is displayed.
[0030]
The route confirmation window 33 includes a route confirmation button 41 for instructing confirmation of the searched route, a next candidate search button 42 for instructing search for a next candidate route, and a route reset button 43 for resetting the start point and the end point. And a cancel button 44 for canceling the route search process.
[0031]
In step S15, it is determined whether or not the next candidate search button 42 has been clicked. If so, the next candidate route is automatically searched in step S16, and the process proceeds to step S17. If not, the process proceeds to step S18. In step S17, as a result of searching for the next candidate, it is determined whether the next candidate exists. If not, a warning (not shown) indicating that the next candidate route does not exist is displayed, and the process returns to step S13. Returns to step S14.
[0032]
In step S18, it is determined whether or not the route reset button 43 has been clicked. If the button has been clicked, the process returns to step S11. If not, the process proceeds to step S19.
[0033]
In step S19, it is determined whether or not the route determination button 41 has been clicked. If the button has not been clicked, the process returns to step S15. If the button has been clicked, the process proceeds to step S20. In step S20, the position information of the route and each branch point in the route is determined. And returns to step S7 in FIG.
[0034]
Although the route search processing using the MPR image has been described, the starting point 101 is obtained by using a bronchi schematic diagram 99 as shown in FIG. 10 and a volume rendering (Volume Rendering Technicque) image 100 of the bronchus as shown in FIG. Alternatively, the route search may be performed by designating the end point 102.
[0035]
The navigation for insertion at the time of observation and treatment by the bronchoscope 2 by the bronchoscope navigation device 6 having the route set as described above will be described. In the following, a case where the route has 10 branch points will be described as an example.
[0036]
As shown in FIG. 12, when navigation by the bronchoscope navigation device 6 is started, a navigation screen 51 as shown in FIG.
[0037]
The navigation screen 51 includes an endoscope live image display area 52 for displaying a live image from the bronchoscope 2, a VBS image display area 53 for displaying a VBS image, and reduction of VBS images at all branch points of the route. In step S21 before the bronchoscope 2 is inserted, a live image is not displayed in the endoscope live image display area 52, but a VBS image is displayed. The display area 53 displays a VBS image 53a at the first branch point of the route, and the branch thumbnail VBS image area 54 displays branch thumbnail VBS images 54 (a) to 54 (j) at all branch points. .
[0038]
The marker 55 is displayed on the VBS image 53a in a manner superimposed on the bronchi on the route. Also, the same frame of the branch thumbnail VBS image as the VBS image 53a displayed in the VBS image display area 53 is displayed in a thick frame or in color, and can be distinguished from other branch thumbnail VBS images. It is possible to easily recognize which branch the VBS image displayed in the area 53 is.
At the stage of step S21, the frame of the branch thumbnail VBS image 54 (a) is displayed as a thick frame or in color.
[0039]
A VBS position display bar 56 is provided below the branch thumbnail VBS image area 54 to indicate the position of the VBS image 53a in the entire VBS image in continuous frame units. The VBS image 53a can be moved to a VBS image of an arbitrary frame by moving the VBS image 53a by using such a method.
[0040]
Further, on the navigation screen 51, a previous button 57, a next button 58 for moving the VBS image 53a to the VBS image of the preceding and following branch point, a left rotation button 59 for rotating the VBS image 53a left or right, and a right rotation A button 60, a video playback button 63 for playing back a VBS image between the branch points specified by the start branch point number setting unit 61 and the end branch point number setting unit 62 as a video, and a playback for setting a playback speed at the time of video playback. A speed setting unit 64 and a rotation speed setting unit 65 for setting the rotation speed of the VBS image during video playback are provided.
[0041]
Further, a distance display section 81 for displaying a distance from the position of the displayed VBS image 53a to the VBS at the end point, and a moving image is reproduced from a thumbnail surrounded by a frame when the previous button 57 or the next button 58 is clicked. A playback range setting unit 82 for setting a thumbnail range, and a playback range display bar 83 indicating a thumbnail of a range to be displayed as a moving image when the previous button 57 or the next button 58 is clicked are provided.
[0042]
When the moving image is reproduced, the range of the thumbnail that has advanced or returned from the currently selected thumbnail by the number set by the reproduction range setting unit 82 is reproduced. Also, for example, a circle-shaped end point marker 84 indicating the direction of the end point specified at the time of setting the route can be superimposed on the VBS image 53a. Displays the end point marker 84.
[0043]
Further, as shown in FIG. 14, the bronchi are named for each route. Regarding the bronchial naming of the IV order and the V order, i, i are determined according to the already named branch of a or b.
ii and α, β. Therefore, when viewed from the branch direction and distribution area of the bronchus, the upper, rear or outer side is defined as i or α, and the lower, front or inner side is defined as ii or β. This nomenclature is basically the same for regional and sub-regional branches.
[0044]
Master ……………………………… 0th order
Intermediate trunk ........................ 0-primary
Leaf support (upper trunk / middle leaf support / lower trunk) ......... I next
Upper ward branch, tongue branch, bottom trunk ............ I-II
Area support …………………… II II… B1
Sub-segment branch ………………………… III-order …… B1a, B1b
Sub-segment branch ............... IV ... B1ai, B1aii
V next ... B1aiα, B1aiβ
Therefore, the bronchial path name is superimposed on the bronchial path name area 66 on the VBS image 53a. Since there is a route whose name is not defined at the end of the bronchus, an area in which the name of the bronchial path is not set is indicated by an untitled display bar 67 below the branch thumbnail VBS image, and in this area, As described later, the operator can arbitrarily set and define the name of the bronchial route.
[0045]
In addition, a cube 68 indicating RAS coordinate indicating the body orientation is superimposed on the VBS image 53a. Note that the orientation of the body may represent a human body.
[0046]
When the insertion of the bronchoscope 2 into the bronchus is started in step S22, as shown in FIG. 15, the live image 52a from the bronchoscope 2 is displayed on the navigation screen 51 in the endoscope live image display area 52 in step S23 as shown in FIG. Is displayed. In FIG. 15, the VBS image display area 53 also displays the VBS image 53a of the first branch point of the route, and the branch thumbnail VBS image area 54 displays the branch thumbnail VBS images 54 (a) to 54 (a) at all the branch points. 54 (j) is displayed, and the frame of the branch thumbnail VBS image 54 (a) is displayed in a thick frame or in color.
[0047]
Next, when the distal end of the bronchoscope 2 reaches the first (first) branch point, the surgeon determines whether or not to depress the freeze switch SW4. The operator continues to insert the bronchus indicated by the marker 55 on the live image 52a simply by looking at the VBS image 53a and the live image 52a in the VBS image display area 53, but the marker 55 is not displayed on the live image 52a. When it is difficult to find the indicated bronchus, the freeze switch SW4 is pressed.
[0048]
In step S25, it is determined whether or not the freeze switch SW4 is turned on. If the switch is turned on, the still image of the live image 52a is captured in step S26, and the still image and the VBS image 53a of the first branch point are known. The similarity is compared by the image processing described above, and if not turned on, the process proceeds to step S27.
[0049]
In step S26, if the similarity is equal to or less than the predetermined value, it is determined that the similarity has been inserted into a route other than the set route (or compared with a VBS image at a different branch point), and a warning is displayed (shown in the drawing). Zu).
[0050]
When it is determined in step S26 that the still image of the live image 52a and the VBS image 53a are similar with a similarity exceeding a predetermined value, the surgeon determines that both images are images at the same branch point, and By operating the rotation switch SW3, the VBS image 53a is rotated in correspondence with the still image of the live image 52a, and in step S27, the rotation amount data is associated with the VBS image of the branch point and the rotation amount data is stored in the VBS image storage unit 16. And the process proceeds to step S28.
[0051]
It is also possible to rotate the VBS image 53a using the left rotation button 59 and right rotation button 60 on the navigation screen 51.
[0052]
When the VBS image 53a is rotated in correspondence with the still image of the live image 52a in this way, the operator can easily find the bronchus indicated by the marker 55 on the live image 52a, and thus continue insertion according to the instruction of the marker 55. .
[0053]
In step S28, it is determined whether the next VBS switch SW1 or the next button 58 has been operated by the operator. If not operated, the process returns to step S25. If the SW1 or the next button 58 has been operated by the operator, In step S29, the VBS image 53a of the frame up to the next (second) branch thumbnail VBS image (b) is displayed in the VBS image display area 53 as a moving image. At this time, the frame of the second branch thumbnail VBS image 54 (b) is displayed as a thick frame or color display, and the frame of the branch thumbnail VBS image 54 (a) is displayed as a frame of another branch thumbnail VBS image.
[0054]
Then, in step S30, it is determined whether or not the lesion has been reached (that is, whether or not the end point of the navigation has been reached). If the lesion has been reached, the processing is terminated. Returning to S25, the processes in steps S25 to S30 are repeated until the lesion reaches the lesion.
[0055]
A specific example of the processing of steps S25 to S30 will be described using the navigation screen 51. As shown in FIG. 16, for example, in the navigation when the vehicle reaches the eighth branch point, the VBS image display area 53 displays the VBS image 53a of the eighth branch thumbnail VBS image 54 (h), and the endoscope is performed. In the mirror live image display area 52, a live image 52a near the eighth branch point is displayed. At this time, only the frame of the branch thumbnail VBS image 54 (h) is displayed in a bold frame or in color, so that the operator can recognize that the navigation is at the eighth branch point.
[0056]
In this state, when the operator presses the SW4 which is a freeze switch (step S25), a still image of a live image is captured. For example, the operator sets the left rotation button 59 and the right rotation button 60 on the navigation screen 51 to a mouse or the like. 17 and clicks (or presses the image rotation switch SW2), as shown in FIG. 17, the VBS image 53a is rotated corresponding to the still image of the live image 52a (step S26), and the VBS image at the branch point is obtained. The rotation amount data is stored in the VBS image storage unit 16 in association with (step S27).
[0057]
Next, when the operator recognizes the bronchus of the insertion destination and operates SW1 or the next button 58 as the VBS switch by the operator (step S28), the ninth display is displayed in the VBS image display area 53 as shown in FIG. The VBS image 53a of the branch thumbnail VBS image 54 (i) is displayed, only the frame of the branch thumbnail VBS image 54 (i) is displayed in a thick frame or in color, and the next navigation position is displayed to the operator at the ninth branch point. It is recognized that there is (step S28), and the same navigation is performed until it reaches the lesion (that is, the end point of the navigation) (step S29).
[0058]
In the ninth branch thumbnail VBS image 54 (i), if there is a route for which bronchial naming has not been performed, “unset” is displayed in the bronchial route name area 66. Therefore, by clicking on the bronchial route name area 66, a branch point name input window 150 is displayed on the navigation screen 51, and the operator can arbitrarily input a desired name to display a route for which no bronchial naming has been performed. The name can be defined.
[0059]
In FIG. 18, for example, when the branch thumbnail VBS image 54 (a) is clicked during navigation, the VBS image 53a of the branch thumbnail VBS image 54 (a) is displayed in the VBS image display area 53 as shown in FIG. At this time, of course, the live image is an image during navigation and does not change.
[0060]
When a moving image playback button 63 is clicked on the navigation screen 51 of FIG. 19, a VBS image is played as a moving image in the VBS image display area 53. The playback area is an area specified by the start branch point number setting unit 61 and the end branch point number setting unit 62. The start branch point number setting section 61 and the end branch point number setting section 62 reproduce the last branch thumbnail VBS image from the branch thumbnail VBS image displayed in the VBS image display area 53 when not manually input. Is done. If the start branch point number setting unit 61 and the end branch point number setting unit 62 are manually input, the VBS image between the specified branch thumbnail VBS images is reproduced in the VBS image display area 53 as a moving image.
[0061]
In FIG. 19, the start branch point number setting unit 61 specifies the branch thumbnail VBS image 54 (a), and the end branch point number setting unit 62 specifies the branch thumbnail VBS image 54 (j). When the button 63 is clicked, as shown in FIG. 20, the branch thumbnail VBS image 54 (a) to the branch thumbnail VBS image 54 (j) are displayed as moving images in the VBS image display area 53.
[0062]
At the time of moving image reproduction at this time, image rotation is performed. In detail, for example, the branch thumbnail VBS image 54 (a) to the branch thumbnail VBS image 54 (g) have no rotation operation (the right rotation button 60 or the operation of the image rotation switch SW2), and the branch thumbnail VBS image 54 ( Assuming that the first rotation operation is performed at h) and the second rotation operation is performed at the branch thumbnail VBS image 54 (i), the rotation amount data is stored in the VBS image storage unit 16 in association with the VBS image at the branch point. Therefore, at the time of moving image reproduction, moving image reproduction without rotation is performed in the branch thumbnail VBS image 54 (a) to the branch thumbnail VBS image 54 (h).
[0063]
When reaching the branch thumbnail VBS image 54 (h), the VBS image is rotated based on the rotation amount data of the first rotation operation, and the first rotation is performed in the branch thumbnail VBS image 54 (h) to the branch thumbnail VBS image 54 (i). The moving image is reproduced with the rotation amount designated by the operation, and further, when reaching the branch thumbnail VBS image 54 (i), the VBS image is rotated based on the rotation amount data of the second rotation operation, and the branch thumbnail VBS image 54 (i) ) To branch thumbnail VBS image 54 (j), the moving image is reproduced with the rotation amount specified by the second rotation operation.
[0064]
Although not shown, the image processing unit 17 of the present embodiment converts the VBS image data stored in the VBS image storage unit 16 via a portable information recording medium such as an MO into a personal computer (hereinafter, referred to as a PC). ) Etc.
[0065]
For example, assuming that bronchial insertion simulation software using VBS image data is installed in a PC, bronchial insertion simulation can be performed on the PC by reading the VBS image data into the PC via an information recording medium. .
[0066]
Specifically, when the bronchial insertion simulation software is started and VBS image data is read via the information recording medium, the PC displays a bronchial insertion simulation screen 200 as shown in FIG. 21 on the monitor. The bronchial insertion simulation screen 200 has almost the same configuration as the navigation screen 51, except that there is no endoscope live image display area 52.
[0067]
In this bronchial insertion simulation, the operator performs bronchial insertion using a moving image of the VBS image 53a prior to the procedure. The path of the VBS image 53a can be arbitrarily named at each branch point, and the VBS image 53a can be rotated by a desired amount at each branch point. In this manner, by rotating at each branch point and associating the rotation amount data with the VBS image 53a, a moving image including rotation can be reproduced as described with reference to FIG.
[0068]
Here, the rotation amount data is stored in the information recording medium in association with the VBS image 53a, and the VBS image 53a having the rotation amount data can be stored again in the VBS image storage unit 16 via the information recording medium. The bronchus insertion navigation described above can be performed using the image 53a.
[0069]
In addition, this bronchial insertion simulation can be used for bronchial insertion education. For example, a doctor who is not proficient in bronchial insertion simulates bronchial insertion using bronchial insertion simulation.
[0070]
At this time, by inputting the name of the path of the VBS image 53a at each branch point, the instructor can determine whether or not the name of the path of the VBS image 53a is correct at each branch point after the simulation is completed. It is possible to deepen the understanding of the position.
[0071]
Further, by rotating the VBS image 53a at each branch point and having the instructed physician determine the rotation state, it is possible to improve the bronchial insertion procedure.
[0072]
Note that the display in FIG. 21 is displayed on the VBS monitor provided separately from the monitor for displaying the endoscope image when the monitor for displaying the endoscope image is dedicated to the endoscope inspection. By displaying the display image of FIG. 21, it is possible to perform bronchial insertion navigation by causing the VBS monitor to display the display image shown in FIG. 21 while observing a live image on the monitor for displaying an endoscope image. Needless to say.
[0073]
[Appendix]
(Additional Item 1) A three-dimensional image generating means for generating a three-dimensional image of a body cavity in the subject based on image data of a three-dimensional region of the subject is provided. In the insertion simulation device to simulate,
Reduced image generating means for generating a plurality of reduced images of the three-dimensional image at all branch points where the body cavity path in the subject branches;
Image rotating means for rotating the three-dimensional image of the reduced image generated by the reduced image generating means;
A rotation amount data storage unit that stores rotation amount data obtained by rotating the three-dimensional image by the image rotation unit in association with the three-dimensional image;
An insertion simulation device characterized by comprising:
[0074]
(Additional Item 2) A three-dimensional image generating means for generating a three-dimensional image of a body cavity in the subject based on image data of a three-dimensional region of the subject,
An endoscope for imaging a body cavity in the subject;
A navigation image generating unit configured to generate a navigation image including an endoscope image of the body cavity in the subject captured by the endoscope and the three-dimensional image;
With
In an endoscope apparatus for observing and treating the inside of the subject while guiding an insertion path of the endoscope into a body cavity in the subject,
Path name associating means for associating the name of the insertion path at the branch point where the body cavity path in the subject branches with the three-dimensional image
An endoscope apparatus comprising:
[0075]
The present invention is not limited to the above-described embodiment, and various changes and modifications can be made without departing from the spirit of the present invention.
[0076]
【The invention's effect】
As described above, according to the present invention, there is an effect that the endoscope can be reliably navigated to the target portion by the guide image corresponding to the actual branch position.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of an endoscope apparatus according to an embodiment of the present invention.
FIG. 2 is a configuration diagram showing a configuration of an input unit in FIG. 1;
FIG. 3 is a flowchart showing a flow of a navigation data generation process performed by the bronchoscope navigation apparatus of FIG. 1;
FIG. 4 is a first diagram showing a route setting screen developed in the process of FIG. 3;
FIG. 5 is a second diagram showing a route setting screen developed in the process of FIG. 3;
FIG. 6 is a flowchart showing a flow of a route setting process of FIG. 3;
FIG. 7 is a first diagram showing a route setting screen developed in the process of FIG. 6;
FIG. 8 is a second diagram showing a route setting screen developed in the process of FIG. 6;
FIG. 9 is a third diagram showing a route setting screen developed in the process of FIG. 6;
FIG. 10 is a first diagram illustrating a modified example of the route search by the bronchoscope navigation device of FIG. 1;
FIG. 11 is a second diagram illustrating a modified example of the route search by the bronchoscope navigation device of FIG. 1;
FIG. 12 is a flowchart showing the flow of a navigation process by the bronchoscope navigation device of FIG. 1;
FIG. 13 is a first diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 14 is a second diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 15 is a third diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 16 is a fourth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 17 is a fifth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 18 is a sixth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 19 is a seventh diagram illustrating the operation of the bronchoscope navigation device in FIG. 1;
FIG. 20 is an eighth diagram illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 21 is a ninth view illustrating the operation of the bronchoscope navigation device of FIG. 1;
FIG. 22 is a view showing the structure of a bronchus
[Explanation of symbols]
1. Endoscope device
2. Bronchoscope
4 Input unit
5. Monitor
6 ... Bronchoscope navigation device
11 ... CT image data capturing unit
12 ... CT image data storage
13 MPR image generation unit
14. Route setting section
15 ... VBS image generation unit
16 VBS image storage
17 ... Image processing unit
18 Image display control unit
19 setting information input section

Claims (1)

  1. Three-dimensional image generating means for generating a three-dimensional image of a body cavity in the subject based on image data of a three-dimensional region of the subject;
    An endoscope for imaging a body cavity in the subject,
    A navigation image generation unit configured to generate a navigation image including an endoscope image of the body cavity path in the subject captured by the endoscope and the three-dimensional image,
    In an endoscope apparatus for observing and treating the inside of the subject while guiding an insertion path of the endoscope into a body cavity in the subject,
    Reduced image generation means for generating a plurality of reduced images of the three-dimensional image at all branch points where the body cavity path in the subject branches;
    Image rotating means for rotating the three-dimensional image of the reduced image generated by the reduced image generating means;
    An endoscope apparatus comprising: a rotation amount data storage unit that stores rotation amount data obtained by rotating the three-dimensional image by the image rotation unit in association with the three-dimensional image.
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