JP2005169070A - Image processing and displaying device and method for controlling the same - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an image processing and displaying device and a method for controlling the same, which are capable of easily judging whether or not there is an inappropriate section for puncturing in a puncture passage from a punctured position to a lesion center and in its neighborhood. <P>SOLUTION: The device is equipped with a data storing means for storing a 3-dimensional volume data, a cross-sectional information generating means for generating the cross-sectional information by reconstructing the 3-dimensional volume data stored in the data storing means, an image displaying device for displaying the cross-sectional image of a subject based on the cross-sectional information generated by the cross-sectional information generating means, a locking means for locking the lesion center on the cross-sectional image displayed by the image displaying means as a rotation center, and an operating means which operates the cross-sectional image rotatably in an arbitrary direction by always displaying the cross-sectional image including the lesion center on the image displaying means. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an image processing display device used for medical treatment, and more particularly, to support a work during a puncture plan and an actual puncture plan in which a puncture needle is inserted into a subject to collect or treat a diseased tissue. The present invention relates to an image processing display apparatus. The present invention also belongs to a technical field of a control method for such an image processing display device.

  Currently, of the three major diseases in Japan, only the mortality rate due to cancer diseases is increasing, but liver cancer accounts for about 10% of these cancer diseases and is increasing. However, in this diagnosis of liver cancer, early detection has become possible due to advances in medical image diagnostic modalities such as ultrasonic diagnostic apparatuses, MRI apparatuses, and X-ray CT apparatuses, such as three-dimensional image display.

  In particular, in the X-ray CT apparatus, a 3D imaging method using a combination system of a high-speed rotating helical scan and parallel detectors such as 4, 8, and 16 columns is used. In the MRI apparatus, a gradient magnetic field / high-frequency magnetic field system is used. Since the 3D imaging method under breath holding has been established by improving the performance of the high-speed imaging method accompanying the improvement in the performance of the RF coil system, the diagnostic ability has been greatly improved as compared with the conventional 2D imaging. Diagnosis based on this 3D image is particularly advanced by 3D CTA (CT angiography).

  On the other hand, hepatic cancer treatment methods include intrahepatic anticancer drug injection therapy, hepatic artery embolization therapy, minimally invasive treatment, open surgery, etc. The law is most often enforced.

  The minimally invasive treatment methods include percutaneous ethanol injection method (PEIT) and microwave puncture cauterization method. Conventionally, the puncture needle is monitored under real-time imaging using an ultrasonic diagnostic device. Has been done.

  Recently, radiofrequency ablation (RFA) has been in the limelight as one of the above-mentioned ablation treatment methods, and its clinical application has been considerably advanced. This RFA includes a single tip, a cool tip, and a multiple deployment needle, RITA, each of which is currently undergoing clinical evaluation. In many cases, these puncture treatments are performed by percutaneous puncture, but laparoscopically (pararography), using the same puncture jig as described above, while directly observing the liver surface or using a special ultrasonic probe A method of performing treatment while using the surface of the liver to look inside the liver is also clinically performed.

  However, in the current state, it cannot be said that the three-dimensional diagnostic image is sufficiently utilized in the stage of puncture treatment, during treatment, and in the treatment follow-up stage. That is, in recent years, three-dimensional image display has been widely used on an independent workstation in clinical practice, but from the viewpoint of puncture treatment support including cell puncture collection (biopsy), a display that is easy for the treating physician to use. There was a problem that the user interface was not enough.

  As specific clinical needs, first, since the entire liver and the periphery including the diaphragm cannot be observed at once by ultrasonic images, search for a safe puncture position on 3D stereoscopic images of 3D-CTA There is something that wants to do it easily. In addition, since the puncture treatment is performed under ultrasonic imaging, a 3D-CTA image cross section (virtual ultrasonic image) assuming an ultrasonic cross section during imaging including the puncture needle is displayed in an easy-to-understand manner on a 3D stereoscopic image. There is also a request to display the determined puncture position so that the relationship between the body surface and the bone can be understood.

  In addition, there is often no space for placing a workstation or the like outside the ultrasonic diagnostic apparatus in a narrow treatment site. For example, it is a fact that a three-dimensional image of an X-ray CT apparatus is operated and confirmed in the treatment site immediately before treatment. There is also a need to search and display the puncture position on the ultrasonic apparatus even immediately before the puncture treatment.

  Regarding such a problem, a puncture assisting apparatus that displays a cross-sectional image according to the position and angle of the puncture ultrasound probe from the three-dimensional volume data has been proposed (see, for example, Patent Document 1). The problem remains that it is difficult to determine whether or not there is an inappropriate site for puncture on or near the puncture needle entry path.

  Moreover, even if the puncture position is determined, there is also a problem that it is difficult to intuitively know where to puncture on the body surface.

  Furthermore, in order to solve this problem, various methods for searching for a virtual ultrasound cross section on a 3D-CTA image have already been proposed, but an ultrasound diagnostic apparatus even if a treatment target is visible on an X-ray CT image. The problem that it is not visible or difficult to see above, and that there are multiple treatment targets, it is not enough to refer to the images obtained in the preoperative plan just before the actual treatment. It had been.

In addition, there is a problem that it is difficult to compare images with other modalities after treatment.
JP 2002-112998 A

  The present invention has been made in view of the problems of such a conventional image processing display device, and it is easy to determine whether there is a puncture path from the puncture position to the center of the affected area and whether there is an unsuitable part for puncture. An object of the present invention is to provide an image processing display device that can be determined and a control method thereof.

  Another object of the present invention is to provide an image processing display device that displays a puncture position in an easily recognizable manner and a control method therefor.

  In addition, another object of the present invention is to easily discriminate each tumor immediately before or during treatment by using information planned before treatment for a tumor or a plurality of tumors that are difficult to distinguish by ultrasound. Another object of the present invention is to provide an image processing display device and a control method thereof.

  Still another object of the present invention is to provide an image processing display device and a control method thereof that can easily compare an image with another modality before or after a puncture treatment plan.

  In order to solve the above-described problems, an image processing display device according to the present invention includes a data storage unit that stores three-dimensional volume data, and a 3 stored in the data storage unit. Cross-section information generating means for reconstructing three-dimensional volume data to generate cross-section information, image display means for displaying a cross-sectional image of a subject based on the cross-section information generated by the cross-section information generating means, and the image display means The locking means that locks the center of the affected area on the cross-sectional image displayed by the rotation center, and the cross-sectional image always displays the cross-sectional image including the center of the affected area on the image display means, and is rotated in an arbitrary direction. Operating means.

  Preferably, as described in claim 2, the image processing display device further punctures either on a plane cut that is a cross-sectional image including the center of the affected area or on a cross-sectional image displayed together with the plane cut. When a puncture position for performing the operation is designated, a puncture path setting means is provided for setting a puncture path by connecting the puncture position and the center of the affected area with a straight line.

  Preferably, the image display means is an orthogonal two-section image having the puncture path as a cross line within a predetermined range of the puncture path set by the puncture path setting means, as described in claim 3. And a cross-sectional image within a range obtained by moving a cross-sectional image orthogonal to the puncture path by a predetermined distance, or, as described in claim 4, the puncture path and a virtual puncture You may synthesize | combine and display a sound wave cross-section area | region.

  In addition, as described in claim 5, the image display means displays a three-dimensional image generated by volume rendering, and the puncture path setting means designates a puncture position based on the three-dimensional image It can also be.

  Alternatively, as described in claim 6, the image display means displays any MPR screen of an arbitrary cross section and three orthogonal cross sections, and the puncture path setting means displays the arbitrary cross section and the three orthogonal cross sections. It is good also as a structure which designates a puncture position based on either of the MPR screens.

  Further, as described in claim 7, the image display means includes a cross-sectional image including a puncture path set by the puncture path setting means, a cross-sectional image including the puncture path and orthogonal to the cross-sectional image, and It is also possible to display a cross-sectional image orthogonal to the puncture path and a three-dimensional image generated by volume rendering, or, as described in claim 8, generated by volume rendering including the puncture path It is also possible to display a composite image of a three-dimensional image and a virtual ultrasonic cross-sectional image, and a live image captured by an ultrasonic diagnostic apparatus.

  On the other hand, preferably, the puncture path setting means can change the designated puncture position when an unsuitable part for puncturing is displayed on these cross-sectional images as described in claim 9. It may be configured.

  Further, as described in claim 10, the data storage means acquires three-dimensional volume data from at least one of an X-ray 3D apparatus, an X-ray CT apparatus, an MRI apparatus, an ultrasonic diagnostic apparatus, and a nuclear medicine diagnostic apparatus. can do.

  Next, in order to solve the above-described problem, a control method for an image processing display device according to an eleventh aspect is based on three-dimensional volume data representing information in a subject, and an image of a cross section in the subject is obtained. A first step of displaying, a second step of setting the position designated on the image displayed in the first step as the affected area center, and a position of the cross section with the affected area center set in the second step as the rotation center The puncture is started by designating a position on the image displayed in the third step, and a third step for generating and displaying an image of the cross-section that has been rotated and moved based on the three-dimensional volume data And a fourth step for setting the position.

  In order to solve the above-described problem, a control method for an image processing display device according to a twelfth aspect is specified on a cross-sectional image generated based on three-dimensional volume data representing information in a subject. Based on the first step for setting a plurality of positions as a plurality of puncture paths and the three-dimensional volume data, a cross-sectional image that is superimposed on the puncture path set by the first step is generated and displayed. And a second step.

  In order to solve the above-described problem, the image processing display device according to claim 13 further generates a body surface image of the subject by surface rendering from the three-dimensional volume data stored by the data storage unit. Surface image generating means is provided, and the image display means superimposes and displays the body surface image generated by the body surface image generating means on the three-dimensional image.

  Alternatively, as described in claims 14 and 15, the image processing display device further obtains the graphic data of the position of the virtual ultrasonic section and the puncture needle from the three-dimensional volume data stored in the data storage means. Graphic data generation means for generating is provided, and the image display means superimposes and displays a graphic based on the graphic data generated by the graphic data generation means on the three-dimensional image.

  Preferably, as described in claim 16, even if the image display means displays the graphic displayed on the three-dimensional image so as to be erasable, as described in claim 16. The index point on the body surface of the subject is superimposed on the three-dimensional image, or, as described in claim 18, the body of the subject on the three-dimensional image. A middle line may be superimposed and displayed.

  On the other hand, in order to solve the above-described problem, an image processing display device according to claim 19 performs either treatment or collection from three-dimensional volume data regarding a three-dimensional region including an affected part of a subject. Region designating means for designating a three-dimensional position and region of the approximate center of two or more affected areas; image display means for displaying a 3D image including the position and region designated by the region designating means; An ultrasonic probe that transmits / receives ultrasonic waves to / from an imaging target, and a position sensor that is attached to the probe and detects a relative position of the ultrasonic probe with respect to the surface of the contributed object, and indicates the designated affected part position Using the position information and the data obtained by the position sensor, the designated affected part position is displayed in correspondence with the ultrasonic image.

  Preferably, the ultrasonic probe is any one of a mechanical probe that mechanically scans a one-dimensional array, a two-dimensional array, and a one-dimensional array.

  In addition, as described in claim 21, the image processing display device is configured to specify a volume shape for 3D scanning from a treatment area of the affected area and an ultrasonic probe position of a one-dimensional array on the body surface. Alternatively, a volume shape that is 3D scanned by any one of a two-dimensional array and a mechanical probe may be displayed on a 3D image including a specified position and a region as described in claim 22. A configuration in which the image is superimposed and displayed on the image can also be adopted.

  More preferably, as described in claim 23, the image display means determines a position of the body mark representing the shape of the subject and a position of the ultrasonic probe in contact with the body surface of the subject. The probe mark shown on the body mark may be displayed based on the information from. Alternatively, as described in claim 24, the image processing display means further includes probe graphic storage means for storing a graphic for displaying the ultrasonic probe, and body surface of the subject by surface rendering from the three-dimensional volume data. Body surface image generating means for generating an image, wherein the image display means is the super image calculated from the data obtained by the position sensor on the body surface image generated by the body surface image generating means. It is also possible to superimpose and display the probe graphic at the sonic probe position.

  Furthermore, in order to solve the above-described problem, a control method for an image processing display device according to claim 25 is a method for obtaining a cross-sectional image and a real-time 2D cross-sectional image extracted from three-dimensional volume data including an affected area designated before treatment. First step of displaying and imaging with information from spatial coordinates of three-dimensional volume data and position sensor data attached to the ultrasonic probe after the real-time 2D cross-sectional image becomes substantially the same cross-section as the cross-sectional image A second step in which the spatial coordinates are the same and both image cross sections are simultaneously displayed synchronously.

  As described above, according to the present invention, it is possible to obtain an image processing display device that can easily determine whether there is a puncture path from the puncture position to the center of the affected part and whether there is an unsuitable part in the vicinity. There is.

  According to the image processing display device of the present invention, the puncture position can be displayed in an easily recognizable manner.

  In addition, according to the image processing display device according to the present invention, information planned before treatment is used for a tumor or a plurality of tumors that are difficult to discriminate with ultrasound, and each tumor is immediately before or during treatment. Can be easily determined.

  Furthermore, according to the image processing display device of the present invention, image comparison with other modalities can be easily performed before or after puncture treatment planning, so that differential diagnosis and treatment effect determination can be easily performed. .

(First embodiment)
Hereinafter, a first embodiment of an image processing display device according to the present invention will be described with reference to the drawings. FIG. 1 shows a schematic configuration of an entire diagnostic system 1 including an image processing display device according to the present embodiment. The diagnostic system 1 includes a three-dimensional data collection device 11 that collects three-dimensional data, and a network such as a local area network (LAN) in a hospital that transmits the three-dimensional volume data collected by the three-dimensional data collection device 11. 13 and the image processing display device 15 that receives the three-dimensional data transmitted by the network 13 and performs the processing described later and displays the result, and displays the image of the puncture needle inserted into the subject in real time. And an ultrasonic diagnostic apparatus 16 for performing the above.

  The three-dimensional data collection apparatus 11 is, for example, an X-ray computed tomography apparatus (X-ray CT apparatus) 17 that captures X-ray tomographic images of a subject, or a magnetic resonance diagnostic apparatus that obtains tomographic images of a subject by magnetic resonance. (MRI apparatus) 18 or an ultrasonic diagnostic apparatus 19 (hereinafter also collectively referred to as “modality”) for obtaining a tomographic image by ultrasonic waves is connected directly or via a network. Then, the three-dimensional volume data obtained by imaging with these modalities is transmitted to the three-dimensional data collection device 11 directly or via a network.

  The three-dimensional data collection device 11 has a function of processing and displaying the obtained data and having a function of internally displaying the data, but a configuration in which an image processing display device configured by, for example, a workstation is connected to the outside It may be. Alternatively, the three-dimensional data collection device 11 may be provided in each of the modalities.

  For example, as shown in FIG. 2, the image processing display device 15 includes a three-dimensional data storage unit 21 that stores three-dimensional volume data obtained via the network 13, and the three-dimensional data stored in the storage unit 21. A three-dimensional reconstruction processing unit 22 for reconstructing a three-dimensional image, and a three-dimensional image generating unit for generating a three-dimensional image including a cross section from the data reconstructed in the three-dimensional reconstruction processing unit 22 23, a three-dimensional image display unit 24 that displays a three-dimensional image including a cross section based on the data generated by the three-dimensional image generation unit 23, and a cross-sectional image displayed on the three-dimensional image display unit 24. When a user such as a doctor specifies the position when the affected part is seen, the affected part position specifying unit 25 that inputs the information of the point to the three-dimensional image generating unit 23, the position of the puncture probe is specified, and the data is three-dimensionally And a probe position specifying unit 26 for inputting the image information generating unit 23. Among these, the memory | storage part 21 is comprised by recording media, such as a semiconductor memory, a hard disk, CD-ROM, a flexible disk, and a memory card.

  The image processing display device 15 is constituted by a workstation, for example, and is controlled by a CPU (not shown). Alternatively, it may be integrated in the ultrasonic diagnostic apparatus 16 having such an image processing display function.

  The input unit 27 is an interface through which the user gives various input instructions to the image processing display device 15 and the like, and various instructions for setting a puncture path are input from the input unit as will be described later. The input unit 27 includes, for example, a keyboard and a mouse when the image processing display device 15 is configured as a workstation. When the image processing display device 15 is integrated in the ultrasonic diagnostic apparatus 16, for example, an operation panel is provided. , Trackball, TCS (Touch Command Screen), etc.

  The ultrasonic diagnostic apparatus 16 images and displays the affected part of the subject obtained by the ultrasonic probe and the position of the puncture needle at the time of puncture. In the present embodiment, the ultrasonic diagnostic apparatus 16 is used as a puncture device, but an X-ray CT apparatus or an MRI apparatus may be used as long as it can be used for puncture.

  Next, the operation of the image processing display device 15 according to the present embodiment configured as described above will be described with reference to the flowchart shown in FIG.

  Three-dimensional volume data such as CT angio taken by a modality such as the X-ray CT apparatus 17 is once collected in the three-dimensional data collection apparatus 11 and then stored in the three-dimensional data storage of the image processing display apparatus 15 via the network 13. Is sent to the unit 21 (step S301).

  Of course, three-dimensional volume data recorded on a storage medium such as MO, CD-R, and DVD-R can be directly input to the ultrasonic diagnostic apparatus 16 and the image processing display apparatus 15 without using a network. is there.

  The three-dimensional volume data stored in the three-dimensional data storage unit 21 is reconstructed as voxel data suitable for three-dimensional image processing by the three-dimensional reconstruction processing unit 22, and then the cross-section and rendering are performed by the three-dimensional image generation unit 23. The image is reconstructed and displayed on the three-dimensional image display unit 24 (step S302).

  Generally, three orthogonal cross sections generated from three-dimensional volume data are an axial cross section perpendicular to the body axis, a sagittal cross section orthogonal to the front surface of the subject and the body axis surface, and parallel to the front surface of the subject and orthogonal to the body axis surface. The plane cut plane 43 displayed as an initial image here is an axial section, and the volume rendering image is displayed on the three-dimensional image display unit 24 as shown in FIG. .

  Further, as shown in FIG. 4A, the display image is adjusted in the volume rendering so that the CT value area 41 representing the bone and the other area 42 are simultaneously displayed, or two areas are displayed. As a separate volume, two volumes can be displayed simultaneously. 43 is a plane cut surface (PC surface) showing a provisional cross-sectional position.

  3, when the user moves or rotates a pointing device such as a mouse or a trackball (not shown) of the input unit 27 and inputs a movement amount and a movement direction, or a rotation direction and a rotation amount. The CPU that does not send a signal to the probe position specifying unit 26 rotates / translates the cross section (plane cut surface) 43 displaying the image of the three-dimensional volume in a desired amount and direction, and displays the result. .

  FIG. 4B is a diagram illustrating an example of the plane cut surface 43 obtained by translating the axial section displayed as the initial image. FIG. 4 (c) shows an example in which the axial section displayed as the initial image is rotated clockwise while maintaining a right angle with the sagittal plane. Similarly, FIG. 4 (d) is counterclockwise. An example of rotational movement is shown.

  The user repeats such parallel movement and rotational movement of the plane cut surface 43 of the display image until the affected part 44 as the treatment site is found (steps S303 to S304).

  Thus, when the plane cut surface 43 including the affected part 44 is obtained as shown in FIG. 4B (step S304: Yes), the user uses the input unit 27 as shown in FIG. When a mouse or the like (not shown) is moved to move the cursor on the screen to the center 45 of the affected area, and when a signal is sent to the CPU by clicking the mouse or the like, the affected area position specifying unit 25 shown in FIG. An instruction is transmitted to and the affected part 44 is specified.

  Following this, in step S305, the affected area position specifying unit 25 locks the affected area center 45 so that 43 is included in the plane cut surface. As a result, the plane cut surface 43 cannot be moved in parallel thereafter, and the affected part center 45 is always included in the plane cut surface 43 as shown in FIG. That is, the probe position specifying unit 26 in the present embodiment constitutes the locking means in the present invention.

  In the next step S306, provisional setting of the puncture position by the puncture probe from the body surface is performed. This is because the user moves the cursor position indicating the body surface position of the plane cut surface 43 displayed on the three-dimensional image display unit 24 using a pointing device such as a mouse or a trackball (not shown) of the input unit 27, By clicking, a signal is sent to a CPU (not shown), and the CPU instructs the probe position specifying unit 26 to do so.

  For example, as shown in FIG. 5A, first, a line 51 on which the puncture probe at the edge of the plane cut surface 43 may be placed is set. Such setting of the line 51 is performed so that the line between the ribs can be seen at the time of imaging by the X-ray CT apparatus 17, for example, a linear shape having a CT value higher than that of the bone and photographed with high brightness, or two landmarks This is performed by manipulating an image containing “” while looking on the plane cut surface 43.

  When the user clicks one point on the line 51 with a mouse or the like, the puncture position is temporarily set. This point is, for example, the center point 52 as shown in FIG. 5A, or one end point 53 on the line 51 where the puncture probe may be placed as shown in FIG. 5B. . Thus, the probe position specifying unit 26 in the present embodiment also constitutes a puncture path setting unit in the present invention.

  In this way, when the puncture position of the probe is provisionally set, a straight line 54 is virtually drawn and connected between the puncture position and the affected part center 45 by the probe position specifying unit 26 in step S307. This straight line 54 means a temporary puncture path until the affected part is reached when the puncture probe is punctured at the temporarily set position as described above.

  In this display state, the user determines whether there is an inappropriate site such as a dangerous blood vessel for puncturing near the temporary puncture path 54 set as described above. For example, if there is a blood vessel near the puncture path 54 (for example, within 10 mm), it is not appropriate to set the path as the puncture path 54. This determination is made by arbitrarily rotating and moving the plane cut surface 43 locked so as to include the affected part center 45.

  If a site inappropriate for puncturing is found near the temporarily set puncture path 54 in this way, the set temporary puncture path 54 is deleted (step S308: No), and the user returns to step S306. The puncture position set temporarily is changed, and the puncture position is temporarily set again at another place. This step is repeated until the puncture path 54 is established.

  If an inappropriate part is not found near the temporary puncture path 54 as described above, the cursor is moved to the “puncture path confirmation” button on the screen of the sectional image display unit 24 by moving the mouse or the like. An instruction to confirm the set provisional puncture path 54 is sent to the CPU of the image processing display device 15 by moving it and clicking on it. Upon receiving this instruction, the CPU transmits a signal to the probe position specifying unit 26 to determine the set temporary puncture path 54 (step S308: Yes).

  Thus, by setting the puncture path 54 by connecting the center of the affected area and the puncture position with a straight line, it is possible to easily detect whether there is an inappropriate site for puncture. Therefore, a position suitable for puncture can be found quickly and easily even immediately before the puncture operation.

  However, in addition to this, the following steps can be added in order to make the setting of the puncture position safe and reliable. That is, in the next step S309, the CPU instructs the three-dimensional image generation unit 23 according to the user's instruction, as shown in FIG. 6 (a), two orthogonal cross sections with the temporary puncture path 54 (straight line) as an intersection line. A total of three cross-sectional images of 63 and 64 and a cross-section 65 perpendicular to the intersection line are generated, and whether or not these three cross-sections are displayed on the three-dimensional image display unit 24 as shown in FIG. Select (step S309). If this display is not selected here (step S309: No), the puncture path 54 is finally determined.

  On the other hand, if this display is selected (step S309: Yes), the following processing is performed. Specifically, this axis is fixed with the provisional puncture path 54 as the central axis, and the shaft rotation operation mode of the plane cut surface 43 that rotates around this rotation axis is entered, and the mouse is used to fit the line between the ribs. The plane cut surface 43 is rotated.

  When the provisional puncture path 54 is determined as described above and the orthogonal section 63 having the provisional puncture path 54 (straight line) as an intersecting line is rotated to the virtual puncture ultrasonic section 66, FIG. ), An ROI (Region Of Interest) 62 representing the range of the ultrasonic cross section corresponding to the type of the ultrasonic probe used in the treatment may be synthesized and displayed.

  Further, on the virtual puncture ultrasonic section 66, when the user clicks the approximate position of the puncture position of the puncture needle with a mouse or the like, the point and the affected part center 45 are combined and displayed as, for example, a dotted line as a virtual puncture needle, It is also possible to display the length of the virtual puncture needle 61 on the virtual puncture ultrasonic section 66 at this time on the same screen.

  As a display method of the virtual puncture needle 61, the puncture path 54 is automatically displayed when an ultrasonic probe line is set according to the puncture needle fixing jig of the ultrasonic probe used for treatment. It may be configured.

  In addition, when the display position of the virtual puncture needle 61 is confirmed, the volume rendering image including the plane cut surface 43 is displayed as a virtual puncture ultrasound including the ROI 62 on another screen or window as shown in FIG. You may make it display centering on the image of the cross section 66. FIG.

  FIG. 6C is a diagram showing an example of a screen display on the three-dimensional image display unit 24 of the three orthogonal cross sections set in this way (step S310). On the upper left of this screen, one of the orthogonal two cross sections 63 and 64 (see FIG. 6A) that rotates around the puncture path 54 as the center axis and intersects the virtual puncture path 54 is ROI. Is displayed in accordance with a virtual puncture ultrasound cross section 66 including a cross section 64 that is orthogonal to the upper left cross section image with respect to the puncture path 54 as the central axis, and below the puncture path 54. An orthogonal cross section 65 is shown. Further, on the two orthogonal cross sections 63 and 64 sharing the central axis, there is a line 67a indicating the position of the cross section 67 perpendicular to the central axis, as shown in FIG. 9A, which is orthogonal to the central axis. The cross sections 63 and 64 are displayed in synchronization.

  In the observation stage of the puncture path 54 described above (step S310), when the above-described inappropriate part is not found, the user moves the mouse or the like on the screen of the three-dimensional image display unit 24 to “confirm puncture path”. An instruction to confirm the set puncture path 54 is sent to the CPU of the image processing display device 15 by moving it over the button and clicking. Upon receiving this instruction, the CPU transmits a signal to the probe position specifying unit 26 to finally determine the set temporary puncture path 54 (step S311: Yes).

  On the other hand, when an inappropriate site as described above is found (step S311: No), when the set puncture position is changed and the puncture position is set again elsewhere, the current virtual puncture ultrasonic cross section When adjustment is performed by changing the position of the puncture path 54 by a rotation operation around the affected part center 45 in 66, in other words, when changing the position of the puncture path 54 only within the same plane cut surface 43 (step S312). : No), the CPU returns to the volume rendering image screen (step S310) including the plane cut surface 43 of FIG. 6A with respect to the probe position specifying unit 26, and sets the ROI 62 and the virtual puncture needle 61 to the current position. The images in FIGS. 6B to 6C are changed in synchronization with the rotation in the plane cut surface 43 at the same time.

  On the other hand, when there is an obstacle (unsuitable part) even in the adjustment of the puncture path 54 in the current virtual puncture ultrasonic section 66 (step S312: Yes), the CPU instructs the probe position according to the user's instruction. The specific unit 26 again returns to the volume rendering image screen including the plane cut surface 43 in FIG. 6A, and rotates the plane cut surface 43 with another intercostal space or under the rib arch as a puncture insertion position. And the position of the virtual puncture path 54 is adjusted. That is, returning to step S306, the puncture position is temporarily set again.

  In this way, the puncture path 54 set in step S308 is displayed and confirmed in three orthogonal cross sections with the puncture path 54 as one intersection line, thereby confirming whether there is an inappropriate site for puncture in the vicinity. Furthermore, it can detect reliably.

(Modification 1)
As a modified example of the virtual puncture ultrasonic section 66, virtual puncture ultrasonic sections 66 corresponding to a plurality of plane cut surfaces 43 between different ribs or under the radial arch may be displayed simultaneously as shown in FIG. . That is, as shown in FIG. 7 (a), arbitrary plane cut surfaces 43, 43A, 43B are included in the affected part center 45, and each cross section has a different position between the ribs or under the radial arch. For example, it is determined and set by designating the probe line position). Then, virtual puncture ultrasonic sections 66, 66A, 66B corresponding to the respective plane cut surfaces 43, 43A, 43B are displayed in parallel as shown in FIG. For example, the user can adjust the puncture needle by selecting an optimal cross section from these cross sections.

(Modification 2)
By the way, in the liver, the position of the diaphragm differs depending on the respiratory phase. That is, in abdominal breathing, it falls at the time of inhalation and rises at the time of exhalation, so an X-ray CT image taken in a breath-hold state at the time of inspiration, and a puncture treatment using an ultrasonic diagnostic apparatus that is not necessarily performed at the time of inspiration Have different relative positions with respect to the ribs of the liver. Therefore, the ultrasonic cross section from between the same ribs shifts in the range of about +1 cm to about -1 cm.

  Accordingly, as shown in FIG. 8 as in FIG. 7, the virtual ultrasonic cross section 66 corresponding to the initial plane cut surface 43 is used as a center to match the intercostal position assumed under different respiratory time phases and under the radial arch. Then, a plurality of plane cut surfaces 43C and 43D having a fixed interval including the affected part center are set, and virtual ultrasonic sections 66C and 66D corresponding to these 43C and 43D are simultaneously displayed in parallel. For example, the user adjusts the puncture needle by selecting an optimal cross-section from one of these cross-sections while comparing with a real-time image displayed on the ultrasonic diagnostic apparatus 16, for example.

  In this way, displaying a plurality of virtual puncture ultrasound cross-sections in parallel is particularly effective in reducing the influence of the respiratory phase.

(Second Embodiment)
Next, a second embodiment of the present invention will be described. This embodiment is another example of the display method after fixing the affected part center 45 in step S305 in the flowchart shown in FIG. 3 of the first embodiment, that is, an orthogonal three-section MPR (Multi Planar Reconstruction) and its inside. Is displayed as a volume image. Therefore, the schematic configuration of the image processing display device 15 according to the present embodiment is substantially the same as that in the first embodiment, and a description thereof will be omitted.

  That is, depending on the user, it may be easier to see with MPR than with a three-dimensional volume image, and it may be easier to find the affected area. The present embodiment is for answering such needs.

  FIG. 9 shows an orthogonal three-section MPR image displayed on the three-dimensional image display unit 24, where (a) plane is a sectional image in a certain direction, (b) plane is on the sectional image of (a) plane. It is an orthogonal cross-sectional image of the axis 102 passing through the affected part center 45, and the (c) plane is an orthogonal cross-sectional image passing through the axis 103 passing through the affected part center 45 on the cross-sectional image of the (a) plane. Further, (d) plane is an image of the entire thorax based on the three-dimensional volume data, and is displayed as a reference image.

  By performing the parallel movement operation of the cross section shown in the planes (a), (b), and (c) of FIG. 9 and / or the rotation operation with the affected part center 45 fixed, at least the cross section shown in the (a) plane, for example, The tip of one puncture needle, that is, the affected part center 45 is displayed at the substantially center. In addition, the plane cut surface 43 of the reference image shown in the plane (d) is also updated and displayed in synchronization with the image operation of the MPR section. Further, on this reference image, a direction indication display 104 indicating the top, bottom, left and right of the (a) plane is synthesized and displayed.

  On the cross section shown in the plane (a) of FIG. 9, the user clicks the tip of the puncture needle as a treatment center lock point (affected part center 45) with a mouse or the like to designate one point in the three-dimensional space. At this point, the designated point is fixed (locked) as in the first embodiment, and the plane cut surface 43 including the affected part center 45 is set in the subsequent rotation operation of the plane cut surface 43 (FIG. 3). Step S305).

  Next, in FIG. 10, on the cross section shown in the plane (a), a rotation operation about the affected part center 45 is performed, and the ultrasonic probe position is designated and virtual as in the first embodiment. The puncture ultrasonic section 66 is determined, and the ROI 62 and the virtual puncture needle 61 are synthesized and displayed as in the case of the first embodiment. The (b), (c), and (d) planes in FIG. 10 are the same as the (b), (c), and (d) planes in FIG. Operations such as position adjustment of the virtual puncture ultrasonic section 66 are performed by a rotation operation around the affected part center 45.

  When the puncture position of the virtual puncture needle 61 is determined, as shown in the planes (a), (b), (c), and (d) in FIG. An orthogonal cross-sectional image with the plane cut surface 43 including, an orthogonal cross-sectional image of the virtual puncture needle 61, and a reference image are displayed (step S310 in FIG. 3).

  As a modification of this embodiment, as shown in FIG. 12, the virtual puncture needle is shown with the display of the three cross sections MPR and the plane cut surface 43 of the (a), (b), and (c) planes shown in FIG. (E) plane (plane (b) in FIG. 11) which is an orthogonal cross-sectional image with the plane cut surface 43 including 61, and (f) plane ((c) in FIG. 11) which is a vertical cross-sectional image for the virtual puncture needle 61. May be displayed as a separate window.

  As described above, in this embodiment, the setting of the puncture path 54 can be performed while looking at the MPR, so that it is possible to answer various clinical needs.

(Third embodiment)
Next, a third embodiment of the image processing display device according to the present invention will be described with reference to the drawings. This embodiment displays another example of the display method for designating the affected part center 45 in step S305 in the flowchart shown in FIG. 3 of the first embodiment. Therefore, the schematic configuration of the image processing display device 15 according to the present embodiment is substantially the same as that in the first embodiment, and a description thereof will be omitted.

  FIG. 13 shows, as a modified example of the method for designating the affected part center 45 (that is, the treatment center lock point), instead of the MPR section, for example, an image of the maximum value projection method which is one display method of volume rendering, and transparency can be set. Use volume rendering display.

  In general, an ultrasonic image has a low contrast as compared with other medical diagnostic devices, and a gallbladder, a tumor, a blood vessel, or the like, which is a display target, may not be clearly visible in a normal volume rendering display. As a means for compensating for such an image having a low contrast, a method of adjusting the contrast of the projected image by adjusting the density value of the voxel value on the ray as a parameter in the rendering process can be considered. The method for photographing the maximum value of the above voxel values is particularly called a maximum value projection method.

  The three-dimensional image generation processing unit 23 of the image processing display device 15 performs a rendering process by the maximum value projection method on one volume data. The maximum value projection method is a rendering process in which the maximum value of the voxel values of the volume data existing on the ray (the ray passes) is used as the pixel value of the projection image. In general, the greater the echo intensity, the greater the corresponding voxel value. Accordingly, it is possible to obtain a projection image obtained by extracting a tissue or a tissue boundary surface having a high echo intensity.

  When the user clicks the center point of the treatment target region (affected area center 45) as the treatment center point on the image at the observation time shown in FIG. 13A, the three-dimensional image generation unit 23 looks at the current volume. The graphic representing the straight line 162 including the click point in the viewing direction V or the three-dimensional pixel (voxel) data having the maximum pixel luminance is embedded in the original volume data. As shown in FIG. 13B, the point 161 is displayed as, for example, a point 161 having the maximum luminance.

  Next, as shown in FIG. 13C, when the volume rendering image is rotated, the straight line graphic 162 or the maximum luminance line is seen as a straight line 162. In this state, the center of the treatment target region is again displayed on the screen. The user clicks the point 45 as the treatment center point, and designates one point in the three-dimensional space as the affected part center 45.

  As a modified example, a volume image viewed from a viewpoint different from 90 degrees, for example, is displayed as two screens from the beginning, and the affected area center 45 is first designated on one image, and then immediately on the other image. Alternatively, a straight line graphic 162 or a maximum luminance line may be displayed.

  As described above, in the present embodiment, when setting the puncture path, the image of the maximum value projection method and the volume rendering display capable of setting the transparency are used. In the display, a puncture path can be easily set even when the gallbladder, tumor, blood vessel, or the like that is the display target cannot be clearly seen.

(Fourth embodiment)
Next, a fourth embodiment of the image processing display device according to the present invention will be described with reference to the drawings. The image processing display device of the present embodiment is basically the same as that of the first embodiment in that it has a step of setting the affected area more precisely in addition to the puncture path setting method in the first embodiment. Since the other steps are substantially the same as those in the first embodiment, the description of the preceding steps is omitted.

  After the three orthogonal cross sections with the puncture path as one intersection line are displayed as shown in FIG. 6A (step S310 in FIG. 3), the cross section 65 perpendicular to the central axis is dragged by the user using a mouse or the like. When the & drop is performed, the CPU that has received the information sends an instruction to the probe position specifying unit 26, and as shown in FIG. 14, the cross section 65 perpendicular to the central axis is crossed from the affected part center 45 to the puncture position. The translation is made along the puncture path 54 by an amount corresponding to the drag amount (step S401).

  The user observes and confirms whether there is an inappropriate site such as the lung, the diaphragm, or the main blood vessel in the vicinity while translating the section 65 perpendicular to the central axis in this way. Such parallel movement is also performed on the two orthogonal cross sections 63 and 64 having the virtual puncture path 54 as an intersection, and observation and confirmation are made whether there are any inappropriate parts such as lungs, diaphragms, and main blood vessels nearby. .

  In the observation stage of the puncture path 54 described above (step S401), if an inappropriate part is not found, the user moves the mouse or the like onto the “puncture path confirmation” button on the screen of the three-dimensional image display unit 24. By clicking, etc., an instruction to confirm the set puncture path 54 is sent to the CPU of the image processing display device 15. The CPU that has received this instruction transmits a signal to the probe position specifying unit 26 to finally determine the set temporary puncture path 54 (step S402: Yes).

  On the other hand, when an inappropriate site as described above is found (step S402: No), when the set puncture position is changed and the puncture position is set again elsewhere, the current virtual puncture ultrasonic cross section When adjustment is performed by changing the position of the puncture path 54 by a rotation operation around the affected part center 45 in 66, in other words, when changing the position of the puncture path 54 only within the same plane cut surface 43 (step S403). : No), the CPU returns to the volume rendering image screen (step S310 in FIG. 3) including the plane cut surface 43 in FIG. 6A with respect to the probe position specifying unit 26, the ROI 62 and the virtual puncture needle 61. Are simultaneously rotated in the current plane cut surface 43, and the images in FIGS. 6B to 6C are changed in synchronization with the rotation.

  On the other hand, when there is an obstacle (unsuitable part) even in the adjustment of the puncture path 54 in the current virtual puncture ultrasonic section 66 (step S402: Yes), the CPU instructs the probe position according to the user's instruction. The specific unit 26 again returns to the volume rendering image screen including the plane cut surface 43 in FIG. 6A, and rotates the plane cut surface 43 with another intercostal space or under the rib arch as a puncture insertion position. And the position of the virtual puncture path 54 is adjusted. That is, returning to step S306 in FIG. 3, the puncture position is temporarily set again.

  The details of how the affected part 44 appears and the range of translation when the three orthogonal cross sections are translated in this way will be described below. FIG. 16 shows the images of the orthogonal cross sections 63 and 64 having the virtual puncture path as the intersecting line and the image of the cross section 65 orthogonal to the intersecting line (see FIG. 6C) when translated as described above. The affected part 44 is schematically enlarged.

  An orthogonal cross section 63 having the virtual puncture path as an intersecting line indicates a state in which the virtual puncture path is not translated, that is, a cross section including the affected part center 45. Therefore, the affected part 44 is visible in the maximum state. On the other hand, the orthogonal cross section 64 intersecting the virtual puncture path and the cross section 65 orthogonal to the intersection line are translated to 64a and 65a, respectively, so that the section where the cross section cuts the affected part can be seen, It looks smaller than the cross section including the affected part center 45.

  On this virtual ultrasonic cross section, a spherical shell 71 (cautery range) 71 centered on the affected part center 45 and larger than the affected part 44 is synthesized and displayed. The size of the spherical shell 71 is specified by specifying the diameter, radius, or volume of the sphere. The parameter specifying the spherical shell 71 is displayed in conjunction with the parallel movement of the three orthogonal cross sections. The circular shell 71 allows the user to confirm the RFA ablation range.

  In this case, the parallel movement of the three orthogonal cross sections can be restricted so as not to exceed the diameter of the spherical shell 71. Thereby, the wasteful movement of the three orthogonal cross sections can be eliminated more than necessary. In this embodiment, the shiftable range is set to be spherical according to the size of the spherical shell 71, but is not limited to this, and is not limited to this, and may be a cube, a rectangular parallelepiped, or a spindle shape depending on the shape of the affected part 44. It can be.

  In order to confirm the three-dimensional region of the ablation range of the RFA, as shown in FIG. 16, the virtual ultrasonic cross section is observed in a mode in which it can be translated in a range in contact with the sphere surface. At this time, the size of the spherical shell of the sphere changes corresponding to the position of the spherical shell 71 on each virtual ultrasonic cross section. By moving the affected part center 45 on the virtual puncture path 54, the three-dimensional area of the RFA ablation range is updated and displayed in synchronization. At this time, if the cross section perpendicular to the virtual puncture axis is located at the center of the affected area, the cross section perpendicular to the virtual puncture axis is updated and displayed at the affected area center 45 in synchronization with the parallel movement. Good.

  Moreover, also when setting a puncture path | pass using MPR demonstrated in 2nd Embodiment, the spherical shell 71 showing a treatment range is designated by the method similar to the above, (a) (b) ( c) The spherical shell 71 may be synthesized and displayed on the cross section of the surface.

  In the present embodiment, in addition to the means in the first embodiment, a cross-sectional image in which the puncture path 54 is an intersection line of two of the three orthogonal cross sections and a parallel image of the cross-sectional image orthogonal to the puncture path 54 are also included. Since the examination is performed, it is possible to more accurately detect whether there is an inappropriate site for puncture in the vicinity.

(Fifth embodiment)
Next, a fifth embodiment of the image processing display device according to the present invention will be described with reference to the drawings. The image processing display device 15 of the present embodiment is the first point in that after the puncture path is set in the first embodiment, an image representing the body surface is superimposed on the three-dimensional image and displayed. Since it is fundamentally different from that in the embodiment and other steps are substantially the same as those in the first embodiment, description of the preceding steps is omitted.

  FIG. 17 is a flowchart for explaining the operation of the image processing display apparatus according to the present embodiment. When the puncture path is confirmed (step S311: Yes in FIG. 3), the entire volume image captured by pressing a button on an operation panel (not shown) on the input unit 27 of the image processing display device 15 or a key on the keyboard. The three-dimensional image generation processing unit 23 of the image processing display device 15 creates an image of only the body surface of the subject by surface (for surface display) rendering (step S501). A three-dimensional image that can confirm the position and shape of the bone of the specimen is created by volume rendering. That is, the three-dimensional image generation processing unit 23 according to the present embodiment constitutes a body surface image generation unit in the present invention.

  In the next step S503, graphic data that graphically indicates the position of the virtual puncture ultrasonic section 66 and the virtual puncture needle 61 is created.

  In step S504, the body surface image and the three-dimensional image obtained in this way are superimposed and displayed. In FIG. 18A, reference numeral 61 denotes a virtual puncture needle, and 66 denotes a virtual puncture ultrasonic section, but as shown in FIG. 18B, the image of the body surface 73 and the position and shape of the bone 41 are shown. Is displayed, and a graphic showing the position of the virtual puncture ultrasonic section 66 and the position of the virtual puncture needle 61 is also displayed.

  When the virtual puncture ultrasonic cross-sectional position 66 or the figure of the puncture needle 61 is difficult to see, it may be possible not to display these. FIG. 19A is a diagram showing a three-dimensional image showing a virtual puncture needle 61 and a virtual ultrasonic section 66 similar to FIG. 18A, and FIG. 19B shows the virtual puncture needle 61 displayed. However, the figure at the position of the virtual puncture ultrasonic section 66 and the state where the affected part 44 is erased are displayed.

  In the present embodiment, the case where the position of the virtual puncture ultrasonic cross-sectional position 66 is displayed after the puncture position by the virtual puncture needle 61 is determined has been described. However, as a modification of the present embodiment, before the puncture position is determined, that is, in the flowchart of FIG. 3, for example, at the stage where the puncture path in step S308 is first set, as in FIG. In synchronization with the display of the image, the virtual puncture ultrasonic cross-sectional position 66 and the figure of the virtual puncture needle 61 can also be displayed.

  In this way, if the virtual puncture ultrasonic cross-sectional position 66 and the figure of the virtual puncture needle 61 are displayed at the stage of determining the puncture position, it is possible to confirm the specific position where the puncture is supposed to be performed. . It is also possible to display the three-dimensional image and the body surface image in synchronization.

  In addition, as shown in FIG. 20, the contour of the body surface is extracted, and based on the information, as the anatomical index of the sternum and rib, for example, the seventh or eighth rib on the xiphoid process or the middle underline When the position between the two is designated on the screen by a user using a position designation device such as a mouse, the index 202 on the body surface and the median line 201 passing through the index 202 are graphically displayed. Is also possible. Thereafter, the curve distance on the body surface from the index 202 to the puncture point can be automatically measured and displayed.

  Furthermore, as shown in FIG. 21, as an anatomical index 202 of the sternum and ribs, for example, imaging such as CT and MRI is performed at the position between the seventh and eighth ribs on the xiphoid process and the middle rib underline, respectively. The land marker 203 corresponding to the method is placed and imaged, the marker 203 is automatically recognized from the CT value and the like, and the index 202 on the body surface and the median line 201 passing through the index 202 are graphically displayed. It is also possible to automatically measure and display the curve distance on the body surface from the point to the puncture point.

  According to the image processing display device according to the present embodiment, a three-dimensional image obtained by volume rendering, a body surface image obtained by surface rendering, a figure showing a virtual ultrasonic cross-sectional position, and the like can be superimposed and displayed. Therefore, the puncture position can be recognized more intuitively.

(Sixth embodiment)
Next, a sixth embodiment of the image processing display device according to the present invention will be described with reference to the drawings. In contrast to the premise that the embodiment described above is mainly used at the time of puncture planning, the present embodiment is basically different in that it is assumed to be used during puncture. Other configurations are substantially the same as those of the first embodiment, and the same reference numerals are given and description thereof is omitted.

  That is, the image processing display device 15 according to the present embodiment uses the virtual puncture ultrasound on the screen of the ultrasound diagnostic device 16 for the purpose of observing the virtual puncture ultrasound cross section immediately before or during puncture at the puncture treatment site. A cross-section and an ultrasonic live image are displayed simultaneously.

  As shown in FIG. 22, one screen is divided into two left and right, a live image (a) by ultrasound is displayed on the right screen, and the image obtained at the time of puncture planning on the left screen, for example, the above-mentioned implementation on the upper left The virtual puncture ultrasound cross-sectional image (b) obtained by the operation in the form is displayed, and the reference image (c) on the CT volume rendering is displayed therebelow. The actual affected area 44 and the actual puncture needle 81 are displayed on the live image by the ultrasonic wave.

  Further, instead of the three-screen display as shown in FIG. 22, as shown in FIG. 23, the live image (a) is displayed on the right screen while the live image displayed on the right is displayed on the left screen. It is also possible to display a virtual puncture ultrasonic diagnostic image (b) having the same pixel size as the image pixel. The live image (a) displayed on the right screen and the virtual puncture ultrasound cross-sectional image (b) are displayed at the same time. The virtual puncture ultrasonic cross-sectional image almost the same as the freeze cross-sectional image is displayed by the image operation.

  Or, for example, when performing puncturing a plurality of times, while observing the live image during the previous puncture, the live image during puncture is frozen and the freeze is performed in order to determine the shift position of the puncture needle tip to be performed next. It is also possible to display a virtual puncture ultrasonic cross section substantially the same as the cross-sectional image by the above-described image operation.

  In this way, by simultaneously displaying the virtual puncture ultrasound cross section and the live image of the ultrasound, comparing both, it is confirmed that the treatment is performed according to the planned puncture pass or that there is no error in the planned puncture pass Can be operated while.

(Seventh embodiment)
Next, a seventh embodiment of the image processing display device according to the present invention will be described with reference to the drawings. FIG. 24 is a schematic diagram of the ultrasound diagnostic imaging system 2 according to the present embodiment.

  The ultrasonic device main body 211 has an image processing display function in addition to processing of ultrasonic transmission / reception and reception signals related to ultrasonic imaging, and is attached to the ultrasonic probe 212 and the ultrasonic probe with respect to the main body 211. A keyboard, trackball, and operation panel 215 as an input device 214 are connected. The ultrasound image and other modality images other than the ultrasound are displayed on the monitor 216.

  The ultrasonic probe 212 includes a mechanical 4D probe that collects a plurality of ultrasonic cross sections by mechanically swinging a one-dimensional array probe portion in addition to a normal one-dimensional array probe, or a real-time 3D probe using a two-dimensional array. Is also included.

  Three-dimensional volume data relating to a three-dimensional region including a diseased tissue is treated using an X-ray computed tomography apparatus (hereinafter referred to as “CT”), a magnetic resonance diagnostic apparatus (MRI), or a diagnostic modality 217 such as an X-ray system. The data is collected in a format such as DICOM and transferred directly to the ultrasound diagnostic apparatus main body 211 or indirectly via a DICOM server, etc., or superposed on a recording medium such as a CD-R. It is taken into the sonic diagnostic apparatus main body 211.

  Note that the ultrasonic apparatus main body 211, the ultrasonic probe 8212, the three-dimensional position sensor 213, the input device 214, the operation panel 215, and the monitor 216 in the present embodiment constitute an image processing display apparatus according to the present invention, which will be described below. The processing is performed under the control of a CPU (not shown) in the ultrasonic apparatus main body 211.

  In this embodiment, it is assumed that three-dimensional volume data is collected by CT and a virtual puncture ultrasound image is displayed on the monitor 216 in puncture treatment for liver cancer. Hereinafter, a typical workflow according to the present embodiment illustrated in FIG. 25 will be described.

  First, as shown in FIG. 26 (a), the target 3D-CT image is displayed on the monitor 216 by VR (volume rendering) display such as displaying bones (step S701), and can be imaged with ultrasound. Three points of structures (such as rib tips) that become the landmarks 218 are marked by a pointing device such as a trackball (step S702). By this marking, one cross section in the 3D-CT imaging space coordinates is designated.

  Next, the landmark 218 is imaged by normal real-time imaging with the ultrasonic probe 212 with a position sensor (step S703), and as shown in FIG. 26B, the three points are corresponded on the CT image. Marking is performed on each ultrasonic cross-sectional image so that attachment is possible (step S704). By this marking, the 3D-CT imaging space coordinates and the ultrasound imaging coordinates are roughly matched.

  The three-point marking on the ultrasonic image may be performed on the cross section of the three-dimensional volume data obtained by performing the 3D scanning so that the three points become the target region of the 3D scanning, for example, by MPR display. .

  If the mechanical 4D / real-time 3D probe is used, those scanning volume shapes 219 are converted into ablation areas that can be calculated from the known tumor treatment center position and ablation area information searched in the preoperative plan in other cases. The volume shape that can be assumed by circumscribed fan scanning is superimposed and displayed on the CT image as shown in FIG. 27 (step S705). At this time, in FIG. 27, the display position of the scanning volume as seen from the contact position 220 of the ultrasonic probe on the body surface is obtained at the time when the ultrasonic probe is actually applied to the probe position planned in advance or actually. The position is calculated corresponding to the information from the position sensor consultation unit 213.

  Based on the position sensor information, it is calculated that the 3D ultrasonic scanning volume shape 219 obtained in this way includes the currently imaged two-dimensional imaging section 221 as shown in FIG. 28 (step S706). When the cross section 221 is included in the 3D ultrasonic scanning volume shape 219 (step S707: Yes), the cross section 221 is superimposed and displayed on the CT screen (a) as shown in FIG. Further, the fact that the cross section 221 is included in the 3D ultrasonic scanning volume shape 219 is displayed on the real-time ultrasonic image (b) side, for example, by turning on a blue / circular indicator 223 (step S708).

  When the cross-section 221 currently imaged is included in the 3D ultrasonic scanning volume shape 219 described above, the ablation area 224 planned at the same time is converted into a CT image cross-section (a) and a real-time ultrasonic imaging image shown in FIG. (B) The image is superimposed and displayed (step S709).

  When the CT image cross section and the real-time ultrasonic image do not match sufficiently (step S707: No), the CT image cross-section at a certain time point is once frozen, and the real-time ultrasonic image side is changed to match the frozen CT image cross-section. The freeze is released at the moment and the synchronization display is performed again. By this operation, the deviation between the two spatial coordinates is corrected (steps S710 to S712).

  When the virtual puncture ultrasonic cross section is determined in these steps, an ROI representing an ultrasonic cross section range corresponding to the type of ultrasonic probe used in treatment may be displayed in a synthesized manner.

  According to the present embodiment, a 3D image of another modality obtained in advance for supporting a puncture treatment plan using an ultrasonic diagnostic apparatus is referred, and a tumor or a plurality of tumors that are difficult to discriminate with ultrasound are detected. Thus, each tumor can be easily discriminated immediately before or during the treatment using information planned before the treatment, so that a more reliable and quick puncture treatment is possible.

  As a modification of the present embodiment, as shown in FIG. 30, a body mark 225 with a probe mark 226 that schematically displays the position of the ultrasonic probe on the subject based on information from the position sensor. It is also possible to add and display. Thereby, it is possible to know at a glance which position of the subject is scanned by the displayed ultrasonic image.

  Alternatively, as shown in FIG. 31, an ultrasonic probe graphic (a figure or a photograph representing a shape) 227 is superimposed on the body surface image obtained by surface rendering displayed on the three-dimensional image display unit 24. You may make it make it.

  This superimposed display is performed by the probe graphic storage means for storing a plurality of graphics of the ultrasonic probe in the ultrasonic diagnostic apparatus main body 211 and the three-dimensional image generation processing unit 23 (not shown) in the ultrasonic diagnostic apparatus main body 211. And a body surface image generation means for generating a body surface image of the subject by surface rendering from the three-dimensional volume data described in the fifth embodiment, and is calculated from the data obtained by the position sensor receiving unit 213. It is obtained by synthesizing the probe graphic 227 on the contact position 220 of the ultrasonic probe on the body surface.

  The ultrasonic probe graphic 227 is displayed at a body surface position (for example, a position instructed by the CPU to the probe position specifying unit 26) necessary for obtaining the plane cut surface 43 displayed on the cross-sectional image display unit 24. Is displayed. The probe graphic storage means may store a plurality of angles of the probe graphic so that the probe graphic is switched according to the specified body surface position, or a plurality of the graphic may be switched depending on the type of the registered or selected probe. A seed probe graphic may be stored. The probe graphic storage means may store a graphic of one representative ultrasonic probe without storing a plurality of graphics.

  Furthermore, as another modified example, the preoperative plan as shown in FIG. 31A, for example, is performed without performing the coordinate alignment of the CT imaging coordinates and the ultrasonic imaging coordinates performed in steps S701 to S704. It is also possible to display a known cross section and an assumed volume shape as shown in FIG. At this time, the cross-section known in the preoperative plan is not linked to the position sensor information and is set to the still image display state.

  Next, when real-time ultrasonic waves shown in FIG. 29B are used to display images that match or are close to known sections in the preoperative plan shown in FIG. 31A, (a) and ( b). Then, the ablation area planned at the time of interlocking is superimposed and displayed on the real-time ultrasonic imaging image of FIG.

  According to this method, it is possible to easily perform coordinate alignment between CT imaging coordinates and ultrasonic imaging coordinates.

  The embodiments described above are for illustrative purposes and do not limit the scope of the invention. Accordingly, those skilled in the art can employ embodiments in which each or all of these elements are replaced by equivalents thereof, and these embodiments are also included in the scope of the present invention. For example, in the above-described embodiment, the application before the puncture treatment plan and during the puncture treatment has been described. However, the embodiment may be applied to simplify image comparison with other modalities after the treatment.

1 is a diagram showing a schematic configuration of an entire diagnostic system including a first embodiment of an image processing display device according to the present invention. 1 is a diagram illustrating a schematic configuration of an image processing display device according to a first embodiment. 6 is a flowchart for explaining the operation of the image processing display device according to the embodiment. It is a figure which shows the example of the three-dimensional image displayed in this embodiment, (a) is the figure which set the plane cut surface, (b) is the figure which translated such a plane cut surface, (c) is a figure. The figure rotated and moved clockwise, (d) is the figure rotated and moved counterclockwise. It is a figure explaining a mode that a puncture path | pass is set by designation | designated of a puncture position, (a) is the figure where the puncture position was temporarily set to the center point of the line | wire in which a puncture probe may be set | placed, (b) The figure set to the same end point. It is a figure explaining an example of the cross-sectional image containing a puncture path, (a) is a figure which shows the volume rendering image containing a plane cut surface, (b) is displayed centering on the image of the virtual puncture ultrasonic cross section containing ROI. (C) is a diagram showing three cross-sections including a puncture path and orthogonal to each other. (A) is a figure which shows an example of the some plane cut surface containing a puncture path | pass, (b) is a figure which displays the corresponding virtual puncture ultrasonic cross section. (A) is a diagram illustrating an example of a plurality of plane cut surfaces including a puncture path that is assumed for each different breathing time phase, (b) is a diagram illustrating the positional relationship between these plane cut surfaces, (c) FIG. 7 is a diagram for displaying a corresponding virtual puncture ultrasonic section. The figure which shows the example of a display in the case of using MPR for the setting of the plane cut surface containing the affected part center in the image processing display apparatus which concerns on 2nd Embodiment. In the previous figure, the virtual ultrasonic cross section was determined, and the ROI and virtual puncture needle were synthesized and displayed. The figure which displayed MPR containing the cross-sectional image which made the virtual puncture needle perpendicular | vertical. The figure which shows an example which displayed each screen of FIG.10 and FIG.11 in parallel. In the image processing display device according to the third embodiment, the plane cut surface including the center of the affected area is set as a display example when using a volume rendering display capable of setting an image of maximum value projection or transparency. (A) is a diagram showing an image at the time of observation, (b) is a diagram in which three-dimensional pixel (voxel) data having the maximum pixel luminance is embedded in original volume data, and (c) is a volume rendering image. Figure rotated. The figure explaining the parallel displacement of three orthogonal cross sections which make a puncture path | route one intersection line in the image processing display apparatus which concerns on 4th Embodiment. 6 is a flowchart for explaining the operation of the image processing display device according to the embodiment. The figure explaining the appearance of an affected part at the time of translating 3 orthogonal cross sections, and the range of translation. 10 is a flowchart for explaining the operation of the image processing display device according to the fifth embodiment. (A) is a diagram showing a three-dimensional image obtained by volume rendering, and (b) is a diagram in which a body surface image obtained by surface rendering and a figure showing a virtual ultrasonic cross-sectional position are superimposed and displayed on (a). (A) is a figure which shows the three-dimensional image obtained by volume rendering, (b) is the figure which superimposed and displayed the body surface image obtained by surface rendering in (a). The figure which shows the example in which the internal line of a subject is displayed as a modification of the image processing display apparatus which concerns on 5th Embodiment. The figure which shows the example by which the parameter | index of the body surface of a subject and a body line are displayed as another modification of the image processing display apparatus which concerns on 5th Embodiment. The figure which the display example of the image processing display apparatus which concerns on 5th Embodiment-the live image by an ultrasonic wave, the virtual puncture ultrasonic cross-sectional image, and the reference image on CT volume rendering-is displayed. The figure by which the other example of a display of the image processing display apparatus which concerns on 5th Embodiment-the live image by an ultrasonic wave, and a virtual puncture ultrasonic cross-sectional image-is displayed. Schematic of an ultrasonic diagnostic imaging system including an image processing display device according to a sixth embodiment. 6 is a flowchart for explaining the operation of the image processing display device according to the embodiment. (A) is a figure explaining the concept of 3 point | pieces in the VR image of 3D-CT, (b) is a figure explaining marking of these 3 points | pieces by an ultrasonic wave. The figure which shows the superimposed display on the VR image of 3D-CT of scanning volume shape. The figure which superimposes and displays the two-dimensional imaging cross-sectional position calculated based on position sensor information. The figure which displays CT sectional drawing and a real-time ultrasonic image in parallel. The figure which shows the example which adds and displays the body mark with a probe mark on FIG. The figure which shows the example which superimposes and displays the graphic of an ultrasonic probe on a body surface image. The figure which displays CT sectional drawing and the real-time ultrasonic image which concern on the modification of this embodiment in parallel.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1, 2 Diagnostic system 11 Three-dimensional data collection device 13 Network 15 Image processing display device 16, 19 Ultrasonic diagnostic device 17 X-ray CT device 18 MRI device 21 Three-dimensional data storage unit 22 Three-dimensional reconstruction processing unit 23 Three-dimensional image Generating unit 24 3D image display unit 25 affected part position specifying part 26 probe position specifying part 27 input part 41 CT value area 42 representing bone 42 area other than CT value area representing bone 43 plane cut surface 44 affected part 45 affected part center 51 Line 52 where puncture probe may be placed Center point 53 End point 54 Puncture path 55 Puncture position 61 Virtual puncture needle 62 ROI
63, 64 An orthogonal cross section 65 intersecting with the virtual puncture path 65 A cross section perpendicular to the intersecting line 66 Virtual puncture ultrasonic section 67 Cross section perpendicular to the central axis 71 Spherical shell (cautery range)
73 Body surface 81 Puncture needle 91, 92, 93 MPR image 102, 103 Axis 104 Direction indication display 161 Maximum luminance point 162 Straight line graphic 201 Midline 202 Index 211 Ultrasonic diagnostic apparatus body 212 Ultrasonic probe 213 Position sensor receiver 214 Input Device 215 Operation panel 216 Monitor 217 Diagnostic modality 218 Landmark 219 Scanning volume shape 220 Contact position 221 of ultrasonic probe on body surface Two-dimensional imaging section 222 Shape 223 indicating affected area Indicator 224 Ablation area 225 Body mark 226 Probe mark 227 Probe Graphic V Gaze direction

Claims (25)

Data storage means for storing three-dimensional volume data;
Cross-section information generating means for reconstructing three-dimensional volume data stored in the data storage means to generate cross-section information;
Image display means for displaying a cross-sectional image of the subject based on the cross-sectional information generated by the cross-section information generating means;
Locking means for locking the affected area center on the cross-sectional image displayed by the image display means as the rotation center;
An operation means for rotating the cross-sectional image in an arbitrary direction by always displaying the cross-sectional image including the center of the affected area on the image display means.
An image processing display device comprising: The image processing display device further specifies the puncture position when a puncture position for puncturing is designated on either a plane cut that becomes a cross-sectional image including the center of the affected part or a cross-sectional image displayed together with the plane cut. 3. The image processing display device according to claim 1, further comprising a puncture path setting unit that establishes a puncture path by connecting the centers of the affected areas with a straight line. In the predetermined range of the puncture path set by the puncture path setting means, the image display means is a range obtained by moving a cross section image orthogonal to the puncture path and a cross section image orthogonal to the puncture path by a predetermined distance. The image processing display device according to claim 1, wherein a cross-sectional image is displayed. The image processing display device according to claim 1, wherein the image display unit synthesizes and displays the puncture path and a virtual puncture ultrasonic cross-sectional area. The image display means displays a three-dimensional image generated by volume rendering,
4. The image processing display device according to claim 1, wherein the puncture path setting means designates a puncture position based on the three-dimensional image. The image display means displays any MPR screen having an arbitrary cross section and three orthogonal cross sections,
The image processing display device according to any one of claims 1 to 3, wherein the puncture path setting means designates a puncture position based on one of the MPR screens having an arbitrary cross section and three orthogonal cross sections. . The image display means includes a cross-sectional image including the puncture path set by the puncture path setting means, a cross-sectional image including the puncture path and orthogonal to the cross-sectional image, a cross-sectional image orthogonal to the puncture path, and volume rendering 4. The image processing display device according to claim 1, wherein the image processing display device displays a three-dimensional image generated by the step. The image display means displays a composite image of a three-dimensional image generated by volume rendering including the puncture path, a virtual ultrasonic cross-sectional image, and a live image captured by an ultrasonic diagnostic apparatus. The image processing display device according to claim 1. 4. The puncture path setting means is configured to be able to change a designated puncture position when a site inappropriate for puncturing is displayed on these cross-sectional images. An image processing display device according to claim 1. The data storage means acquires three-dimensional volume data from at least one of an X-ray 3D apparatus, an X-ray CT apparatus, an MRI apparatus, an ultrasonic diagnostic apparatus, and a nuclear medicine diagnostic apparatus. The image processing display device according to any one of the above. A first step of displaying an image of a cross section in the subject based on the three-dimensional volume data representing the information in the subject;
A second step of setting the position designated on the image displayed in the first step as the affected area center;
A third step of rotating and moving the position of the cross section around the center of the affected area set in the second step, and generating and displaying an image of the rotated cross section based on the three-dimensional volume data;
A fourth step of setting a puncture start position by designating a position on the image displayed in the third step;
An image processing display device control method comprising: A first step of setting a plurality of positions designated on a cross-sectional image generated based on three-dimensional volume data representing information in the subject as a plurality of puncture paths;
A second step of generating and displaying cross-sectional images respectively superimposed on the puncture path set in the first step based on the three-dimensional volume data;
An image processing display device control method comprising: The image processing display device further includes body surface image generation means for generating a body surface image of the subject by surface rendering from the three-dimensional volume data stored by the data storage means,
4. The image processing display device according to claim 1, wherein the image display unit superimposes and displays the body surface image generated by the body surface image creation unit on the three-dimensional image. 5. The image processing display device further includes graphic data generating means for generating graphic data of any one of the position of the virtual ultrasonic cross section and the puncture needle from the three-dimensional volume data stored in the data storage means,
14. The image processing display device according to claim 13, wherein the image display means superimposes and displays a graphic based on the graphic data generated by the graphic data generation means on the three-dimensional image. The image processing display device further includes graphic data generating means for generating graphic data of any one of the position of the virtual ultrasonic section and the puncture needle from the three-dimensional volume data stored in the data storage means,
The image processing display according to any one of claims 1 to 3, wherein the image display means displays a graphic based on the graphic data generated by the graphic data generation means so as to overlap the three-dimensional image. apparatus. 16. The image processing display device according to claim 15, wherein the image display means displays the graphic displayed superimposed on the three-dimensional image so as to be erasable. The image processing display device according to claim 13, wherein the image display unit superimposes and displays an index point on the body surface of the subject on the three-dimensional image. The image processing display device according to claim 13, wherein the image display unit superimposes and displays the body line of the subject on the three-dimensional image. A region designating unit for designating a three-dimensional position and a region of an approximate center of one or more affected parts for performing either treatment or collection from three-dimensional volume data relating to a three-dimensional region including the affected part of the subject;
Image display means for displaying a 3D image including the position and area designated by the area designation means;
An ultrasound probe that transmits and receives ultrasound to and from an imaging target inside the subject; and
A position sensor that is mounted on the ultrasonic probe and detects a relative position of the ultrasonic probe with respect to the surface of the subject;
And displaying the designated affected part position in correspondence with each other on the ultrasonic imaging image using the position information indicating the designated affected part position and the data obtained by the position sensor. Processing display device.   The image processing display device according to claim 19, wherein the ultrasonic probe is any one of a one-dimensional array, a two-dimensional array, and a mechanical probe that mechanically scans the one-dimensional array. The image processing display device superimposes and displays a volume shape for 3D scanning on a 3D image including a designated position and area of the affected area from the treatment area of the affected area and the ultrasonic probe position of the one-dimensional array on the body surface. The image processing display device according to claim 19, characterized in that:   20. The image processing display according to claim 19, wherein the image processing display device superimposes and displays a volume shape to be 3D scanned by any one of a two-dimensional array and a mechanical probe on a 3D image including a designated position and a region. apparatus.   The image display means includes a body mark that represents the shape of the subject and a probe mark that indicates the position of the ultrasonic probe in contact with the body surface of the subject on the body mark based on information from the position sensor. The image processing display device according to claim 19, wherein: The image processing display means further includes
Probe graphic storage means for storing a graphic for displaying the ultrasonic probe;
Body surface image generation means for generating a body surface image of the subject by surface rendering from the three-dimensional volume data;
With
The image display means superimposes and displays the probe graphic on the ultrasonic probe position calculated from the data obtained by the position sensor on the body surface image generated by the body surface image creation means. The image processing display device according to claim 19. A first step of displaying a cross-sectional image and a real-time 2D cross-sectional image extracted from three-dimensional volume data including an affected area designated before treatment;
After the real-time 2D cross-sectional image becomes substantially the same cross section as the cross-sectional image, the spatial coordinates of the three-dimensional volume data and the imaging spatial coordinates based on the information from the position sensor data attached to the ultrasonic probe are the same, And a second step of synchronously displaying both image sections simultaneously. A method for controlling an image processing display device, comprising:

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