JP2005342434A - Infrared observation system and specifying method of lesion by infrared observation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an infrared observation system for an operation instantaneously visualizing the blood flow distribution of an organ surface or the like as an image, analyzing the image, objectively, easily and precisely determining a treatment object site, performing an appropriate treatment and confirming a treatment effect. <P>SOLUTION: This infrared observation system is at least provided with an observation apparatus which is constituted of a light source device 7 emitting a light of a first wavelength range including the wavelength of 805 nm and a light of a second wavelength range non-including the wavelength of 805 nm and having a wavelength longer than that, an image pickup device capturing respective images in the first and second wavelength ranges of a subject irradiated with the light emitted from the light source device, and a display device displaying respective images of the first and second wavelength ranges captured by the image pickup device as either of color components of red, green, or blue. This observation system is further provided with an image analysis means 25 administering infrared absorbent pigment to a patient and detecting and quantifying the amount of the infrared absorbent pigment, and the display means visualizes and displays the analysis results by the image analysis means. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an infrared observation system, and more particularly to an infrared observation system including a surgical endoscope apparatus having a light source device and an imaging means. More specifically, the imaging means mainly captures blood flow information of a living body. It relates to an infrared observation system for surgery that makes it easy to perform surgical treatment by identifying lesions for ischemic diseases etc. by creating data and displaying the images or quantifying them by image analysis techniques is there.

  In recent years, an endoscopic surgical operation in which an endoscope or the like is inserted into a body cavity such as an abdominal cavity or a chest cavity to perform a surgical operation has been widespread. Examples of the endoscope apparatus used in such endoscopic surgery include an electronic endoscope using an imaging device such as a charge coupled device (CCD).

  Conventional electronic endoscopes can display a clear moving image in real time on a color monitor, and have been widely used in recent years. In this electronic endoscope, since visible light is normally used as observation light, an endoscopic image displayed on the monitor based on image data obtained and output through predetermined signal processing is obtained. It becomes an observation image close to direct view.

  As another conventional electronic endoscope, for example, there is an infrared electronic endoscope that can observe infrared light by using an imaging device having sensitivity to near-infrared light. This infrared electronic endoscope uses near-infrared light, which is less absorbed by hemoglobin and water, which are the main causes of light absorption in the living body, so information on deep tissue that is difficult with normal visible light There is an advantage that it is useful for imaging.

  In the observation using an infrared electronic endoscope as described above, a drug such as indocyanine green (ICG), which is an infrared absorbing dye having an absorption peak in the near infrared light near 805 nm in blood, is used. Is used as a contrast medium by intravenous injection. By intravenously injecting this ICG, a shadow is generated in a blood vessel portion of a living body such as a mucous membrane or serosa, and the running state of the blood vessel can be observed more clearly as compared with the case where no drug is used.

  Further, as a monitor for displaying an endoscopic image, four signals including R, G, B signals and synchronization signals indicating the red component, the green component, and the blue component of the image are input, and the R, G, B signals are input. Are mainly displayed on a cathode ray tube or a liquid crystal display device in correspondence with phosphor dots that generate red, green, and blue light, respectively.

  As an infrared endoscope system as a conventional infrared observation system, various proposals have been made by, for example, Japanese Patent Laid-Open No. 2000-41942.

  The infrared endoscope system disclosed in the above Japanese Patent Application Laid-Open No. 2000-41942 emits light in a first wavelength band including a wavelength of 805 nm and light in a second wavelength band not including a wavelength of 805 nm. Light source means, imaging means for capturing an image of a first wavelength band and an image of a second wavelength band of a subject irradiated with light emitted from the light source means, and a first image captured by the imaging means And a display device that displays an image in the wavelength band as a green component and displays an image in the second wavelength band as at least one color component of a red component or a blue component. With such a configuration, the reflected light in the second wavelength band can be observed with high contrast.

  On the other hand, in the endoscopic surgery, a surgical operation (Open Surgery) that has been conventionally performed under abdominal or thoracotomy is performed using a predetermined endoscopic system and a dedicated treatment tool that are used for the endoscopic surgery. By using (surgical tool), there is an effect that invasiveness to a patient can be reduced.

  Specifically, in laparoscopic surgery, surgery can be performed simply by opening a plurality of (3-4) laparoscopic holes of about 5 mm to 12 mm in the abdominal wall. For this reason, compared with the conventional open abdominal thoracotomy (Open Surgery), so-called patient quality of life (QOL) such as postoperative pain reduction, hospitalization period reduction, and cosmetics can be remarkably improved.

Endoscopic surgery is used for many diseases. Thoracoscopic surgery is used for pulmonary emphysema and pneumothorax. Laparoscopic surgery is used for cholecystectomy and surgery for gastrointestinal diseases such as stomach or large intestine. It is applied in various field diseases such as surgery for diseases.
Japanese Patent Laid-Open No. 2000-41942

  However, in an endoscopic operation, the tissue cannot be directly touched, so that there is no tactile sensation and the procedure becomes complicated. In addition, compared to the case where the surgeon directly observes the affected area, the arterial pulsation can be palpated with respect to the difficulty caused by the difference in the resolution and stereoscopic effect of the displayed image, and particularly the blood flow information in the visual field. It has been pointed out that the difference from the case of open surgeries (Open Surgery), such as difficulty in evaluating peripheral blood flow as a result, has been pointed out. Providing to the surgeon is a very important issue.

  The present invention has been made in view of the above points, and its object is to focus on blood flow on the surface of an organ, etc., and visualize blood flow distribution as an image in real time. It is an object to provide an infrared observation system for surgery and its method capable of objectively easily and accurately judging a treatment target site by performing analysis and confirming an appropriate treatment and treatment effect.

  Also, improve the problems in conventional endoscopic surgery, acquire information that cannot be obtained by direct viewing by combining infrared light and imaging means, and contribute to the improvement of safety and results of surgery It is to provide an infrared observation system for surgery.

  In order to achieve the above object, an infrared observation system according to the present invention includes light in a first wavelength band that includes a wavelength of 805 nm and light in a second wavelength band that does not include a wavelength of 805 nm and is longer than that. A light source device that emits light, an image pickup device that picks up an image of the first wavelength band and an image of the second wavelength band of a subject irradiated with light emitted from the light source device, and the image pickup device Infrared including at least an observation device including a captured image of the first wavelength band and the image of the second wavelength band as a red, green, or blue color component, respectively. In the observation system, an infrared absorption dye is administered to a patient, and an image analysis means for detecting and quantifying the dye amount of the infrared absorption dye is provided, and the display device images the analysis result by the image analysis means. And wherein the Shimesuru.

  According to the present invention, focusing on blood flow on the surface of an organ or the like, the blood flow distribution is visualized as an image in real time, and analysis of this image is performed to easily and accurately determine a treatment target site. In addition, it is possible to provide an infrared observation system for surgery and a method thereof capable of confirming appropriate treatment and treatment effect.

  In addition, it is possible to provide an infrared observation system for surgery that can acquire information that cannot be obtained by direct viewing by combining infrared light and imaging means, and can contribute to improvement of safety and results of surgery.

The present invention will be described below with reference to the illustrated embodiments.
FIG. 1 is a block configuration diagram showing an overall configuration of an endoscope apparatus used in an infrared observation system (infrared endoscope system) according to a first embodiment of the present invention. FIG. 2 is a diagram showing a configuration of an infrared-visible switching filter provided in the light source device in the endoscope apparatus of FIG. FIG. 3 is a diagram showing a configuration of an RGB rotation filter provided in the light source device in the endoscope apparatus of FIG. FIG. 4 is a diagram for explaining characteristics when the infrared / visible switching filter of FIG. 2 and the RGB rotation filter of FIG. 3 are combined. FIG. 5 is a diagram showing the flow of the setting procedure of the image analysis process. FIG. 6 is a graph showing transmission characteristics depending on the wavelength of ICG. FIG. 7 is a graph showing the relationship between the time course after ICG administration and the blood concentration. FIG. 8 is an enlarged schematic view of a main part showing a part of lung tissue in an enlarged manner. FIG. 9 is a diagram schematically showing the relationship between the wavelength of light and the observation depth. FIG. 10 is an artificially created emphysema model and lung tissue images of normal sites. FIG. 11 is a graph showing the relationship between the elapsed time after intravenous injection of ICG and the ICG concentration in the blood flow under the pulmonary pleura. FIG. 12 is a block configuration diagram showing an outline of an internal configuration of an image processing circuit provided in the processor of the infrared observation system of the present embodiment. FIG. 13 shows an example of an image analysis display that is displayed as a result of processing by the image processing circuit, and is a diagram in which the ICG dye amount (color density) after intravenous injection of ICG is displayed as a thoracoscopic image. FIG. 14 is a diagram showing another example of image analysis display displayed as a result of processing by the image processing circuit. FIG. 15 is a diagram illustrating another example of an image analysis display displayed as a result of processing by the image processing circuit, and a display example when an emphysematous change is evaluated with a time delay. FIG. 16 shows an example of means for fixing the observation range in thoracoscopic surgery using the above-described infrared observation system for emphysema and pneumothorax, and is a part of the observation device (thoracoscope) connected and fixed to the operating table. It is a figure which shows the scope holder which hold | maintains and fixes.

  An endoscope apparatus 1 constituting a part of an infrared endoscope system, which is an infrared observation system according to an embodiment of the present invention, is a light source means for emitting an illumination light beam for observation as shown in FIG. A light source device 7, a scope 2 for insertion into a body cavity, a processor 3 that receives an image signal acquired by an imaging device (CCD) 15 provided in the scope 2 and performs predetermined signal processing, and the processor 3. A monitor 4 that is a display device that receives an image signal for display output from 3 and displays an image, and a digital filing device that records a digital image signal, a photography device that records an image as a photograph, and the like It is mainly composed of the device 5 and the like.

  The light source device 7 includes a lamp 8 that is an illumination member such as a xenon lamp that emits light, an infrared-visible switching filter 9 that is provided on the illumination optical path of the lamp 8 and limits a transmission wavelength, and the infrared-visible switching filter. 9, a motor 10 that performs switching driving, an RGB rotary filter 11 that includes a plurality of filters that limit the wavelength band of light to be transmitted, a motor 12 that rotationally drives the RGB rotary filter 11, and an irradiation light amount of the lamp 8. The illumination light stop 13 to be limited and the filter changeover switch (SW) 16 for generating an instruction signal or the like for switching the infrared / visible changeover filter 9 are provided.

  The scope 2 is a light guide fiber 14 that transmits illumination light from the light source device 7 to the distal end portion of the scope 2 and an imaging unit that images light from the subject, for example, a charge coupled device (CCD). The image pickup apparatus includes a solid-state image sensor (hereinafter simply referred to as an image sensor) 15.

  In addition, an operation signal (not shown) provided on the hand side of the scope 2 generates an instruction signal for executing a recording operation such as an image using the peripheral device 5 at a position where the user can easily press it. A release switch (SW) 17 and an image processing setting switch (SW) 19 for generating an instruction signal for setting image analysis processing are disposed.

  Note that the setting of image analysis processing performed using the image processing setting switch 19 is performed according to the procedure shown in FIG.

  Here, the setting procedure of the image analysis processing by the endoscope apparatus 1 (see FIG. 1) in the infrared endoscope system of the present embodiment will be briefly described below with reference to FIG.

  The setting of the image analysis process is a process that is first executed before actual use of the endoscope apparatus 1 is started. When the power supply of the endoscope apparatus 1 is turned on and is in a state where it can be used (preparation state), an arbitrary setting is performed by operating the image processing setting switch 19 described above.

  When the endoscope apparatus 1 is in the above-described preparation state, the CPU 31 (see FIG. 1) is in an analysis method selection input standby state (step S1 in FIG. 5).

In this analysis technique selection input standby state, the user can arbitrarily select various processes using the image processing setting switch 19. The processing that can be selected here is, for example: Time distribution (1) processing: The target site is detected by detecting the time until the ICG concentration reaches the peak value (see the symbols N1, B1, E1, and E2 in FIG. 11). Processing for detecting whether it is normal or abnormal (step S2 in FIG. 5).

  When this process is selected, the process enters a standby state for a threshold setting input operation in the next step S3. Here, the user arbitrarily inputs a set time (for example, second time (sec.)). Thereafter, image analysis processing is performed. The result is displayed on the display screen of the monitor 4 in step S15.

Time distribution (2) processing: ICG rendering time, that is, ICG rendering start time (minimum concentration limit value (code Ns, Bs, E1s, E2s in FIG. 11)) to ICG rendering end time (code END in FIG. 11) ) To detect whether the target site is normal or abnormal (step S4 in FIG. 5).

  When this process is selected, a comparison process between the normal part and the designated area is executed (step S5 in FIG. 5). Prior to this, the user designates the analysis area using a predetermined input means.

  Thereafter, image analysis processing is performed. The result is displayed on the display screen of the monitor 4 in step S15.

Display based on ICG amount (1) process: a process of displaying an image analysis result based on still image data in an ICG rendering state after a predetermined time has elapsed (step S6 in FIG. 5).

  When this process is selected, the CPU 31 enters a process selection input standby state. Here, the user selects a desired process (A process or B process) using a predetermined input means (step S7 in FIG. 5).

  Of the processes that can be selected here, the process A is, for example, when the ICG rendering of the normal site reaches the maximum concentration (peak value) (reference numeral N1 in FIG. 11), or after the time set arbitrarily in the next processing step. This is a process for displaying the state of the target part.

  Further, the B process is performed, for example, on the state of the target part after a predetermined time α (sec.) Elapses (symbol Ns + α (sec.)) From the ICG rendering start time (symbol Ns in FIG. 11) of the normal part Is a process of displaying.

  When the above-described process A is selected, the time is automatically set in the case of the ICG maximum density. However, in the case where it is arbitrarily set, the time is input by the user in step S8. When the process B is selected, a setting process for a predetermined time α (sec.) Is performed in step S9.

  Thereafter, a predetermined image analysis process is performed based on these. The result is displayed on the display screen of the monitor 4 in step S15.

-Display by ICG amount (2) In the processing (step S10 in FIG. 5), when the ICG rendering reaches the maximum concentration (peak value), for example, the ICG rendering for each part within the observation range of the target part is performed. Processing for performing image analysis of the rendering state at the time when the maximum density (peak value) is reached (reference numerals N1, B1, E1, E2 in FIG. 11) (A processing; step S12 in FIG. 5). Alternatively, an image analysis process (B process; step S13 in FIG. 5) for comparing the normal part with the designated area based on still image data at the time when the ICG depiction of the normal part reaches the maximum density (peak value). It is carried out.

  Here, which process is to be selected is arbitrarily determined by the user (step S11 in FIG. 5). Thereafter, image analysis processing is performed. The result is displayed on the display screen of the monitor 4 in step S15.

  The processor 3 includes a preprocess circuit 20 having an A / D conversion circuit, a color balance correction circuit, and the like, a select circuit 23, three simultaneous memories 24r, 24g, and 24b, and an image processing circuit that is an image analysis unit. 25, a color tone adjustment circuit 26, three D / A conversion circuits 27r, 27g, and 27b, an encoding circuit 28, a light control circuit 29, an exposure time control circuit 30, and each circuit of the processor 3. CPU31 etc. which control it automatically are comprised.

  A predetermined control signal is output from the CPU 31 to each part of the processor 3. Thereby, the CPU 31 controls each circuit constituting the processor 3.

  In addition, the CPU 31 outputs an image recording instruction signal that is a control signal for instructing an image recording operation to the peripheral device 5 such as a digital filing device or a photography device. Further, the CPU 31 outputs a filter switching instruction signal, which is a control signal for instructing the light source device 7 to perform the switching operation of the infrared / visible switching filter 9.

  The operation of the endoscope apparatus 1 of the present embodiment configured as described above will be described below.

  As shown in FIG. 1, light in a wavelength region including a visible region and a near infrared region is emitted from the lamp 8 of the light source device 7. The light emitted from the lamp 8 sequentially passes through the infrared / visible switching filter 9, the illumination light stop 13, and the RGB rotary filter 11 and enters the light guide fiber 14 of the scope 2.

  As shown in FIG. 2, FIG. 4A and FIG. 4B, the infrared / visible switching filter 9 transmits a visible light transmitting filter 35 for normal observation that transmits only visible light, and transmits light in the near infrared region used for infrared observation. And two filters, an infrared light transmitting filter 36. When either one of the visible light transmitting filter 35 and the infrared light transmitting filter 36 is selected by operating the filter selector switch 16 disposed on the front panel of the light source device 7, the driving force of the motor 10 is driven. The infrared visible switching filter 9 is rotated. As a result, the filter inserted in the optical path is switched. Here, the visible light transmission filter 35 is formed so as to transmit light having a wavelength in the visible region. The infrared light transmission filter 36 is formed so as to transmit light having a wavelength in the near infrared region.

  The illumination light diaphragm 13 limits the amount of light emitted from the light source device 7 in accordance with the dimming signal output from the dimming circuit 29 of the processor 3, and saturation occurs in the image captured by the image sensor 15. It is provided in order not to exist.

  As shown in FIG. 4, the RGB rotary filter 11 includes three filters, an R filter 37, a G filter 38, and a B filter 39 that limit the wavelength band of light to be transmitted. The motor 12 is rotationally driven by a timing signal generated by a synchronization signal generator sent from the processor 3. Thereby, light of different wavelength bands is sequentially transmitted.

  As shown in FIGS. 4C, 4D, and 4E, the R filter 37, the G filter, and the B filter respectively transmit red, green, and blue light beams at wavelengths in the visible region. In other words, when the visible light transmission filter 35 is inserted in the optical path, the RGB rotation filter 11 sequentially transmits red, green, and blue light.

  The R filter 37, the G filter 38, and the B filter 39 transmit not only light having a wavelength in the visible region but also light having a wavelength in the near infrared region, as shown in FIG. Therefore, when the infrared light transmission filter 36 is inserted in the optical path, a light beam having a predetermined wavelength is transmitted instead of red, green, and blue. In this case, for example, the R filter 37r transmits red light and a wavelength of 805 nm ± 15 nm on the near infrared side, and the G filter 37 transmits green light and a wavelength of 805 nm ± 15 nm in the near infrared region, and the B filter. 37 transmits blue light and light in a wavelength band of 930 nm ± 20 nm, respectively.

  That is, when the visible light transmission filter 35 for normal observation of the infrared / visible switching filter 9 is selected as shown in FIGS. 4C, 4D, and 4E, the wavelength region indicated by the symbol A is the light guide of the scope 2. The light enters the fiber 14. In addition, when the infrared light transmission filter 36 for infrared observation is selected, the wavelength region indicated by symbol B is incident on the light guide fiber 14 of the scope 2.

  The light beam incident on the light guide fiber 14 is emitted from the distal end of the scope 2 and is irradiated toward a subject such as the digestive tract. The imaging element 15 provided at the distal end portion of the scope 2 receives light scattered and reflected by the subject. The image sensor 15 is driven and controlled in synchronization with the rotation of the RGB rotary filter 11. As a result, image signals corresponding to the irradiation lights of the R filter 37, the G filter 38, and the B filter 39 are sequentially output to the processor 3.

  Note that the image pickup device 15 incorporates a so-called electronic shutter (not shown) as means for adjusting the charge accumulation time. This electronic shutter adjusts the exposure time of an image obtained by adjusting the time from charge sweep-out to readout.

  The image signal input to the processor 3 is subjected to predetermined signal processing such as conversion from an analog signal to a digital signal in the preprocess circuit 20, and then the three simultaneous memories 24 r, 24 g, 24b is selectively stored.

  The image signals stored in each of the synchronization memories 24r, 24g, and 24b are read at the same time so that the R filter 37, the G filter 38, and the B filter 39 are sequentially inserted into the optical path (so-called frame sequential image). Signal) is synchronized.

  An output signal from the preprocess circuit 20 is input to the dimming circuit 29. The dimming circuit 29 creates a dimming signal for keeping the brightness of an image obtained according to the magnitude of the input image signal approximately constant. This dimming signal adjusts the amount of light emitted from the light source device 7 by controlling the illumination light stop 13 of the light source device 7. The light control circuit 29 is controlled by a predetermined control signal from the CPU 31.

  Further, an output signal from the preprocess circuit 20 is input to the exposure time control circuit 30. The exposure time control circuit 30 generates an electronic shutter control signal for controlling the exposure time of the electronic shutter of the image sensor 15 in order to keep the brightness of the image obtained according to the magnitude of the input image signal approximately constant. Output.

  That is, the exposure time control circuit 30 controls the exposure time by a predetermined control signal from the CPU 31 so that the exposure time is maximized.

  As described above, the image signals output from the synchronization memories 24r, 24g, and 24b are subjected to image processing and color tone adjustment processing by the image processing circuit 25 and the color tone adjustment circuit 26. Thereafter, the R, G, and B signals are converted into analog signals by the three D / A conversion circuits 27r, 27g, and 27b and output to the monitor 4. An image of the subject is displayed on the monitor 4. The peripheral device 5 outputs an image signal that has been encoded by the encoding circuit 28. For example, the image signal recording process or the like is performed in each device in accordance with an image recording instruction signal from the CPU 31, for example. Is made.

  In this embodiment, a wavelength of 805 nm is displayed as an R component (red component) and a G component (green component) and a wavelength of 930 nm is displayed as a B component (blue component) on the monitor 4 at the time of infrared light observation. . The graph shown in FIG. 6 shows the transmission characteristics of ICG. In the graph shown in FIG. 6, the horizontal axis represents wavelength and the vertical axis represents transmittance. Here, the wavelength at which the transmittance is low indicates that the absorption of light by ICG is large. With ICG alone, the wavelength with the largest absorption (lowest transmittance) is slightly shorter than 800 nm. However, ICG administered in vivo rapidly binds to serum proteins and is optically stabilized, and has a characteristic that the maximum absorption wavelength immediately shifts from the wavelength of 785 nm of the aqueous solution to the wavelength of 805 nm. Therefore, FIG. 6 shows that blood ICG has the lowest transmittance at a wavelength of 805 nm. Therefore, the R component (red component) and G component (green component) during infrared light observation are efficiently absorbed by the ICG, and the reflection component having a wavelength of 805 nm is extremely small. On the other hand, at a wavelength near 930 nm to which the B component (blue component) is assigned, light absorption by ICG is small as shown in FIG.

  Accordingly, if ICG is intravenously injected into the subject, an image with a wavelength of 805 nm becomes a high-contrast image because the blood vessel portion becomes dark due to light being absorbed by the ICG. On the other hand, an image with a wavelength of 930 nm is an image with low contrast because the blood vessel portion does not become so dark because the absorption of light by ICG is small.

  As described above, the wavelength 805 nm is assigned to the G component and the R component of the monitor 4, and the wavelength 930 nm is assigned to the B component of the monitor 4. From this, on the monitor 4, an image in which the blood vessel portion is stained blue as a result of absorption by ICG is observed.

  Furthermore, intravenously administered ICG is selectively taken into the liver from the blood, and excreted in the bile in a free form from the liver without excretion from the enterohepatic circulation or kidneys. The concentration decreases.

  FIG. 7 shows the relationship between ICG administration time and blood concentration. As shown in FIG. 7, the blood concentration decreases exponentially. For this reason, it is considered that blue (drawing color of the blood vessel portion) drawn on the image becomes thinner in correlation with the time delay until drawing. In FIG. 7, for example, blood concentration (mg / dl) when 0.5 mg / kg ICG per body weight is administered is shown.

  On the other hand, when observing the lung with a thoracoscope, it is as follows.

  FIG. 8 is an enlarged schematic view of a main part showing a part of lung tissue in an enlarged manner, and conceptually shows a part of normal lung and a part causing emphysematous change.

  Normally, the normal lung 61 has a high tissue density and abundant blood flow on the lung surface. On the other hand, since blood flow is sparse in the areas where emphysematous changes have occurred (called emphysema lungs) 62a and 62b, and there is no blood flow in emphysema (Bulla) 62a and 62b, it is combined with ICG. When the blood flow is visualized by the above, the color of ICG is not drawn in the part of emphysema lung 62 that causes pneumothorax. In this case, since infrared light used as observation light has high tissue permeability as shown in FIG. 9, blood flow deeper than the lung surface can be visualized as compared with conventional observation using visible light. That is, as shown in FIG. 9, infrared light (IR) has higher tissue permeability than visible wavelengths (B, G, R), and light reaches deeper than visible wavelengths.

  For this reason, if infrared light (IR) is used, minute emphysema hidden below the lung surface that could not be visualized with normal light (visible light; visible wavelengths R, G, B). (Bulla) Up to 62b (see FIG. 8) can be rendered as an image.

  In FIG. 8, reference numeral 63 indicates an artery, reference numeral 64 indicates a vein, reference numeral 65 indicates a pleura, reference numeral 66 indicates an alveoli, and reference numeral 67 indicates a capillary plexus.

  In addition, according to the results of basic research so far, it is pathological that ICG is rendered with a delay of about ten to several tens of seconds in areas with emphysematous changes compared to normal areas. It is clear that it can also be illuminated.

  FIG. 10 shows an pulmonary emphysema model artificially created by injecting an enzyme called PPE (Porcine Pancreatic Elastase) into a dog and a lung tissue image of a normal site. Among these, (A) shows a normal tissue image. (B) shows lung tissue images after the lapse of 0 days after PPE injection, (C) shows lung tissue images after 18 days after PPE injection, and (D) shows lung tissue images after 33 days after PPE injection. Respectively. Note that (A) is an image with a magnification of 40 times, and (B), (C), and (D) are images with a magnification of 100 times.

  After intravenous injection of ICG to this lung tissue, tissue images (B), (C), (D) of the area where the ICG was depicted under a two-wavelength infrared light observation with a delay of about 15 seconds In comparison with the normal tissue (A), it is clear that a histological image of emphysema accompanied by destruction of alveolar structure is observed.

  Furthermore, since dust deposition is observed with age, lungs are affected by dust by assigning pseudo colors to blood flow information using infrared light of multiple wavelengths in intrathoracic observation. The emphysema site can be depicted more clearly. In the case of a single wavelength, since it is a monochrome image, there is a tendency that it is difficult to distinguish between dust particles and the density of normal lung and emphysema lung.

  FIG. 11 is a graph showing the relationship between the elapsed time after intravenous injection of ICG and the ICG concentration in the blood flow under the pulmonary pleura. In FIG. 11, the five curves are, in order from the top of the mountain, representative normal lung (solid line), lungs at the boundary between normal lung and emphysema lung (dashed line), and representative emphysema lung. The example (solid line) is shown, and the ICG dye maximum values (N1, B1, E1, E2, E3) at which the drawing of ICG at each site is the maximum density are shown.

  It is shown that the longer the time until the rendering of ICG, the more the emphysema progressed, and the longer the time required for rendering. This shows that the maximum dye amount tends to decrease.

  Therefore, it is possible to discriminate emphysema lungs from normal lungs based on the color density of the lung surface and the time of density change in infrared light observation.

  Next, the operation of the image processing circuit 25 will be described below with reference to the block diagram of FIG.

  The image signals (RGB signals) output from the synchronization memories 24r, 24g, and 24b are taken into the frame memory 25c that stores the color with the maximum dye amount by the first selector 25a in the first frame for image processing.

  Here, the first frame designation (start of image processing) may be performed by pressing the release switch (SW) 17 of the operation unit of the scope 2 in FIG. 1 simultaneously with the ICG injection. Alternatively, it may be performed automatically when the ICG is drawn on the screen.

  Next, the dye amount at each position of the next frame is calculated by the first dye amount calculating circuit 25d, and the dye amount at each position of the frame stored in the frame memory 25c by the second dye amount calculating circuit 25e. Is calculated. Then, both are compared by the comparison circuit 25f, and the color information (RGB) stored in the frame memory is updated at the position where the density is changed in the increasing direction. Also, the color information is not updated when the density changes in a decreasing direction.

  Thereafter, color information is compared and color information is updated at each point of the frame memory in the same procedure. As a result, the image having the most pigment during the image processing time is finally output from the output A. At the same time, the RGB signal is directly output to the color tone adjustment circuit 26 as the output C shown in FIG.

  As described above, the relationship between the ICG administration time and the blood concentration tends to decrease exponentially as shown in FIG. Therefore, when there is a time delay until rendering, it is considered that the amount of ICG dye decreases with a correlation with the time delay.

  Therefore, by performing the processing by the image processing circuit 25 described above, the maximum ICG concentration in the bloodstream of the part (the color information at the peak point in FIG. 11), regardless of the elapsed time after the ICG intravenous injection shown in FIG. ) Will be displayed.

  FIG. 13 shows a display example on the display screen of the monitor 4 at this time. As shown in FIG. 13, since the ICG pigment amount (color density) is displayed as a thoracoscopic image, the emphysematous change is quantified, and the ratio of the blue component allocated to a certain threshold (for example, a wavelength of 930 nm) is determined. (50%) can also be binarized.

  The threshold value may be set in advance. Further, as will be described later, as shown in FIG. 14, a desired area on the screen is designated, and a threshold value generation circuit (not shown) based on the average dye amount of the designated area or the deviation width based on the average dye quantity. ) May be used for setting.

  The desired area is designated by the user designating desired coordinates in the screen using a keyboard (not shown) or a pointing device (not shown) such as a mouse. A plurality of areas to be specified may be specified.

  Further, as shown in FIG. 14, the processed image (Digitalized Image) H may be displayed side by side on the same screen as the actual image (Normal Image) G of the thoracoscope. In the example illustrated in FIG. 14, the processing image H is explicitly marked with the designated area J designated by the user as described above. Further, a diagram representing the threshold value is displayed in the vicinity of the processed image H.

  In addition, a different monitor for image reference may be prepared separately, and the processed image may be displayed on this separate monitor.

Here, the equation for obtaining the ICG dye amount (IICG) is as follows: Rin, Gin, Bin are the magnitudes of the signals R, G, B input to the dye amount calculation circuit (25d, 25e).
IICG = Log (Bin / Rin)
It is represented by

  On the other hand, emphysematous changes can be evaluated only by time delay. In this case, the following configuration and procedure may be performed.

  That is, in addition to the procedure for calculating the maximum dye amount described with reference to FIG. 12 described above, the RGB signal to be compared with the information in the frame memory 25c is the color generation circuit 25g only when the density change is increased in the comparison circuit 25f. Assign the color and superimpose the thoracoscopic image.

  That is, the image signals (RGB signals) output from the above-described synchronization memories 24r, 24g, and 24b are compared for the amount of dye for each point of the frame in the procedure for calculating the maximum amount of dye, and the result is the second selector. Also input to 25b.

  On the other hand, a color generation circuit 25g that uniformly generates a pseudo color is input according to the time (number of sheets) from the first frame in which image processing is performed on the reference RGB signal. In the first frame designation (start of image processing), the information output from the color generation circuit 25g is directly taken into the memory 25h that stores pseudo colors by the second selector 25b.

  Thereafter, in response to the comparison result of the dye amount input to the second selector 525b, the pseudo color information (RGB signal) generated by the color generation circuit is stored in the memory 25h only at the portion where the calculated density is high. (Updated). If the calculated density changes in the direction of decreasing, the color information is not updated.

  Thereafter, the same processing is performed, and the distribution of time until the maximum dye amount is finally detected is displayed.

  The RGB signal stored in the memory 25h and the signal from the output C directly output are superimposed as a time distribution.

  For example, as shown in FIG. 15, an image as shown in the figure can be obtained by assigning the red color as the time until the maximum amount of dye is detected increases. Thereby, it can be easily determined that the greater the red component, the greater the emphysematous change. Furthermore, from the correlation between the delay time and emphysema lung, for example, by setting a threshold value with a delay time from a normal site (for example, about 10 seconds to 60 seconds), binarization display can be performed. Specifically, for example, in FIG. 15, the threshold value is a part D displayed by a broken line, and the part of the part D surrounded by the broken line and the other part are displayed in different colors.

  Further, it is possible to display a distribution of the total time when the calculated dye amount shows a predetermined concentration or more, or to display a binarized value by providing a threshold value for a predetermined time, for example, 30 seconds. . An example of display in this case is shown in FIG. 15. In this case, since the part having a long total time is a normal part, only the point where the blue side part is normal is different from the display of the delay time.

  As described above, the longer the total time in which the ICG is depicted, the closer to the normal lung (see FIG. 11). From this, it is also possible to assign a color at the rendering time and display as shown in FIG. In this case, the threshold value is set by comparison with the time of the longest rendered region as a reference.

  When performing the above-described image processing analysis, it is necessary to fix the field of view of the scope 2 or to track the feature points in the image and specify the observation position. In the case of the former, as shown in FIG. 16, an imaging means such as a scope is fixed by, for example, a holder fixed to the surgical bed.

  In the case of Open Surgery, a surgical light or the like may be fixed at a position where the entire surgical field can be observed. However, the observation light has only two wavelengths.

  Moreover, simply, an image at the time when a portion where the ICG concentration shows a peak (a portion considered to be the portion where the blood flow is most abundant in the normal portion) is captured, and the amount of dye in each portion of the image is determined. Binarization display can also be performed using a threshold set in the same procedure as described above.

  In addition, the area that is clearly known to be normal is designated as an area, and the average amount of dye in the whole screen (one frame of the image) when the average value of the amount of dye in the normal part shows the apex. The image at the time when indicates a vertex can also be used in the same manner.

  Furthermore, a set time such as 15 seconds may be set in advance.

  Alternatively, the evaluation may be performed after α seconds (specifically, about ten or more seconds) after the ICG is first drawn.

  Note that, as described above, FIG. 5 is a flow chart collectively showing the setting procedure of the image analysis method by the infrared endoscope system of the present embodiment. The processed image created after these image analysis processes are displayed on the display screen of the monitor 4 in a predetermined display form. At this time, predetermined image data processing is performed and binarized display is performed.

  Furthermore, based on these images, a process of enhancing the shade of blue may be performed, and an image of the processing result may be displayed. In this case, the enhancement coefficient α based on the difference between the calculated average dye amount and the dye amount is calculated for each pixel.

α = IICG-Ave (IICG)
Here, Ave (IICG) is an average value for one frame of the image (entire frame or selection range), and the output signals Rout, Gout, and Bout are:
Rout = Rin × exp (h × kR × α)
Gout = Gin × exp (h × kR × α)
Bout = Bin × exp (h × kR × α)
It can be expressed as Here, kR, kG, and kB are coefficients determined by the absorption rate for each color of the target dye. H is a coefficient (determined by the dye enhancement level set by the CPU) representing the degree of enhancement.

  According to this, since the enhancement processing is performed using the enhancement coefficient that is the difference between the amount of pigment and the average amount of pigment, even an image showing a biased color distribution can be effectively enhanced.

  Here, a specific method of using thoracoscopic surgery using the above-described infrared endoscope system for emphysema will be described below.

  First, (1) The patient is placed under one-sided ventilation under general anesthesia and the patient is placed in a lateral position with the affected side up.

  Next, (2) the power source of the light source device 7 and the processor 3 of the endoscope apparatus 1 (see FIG. 1) and other peripheral devices are turned on (turned on).

  (3) After a lamp switch (not shown) of the light source device 7 is turned on, white balance is obtained in the normal observation mode (visible light observation mode).

  (4) Set the image analysis processing (see Fig. 5). At this time, the analysis area is designated as necessary.

  (5) Similar to general thoracoscopic surgery, a necessary number of incisions for connecting the outside of the body and the inside of the chest cavity are provided, and a trocar, that is, a guide tube having a diameter of about φ5 mm to φ10 mm is placed between the chest wall ribs.

  (6) Insert the scope into the chest cavity. Then, the inside of the thoracic cavity is observed in the normal observation mode (visible light observation mode). This confirms the position of the emphysema (Bulla) and the observation area.

  (7) Pull out the scope (treatment tool) as needed. Then, air is sent to the affected lung, which has been degassed, with an appropriate pressure via a tracheal tube. Thereby, the whole lung is expanded.

  (8) Thereafter, the internal pressure of the bronchus on the affected side is released to atmospheric pressure for a while, that is, it is in a deflated state. Thereafter, the thoracoscope is inserted again into the chest cavity. From this time point, the lung parenchyma is not touched until the process (10).

  In addition, since the non-aerated lung, that is, the atelectasis, has a high tissue density, blood vessels are densely present. When the lung parenchyma is touched during intrathoracic observation, there is a difference between the aerated state and the airless state compared to the untouched part. This can lead to inaccurate ICG density detection during infrared observation. Therefore, it is desirable that the entire lung on the affected side is expanded and then uniformly deaerated, that is, the bronchial pressure is released to atmospheric pressure.

  (9) Check the observation range with the observation device. Then, the observation range is fixed by switching to the infrared observation mode. In this case, for example, as shown in FIG. 16, a scope holder 72 that is connected and fixed to an operating table 70 on which a patient 100 is placed and that holds and fixes a part of a thoracoscope 71 that is an observation apparatus may be used. It may be held by a surgical assistant.

  (10) ICG is administered intravenously to the patient. Here, the calculation by the image processing circuit 25 is started.

  In this case, the dose of ICG is 0.5 to 5 mg / kg per patient body weight. Intravenous administration is performed as much as possible (within a few tens of seconds) through a previously placed intravenous line.

  (11) The image processing result is displayed on the display device (monitor 4) of the observation device.

  (12) While observing the processing results, perform marking using an appropriate instrument such as an electric knife or clip as necessary.

  For this marking treatment, for example, an energy treatment tool for a thoracoscope using high frequency, ultrasonic waves, heat or the like is used. In addition, for example, a needle thread, a clip, or the like may be used.

  Following this, the site is excised with an incision means, and then the incision site is sutured using a predetermined suturing means. The suturing means used in this case is preferably an automatic suturing machine, for example. However, if it is very small, it may be sewn by an energy treatment device such as a high-frequency electric knife, an ultrasonic coagulator, or a laser knife.

  (13) If necessary, repeat the above work steps (7) and later.

  (14) After the treatment of emphysema lesions is completed, perform a leak test, that is, after filling the thoracic cavity with physiological saline, perform intrabronchial pressure to check for leaks.

  In the present embodiment, the image processing circuit 25 is provided inside the processor 3 as shown in FIG. 1. However, the present invention is not limited to such a configuration. For example, the image processing circuit 25 is provided separately. It may be.

  In the above-described example, the indication for emphysema lesions is shown. However, as an indication for surgery using the same analysis method, other applications such as mesenteric artery embolism, myocardial infarction and angina can be considered.

  Next, a method of using the infrared endoscope system of this embodiment when observing the mesentery of mesenteric artery embolism with a laparoscope is as follows.

  Mesenteric artery occlusion that occurs after surgery or the like is a disease with a very poor prognosis that in many cases, a small thrombus is clogged in a thin mesenteric artery that is branched in many, thereby causing necrosis of the intestinal tract. The treatment or operation method is generally as follows.

  That is, under laparotomy, the thrombus position is determined by palpating the thrombus of the superior mesenteric artery, and after performing a thrombus removal operation for a thick artery having a diameter of about 5 mm branched from the abdominal aorta, the intestinal tract that has entered necrosis Perform excision.

  However, even if the mesenteric artery is looped around the periphery and clogged at one location, blood flow may enter from around it to avoid necrosis. Therefore, under the present circumstances, the degree of necrosis of the intestinal tract tissue is estimated from the color change of the serosa surface of the intestinal tract. Yes. However, it is very difficult to judge accurately because subjective evaluation is included in the judgment of the information. In this case, if the intestinal tract is cut too much to adversely affect the digestion and absorption function, conversely, if a portion that is irreversibly necrotized is left, a perforation may occur in the intestinal tract after the operation.

  In the above-mentioned infrared endoscope system, tissue blood flow distribution is visualized, image analysis is performed and quantified in the same manner as in the case of emphysema, and an analysis image is displayed on the display screen of the monitor 4, thereby providing an objective. In addition, the treatment region can be specified accurately and overcutting and uncutting can be prevented. In this case, observation is made mainly on the intestinal canine arteriovenous and the serosa side of the anterior intestinal wall where blood flows. Note that the observation is not limited to laparoscopic, but can be performed under laparotomy.

  A specific method of laparoscopic use of the above-mentioned infrared endoscope system for the mesentery of mesenteric artery embolism under laparoscope will be described below.

  First, (1) The patient is observed under general anesthesia with laparotomy or laparoscope.

  Next, (2) the power source of the light source device 7 and the processor 3 of the endoscope apparatus 1 (see FIG. 1) and other peripheral devices are turned on (turned on).

  (3) After a lamp switch (not shown) of the light source device 7 is turned on, white balance is obtained in the normal observation mode (visible light observation mode).

  (4) Set image analysis processing (see FIG. 5). At this time, the analysis area is designated as necessary.

  (5) In the case of laparoscopic surgery, a necessary number of incisions for connecting the outside of the body and the abdominal cavity are provided, and a trocar, that is, a guide tube having a diameter of about φ5 mm to φ10 mm is placed on the abdominal wall. After that, pneumothorax treatment is performed to secure the surgical field by sending carbon dioxide into the abdominal cavity.

  (6) Insert the scope and treatment tool into the abdominal cavity. Then, the intra-abdominal search is performed in the normal observation mode (visible light observation mode).

  (7) After switching the observation device to the infrared observation mode, ICG is administered into the patient's vein. Here, the calculation by the image processing circuit 25 is started.

  In addition, the dosage of ICG at this time shall be a dosage of 0.5 to 5 mg / kg per patient body weight. Intravenous administration is performed as much as possible (within a few tens of seconds) through a previously placed intravenous line.

  (8) Expand the mesentery with the treatment tool and observe the serosal surface of the anterior intestinal wall. Here, the range in which the ICG is drawn, the range in which the ICG is not drawn, and the range in which the ICG is drawn with a delay are confirmed. Then, a marking process is performed as necessary. The ischemic site is identified by this work process.

  (9) Furthermore, an artery flowing into the ischemic site is identified.

  (10) After switching from the infrared observation mode to the normal observation mode, the thrombectomy for the artery flowing into the ischemic site is performed. Thereafter, the ischemic site of the intestine is further excised.

  (11) If necessary, repeat the work steps from (5) above. This confirms that there is no ischemic site (evaluates the surgical effect).

  Next, the method for using the infrared endoscope system of the present embodiment when observing the coronary artery of myocardial infarction and angina with thoracoscope is as follows.

  Myocardial infarction and angina pectoris are a state of blood flow interruption or deficiency due to occlusion or stenosis of the coronary artery, which is the heart's nutritional blood vessel. The surgical procedure uses the aorta, internal thoracic artery, etc. and bypasses to the periphery of the blocked coronary artery. At that time, the site to be bypassed is determined based on the result of the angiographic examination before surgery and the degree of arteriosclerosis at that site. Further, after the bypass, the blood flow of the bypass is measured with an electromagnetic flow meter or a Doppler blood flow meter to check the resumption of blood flow.

  In determining the bypass site, when the conventional coronary artery state is independently determined by quantifying and grasping the blood flow volume of the tissue (heart) during the operation with the infrared endoscope system of the present embodiment and In comparison, the functional evaluation of the tissue is possible, and the bypass site can be determined more accurately.

  Furthermore, the improvement of the tissue blood flow after bypass can be quantitatively evaluated as an image during the operation, and the surgical results can be improved. Note that the observation is not limited to laparoscopic, but can also be performed under laparotomy.

  In performing the quantification, it is necessary to fix the visual field during the image processing time. However, when the observation target is the heart, there is an influence of pulsation, and therefore, as shown in FIG. 12, the data of the electrocardiograph 69 attached to the patient is taken into the CPU 31 of the processor 3 to store the maximum color of the dye. By controlling the timing of loading into the memory 25c, the influence of pulsation can be eliminated.

  A specific method for using myocardial infarction and angina pectoris with thoracoscopic assistance using the above-described infrared endoscope system is as follows.

  (1) Under general anesthesia, observe the patient with thoracotomy or thoracoscope.

  Next, (2) the power source of the light source device 7 and the processor 3 of the endoscope apparatus 1 (see FIG. 1) and other peripheral devices are turned on (turned on).

  (3) After a lamp switch (not shown) of the light source device 7 is turned on, white balance is obtained in the normal observation mode (visible light observation mode).

  (4) Set image analysis processing (see FIG. 5). At this time, the analysis area is designated as necessary.

  (5) In the case of thoracoscopic surgery, a necessary number of incisions for connecting the outside of the body and the inside of the chest cavity are provided, and a trocar, that is, a guide tube having a diameter of about φ5 mm to φ10 mm is placed on the chest wall.

  (6) Insert the scope and treatment instrument into the chest cavity. Then, observation in the thoracic cavity is performed in the normal observation mode (visible light observation mode).

  (7) After switching the observation device to the infrared observation mode, ICG is administered into the patient's vein. Here, the calculation by the image processing circuit 25 is started.

  In addition, the dosage of ICG at this time shall be a dosage of 0.5 to 5 mg / kg per patient body weight. Intravenous administration is performed as much as possible (within a few tens of seconds) through a previously placed intravenous line.

  (8) By observing the surface of the heart, marking a part where ICG is not depicted or a part where ICG is depicted late, that is, an ischemic part is performed. And a bypass part is determined compared with preoperative evaluation.

  (9) Wear a cardiopulmonary bypass and perform bypass. When performing under thoracoscopic observation, it is performed after switching from the infrared observation mode to the normal observation mode. If you do it under open chest, do it directly.

  (10) Remove the heart-lung machine and evaluate the improvement of the tissue blood flow at the ischemic site before the bypass blood flow resumption operation again by the procedure after the above (6).

  In addition, other diseases such as uneven distribution of blood flow may be used for neoplastic lesions such as liver tumors, lymphoid tumors, renal tumors, pancreatic tumors, and adrenal tumors.

  Tumors generally regenerate tumor blood vessels and are richer in blood flow than normal tissues. Therefore, by observing the abdominal cavity and thoracic cavity in real time with the infrared endoscope system of this embodiment, The spread of the tumor can be confirmed and important information is provided for the surgical operation.

  As described above, according to the above-described embodiment, light in the first wavelength band including the wavelength of 805 nm and light in the second wavelength band that does not include the wavelength of 805 nm and is longer than that are emitted. The color components to be displayed in the light source device and the first wavelength band image and the second wavelength band image of the subject irradiated with the light emitted from the light source device are respectively assigned to red, green, and blue. Then, ICG (infrared absorbing dye) is imaged with light of the second wavelength band and displayed with the assigned color components. As a result, it is possible to display and identify a deep blood flow (blood vessel running) that cannot be visualized with normal light (visible light) by displaying the presence of ICG by using any color component of red, green, or blue. Become.

  When ICG is administered intravenously in diseases where the blood flow in the organ differs from that in normal tissues, such as ischemic diseases, the region rich in blood flow absorbs light in the first wavelength band (805 nm) and has a longer wavelength than that. Since only the light in the second wavelength band on the side is reflected, the color assigned to the second wavelength band is rendered immediately after intravenous injection. On the other hand, in a region where blood flow is insufficient, light of the first and second wavelength bands is reflected until a certain amount of time passes after at least ICG is intravenously administered. It is drawn to.

  As described above, it is possible to obtain color information of an image, information on a time delay until rendering, and the like in real time during an operation, and it is possible to easily identify an ischemic site based on such information.

  For example, in healthy lungs with abundant blood flow and emphysema lungs that are essentially vacuole and have no blood flow, emphysema lungs have insufficient blood flow, so at least some time after intravenous administration of ICG. Until the time elapses, light in the first and second wavelength bands is reflected, and as a result, the light is rendered white in the meantime.

  Furthermore, the evaluation of the lesion is different for each user, such as a surgeon, because it is possible to quantitatively evaluate the macroscopic evaluation by processing the displayed image data and digitizing the color components. A highly reliable evaluation can be obtained. In particular, when there is a time delay before ICG is intravenously injected and rendered as a color assigned to a lesion, image analysis processing (calculation processing) is performed, for example, to reduce the degree of emphysematous change. It is easy to evaluate and judge objectively and accurately.

  The present invention has an object to obtain image information that cannot be obtained by direct viewing by using a wavelength in the near-infrared region and an image sensor such as a CCD. Therefore, it goes without saying that the subject of the present invention is not limited to endoscopic surgery.

  Furthermore, as applicable diseases, as described above, the present invention can be applied to all those having a difference in blood flow between a normal part and a lesion part such as an ischemic disease.

  Therefore, according to this, paying attention to blood flow on the organ surface and the like, the blood flow distribution is visualized as an image in real time, and by analyzing this image, the treatment target site can be objectively easily and accurately detected. It is possible to provide an infrared endoscope system (infrared observation system) for surgery that can make a judgment and confirm an appropriate treatment and therapeutic effect.

  In addition, it improves the problems in conventional endoscopic surgery and can acquire information that cannot be obtained by direct viewing by combining infrared light and imaging means, contributing to improved safety and results of surgery. An infrared endoscope system (infrared observation system) for surgery can be provided.

The block block diagram which shows the whole structure of the endoscope apparatus used for the infrared observation system (infrared endoscope system) of the 1st Embodiment of this invention. The figure which shows the structure of the infrared visible switching filter provided in the light source device in the endoscope apparatus of FIG. The figure which shows the structure of the RGB rotation filter provided in the light source device in the endoscope apparatus of FIG. The figure explaining the characteristic at the time of combining the infrared visible switching filter of FIG. 2, and the RGB rotation filter of FIG. The figure which shows the flow of the setting procedure of the image analysis process performed in the endoscope apparatus of FIG. The graph which shows the transmission characteristic by the wavelength of ICG. The graph which shows the relationship between the time passage after ICG administration, and the blood concentration. The principal part expansion schematic which expands and shows a part of lung tissue. The figure which shows typically the relationship between the wavelength of light and observation depth. Artificial pulmonary emphysema model and lung tissue image of normal part. The graph which shows the relationship between the elapsed time after intravenous injection of ICG, and the ICG density | concentration in the blood flow under pulmonary pleura. The block block diagram which shows the outline of the internal structure of the image processing circuit provided in the processor of the infrared observation system of FIG. The figure which shows an example of the image analysis display displayed as a result of the process by the image processing circuit of FIG. 12, and displayed the ICG pigment amount (color density) after intravenous injection of ICG as a thoracoscopic image. The figure which shows another example of the image analysis display displayed as a result of the process by the image processing circuit of FIG. The figure which shows the other example of the image analysis display displayed as a result of the process by the image processing circuit of FIG. 12, and shows the example of a display at the time of evaluating emphysematous change with a time delay. 1 shows an example of means for fixing an observation range in thoracoscopic surgery for emphysema and pneumothorax using the infrared observation system of FIG. 1, and a scope holder that holds and fixes a part of an observation device (thoracoscope) connected and fixed to an operating table. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscopic device 2 ... Scope 3 ... Processor 4 ... Monitor 5 ... Peripheral device 7 ... Light source device 9 ... Infrared visible switching filter 11 ... Rotation filter 14 ... Light guide fiber 15 ... ... Image sensor 16 ... Filter switch 19 ... Image processing setting switch 25 ... Image processing circuit 25a ... First selector 25b ... Second selector 25c ... Frame memory 25d ... First dye amount calculation circuit 25e ... ... second dye amount calculation circuit 25f ... comparison circuit 25g ... color generation circuit 25h ... memory 26 ... tone adjustment circuits 27r, 27g, 27b ... D / A conversion circuit 30 ... exposure time control circuit 35 ... Visible light transmission filter 36 ... Infrared light transmission filter 69 ... Electrocardiograph 71 ... Thoracoscope 72 ... Scope holder agent Patent attorney Susumu Ito

Claims (18)

A light source device that emits light in a first wavelength band including a wavelength of 805 nm and light in a second wavelength band that does not include a wavelength of 805 nm and that is longer than the wavelength band, and light emitted from the light source device An imaging apparatus that captures the image of the first wavelength band and the image of the second wavelength band of the irradiated subject, the image of the first wavelength band captured by the imaging apparatus, and the second wavelength In an infrared observation system including at least an observation device including a display device that displays an image of a band as a color component of either red, green, or blue, the infrared observation system is administered to a patient. Equipped with image analysis means to detect and quantify the amount of dye in the absorbing dye,
An infrared observation system, wherein the display device images and displays an analysis result by the image analysis means. 2. The image analysis unit according to claim 1, wherein the image analysis unit detects a time from when a dye amount of the infrared absorbing dye reaches a maximum density to a maximum concentration, and performs image analysis based on the detection result. Infrared observation system. The infrared display according to claim 2, wherein the display device displays a time distribution by applying a pseudo color every time from when the dye amount of the infrared absorbing dye reaches a maximum density. Observation system. 2. The infrared observation according to claim 1, wherein the image analysis unit detects a time from a drawing start time to a drawing end time of the infrared absorbing dye, and performs image analysis based on the detection result. system. 5. The infrared observation system according to claim 4, wherein the display device displays a time distribution with a pseudo color for each time from the start of rendering of the infrared absorbing dye to the end of rendering. The image analysis means performs image analysis for comparing the amount of dye between a normal region and a designated region based on still image data of a drawn state of the infrared absorbing pigment after a predetermined time has elapsed. The infrared observation system according to 1. The infrared observation according to claim 6, wherein the predetermined time for acquiring still image data in a rendered state of the infrared absorbing dye is a set value arbitrarily set by a predetermined input means. system. The infrared observation system according to claim 6, wherein the predetermined time for acquiring still image data in a rendered state of the infrared absorbing dye is a preset eigenvalue. The infrared observation system according to claim 1, wherein the image analysis unit detects the maximum dye amount of the infrared absorbing dye and performs image analysis based on the detection result. The image analysis means performs an image analysis for quantifying a color component based on still image data of a drawing state of the infrared absorbing dye after a lapse of a predetermined time from the drawing start time by the infrared absorbing dye. The infrared observation system according to claim 1. 11. The display device according to claim 2, wherein the display device can switch and display an image captured by the imaging device and an image generated as a result of image analysis processing by the image analysis means. The infrared observation system according to any one of the above. 3. The display device according to claim 2, wherein the display device displays an image captured by the imaging device and an image generated as a result of the image analysis processing by the image analysis unit side by side on the same screen. Item 15. The infrared observation system according to any one of Items 10 to 10. The infrared observation system according to any one of claims 1 to 12 is an infrared endoscope system. A light source device that emits light in a first wavelength band including a wavelength of 805 nm and light in a second wavelength band that does not include a wavelength of 805 nm and that is longer than the wavelength band, and light emitted from the light source device An imaging apparatus that captures the image of the first wavelength band and the image of the second wavelength band of the irradiated subject, the image of the first wavelength band captured by the imaging apparatus, and the second wavelength In a method for identifying a lesion by an infrared observation system comprising at least an observation device comprising a display means for displaying an image of a band as a color component of either red, green, or blue,
Administering an infrared absorbing dye to a patient;
Observing the imaging range of the infrared absorbing dye with the observation device;
A method for identifying a lesion using an infrared observation system, comprising an image analysis processing step for detecting and quantifying the amount of the infrared absorbing pigment. The method for identifying a lesioned part by an infrared observation system according to claim 14, further comprising the step of imaging the analysis result obtained by the image analysis processing step and displaying the result on the display device. The site | part observed with the said observation apparatus is in a thoracic cavity, The identification method of the lesioned part by the infrared observation system of Claim 14 characterized by the above-mentioned. The method for identifying a lesion site by an infrared observation system according to claim 14, further comprising a step of performing a treatment according to an analysis result obtained by the image analysis processing step. The lesion identification method using the infrared observation system according to any one of claims 14 to 17 is performed using an infrared endoscope system.