JP2006020716A - X-ray circulatory organ diagnostic system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an X-ray circulatory organ diagnostic system capable of improving the operability of an X-ray inspection, suppressing a patient from being exposed with X rays and efficiently and precisely calculate a cardiac ejection fraction. <P>SOLUTION: The X-ray circulatory organ diagnostic system 10 comprises: a photographing position storage means 31 for storing various photographing positions; a pixel size computation means 35 for computing a pixel size on the basis of image data D<SB>P1</SB>acquired by photographing a calibration object P1 according to the various photographing positions; a pixel size storage means 36 for storing the photographing position and the pixel size in correspondence; an image storage means 34 for storing respective frame images acquired by photographing a patient P2 according to the required photographing position; a frame image selection means 47 for selecting an ED frame image and an ES frame image of the left ventricle from the respective frame images; a pixel size extraction means 46 for extracting the pixel size corresponding to the required photographing position; a left ventricle volume value measurement means 48 for measuring EDV (end diastolic volume) and ESV (end systolic volume) from the ED frame image, the ES frame image and the pixel size; and a cardiac ejection fraction calculation means 49 for calculating the cardiac ejection fraction by using the EDV and the ESV. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an X-ray cardiovascular diagnosis system that analyzes a patient's cardiac function from X-ray image data acquired by imaging a patient's left ventricle.

  In cardiac catheter inspection using an X-ray cardiovascular diagnostic system, cardiac ejection rate measurement using a captured left ventricular contrast image is performed to quantitatively evaluate a patient's cardiac function. In cardiac ejection fraction measurement, the state of heart wall motion is ascertained and the blood volume per heartbeat is calculated to evaluate the function of the patient's heart and identify the lesion site. .

  In order to perform quantitative evaluation of cardiac function using an X-ray image, it is first necessary to perform pixel (pixel) calibration processing on the contrast image. In the pixel calibration process, a pixel size (correlation between a pixel and an actual length) is calculated.

  Since the X-ray image is a transmission image, the pixel size differs depending on the spatial position of the contrast object. For example, the pixel size increases as the contrast object is closer to the detector. For this reason, it is important to execute a pixel calibration process suitable for the contrast object to be noticed in the image.

As a pixel calibration processing method, before and after the left ventricle imaging of a patient, a calibration object with a known length is imaged, and the length of the calibration object and the number of pixels on the screen required to express the length are calculated. ,
[Equation 1]
There is a method of calculating the pixel size by pixel size = calibration object length / number of pixels.

Further, the distance between the detector and the X-ray tube (SID: Source-Image Distance), the geometric magnification calculated from the distance between the contrast object and the detector, and the detector front surface (that is, the geometric magnification ratio is 1). From the pixel size of
[Equation 2]
Geometric magnification = SID / (SID−distance between contrast object and detector)
There is a method of calculating the pixel size by the pixel size at the time of pixel size = geometric magnification 1 / geometric magnification.

  Furthermore, from a series of left ventricular image data consisting of a plurality of frame images, an end diastolic (ED) frame image in which the left ventricle expands most and an end systole (ES in which the left ventricle contracts most) : End Systolic) ES frame image.

Next, the inner wall (edge) of the left ventricle is designated based on the contrast image of the left ventricle filled with the contrast agent in the ED frame image and the ES frame image. Based on the specified left ventricular wall location information, pixel size and various patient information (height, weight, heart rate, etc.), a general calculation model is used to calculate left ventricular volume and wall motion. An analysis result is calculated (see, for example, “Patent Document 1”).
Japanese Patent Laid-Open No. 9-238932

  However, pixel calibration processing is performed to perform quantitative evaluation of cardiac functions such as cardiac ejection fraction measurement, but imaging operations for calibration objects before and after left ventricular imaging, and pixel size calculation operations based on the calibration object images Was required, and this was an operator workload before and after left ventricular photography.

  In the cardiac ejection fraction measurement, the contrast agent cannot always accurately represent the intracardiac wall in the selection operation of the ED frame image and the ES frame image and the designation and correction operation of the edge on each frame image. It is difficult to automate. For this reason, the cardiac ejection fraction measurement tends to be a post-work after the inspection, and has become an operator workload.

  Prior to imaging of the patient's left ventricle, an imaging position such as an imaging angle and a top board is set by auto-positioning. However, in actuality, it is necessary to finely adjust the top plate in the horizontal direction after auto-positioning due to individual differences of the patient P placed on the top plate. Therefore, after auto-positioning is set, the patient's left ventricle is irradiated with fluoroscopic X-rays and the position is fine-adjusted while viewing the fluoroscopic image displayed on the monitor. It was inevitable.

  Further, in calculating the ejection fraction, the operator manually selects an ED frame image and an ES frame image from a plurality of ED frame image candidates and ES frame image candidates displayed on the monitor screen based on the ECG waveform data. Was selected. Therefore, the selected ED frame image and ES frame image vary depending on the operator, and the workload of the selection operation for the operator is large.

  In addition, if the difference in imaging time between the selected ED frame image and the ES frame image is relatively large, it will be affected by subtle changes in the patient on the top and the flow of the contrast image. There was a problem with the calculation accuracy of ejection fraction.

  The present invention has been made in consideration of the above-described circumstances, and can eliminate the pixel calibration operation that requires a large workload for the operator when measuring the cardiac ejection fraction, and can improve the workability of the X-ray inspection. An object is to provide a cardiovascular diagnostic system.

  A second object of the present invention is to provide an X-ray cardiovascular diagnosis system that can suppress X-ray exposure to a patient during fine adjustment operation of the top board.

  Furthermore, a third object of the present invention is to provide an X-ray circulatory diagnosis system capable of calculating a cardiac ejection fraction efficiently and accurately.

  In order to solve the above-described problem, an X-ray circulatory organ diagnosis system according to the present invention performs imaging of a left ventricle including at least the left ventricle of a patient's heart to generate a video signal, and this imaging measurement Image data consisting of each frame image from the video signal of the unit, a processor unit for analyzing the cardiac function of the patient based on the image data, a monitor for displaying the frame image and the result of the analysis, In an X-ray circulatory diagnosis system having an operation input unit capable of performing operation input on a monitor screen, imaging position storage means for storing various imaging positions of the imaging measurement unit, and stored in the imaging position storage means The calibration object is photographed according to various photographing positions to acquire image data, and pixel calibration processing is performed based on the image data to perform the above various Pixel size calculation means for calculating a pixel size for each shooting position, pixel size storage means for storing the various shooting positions and the pixel size in association with each other, and various shooting positions stored in the shooting position storage means Image storage means for storing image data consisting of each frame image acquired by imaging the patient according to a required imaging position, and from each frame image stored in the image storage means, from the end diastole of the left ventricle A frame image selection means for selecting a frame image and an end systole frame image; a pixel size extraction means for extracting a pixel size corresponding to the required photographing position from the pixel size storage means; and the frame image selection means. End-diastolic frame image and end-systolic frame Left ventricular volume value measuring means for measuring an end-diastolic volume value and an end-systolic volume value, and a left ventricular volume value measuring means from the image and the pixel size extracted by the pixel size extracting means. And a cardiac ejection fraction calculating means for calculating the cardiac ejection fraction using the end diastolic volume value and the end systolic volume value.

  An X-ray circulatory system diagnosis system according to the present invention includes an imaging measurement unit that performs imaging of a left ventricle including at least the left ventricle of a patient's heart to generate a video signal, and each frame from the video signal of the imaging measurement unit. A processor unit that acquires image data including images and analyzes the cardiac function of the patient based on the image data, a monitor that displays each frame image and the analysis result, and an operation input on the screen of the monitor An X-ray circulatory diagnostic system comprising an operation input unit capable of performing imaging calibration according to the various imaging positions stored in the imaging position storage unit, and imaging position storage means for storing various imaging positions of the imaging measurement unit An object is photographed to obtain image data, and a graphic image of the calibration object is created for each of the various photographing positions based on the image data. The patient is photographed according to the required photographing position among the graphic image creating means, the graphic storage means for storing the various photographing positions and graphic images in association with each other, and the various photographing positions stored in the photographing position storage means. Image storage means for storing image data composed of each frame image acquired in this manner, and a monitor for displaying a graphic image of the calibration object corresponding to the required photographing position.

  Furthermore, an X-ray cardiovascular diagnostic system according to the present invention includes a radiographing measurement unit that performs left ventricular radiography including at least the left ventricle of a patient's heart to generate a video signal, and each frame from the video signal of the radiographing measurement unit. A processor unit that acquires image data including images and analyzes the cardiac function of the patient based on the image data, a monitor that displays each frame image and the analysis result, and an operation input on the screen of the monitor In an X-ray circulatory system diagnosis system including an operation input unit capable of performing imaging, an imaging position storage function for storing various imaging positions of the imaging measurement unit is stored in the processor unit, and a calibration object is imaged for each of the various imaging positions. Image data is acquired, and pixel calibration processing is performed on the basis of the image data to set the pixel size for each of the various shooting positions. A pixel size calculation function for calculating, a pixel size storage function for storing the various shooting positions in association with the pixel size, and a required shooting position among the various shooting positions stored by the shooting position storage function In accordance with the imaging measurement unit position setting function for setting the position of the imaging measurement unit according to the above, the patient is imaged by the imaging measurement unit at the required imaging position to obtain image data consisting of each frame image, and from each of these frame images An image storage function for storing the image data, an end-diastolic frame image selection function for selecting the end-diastolic frame image of the left ventricle from each frame image stored by the image storage function, and the image storage function The left ventricular end systolic frame image is selected from the frame images stored in End-systolic frame image selection function, pixel size extraction function for extracting the pixel size corresponding to the required photographing position from the pixel size stored by the pixel size storage function, the extended end-stage frame image selection function, and the contraction The left ventricle that measures the end-diastolic volume value and the end-systolic volume value from the end-diastolic frame image and end-systolic frame image selected by the end-frame image selection function and the pixel size extracted by the pixel size extraction function A program for realizing a volume value measuring function and a cardiac ejection fraction calculating function for calculating a cardiac ejection fraction using the end diastolic volume value and the end systolic volume value was recorded.

  In addition, an X-ray circulatory system diagnosis system according to the present invention includes an imaging measurement unit that performs left ventricular imaging including at least the left ventricle of a patient's heart to generate an image signal, and each of the imaging signals from the imaging measurement unit. A processor unit that acquires image data including frame images and analyzes the cardiac function of the patient based on the image data, a monitor that displays the frame images and the analysis results, and an operation on the screen of the monitor In an X-ray circulatory diagnosis system having an operation input unit capable of inputting, an imaging position storage function for storing various imaging positions of the imaging measurement unit in the processor unit, and a calibration object is imaged for each imaging position. A graphic image creating machine that obtains image data and creates a graphic image of the calibration object for each of the various photographing positions based on the image data. A graphic image storage function for storing the various photographing positions and graphic images in association with each other, and the position of the photographing measurement unit according to a required photographing position among the various photographing positions stored by the photographing position storage function. An imaging measurement unit position setting function for setting the image and an image in which the patient is imaged by the imaging measurement unit at the required imaging position to acquire image data composed of each frame image, and to store the image data composed of each frame image A program for realizing a storage function and a graphic image display function for displaying a graphic image of the calibration object corresponding to the required imaging position as an estimated position of the left ventricle of the patient was recorded.

  According to the X-ray circulatory system diagnosis system according to the present invention, it is possible to omit the pixel calibration operation that requires a large work load for the operator when measuring the cardiac ejection fraction, thereby improving the workability of the X-ray examination.

  Moreover, according to the X-ray circulatory organ diagnosis system according to the present invention, X-ray exposure to the patient during the fine adjustment operation of the top board can be suppressed.

  Furthermore, according to the X-ray cardiovascular diagnosis system of the present invention, the cardiac ejection fraction can be calculated efficiently and accurately.

  An embodiment of an X-ray cardiovascular diagnosis system according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a block diagram showing an embodiment of an X-ray cardiovascular diagnosis system according to the present invention.

  FIG. 1 shows an end-diastolic volume (EDV) at the end diastole (ED) of at least the left ventricle of the heart based on a plurality of frame images continuously obtained at regular intervals. X-ray circulatory device that measures end-systolic volume (ESV) at the end systolic (ES) and calculates the cardiac ejection fraction (EF) based on these EDV and ESV 1 shows a diagnostic system 10.

The X-ray circulatory diagnostics system 10 mainly includes an imaging measurement unit 11 for generating a video signal S _P by performing imaging of the subject P (the calibration object P1 or patient P2), the image of the imaging measurement unit 11 It acquires image data from the signal S _P, and a processor unit 12 for calculating a Kokoroka fraction is provided on the basis of the image data. The imaging measurement unit 11 is installed in an X-ray examination room where a patient actually enters and receives fluoroscopy and imaging, while the processor unit 12 is installed in an operation room. A proximity console may be installed in the X-ray examination room.

The imaging measurement unit 11 receives an X-ray tube 20 as a radiation source that emits X-rays toward the subject P, and transmitted X-rays transmitted through the subject _P, and outputs a video signal SP. An X-ray TV apparatus 21 as a system is provided. The X-ray TV apparatus 21 includes an I.V. which converts transmitted X-rays transmitted through the subject P into an optical image. I. (Image Intensifier) 22 and this I.I. I. An optical system 23 that corrects the optical image output from 22 to an appropriate size and an X-ray TV camera 24 that converts the optical image into a video signal are installed. In addition, I.I. I. The video system from 22 to the X-ray TV camera 24 may be replaced with a flat panel detector (FPD).

  I. I. 22 is composed of a large vacuum tube composed of an input fluorescent screen, a photocathode, a focusing electrode, an anode and an output fluorescent screen (not shown), an input window, a high voltage power source, and the like. In addition, I.I. I. An X-ray grid (not shown) that cuts X-ray scattered light transmitted through the subject P may be provided on the X-ray incident side of 22.

  The imaging measurement unit 11 includes a top plate 26 on which the subject P is placed, and a C arm drive mechanism 27 that supports a C arm (not shown) including the X-ray tube 20 and the X-ray TV device 21. Provided.

  FIG. 2 is an external view of the C-arm structure imaging measurement unit 11 included in the X-ray cardiovascular diagnosis system 10 as viewed from the head side.

  An imaging measurement unit 11 of the X-ray cardiovascular diagnosis system 10 shows a C-arm 30 supported by a C-arm drive mechanism 27, an X-ray tube 20 at one end of the C-arm 30 and an X-ray at the other end of the C-arm 30. Each of the line TV devices 21 is provided, and both of them are arranged to face each other with a top plate 26 on which the subject P is placed. The C-arm 30 is capable of C-arm rotational movement (CRA (Cranial view) / CAU (Caudal view)) and C-arm circular movement (RAO (Right Anterior Oblique view) / LAO (Left Anterior Oblique view)).

  The top plate 26 can freely move left and right (C-LAT: left and right in the figure), vertically move (C-VERT: up and down in the figure), and roll (ROLL).

  In the imaging measurement unit 11 shown in FIG. 2, the X-ray tube 20 is an under table positioned below the top plate 26, but is not limited to the under table. It may be an overtable where the tube 20 is positioned above the top plate 26.

  According to the imaging / measurement unit 11 having the C-arm structure shown in FIG. 2, a doctor or the like can directly touch the patient P2 using the open end of the C-arm 30 as a component thereof. While performing surgery or examination such as inserting a catheter into the body of P2, X-ray imaging related to angiography and the like can be performed simultaneously.

  Further, the processor unit 12 of the X-ray circulatory diagnosis system 10 shown in FIG. 1 includes, for example, a dedicated processor (CPU: Central Processing Unit) equipped with a microcomputer or the like. The processor unit 12 stores (installs) a program for realizing a left ventricular imaging preprocessing function and a left ventricular imaging function.

Further, the processor unit 12 has various shooting positions storing means 31 for storing various shooting positions of the shooting measuring section 11 and various shooting positions stored in the shooting position storing means 31 according to various shooting positions. an imaging system controller 32 for controlling the photographing position, the video signal S _P output X-ray TV apparatus 21 by the imaging of the subject P to an image (moving image) data D _P of the digital amount in each imaging position of the imaging measurement unit 11 an a / D converter 33 for converting, is provided an image storage unit 34 for storing the digitally converted image data D _P.

Furthermore, the processor unit 12, calculates various shooting position pixel size for each by the image data D _P1 on Calibration object P1 is the subject P by the calibration processing (correlation between the actual length of a pixel with the calibration object P1) Pixel size calculation means 35, pixel size storage means 36 for storing various photographing positions and pixel sizes in association with each other (photographing position) / (pixel size) correspondence table, and image data D _P1 related to the calibration object P1. Graphic image creating means 37 for creating a graphic image for each of various photographing positions, and graphic image storage means 38 for storing various photographing positions and graphic images in association with each other as a (photographing position) / (graphic image) correspondence table; Is provided.

In addition, the processor unit 12 receives an ECG (Electro Cardio Gram) waveform signal s from the electrocardiograph 40 placed on the patient P2 as the subject P as a digital quantity for each sampling period according to the imaging period. an a / D converter 41 for converting the ECG waveform data d, the ECG waveform storage means 42 for storing the digitally converted ECG waveform data d, temporal and ECG waveform of each frame image of the image data _{D P2} about the patient P2 Image processing means 43 for associating the time points of the sampling points of data d with each other and processed image storage means 44 for storing image data _DP2 and ECG waveform data d in association with each other are installed.

The processor unit 12 also includes a pixel size extraction unit 46 that extracts a pixel size corresponding to a required imaging position of the imaging measurement unit 11 in the left ventricular imaging of the patient P2 from the pixel size storage unit 36, and image data D related to the patient P2. A frame image selection means 47 for selecting an ED frame image and an ES frame image of the left ventricle for the patient P2 based on the _P1 and ECG waveform data d, and an ED frame image of the left ventricle selected by the frame image selection means 47 The left ventricular volume value measuring means 48 for measuring EDV and ESV from the ES frame image and the pixel size extracted by the pixel size extracting means 46, and the EDV and ESV measured by the left ventricular volume value measuring means 48 And a cardiac ejection ratio calculating means 49 for calculating the cardiac ejection ratio using the.

Furthermore, the processor unit 12, the image data _{D P2} etc. D / A converter 51 to analog conversion is provided about the graphic data and patient P2 on Calibration objects P1, the processor unit 12 outside, the D / A converter 51 Is provided with a monitor 52 for displaying a graphic image of the calibration object P1, an image of the patient P2, and the like from the data converted in analog. Furthermore, the processor unit 12 inputs a graphical element such as an icon, a button, and an arrow associated with an image display and processing instruction such as the number of frames of an image and image processing on the monitor 52 screen. A GUI (Graphical User Interface) that can be operated and input using a section (pointing device) 55 is implemented.

  Next, a preprocessing function for left ventricular imaging realized by a program recorded in the processor unit 12 of the X-ray cardiovascular diagnosis system 10 will be described with reference to the flowchart shown in FIG.

  In the X-ray circulatory system diagnosis system 10, as preprocessing for performing left ventricular imaging of the patient P2, various imaging positions of the imaging measurement unit 11 assumed to be set in left ventricular imaging are used as imaging position storage means. 31 (step S1).

  As the imaging position of the imaging measurement unit 11, for example, CRA / CAU and RAO / LAO which are arm angles of the C arm 30, the position of the top plate 26, and the X-ray tube 20 to the I.D. I. There are 22 distance image enlargement factors.

The photographing measurement unit 11 is controlled in accordance with various photographing positions of the photographing measurement unit 11 stored in the photographing position storage unit 31, and a calibration object (steel ball) P1 having a known length is photographed. After the image data D _P1 on Calibration object P1 is digitally converted by the A / D converter 33 is stored in the image storage unit 34 for each different imaging position.

Image data D _P1 related to the calibration object P1 stored in the image storage means 34 is read into the pixel size calculation means 35. In this pixel size calculation means 35, pixel (pixel) calibration processing is performed based on the image data _DP1, and the pixel size on the screen is calculated for each of various shooting positions (step S2).

The pixel size is calculated from the length of the calibration object P1 whose length is known and the number of pixels on the screen required to express the length.
[Equation 3]
Pixel size = calculated by the length of the calibration object P1 / the number of pixels.

  The pixel size calculated by the above formula is stored in the pixel size storage means 36 as a (photographing position) / (pixel size) correspondence table corresponding to various photographing positions (step S3).

In addition, the image data D _P1 related to the calibration object P1 stored in the image storage unit 34 is read into the graphic image creating unit 37. In this graphic image creating means 37, an image related to the calibration object P1 is converted into a graphic based on the image data D _P1 and a graphic image is created for each of various photographing positions (step S4). This graphic image is an image of the calibration object P1 simulated by a figure such as a circle. The created graphic image is stored in the graphic image storage means 38 as a (photographing position) / (graphic image) correspondence table corresponding to various photographing positions (step S5).

  Next, a left ventricular imaging function realized by a program recorded in the processor unit 12 of the X-ray cardiovascular diagnosis system 10 will be described with reference to the flowchart shown in FIG.

  In the X-ray cardiovascular diagnosis system 10, a required imaging position is selected from various imaging positions stored in the imaging position storage unit 31 when the left ventricle imaging of the patient P <b> 2 is performed. In accordance with the required shooting position data, the shooting measuring unit 11 is automatically moved to the required shooting position by the auto-positioning function, and the shooting measuring unit 11 is set (step S11). For example, in the auto-positioning function, the imaging position of the imaging measurement unit 11 is associated with “number” and stored in the imaging position storage unit 31, and the operation input unit 55 is used when imaging the left ventricle of the patient P 2. The shooting position can be reproduced simply by specifying the number and a simple trigger switch operation.

  In the set of the imaging measurement unit 11 by the auto-positioning function, the target position to be displayed on the screen, for example, the center position of the screen, depending on the position of the patient P2 on the top plate 26 and the position of the left ventricle itself (individual difference of the patient P2) There may be a difference between the actual position of the left ventricle actually displayed on the screen. In that case, the top plate 26 is finely adjusted manually by the operator in the horizontal direction (left and right direction in FIG. 2) as required (step S12).

  Further, the fine adjustment operation in the horizontal direction of the top plate 26 in step S12 is performed as follows. That is, the graphic image of the calibration object P1 corresponding to the required imaging position set in step S11 is referred to the various (imaging position) / (graphic image) correspondence tables stored in step S5, and the left of the patient P2 A graphic image of the calibration object P1 corresponding to the required imaging position during ventricular imaging is provided. The position of the graphic image of the calibration object P1 is taken as the estimated position of the left ventricle. The estimated position is displayed on the monitor 52, and the target position is displayed on the monitor 52 as a graphic image expressed as a graphic such as a circle. The operator uses the GUI so that the estimated position approaches the target position. The top plate 26 is moved in the horizontal direction.

  When the operator moves the position of the top plate 26, the graphic image of the calibration object P1 corresponding to the moved position (imaging position) of the top plate 26 is displayed again on the monitor 52 as the estimated position of the left ventricle. The operator uses the GUI to move the top plate 26 in the horizontal direction so that the estimated position approaches the target position. The operator repeats the operation of moving the position of the top plate 26 as necessary to finely adjust the position of the top plate 26.

  Further, the fine adjustment operation in the horizontal direction of the top plate 26 in step S12 may be performed as follows. That is, the graphic image of the calibration object P1 corresponding to the required imaging position set in step S11 is referred to the various (imaging position) / (graphic image) correspondence tables stored in step S5, and the left of the patient P2 A graphic image of the calibration object P1 corresponding to the required imaging position during ventricular imaging is provided. The position of the graphic image of the calibration object P1 is taken as the estimated position of the left ventricle. The estimated position is displayed on the monitor 52, and a direction in which the estimated position is to be moved is instructed on the screen of the monitor 52 by a GUI such as an arrow so that the estimated position approaches the target position. The operator finely adjusts the position of the top plate 26 by moving the top plate 26 in the horizontal direction while looking at the arrows displayed on the screen of the monitor 52.

  Therefore, the top plate 26 can be moved in the horizontal direction without exposing the patient P2 with fluoroscopic X-rays, and the fine adjustment operation of the position of the top plate 26 can be performed. Can support adjustment operations.

  Note that the distribution of image density values in a region of interest (ROI) specified in advance may be used for specifying the position of the left ventricle in the fine adjustment operation in the horizontal direction of the top plate 26 in step S12. . For example, in the case of an unsubtraction image at the required imaging position of the imaging measurement unit 11, the contrast density is injected into the left ventricle of the patient P2, so the image density value becomes low. The actual position of the left ventricle is specified by the level of the image density value.

Subsequently, at the required imaging position of the imaging measurement unit 11 set in step S11 or S12, the X-ray tube 20, I.D. I. 22, the optical system 23 and the X-ray TV camera 24 are controlled, and X-rays are exposed to the left ventricle of the patient P2. The video signal S _P2 generated by the photographing measurement unit 11 is converted into image data D _P2 as a digital quantity for each frame image by the A / D conversion unit 33 and stored in the image storage unit 34 ( At the same time as step S13), the ECG waveform signal s from the electrocardiograph 40 of the imaging measurement unit 11 is converted into a digital quantity at every sampling period preset by the A / D conversion unit 41 according to the X-ray imaging period. Is converted to ECG waveform data d and stored in the ECG waveform storage means 42.

The image data _{D P2} and ECG waveform data d is stored in the processed image storage means 44 through the image processing unit 43. In the image processing unit 43, a time phase of the sampling points of the time phase and ECG waveform data d of each frame image of the image data D _P2 is associated with each other.

  Next, in order to quantitatively grasp the motor function of the heart, the pixel size extraction unit 46 stores the pixel size corresponding to the required imaging position set in step S11 or S12 in the pixel size storage unit 36 ( The pixel size corresponding to the required imaging position at the time of left ventricular imaging of the patient P2 is extracted by referring to the imaging position) / (pixel size) correspondence table (step S14).

The frame image selection means 47 selects an ED frame image of the left ventricle from each frame image based on the image data _DP1 and the ECG waveform data d (step S15), and the left ventricle from each frame image. ES frame images are selected (step S16). In the left ventricular volume measuring means 48, the EDV and ESV are generally calculated from the pixel size extracted in step S14 and the ED frame image and ES frame image selected in steps S15 and S16, respectively. (Step S17).

  Here, the selection of the ED frame image in step S15 is performed based on the R wave included in the ECG waveform by, for example, moving picture frame advance operation and electrocardiogram synchronous reproduction. First, a plurality of ED frame image candidates based on the R wave are displayed in a selectable catalog (thumbnail) on the monitor 52 via the D / A converter 46. The operator arbitrarily selects an ED frame image from a plurality of ED frame image candidates displayed in the catalog on the monitor 52. As the ED frame image in step S15, a predetermined frame image, for example, a frame image based on the R wave at the Nth heartbeat, may be automatically selected as the ED frame image.

  Then, if necessary, the monitor 52 reproduces the ED frame image selected in step S15 and the frame image whose shooting time is before and after, and the operator relatively confirms the validity of the selected ED frame image. It can be so.

  On the other hand, the selection of the ES frame image in step S16 is performed based on the T wave and the U wave (between the T wave and the U wave) included in the ECG waveform by, for example, frame-by-frame moving operation and electrocardiogram synchronous reproduction. It is. In addition, in order to suppress the influence of the variation of the position of the patient P2 on the top plate 26 and the contrast of the contrast image, the ES frame image candidate selected from the plurality of ES frame image candidates based on the T wave and the U wave is selected in step S15. The ES frame images immediately before and immediately after the shooting time of the ED frame image are automatically selected.

  Then, if necessary, the monitor 52 reproduces the ES frame image selected in step S16 and the frame image whose shooting time is before and after, and the operator relatively confirms the validity of the selected ES frame image. It can be so.

  Note that the selection of the ES frame image in step S16 may be performed by the same operation as the selection of the ED frame image in step S15. That is, first, a plurality of ES frame image candidates based on the T wave and the U wave are displayed in a catalog so as to be selectable on the monitor 52 via the D / A converter 46. The operator arbitrarily selects an ES frame image from a plurality of ES frame image candidates displayed in the catalog on the monitor 52. As the ES frame image in step S16, a predetermined frame image, for example, a frame image based on the T-wave and the U-wave at the Nth heartbeat, is automatically selected as the ES frame image from each frame image. Also good.

  In steps S15 and S16, the ED frame image candidate and the ES frame image candidate are catalog-displayed on the monitor 52 based on the ECG waveform. However, based on the density change of the pixel value in the designated ROI, the ED frame image Candidates and ES frame image candidates may be catalog displayed on the monitor 52. For example, in the case of a subtraction image, the minimum pixel value is an ED frame image candidate, and the maximum pixel value is an ES frame image candidate. At this time, the number of data in the ROI may be thinned out in order to shorten the processing time. The ROI is graphically displayed as a target position so that the left ventricle can be positioned in this ROI during imaging.

In the cardiac ejection rate calculating means 49, using the EDV and ESV measured in step S17,
[Equation 4]
Ejection rate (EF) = ((EDV−ESV) / EDV) × 100 (%)
Thus, the cardiac ejection fraction is calculated (step S18). The calculation result of the cardiac ejection ratio may be displayed on the monitor 52.

According to the X-ray cardiovascular diagnosis system 10 according to the present embodiment, the pixel size corresponding to the imaging position of the imaging measurement unit 11 in the left ventricular imaging of the patient P2 based on the image data D _P1 of the calibration object P1 previously captured. Therefore, it is possible to omit the pixel calibration operation, which has a heavy workload on the operator when measuring the cardiac ejection fraction, and to improve the workability of the X-ray inspection.

Further, according to the X-ray cardiovascular diagnosis system 10 according to the present embodiment, it corresponds to the imaging position of the imaging measurement unit 11 in the left ventricular imaging of the patient P2 based on the image data D _P1 of the calibration object P1 previously captured. By displaying the graphic image of the calibration object P1 on the monitor 52 as the estimated position of the left ventricle, X-ray exposure to the patient P2 during the fine adjustment operation of the top plate 26 can be suppressed.

  Furthermore, according to the X-ray circulatory organ diagnosis system 10 according to the present embodiment, the imaging time varies with the ED frame image selected in step S15 among the plurality of ES frame image candidates based on the T wave and the U wave. Since the ES frame image is automatically selected, the ejection fraction can be calculated efficiently and accurately.

1 is a block diagram showing an embodiment of an X-ray cardiovascular diagnosis system according to the present invention. The external view which looked at the imaging | photography measurement part of the C arm structure which has in an X-ray cardiovascular diagnosis system from the head side. The flowchart which shows the pre-processing function implement | achieved by the program recorded on the processor part of the X-ray cardiovascular diagnosis system which concerns on this invention. The flowchart which shows the left ventricular imaging function implement | achieved by the program recorded on the processor part of the X-ray-cardiovascular-diagnosis system which concerns on this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 X-ray cardiovascular diagnosis system 11 Imaging | photography measurement part 12 Processor part 31 Imaging position storage means 34 Image storage means 35 Pixel size calculation means 36 Pixel size storage means 37 Graphic image creation means 38 Graphic image storage means 40 Electrocardiograph 42 ECG waveform Storage means 46 Pixel size extraction means 47 Frame image selection means 48 Left ventricular volume value measurement means 49 Cardiac ejection rate calculation means 52 Monitor

Claims (14)

An imaging measurement unit that performs left ventricular imaging including at least the left ventricle of the patient's heart to generate a video signal, and obtains image data including each frame image from the video signal of the imaging measurement unit, and based on the image data An X-ray cardiovascular diagnostic system comprising: a processor unit for analyzing the cardiac function of the patient; a monitor for displaying the frame images and the results of the analysis; and an operation input unit capable of performing operation input on the screen of the monitor. In
Shooting position storage means for storing various shooting positions of the shooting measuring unit;
A calibration object is photographed according to various photographing positions stored in the photographing position storage means to acquire image data, and pixel calibration processing is performed based on this image data to calculate a pixel size for each of the various photographing positions. Pixel size calculation means for
Pixel size storage means for storing the various photographing positions and the pixel size in association with each other;
Image storage means for storing image data composed of each frame image acquired by imaging the patient according to a required imaging position among various imaging positions stored in the imaging position storage means;
Frame image selection means for selecting an end-diastolic frame image and an end-systolic frame image of the left ventricle from each frame image stored in the image storage means;
Pixel size extraction means for extracting a pixel size corresponding to the required photographing position from the pixel size storage means;
The left ventricle that measures the end-diastolic volume value and the end-systolic volume value from the end-diastolic frame image and end-systolic frame image selected by the frame image selecting unit and the pixel size extracted by the pixel size extracting unit Volume value measuring means;
An X-ray circulator comprising: a cardiac ejection fraction calculating means for calculating a cardiac ejection fraction using the end diastolic volume value and the end systolic volume value measured by the left ventricular volume value measuring means Diagnostic system. An imaging measurement unit that performs left ventricular imaging including at least the left ventricle of the patient's heart to generate a video signal, and obtains image data including each frame image from the video signal of the imaging measurement unit, and based on the image data An X-ray cardiovascular diagnostic system comprising: a processor unit for analyzing the cardiac function of the patient; a monitor for displaying the frame images and the results of the analysis; and an operation input unit capable of performing operation input on the screen of the monitor. In
Shooting position storage means for storing various shooting positions of the shooting measuring unit;
A graphic for capturing a calibration object according to the various photographing positions stored in the photographing position storage means to acquire image data, and creating a graphic image of the calibration object for each of the various photographing positions based on the image data Image creation means;
Graphic storage means for storing the various photographing positions and graphic images in association with each other;
Image storage means for storing image data composed of each frame image acquired by imaging the patient according to a required imaging position among various imaging positions stored in the imaging position storage means;
An X-ray circulatory diagnosis system, comprising: a monitor that displays a graphic image of the calibration object corresponding to the required imaging position. An electrocardiograph placed on the patient, an image processing means for associating a time phase of image data composed of each frame image acquired by imaging the patient and a time phase of sampling points of the electrocardiogram waveform data, The X-ray cardiovascular diagnosis system according to claim 1, further comprising a processing image storage unit that stores image data and the electrocardiogram waveform data in association with each other. An imaging measurement unit that performs left ventricular imaging including at least the left ventricle of the patient's heart to generate a video signal, and obtains image data including each frame image from the video signal of the imaging measurement unit, and based on the image data An X-ray cardiovascular diagnostic system comprising: a processor unit for analyzing the cardiac function of the patient; a monitor for displaying the frame images and the results of the analysis; and an operation input unit capable of performing operation input on the screen of the monitor. In
In the processor unit,
A shooting position storage function for storing various shooting positions of the shooting measurement unit;
A calibration object is photographed for each of the various photographing positions to obtain image data, and pixel size calculation function for calculating a pixel size for each of the various photographing positions by performing pixel calibration processing based on the image data;
A pixel size storage function for storing the various shooting positions and the pixel size in association with each other;
Among various shooting positions stored in the shooting position storage function, a shooting measurement unit position setting function for setting the position of the shooting measurement unit according to a required shooting position;
An image storage function for acquiring image data consisting of each frame image by capturing the patient in the imaging measurement unit at the required imaging position, and storing the image data consisting of each frame image;
An end-diastolic frame image selection function for selecting an end-diastolic frame image of the left ventricle from each frame image stored by the image storage function;
An end systolic frame image selection function for selecting an end systolic frame image of the left ventricle from each frame image stored by the image storage function;
A pixel size extraction function for extracting the pixel size corresponding to the required shooting position from the pixel size stored in the pixel size storage function;
From the end diastole frame image and the end systole frame image selected by the end diastole frame image selection function and the end systole frame image selection function, and the pixel size extracted by the pixel size extraction function, the end diastole volume value And a left ventricular volume measurement function for measuring the end systolic volume value,
An X-ray cardiovascular diagnostic system, wherein a program for realizing a cardiac ejection fraction calculation function for calculating a cardiac ejection fraction using the end diastolic volume value and the end systolic volume value is recorded. In the end-diastolic frame image selection function, the time phase of the image data composed of each frame image acquired by imaging the patient and the time phase of the sampling point of the electrocardiogram waveform data are associated with each other, and the electrocardiogram waveform data is 5. The X-ray cardiovascular diagnosis system according to claim 4, wherein a predetermined frame image is selected based on the selected frame image. In the end-diastolic frame image selection function, the time phase of the image data composed of each frame image acquired by imaging the patient and the time phase of the sampling point of the electrocardiogram waveform data are associated with each other, and the electrocardiogram waveform data is 5. The X-ray cardiovascular diagnosis system according to claim 4, wherein a plurality of end-diastolic frame image candidates are displayed based on the selection. In the end systolic frame image selection function, the time phase of the image data composed of each frame image acquired by imaging the patient and the time phase of the sampling point of the electrocardiogram waveform data are associated with each other, and the electrocardiogram waveform data is 5. The X-ray cardiovascular diagnosis system according to claim 4, wherein a predetermined frame image is selected based on the selected frame image. In the end systolic frame image selection function, the time phase of the image data composed of each frame image acquired by imaging the patient and the time phase of the sampling point of the electrocardiogram waveform data are associated with each other, and the electrocardiogram waveform data is The X-ray cardiovascular diagnosis system according to claim 4, wherein a plurality of end systolic frame image candidates are displayed based on the selection. 5. The end systole frame image selection function selects an end systole frame image immediately before and immediately after a shooting time of an end diastole frame image selected by the end diastole frame image selection function. The X-ray cardiovascular diagnosis system described. 9. The X-ray cardiovascular diagnosis system according to claim 6, wherein the plurality of end-diastolic frame image candidates or end-systolic frame image candidates are displayed as a catalog. 5. The end-diastolic frame image selected by the end-diastolic frame image selection function and the end-systolic frame image selection function, and a frame image whose shooting time is before and after the end-systolic frame image are displayed. X-ray cardiovascular diagnostic system. Selecting the end-diastolic frame image and the end-systolic frame image using the density change of the pixel value in the designated region of interest by the end-diastolic frame image selecting function and the end-systolic frame image selecting function; The X-ray cardiovascular diagnosis system according to claim 4. An imaging measurement unit that performs left ventricular imaging including at least the left ventricle of the patient's heart to generate a video signal, and obtains image data including each frame image from the video signal of the imaging measurement unit, and based on the image data An X-ray cardiovascular diagnostic system comprising: a processor unit for analyzing the cardiac function of the patient; a monitor for displaying the frame images and the results of the analysis; and an operation input unit capable of performing operation input on the screen of the monitor. In
In the processor unit,
A shooting position storage function for storing various shooting positions of the shooting measurement unit;
A graphic image creating function for photographing a calibration object for each photographing position and obtaining image data, and creating a graphic image of the calibration object for each of the various photographing positions based on the image data;
A graphic image storage function for storing the various photographing positions and graphic images in association with each other;
Among various shooting positions stored in the shooting position storage function, a shooting measurement unit position setting function for setting the position of the shooting measurement unit according to a required shooting position;
An image storage function for acquiring image data consisting of each frame image by capturing the patient in the imaging measurement unit at the required imaging position, and storing the image data consisting of each frame image;
An X-ray cardiovascular diagnostic system, wherein a program for realizing a graphic image display function for displaying a graphic image of the calibration object corresponding to the required imaging position as an estimated position of the left ventricle of the patient is recorded. The actual position of the left ventricle of the patient is displayed according to the level of the image density value in each frame image acquired at the required imaging position, using a distribution of image density values in a region of interest specified in advance. The X-ray cardiovascular diagnosis system according to claim 13.

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