JP2006109959A - Image diagnosis supporting apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an image diagnosis supporting apparatus for supporting a diagnosis by displaying an abnormal area considered to be abnormal in a medical image and a degree of seriousness showing a degree of the seriousness of the abnormality in a manner to differentiate easily and instantly from the image of the abnormal area. <P>SOLUTION: The abnormal area and the degree of seriousness are displayed on a display device by extracting the abnormal area (a calcified area of coronary arteries in an example of supporting a heart disease) considered to be an abnormal candidate through performing prescribed image processing on the medical image and by obtaining a degree of seriousness (a calcium score of the coronary arteries in the example of supporting the heart disease) showing the degree of seriousness of the abnormality from the image of the abnormal area. One of a plurality of degrees of seriousness or abnormal areas displayed on the display device is specified. The specified degree of seriousness is displayed by differentiating from the other degrees of seriousness, and the abnormal area corresponding to the specified degree of seriousness is displayed by differentiating from the other abnormal areas. Alternately, the specified abnormal area is displayed by differentiating from the other abnormal areas, and the degree of seriousness corresponding to the specified abnormal area is displayed by differentiating from the other degree of seriousness. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an image diagnosis support apparatus, and more particularly to an image diagnosis support apparatus that supports diagnosis by displaying an abnormal area that appears to be abnormal in a medical image and an abnormality level of the abnormal area in an easily and instantly identifiable manner. .

Conventionally, an image taken with an X-ray CT apparatus or MRI apparatus is analyzed using a computer, and the abnormal region that seems to be abnormal is extracted using this analysis result, and this is presented to the doctor to diagnose the doctor. Various diagnostic support is being conducted.
As one example, there is a support method for displaying a region that is considered abnormal from a tomographic image of the heart taken by an X-ray CT apparatus and the degree of the abnormality.

In Patent Document 1, when the inside of the heart or coronary artery has undergone calcification, a value called a calculus score is calculated from the CT value of the calcified region, and this score is used as an index of heart disease. Is disclosed.
In this diagnosis support method, in order to make it easy for a doctor to make a diagnosis, a method of displaying the calcification region and a calculus score in this region is used.

As another example, in Patent Document 2, image data is analyzed using a digital image processing technology by a computer, and a candidate lesion area that is considered to be a lesion such as lung cancer or breast cancer is extracted, and this is given to a doctor. Some of them provide diagnosis support.
In this method, the extracted lesion candidate shadow area is surrounded by a marker and displayed in an identifiable manner. In this display method, further establishment of a lesion (hereinafter referred to as lesion confidence) is obtained, and the size and thickness of the lesion candidate shadow area is displayed according to the lesion confidence, or the lesion confidence is high. Colors are sequentially displayed such as red, yellow, and blue, and lesion candidate shadows themselves are displayed in different colors.
Special table 2002-531199 gazette JP 2002-325761 A

  A method for calculating a calcified score of a calcified region from a tomographic image of the heart taken by the X-ray CT apparatus and supporting the diagnosis of heart disease is as follows. There is no problem because it can be clearly identified by enclosing it with markers and displaying the calculus score of the area.

  However, when there are a plurality of calcified regions and the calcum scores in these regions are the same, including the distinction from other calcified regions with different calcum scores, the association between the calcified region and the calcum score, In other words, it is difficult to determine which calcified area the calculated calcus score is.

  Further, when performing diagnostic support with the diagnostic imaging support apparatus disclosed in Patent Document 2, the diagnostic imaging support apparatus extracts the extracted lesion candidate shadow areas such as red, yellow, and blue in descending order of focal certainty. If there are multiple lesion candidate shadows with the same certainty factor, the other candidate lesion shadows with different lesion certainty factors can be displayed. Including these distinctions, it was very difficult to determine which focus candidate shadows correspond to multiple focus certainty factors.

  Such a problem is not limited to the above-described example, and may also occur in diagnosis support apparatuses such as other image diagnosis support and MRI images, ultrasonic images, and X-ray images taken by an X-ray CT apparatus. .

  An object of the present invention is to support diagnosis by displaying an abnormal region that appears to be abnormal in a medical image and a severity indicating the severity of the abnormality from the image of the abnormal region in an easily and instantly distinguishable manner. The object is to provide an image diagnosis support apparatus.

The image diagnosis support apparatus of the present invention for solving the above problems is achieved by the following means.
(1) An abnormal area extraction unit that performs predetermined image processing on a medical image to extract an abnormal area that is a candidate for abnormality, and a degree of abnormality severity from the abnormal area image extracted by the abnormal area extraction unit And a display for displaying the severity detected by the severity detection means and identifying and displaying the abnormal area extracted by the abnormal area extraction means in the medical image An image diagnosis support apparatus, wherein the display means designates one of a plurality of seriousness or abnormal areas displayed on the display means, and the designated severity Is identified and displayed as another severity, and the abnormal region corresponding to the specified severity is displayed separately from other abnormal regions, or the specified abnormal region is displayed as another abnormal region. And the specified The severity corresponding to the abnormal area is for displaying identify other severity.

  The display means displays a medical image including a plurality of abnormal areas extracted by the abnormal area extraction means and respective severity levels corresponding to the plurality of abnormal areas detected by the severity detection means. ing. In this case, it is convenient that the severity is listed by adding a means for identifying the severity, for example, a number.

When a surgeon such as a doctor displays an abnormal area corresponding to the severity to be observed from the list, the operator designates one corresponding severity from the list and is displayed on the display means. An image of an abnormal area corresponding to the designated severity in a medical image is identified and displayed as an image of another area.
On the other hand, when it is desired to know the severity of the abnormal region to be observed, an image portion that is considered to be abnormal in the medical image is designated, and the designated image portion region is distinguished from other abnormal regions. In addition to being displayed, one severity in the list is distinguished from the other severity.

  By displaying in this way, even when there are multiple abnormal areas with the same severity, the abnormal area corresponding to the specified severity can be distinguished from other abnormal areas and displayed. Severity corresponding to the abnormal area can be distinguished from other severity and displayed, so the abnormal area and severity that cause confusion to doctors and other operators who have been a problem in the past It is possible to solve the problem that it is difficult to observe the image in association with each other.

  In the present invention, in order to further facilitate observation of an image by associating an abnormal region with a severity, the following display is performed.

(1-1) The abnormal area corresponding to the specified severity is displayed in color hatching or color translucent.
As described above, the abnormal region corresponding to the severity specified by displaying in color hatching or color translucent becomes clear at a glance.

(1-2) The abnormal region corresponding to the specified severity is displayed surrounded by a solid line or a broken line.
By displaying the abnormal area surrounded by a solid line or a broken line, the image of the abnormal area remains the original image, so the subtle shading of the image in the abnormal area is read to make it more precise than (1-1) above. Will be able to make a correct diagnosis.

(1-3) The abnormal area corresponding to the specified severity is displayed in color hatching or color translucent, and the abnormal area is displayed surrounded by a solid line or a broken line.
By displaying in this way, the abnormal area becomes clear at a glance and the distinction between the abnormal area and other abnormal areas becomes clear.

(1-4) Select whether to display the abnormal area corresponding to the specified severity in color hatching or color translucent, or to display the abnormal area surrounded by a solid line or a broken line.
In image diagnosis, there are cases where it is only necessary to know the abnormal region, and there are cases where it is desired to accurately interpret the inside of the abnormal region with the original image intact. Improved operability.

(1-5) In the above (1-1), (1-3) or (1-4), the color hatched or color translucent display color of hue, lightness, saturation not including achromatic color. The color gradation obtained by any one or any combination thereof is assigned from one color system of RGB, XYZ, UVW, and LAB.
Since color hatching or color translucency can be displayed in different colors that do not include an achromatic color according to the degree of severity, the degree of seriousness in the abnormal region can be identified at a glance.

(1-6) In the above (1-2), (1-3) or (1-4), the solid line or broken line color surrounding the abnormal area is any one of hue, lightness and saturation including achromatic color. Alternatively, it is assigned from a color gradation obtained by an arbitrary combination or one color system of RGB, XYZ, UVW, and LAB.
The solid line or broken line surrounding the abnormal area can be displayed in different colors including achromatic colors according to the degree of severity, so that the severity of the abnormal area can be identified at a glance and the abnormal area can be identified in the original image. Interpretation is possible as it is.

(1-7) When the display mode of the designated severity is achromatic display, the achromatic display is displayed in reverse so that it can be distinguished from other severity.
By highlighting only the specified severity, the distinction from other severity becomes clearer.

(1-8) The specified severity is displayed in the same color as the color indicating the abnormal region corresponding to the severity.
Since the designated severity and the abnormal region corresponding to this severity are displayed in the same color, the correspondence between the severity and the abnormal region becomes clearer.

(1-9) The designation of one of the severity or abnormal areas is made by operating the pointing device.
By clicking on the severity or abnormal area to be observed displayed on the display means with a pointing device such as a mouse, the severity or abnormal area can be designated by a simple operation.

  Furthermore, the present invention applies the above solution to the support for diagnosing the degree of calcification of the coronary artery from the heart image taken by the X-ray CT apparatus as follows.

(2) In the above (1), the medical image is an image of a heart taken by an X-ray CT apparatus, the abnormal region is a calcified region of a cardiac coronary artery, and the severity is a calculus score . That is, a calcified region extracting unit that performs predetermined image processing on a heart image to extract a calcified region that is a candidate for calcification, and a calcified region image extracted by the calcified region extracting unit. And a calcification score calculation means for calculating a calcification score which is the degree of serious calcification, and a calcification area extracted by the calcification area extraction means is identified and displayed in the tomographic image and by the calculus score calculation means. An image diagnosis support apparatus including a display unit for displaying the calculated calculus score, wherein the display unit specifies one of a plurality of calculus scores or a calcified region displayed on the display unit. The designated calcum score is distinguished from other calculus scores and displayed. The calcified area corresponding to the core is displayed as distinguished from other calcified areas, or the designated calcified area is displayed as distinguished from other calcified areas and displayed in the designated calcified area. The corresponding calcium score is distinguished from other calcium scores and displayed.

The display means displays an image including a plurality of calcification areas extracted by the calcification area extraction means and a respective calcification score corresponding to the plurality of calcification areas calculated by the calcification score calculation means. ing.
In this case, it is convenient to add a means for identifying the calcium scores to each other, for example, by adding a number or the like, and list them.

  When an operator such as a doctor displays a calcification region corresponding to a calculus score to be observed from the list, if one calculus score corresponding to the calcification score is specified from the list, the operator displays the calcification score on the display means. The image of the calcified region corresponding to the designated calculus score in the existing image is identified and displayed from the image of the other region.

  On the other hand, when it is desired to know the calcium score of the calcified region to be observed, if an image portion that is considered to be abnormal in the tomographic image is specified, the specified image portion region is distinguished from other calcified regions. In addition, one calcium score in the list is displayed separately from the other calcium scores.

  By displaying in this way, even if there are multiple calcified areas with the same calculus score, it is also possible to distinguish and display the calcified area corresponding to the specified calculus score from other calcified areas. The calcification score corresponding to the calcified region can be distinguished from other calculus scores and displayed, so the calcification score and the calculus score that cause confusion to the surgeon such as a doctor who has been a problem in the past It is possible to solve the problem that it is difficult to observe the image in association with each other.

  In the present invention, in order to facilitate observation of an image by further associating a calcified region and a calculus score, the following is displayed.

(2-1) The calcified area corresponding to the designated calculus score is displayed in color hatching or color translucent.
Thus, the calcified region corresponding to the calculus score designated by displaying in color hatching or color translucent becomes clear at a glance.

(2-2) A calcified region corresponding to the designated calculus score is displayed surrounded by a solid line or a broken line.
By displaying the calcified region surrounded by a solid line or a broken line, the image of the calcified region remains the original image, so the fine gradation of the black and white 256-tone image in the calcified region is read and the above ( More accurate diagnosis than 2-1) can be made.

(2-3) The calcified region corresponding to the designated calculus score is displayed in color hatching or color translucent and the calcified region is displayed surrounded by a solid line or a broken line.
By displaying in this way, the calcified region becomes clear at a glance and the distinction between the calcified region and other calcified regions becomes clear.

(2-4) Select whether to display the calcified area corresponding to the specified calculus score with color hatching or color translucent, or to display the calcified area surrounded by a solid line or a broken line. .
In image diagnosis, there are cases where it is only necessary to know the calcified region, and cases where it is desired to accurately interpret the calcified region as it is as the original image. , Display operability is improved.

(2-5) In the above (2-1), (2-3) or (2-4), the color displayed by color hatching or color translucent is a hue, brightness, or saturation that does not include an achromatic color. The color gradation obtained by any one or any combination thereof is assigned from one color system of RGB, XYZ, UVW, and LAB.
Since color hatching or color translucency can be displayed in different colors that do not include an achromatic color according to the calculus score, the degree of calcification in the calcified region can be identified at a glance.

(2-6) In the above (2-2), (2-3) or (2-4), the solid line or broken line surrounding the calcified region is any of hue, brightness, and saturation including achromatic color. Or color gradation obtained by any combination thereof, or one color system of RGB, XYZ, UVW, and LAB.
The solid line or broken line surrounding the calcified area can be color-coded with colors including achromatic colors according to the calculus score, so that the degree of calcification in the calcified area can be identified at a glance and the calcified area can be identified in the original. Interpretation is possible with images.

(2-7) When the display mode of the designated calculus score is achromatic display, the achromatic display is displayed in reverse video so as to be distinguished from other calculus scores.
By highlighting only the designated calcium score, the distinction from other calcium scores becomes clearer.

(2-8) The designated calcum score is displayed in the same color as the color indicating the calcified region corresponding to the calcum score.
Since the designated calcum score and the calcified area corresponding to the calcified score are displayed in the same color, the correspondence between the calcified score and the calcified area is further clarified.

(2-9) The designation of one of the calcium score or the calcified area is performed by operating a pointing device.
By clicking a calculus score or calcified region to be observed displayed on the display means with a pointing device such as a mouse, the calculus score or calcified region can be designated by a simple operation.

  Furthermore, the present invention applies the above solution to support for diagnosing the degree of lung cancer from lung field images taken with an X-ray CT apparatus as follows.

(3) In the above (1), the medical image is an image of a lung field imaged by an X-ray CT apparatus, and an image from which a lesion candidate shadow region that seems to be a candidate for a cancer lesion can be extracted from the image. The abnormal region is the lesion candidate shadow region, and the severity is a lesion certainty factor indicating a probability that the lesion candidate shadow is a lesion.

  That is, a lesion candidate shadow region extracting unit that performs predetermined image processing on a lung field image to extract a lesion candidate shadow region that is a candidate for a lesion, and a lesion candidate shadow region extracted by the lesion candidate shadow region extracting unit A focus certainty detection means for detecting a focus certainty from the image of the image, and a lesion candidate shadow area extracted by the focus candidate shadow area extracting means is identified and displayed in the image and detected by the focus certainty detection means And a display means for displaying the determined focus certainty factor, wherein the display means displays one of a plurality of focus certainty factors or focus candidate shadow areas displayed on the display means. The specified lesion certainty factor is identified and displayed as another lesion certainty factor, and a lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed as another lesion candidate shadow region. The identified lesion candidate shadow area is identified and displayed as another lesion candidate shadow area, and the lesion certainty corresponding to the designated lesion candidate shadow area is displayed as another lesion confidence. Are identified and displayed.

  The display means includes an image including a plurality of lesion candidate shadow areas extracted by the lesion candidate shadow area extraction means and respective lesion beliefs corresponding to the plurality of lesion candidate shadow areas detected by the lesion confidence detection means. The degree and are displayed.

  In this case, it is convenient to add a means for identifying the lesion certainty factors, for example, a number, etc. to the lesion certainty factors and list them.

  When an operator such as a doctor displays a lesion candidate shadow region corresponding to a certainty factor of the lesion to be observed from the list, if one corresponding certainty factor is specified from the list, the display means An image of a lesion candidate shadow region corresponding to the designated lesion certainty factor in the displayed image is identified and displayed from images of other lesion candidate shadow regions.

  On the other hand, when it is desired to know the lesion certainty of the lesion candidate shadow region to be observed, if an image portion that is considered to be a lesion to be observed in the image is designated, the region of the designated image portion is different from other lesion candidate shadow regions. While being identified and displayed, one certainty factor in the list is distinguished from the other certainty factors and displayed.

  By displaying in this way, even when there are a plurality of lesion candidate shadow regions having the same lesion certainty factor, the lesion candidate shadow region corresponding to the designated lesion certainty factor can be distinguished from other lesion candidate shadow regions and displayed. On the other hand, it is possible to distinguish and display the certainty factor corresponding to the designated candidate lesion area of the lesion from other certainty factors. It is possible to solve the problem that it is difficult to observe an image by associating a certain lesion candidate shadow region with the certainty of the lesion.

  In the present invention, in order to further facilitate observation of an image by associating a lesion candidate shadow region with a lesion certainty factor, the following display is performed.

(3-1) The lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed in color hatching or color translucent.
In this way, the lesion candidate shadow region corresponding to the certainty factor of the lesion designated by displaying in color hatching or color translucent becomes clear at a glance.

(3-2) A lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed surrounded by a solid line or a broken line.
By displaying the lesion candidate shadow region surrounded by a solid line or a broken line, the image of the lesion candidate shadow region remains the original image, so the subtle shading of the monochrome 256-tone image of the lesion candidate shadow region is read. More accurate diagnosis than (3-1) above can be made.

(3-3) The lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed in color hatching or color translucent, and the lesion candidate shadow region is displayed surrounded by a solid line or a broken line.
By displaying in this way, the lesion candidate shadow region becomes clear at a glance and the distinction between the lesion candidate shadow region and other lesion candidate shadow regions becomes clear.

(3-4) Select whether to display the lesion candidate shadow area corresponding to the specified lesion certainty in color hatching or color translucent, or to display the lesion candidate shadow area surrounded by a solid line or a broken line. To display.
In image diagnosis, there are cases where it is sufficient to know only the lesion candidate shadow area, and there are cases where it is desired to accurately interpret the lesion candidate shadow area as it is in the original image. As a result, display operability is improved.

(3-5) In the above (3-1), (3-3) or (3-4), the color to be displayed in color hatching or color translucent is a hue, brightness, or saturation that does not include an achromatic color. The color gradation obtained by any one or any combination thereof is assigned from one color system of RGB, XYZ, UVW :, or LAB.
Since color hatching or color translucency can be displayed in different colors that do not include an achromatic color according to the lesion certainty factor, the probability that the lesion candidate shadow region is a lesion can be identified at a glance.

(3-6) In the above (3-2), (3-3), or (3-4), the solid line or broken line color surrounding the lesion candidate shadow region is a hue, brightness, or saturation color including an achromatic color. The color gradation obtained by any one or any combination thereof is assigned from one color system of RGB, XYZ, UVW, and LAB.
The solid line or broken line surrounding the lesion candidate shadow area can be displayed in different colors including achromatic colors according to the certainty of the lesion, so that the probability that the lesion candidate shadow area is a lesion can be identified at a glance and the lesion candidate shadow area Can be interpreted as the original image.

(3-7) When the display mode of the designated lesion certainty level is achromatic display, the achromatic color display is displayed in reverse so as to be distinguished from other focal certainty levels.
By highlighting only the specified lesion certainty, the distinction from other lesion certainty is further clarified.

(3-8) The specified lesion certainty factor is displayed in the same color as the color indicating the lesion candidate shadow region corresponding to the lesion certainty factor.
Since the designated lesion certainty factor and the lesion candidate shadow region corresponding to this lesion certainty factor are displayed in the same color, the correspondence between the lesion certainty factor and the lesion candidate shadow region is further clarified.

(3-9) The designation of one of the lesion certainty factor or the lesion candidate shadow region is performed by operating the pointing device.
By clicking the focus certainty factor or lesion candidate shadow region to be observed displayed on the display means with a pointing device such as a mouse, the lesion certainty factor or lesion candidate shadow region can be designated by a simple operation.

  According to the present invention, even when there are a plurality of abnormal areas having the same severity, the abnormal area corresponding to the specified severity can be distinguished from other abnormal areas and displayed. It is also possible to distinguish and display the severity corresponding to the other seriousness, so that the abnormal area and the severity that cause confusion to the surgeon such as a doctor who has been a problem in the past are associated with each other. Thus, it is possible to solve the problem that it is difficult to observe the image.

  By applying this invention to support for diagnosing the degree of calcification of the coronary artery from the heart image taken with an X-ray CT apparatus, even when there are a plurality of calcification regions having the same calculus score, the specified calculus score It is possible to distinguish and display the calcified area corresponding to the other calcified area, or conversely, the calcified score corresponding to the specified calcified area can be displayed separately from the other calcified score. The image can be observed by associating the digitized region with the calcium score.

  Furthermore, by applying the above invention to support for diagnosing the extent of lung cancer from lung field images taken with an X-ray CT apparatus, even if there are multiple candidate shadow regions with the same lesion confidence, the specified lesion confidence The lesion candidate shadow area corresponding to the degree can be displayed separately from other lesion candidate shadow areas, or conversely, the lesion confidence corresponding to the designated lesion candidate shadow area can be distinguished from the other lesion confidence areas and displayed. Therefore, the image can be observed by associating the lesion candidate shadow region with the lesion certainty factor.

  As described above, according to the present invention, an abnormal region that appears to be an abnormality in a medical image and a severity that represents the degree of the abnormality from the image of the abnormal region are associated with each other and displayed in an easily and instantly identifiable manner. Thus, the diagnosis of a doctor or the like can be supported.

  A preferred embodiment of an image diagnosis support apparatus according to the present invention is a method for supporting diagnosis of a heart disease from a tomographic image of a heart taken by an X-ray CT apparatus, and a tomographic image of a lung field also taken by an X-ray CT apparatus A method for supporting diagnosis of lung cancer will be described below in detail with reference to the accompanying drawings.

  FIG. 1 is a block diagram showing a hardware configuration of the entire diagnostic imaging support apparatus to which the present invention is applied. This image diagnosis support apparatus extracts an abnormal region that appears to be abnormal in the medical image based on a medical image collected with respect to a target portion of a subject with an X-ray CT apparatus or the like, displays this, or displays these abnormalities Severity indicating the degree of abnormality is obtained from the image of the region and displayed.

  This diagnostic imaging support apparatus includes a central processing unit (CPU) 1 that controls the operation of each component, a main memory 2 that stores a control program of the apparatus, and a plurality of tomographic image data and programs. A magnetic disk 3, a display memory 4 for temporarily storing image data for display, a color CRT display 5 as a display device for displaying an image based on the image data from the display memory 4, and a soft switch on the screen The mouse 6 and its controller 7 to be operated, a keyboard 8 having keys and switches for setting various parameters, and a common bus 10 for connecting the above components.

  In this embodiment, a case where only the magnetic disk 3 is connected as a storage device other than the main memory 2 is shown, but in addition to this, a floppy disk drive, a hard disk drive, a CD-ROM drive, a magneto-optical disk ( MO) drive, ZIP drive, PD drive, DVD drive, etc. may be connected.

  Furthermore, it can be connected to various communication networks such as LAN (local area network), the Internet, and telephone lines via a communication interface (not shown) so that image data can be exchanged with other computers. Also good. Further, the exchange of image data may be performed by connecting a medical image diagnostic apparatus such as an X-ray CT apparatus or an MRI apparatus that can collect an image of a subject to the LAN or the like.

[1] An example in which the present invention is applied to support diagnosis of an X-ray CT image heart disease Before describing the embodiment, a calculus score obtained from a cardiac tomographic image taken with an X-ray CT apparatus will be described first.

If the calcification of the coronary artery progresses, it is likely to become ischemic heart diseases such as angina pectoris and myocardial infarction in the future. This calcification is evaluated by a calcium score, and it has been reported in the United States that there is a high correlation between the calcium score and ischemic heart disease.
Therefore, the calcium score indicates the degree of calcification of the coronary arteries. If this score is high, there is a high possibility that angina or myocardial infarction will occur in the future, which is an index for predicting ischemic heart disease.
Further, not only the calcification of the coronary arteries but also the calcification of the aorta is treated as a similar index.

For the calculation of the calculus score, a “calculation method called Agatston” is used as a standard calculation method.
The algorithm for calculating the calculus score is relatively simple. In the CT tomographic image of the heart, an area with a CT value of 130 or more is judged as a calculus component, that is, a calcified area. It is not treated as a conversion area.

  In the following embodiment, a description will be given assuming that the magnetic disk 3 stores a tomographic image of the heart taken by an X-ray CT apparatus.

FIG. 2 shows a flowchart of processing for extracting a calcified region from a tomographic image of the heart and calculating and displaying a calculus score of the calcified region.
The CPU 1 in FIG. 1 operates according to the flowchart in FIG.

[Step 12] The CPU 1 searches for an image file in the magnetic disk 3 using the input keyboard 8 for a CT image for diagnosis support, and reads the CT image for diagnosis support.

[Step 13] The CPU 1 extracts a heart region including the coronary artery from the heart CT image read in step 12. For the region extraction, a method is used in which a heart region is clicked with several mice 6 to obtain the CT value of the pixel and only the heart region is extracted by threshold processing with surrounding pixels based on the CT value.
In this extraction process, in order not to extract the vertebrae and sternum as a heart region, the region is limited to a rectangular region or the like in advance so that the threshold processing does not reach outside the periphery of the heart, or preprocessing for extracting the heart region Extract vertebra and sternum regions. This is easy because the CT value of the bone region is very high compared to the surrounding soft tissue and lung field regions.
If the extracted bone region is subtracted from the original image and the heart is extracted using the subtracted image, the adjacent vertebra and sternum are not extracted, and only the heart region can be extracted. The coronary artery causing calcification is extracted from the heart region image thus extracted. Since the coronary artery in which calcification has occurred has a CT value that is significantly different from that in a normal case, it can be performed by simple threshold processing.
A region where calcification occurs (calcification region) is extracted by performing such a process. When there are two or more calcification regions, these calcification regions are separated.

[Step 14] The CPU 1 calculates a calcium score of the calcified region extracted in Step 13. In calculating the calculus score, an agaston score, which is a standard calculation algorithm, is used.

[Step 15] The CPU 1 associates the calcified region extracted in Step 13 with the calcified score of the calcified region calculated in Step 14, and displays it on the CTR color display 5 as shown in FIG.
FIG. 3 is an example in which a white portion in the heart is a calcified region and there are a plurality of calcified regions, and a calculus score corresponding to the calcified region is listed and displayed in the right column of the display screen. .
The list shows that there are three calcified regions with the same calcium score.

[Step 16] In order to distinguish and display a calcification score corresponding to a calcification region to be diagnosed or a calcification region corresponding to a calcification score to be diagnosed from other calcification regions or calcification scores, a plurality of calcification regions or calcifications are displayed. Specify one of the scores. For example, one of the plurality of calcification regions or the calcium score displayed in FIG.

[Step 17] When one of a plurality of calcified areas is specified, the specified calcified area is color-hatched and displayed as distinguished from other calcified areas as shown in FIG. The calculus score corresponding to the designated calcified region is displayed in reverse video so as to be distinguished from other calculus scores.

The designated calcified region may be distinguished from other calcified regions using the following means.
(1) A color translucent display is performed in the designated calcified region.
(2) The designated calcified area is displayed with color hatching or color translucent, and the calcified area is displayed surrounded by a solid line or a broken line.
(3) The color displayed by color hatching or color translucent is a color gradation or RGB system, XYZ obtained by any one of hue, lightness, saturation, or any combination thereof not including the achromatic color shown in FIG. Allocate from one of the color systems of UV, UVW and LAB.
In particular, in the case of an XYZ color system, the hue, brightness, and saturation can be assigned on the XYZ chromaticity diagram shown in FIG.
(4) The solid or broken line color surrounding the specified calcified region is a color gradation obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof, or RGB, XYZ, Allocate from one color system of UVW or LAB.

  Further, the display of the calcification score corresponding to the designated calcification area may be displayed in the same color as the color for displaying the calcification area corresponding to the calcification score.

[Step 18] When one of a plurality of calculus scores is designated, as shown in FIG. 4, the designated calculus score is displayed in a highlighted manner so as to be distinguished from other calculus scores. The calcified area corresponding to the calcium score is displayed in color hatching so as to be distinguished from other calcified areas.

Note that the calcified region corresponding to the designated calculus score may be distinguished from other calcified regions using the following means.
(5) A color translucent display is displayed in the calcified region corresponding to the designated calcium score.
(6) The calcified area corresponding to the designated calcium score is displayed in color hatching or color translucent, and the calcified area is displayed surrounded by a solid line or a broken line.
(7) The color to be displayed by color hatching or color translucency is a color gradation obtained by any one of hue, lightness, saturation, or any combination thereof not including the achromatic color shown in FIG. Allocate from one of the color system of UV, UVW and LAB.
In particular, in the case of an XYZ color system, the hue, brightness, and saturation can be assigned on the XYZ chromaticity diagram shown in FIG.
(8) The solid or broken line color surrounding the designated calcified region is a color gradation obtained by any combination of hue, brightness, saturation including an achromatic color, or any combination thereof, RGB system, XYZ system, Allocate from one color system of UVW or LAB.

Moreover, the display of the designated calculus score may be displayed in the same color as the color for displaying the calcification region corresponding to the designated calculus score.
By displaying in this way, the correspondence between the calcified region and the calcium score corresponding to the calcified region is clarified, and as a result, a doctor's image diagnosis can be performed efficiently.

  In the first embodiment, the calcified region is displayed with color hatching or color translucent, but a doctor or the like may want to make a diagnosis by reading the subtle shades of 256 gray levels of the original image. In this case, the calcified area is left as the original image, and a line surrounding the calcified area is surrounded by a color line, an easily recognized solid line, or a broken line.

  The calcified area is displayed on the CRT display 5 as a black and white 256-level grayscale image. In the flowchart for executing this, only the contents of step 17 and step 18 in FIG. 2 are different, and the other steps 11 to 16 are the same. Therefore, step 17 and step 18 in FIG. 2 will be described as step 27 and step 28 in the second embodiment, respectively.

[Step 27] When one of a plurality of calcification regions is designated, the designated calcification region is displayed as distinguished from other calcification regions surrounded by a solid line, as shown in FIG. The calcium score corresponding to the designated calcified area is displayed in reverse video so as to be distinguished from other calcium scores. Note that the designated calcification region may be surrounded with a broken line and displayed separately from other calcification regions.

The solid line or broken line color surrounding the specified calcified region is a color gradation or RGB system obtained by any combination of hue, brightness, saturation including achromatic colors, XYZ system, UVW system, Allocates from one of the LAB color systems.
Further, the display of the calcification score corresponding to the designated calcification area may be displayed in the same color as the color for displaying the calcification area corresponding to the calcification score.

[Step 28] When one of a plurality of calculus scores is designated, as shown in FIG. 7, the designated calculus score is displayed in a highlighted manner so as to be distinguished from other calculus scores. The calcified area corresponding to the calculus score is displayed by being surrounded by a solid line and distinguished from other calcified areas.
Note that the calcification region corresponding to the designated calculus score may be displayed by being surrounded by a broken line and distinguished from other calcification regions.

  The solid line or broken line color surrounding the calcified area corresponding to the specified calculus score is a color gradation or RGB system obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof, XYZ Allocate from one of the color systems of UV, UVW and LAB.

  Further, the designated calculus score may be displayed in the same color as the calcification area corresponding to the calcification score.

  By displaying as in Example 2 above, the correspondence between the calcium score and the calcified region is clearly displayed, and the image in the calcified region remains the original image. By reading the light and shade, it becomes possible to make a more accurate diagnosis than in the first embodiment.

  A doctor or the like may want to select and use the first and second embodiments according to the purpose of diagnosis and the site to be diagnosed. That is, there are a case where display within the calcified region may be color hatching or color translucent and a case where the original image itself is desired to be displayed. This does not need to be interpreted very precisely, but it is necessary to know the calcified score of the calcified area and the calcified score of this area, as well as the relationship between the calcified area and the calcum score, as well as the calcified area. This is when you want to interpret.

  In the third embodiment, means for selecting the first and second embodiments is provided (this selection signal may be input from the keyboard 8, or the color CRT display 5 is provided with a selection means using a soft switch. (You may select it by clicking with the mouse 6), select either Example 1 or Example 2 with this selection means, and then select the flowchart of FIG. 2 (Example 1 was selected) In this case, the processing may be performed in accordance with Steps 17 and 18, and when Example 2 is selected, the processing is performed in accordance with Steps 27 and 28).

As described above, the example in which the present invention is applied to the diagnosis support of the heart disease of the X-ray CT image has been described in the first example, the second example, and the third example. However, the present invention is not limited to these examples. .
For example, the calculus score is displayed in the right column of the CRT display, but this may be in the left column, and the position is not limited as long as the image is not disturbed.

  In addition, the image including the calcified region and the calcium score in the calcified region are displayed on the same screen, but if the correspondence between the calcified region and the calcium score is taken, the mineralized region and the calcium score are Each may be displayed on a separate monitor.

  In the above embodiment, the case where the image data already taken from the magnetic disk 3 is read and the diagnosis is supported has been described. However, a LAN (local area) is provided via a communication interface not shown in the block diagram of FIG. If an X-ray CT apparatus is connected to the network) and the above method is used every time an image is taken, diagnosis support almost in real time can be performed.

[2] An example in which the present invention is applied to support diagnosis of a chest disease on an X-ray CT image In a medical image, a blood vessel, a cross section of a blood vessel, a cross section of a bronchus, etc. are shown in addition to a shadow such as cancer Even if the medical image is directly subjected to image processing, it is very difficult to extract a lesion candidate shadow that is a lesion candidate.

As described in the prior art, Japanese Patent Application Laid-Open No. 2002-325761 of Patent Document 1 discloses extracting the lesion candidate shadow and displaying the extracted lesion candidate shadow in the medical image in an identifiable manner. ing.
In this case, the lesion candidate shadow is surrounded by a marker and displayed in an identifiable manner. In addition, the probability (focal confidence) that the lesion candidate shadow is a lesion is obtained, and when the marker is displayed, its size and thickness are displayed according to the certainty of the lesion, or red in descending order of the lesion confidence. , Yellow, blue, etc. are devised for easy identification by color-coded display.

FIG. 8 is an example in which shadows (focal candidate shadows) that are candidates for lung cancer are extracted from a chest CT image by the above method, and the extracted lesion candidate shadow regions 1 to 3 are surrounded by a circle line.
In FIG. 8, when there are a plurality of same lesion certainty factors, it is difficult to take correspondence between the lesion certainty factors and the lesion candidate shadow regions.
Therefore, this problem can be solved by the same method as the diagnosis support for heart disease in the X-ray CT image of Example 1 above.
Specific examples will be described in detail below.

FIG. 9 shows a flowchart of a process of extracting a lesion candidate shadow region from a chest CT image and obtaining and displaying the lesion certainty factor of this lesion candidate shadow region.
The CPU 1 in FIG. 1 operates according to the flowchart in FIG.

[Step 32] The CPU 1 searches for an image file in the magnetic disk 3 using the input keyboard 8 for the chest CT image for supporting diagnosis, and reads the CT image for supporting diagnosis.

[Step 33] The CPU 1 extracts a lung cancer lesion candidate shadow region from the chest CT image read in step 32 by the method of Patent Document 1.

[Step 34] The CPU 1 obtains the lesion certainty factor of the lesion candidate shadow area extracted in step 33 by the method of Patent Document 1.

[Step 35] The CPU 1 associates the focus candidate shadow area extracted in Step 33 with the focus certainty of the focus candidate shadow area obtained in Step 34, and displays it on the CTR color display 5 as shown in FIG. To do.
FIG. 10 shows an example in which three lesion candidate shadow areas exist, and the lesion certainty factors corresponding to the lesion candidate shadow areas are listed and displayed in the right column of the display screen.
The list indicates that there are two lesion candidate shadow regions having the same lesion certainty factor.

[Step 36] In order to distinguish and display a lesion candidate shadow region corresponding to a lesion candidate shadow region to be diagnosed or a lesion candidate shadow region corresponding to a lesion confidence to be diagnosed from other lesion candidate shadow regions or lesion certainty factors, One of the candidate lesion shadow areas or the certainty of the lesion is designated. For example, one of a plurality of lesion candidate shadow areas or lesion certainty factors displayed in FIG. 10 is designated by clicking with the mouse 6.

[Step 37] When one of a plurality of lesion candidate shadow regions is designated, as shown in FIG. 11, the designated lesion candidate shadow region is color-hatched to be distinguished from other lesion candidate shadow regions. The lesion certainty factor corresponding to the designated lesion candidate shadow region is displayed in reverse video so as to be distinguished from other lesion certainty factors.

The designated lesion candidate shadow region may be distinguished from other lesion candidate shadow regions using the following means.
(9) The specified lesion candidate shadow region is displayed in a color translucent manner.
(10) The designated lesion candidate shadow area is displayed in color hatching or color translucent, and the lesion candidate shadow area is displayed surrounded by a solid line or a broken line.
(11) The color displayed by color hatching or color translucent is a color gradation obtained by any one of hue, lightness, saturation, or any combination thereof not including the achromatic color shown in FIG. 5, or RGB, XYZ Allocate from one of the color systems of UV, UVW and LAB.
In particular, in the case of an XYZ color system, the hue, brightness, and saturation can be assigned on the XYZ chromaticity diagram shown in FIG.
(12) The color of the solid line or broken line surrounding the designated lesion candidate shadow region is a color gradation obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof, or RGB, XYZ Allocate from one color system of UVW system and LAB system.

  Moreover, the display of the lesion certainty factor corresponding to the designated lesion candidate shadow region may be displayed in the same color as the color for displaying the lesion candidate shadow region corresponding to the lesion certainty factor.

[Step 38] When one of a plurality of lesion certainty factors is designated, as shown in FIG. 11, the designated lesion certainty factor is highlighted and displayed separately from other lesion certainty factors, The lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed in color hatching so as to be distinguished from other lesion candidate shadow regions.
Note that a lesion candidate shadow region corresponding to the designated lesion certainty factor may be identified from other lesion candidate shadow regions using the following means.

(13) A color semi-transparent display is made in the lesion candidate shadow region corresponding to the designated lesion certainty factor.
(14) The lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed with color hatching or color translucent, and the lesion candidate shadow region is displayed surrounded by a solid line or a broken line.
(15) The color hatching or color translucent display color is a color gradation obtained by any one of hue, lightness, saturation, or any combination thereof not including the achromatic color shown in FIG. 5, or RGB, XYZ Allocate from one of the color systems of UV, UVW and LAB.
In particular, in the case of an XYZ color system, the hue, brightness, and saturation can be assigned on the XYZ chromaticity diagram shown in FIG.
(16) The color of the solid line or the broken line surrounding the lesion candidate shadow area corresponding to the specified lesion certainty factor is a color gradation obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof. Alternatively, it is assigned from one color system among RGB, XYZ, UVW, and LAB.

  Further, the designated lesion certainty factor may be displayed in the same color as the color for displaying the lesion candidate shadow region corresponding to the designated lesion certainty factor.

  By displaying in this way, the correspondence between the lesion candidate shadow region and the lesion certainty factor corresponding to this lesion candidate shadow region is clarified, and as a result, a doctor's image diagnosis can be performed efficiently. .

  In the fourth embodiment, the lesion candidate shadow area is displayed with color hatching or color translucent. However, a doctor or the like may want to make a diagnosis by reading subtle shades of black and white 256 gradations of the original image. In this case, the lesion candidate shadow area is left as the original image, and the line surrounding the lesion candidate shadow area is surrounded by a color line, a solid line that is easy to recognize, or a broken line. The lesion candidate shadow area is displayed on the CRT display 5 as a black and white 256-level grayscale image. In the flowchart for executing this, only the contents of step 37 and step 38 in FIG. 9 are different, and the other steps 31 to 36 are the same. Therefore, step 37 and step 38 in FIG. 9 are described as step 47 and step 48 in the fifth embodiment, respectively.

[Step 47] When one of a plurality of lesion candidate shadow areas is designated, as shown in FIG. 12, the designated lesion candidate shadow area is surrounded by a solid line to be distinguished from other lesion candidate shadow areas. The lesion certainty factor corresponding to the designated lesion candidate shadow region is displayed in reverse video so as to be distinguished from other lesion certainty factors. The designated lesion candidate shadow region may be displayed by being surrounded by a broken line so as to be distinguished from other lesion candidate shadow regions.

  The solid line or broken line color surrounding the designated lesion candidate shadow area is a color gradation obtained by any combination of hue, brightness, saturation including an achromatic color, or any combination thereof, RGB system, XYZ system, UVW system Allocate from one color system in the LAB system.

  Moreover, the display of the lesion certainty factor corresponding to the designated lesion candidate shadow region may be displayed in the same color as the color for displaying the lesion candidate shadow region corresponding to the lesion certainty factor.

[Step 48] When one of a plurality of lesion certainty factors is designated, as shown in FIG. 12, the designated lesion certainty factor is highlighted and displayed separately from other lesion certainty factors, A lesion candidate shadow region corresponding to the designated lesion certainty factor is displayed by being surrounded by a solid line and distinguished from other lesion candidate shadow regions.
It should be noted that the lesion candidate shadow region corresponding to the designated lesion certainty factor may be displayed by being surrounded by a broken line and distinguished from other lesion candidate shadow regions.

The solid line or broken line color surrounding the lesion candidate shadow area corresponding to the specified lesion certainty factor is a color gradation or RGB system obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof Allocate from one color system of XYZ, UVW, and LAB.
Further, the designated lesion certainty factor may be displayed in the same color as the color for displaying the lesion candidate shadow region corresponding to this lesion certainty factor.

  By displaying as in Example 5 above, the correspondence between the focus certainty factor and the focus candidate shadow area is clearly displayed, and the image in the focus candidate shadow area remains the original image, so that the monochrome 256 gradations This makes it possible to make a more accurate diagnosis than in Example 4.

  A doctor or the like may want to select and use Example 4 and Example 5 according to the purpose of diagnosis and the diagnosis site. That is, there are a case where color hatching or color translucent display is sufficient in the lesion candidate shadow region and a case where the original image itself is desired to be displayed. This does not need to be interpreted very precisely, but it is only necessary to know the lesion candidate shadow area and the lesion confidence in this area, and the relationship between the lesion candidate shadow area and the lesion confidence, as well as the lesion candidate shadow. This is the case when it is desired to accurately interpret the area.

  In the sixth embodiment, a means for selecting the fourth and fifth embodiments is provided (this selection signal may be input from the keyboard 8, or the color CRT display 5 is provided with a selection means using a soft switch. (You may select it by clicking with the mouse 6), select either Example 4 or Example 5 with this selection means, and then select the flowchart of FIG. 9 (Example 4 was selected) In this case, the processing may be performed according to steps 37 and 38, and when the embodiment 5 is selected, the processing is performed according to steps 47 and 48).

  As described above, the example in which the present invention is applied to the diagnosis support for the chest disease of the X-ray CT image has been described in Example 4, Example 5, and Example 6, but the present invention is not limited to these examples. It can also be applied to breast cancer and other diseases.

  Also, in the display of the candidate shadow area and the certainty of the lesion, for example, the certainty of the lesion is displayed in the right column of the color CRT display 5, but this may be in the left column, which is a place that prevents image interpretation. If not, the position is not limited.

  Furthermore, the image including the lesion candidate shadow region and the lesion certainty factor in the lesion candidate shadow region are displayed on the same screen, but if the correspondence between the lesion candidate shadow region and the lesion certainty factor is taken, the lesion The candidate shadow area and the lesion certainty factor may be displayed on separate monitors.

  In the fourth embodiment, the fifth embodiment, and the sixth embodiment, the case where the CT image already taken from the magnetic disk 3 is read and the diagnosis is supported is described, but it is not illustrated in the configuration block diagram of FIG. If an X-ray CT apparatus is connected to a LAN (local area network) via a communication interface and the above method is used each time an image is taken, diagnosis support can be performed at that location.

  As described above, as a preferred embodiment of the image diagnosis support apparatus according to the present invention, a method for supporting diagnosis of a heart disease from a tomographic image of the heart imaged by an X-ray CT apparatus, and a tomogram of a chest imaged by the X-ray CT apparatus are used. The method for assisting diagnosis of lung cancer from an image has been described as an example, but the present invention is not limited to these, and other image diagnosis support and MRI images, ultrasound images, The same applies to diagnosis support for X-ray images and the like.

  That is, an abnormal region that is a candidate for abnormality by performing predetermined image processing on the medical image captured by the above-described medical image diagnostic apparatus (a calcification region in the example of heart disease support, a lesion candidate shadow region in the example of chest disease support) ) Is extracted, and the severity indicating the degree of severity of the abnormality (calcus score in the case of heart disease support, focus confidence in the example of chest disease support) is obtained from the image of the abnormal region, and the abnormal region is overlapped. The severity is displayed on the display device. Then, one of a plurality of seriousness or abnormal areas displayed on the display device is designated, the designated seriousness is distinguished from other seriousness and displayed, and the designated is designated. The abnormal area corresponding to the severity is displayed as distinguished from other abnormal areas, or the designated abnormal area is displayed as distinguished from other abnormal areas and corresponds to the designated abnormal area. Seriousness is distinguished from other seriousness and displayed.

1 is a block diagram showing a hardware configuration of an entire diagnostic imaging support apparatus to which the present invention is applied. FIG. 3 is a flowchart for executing the first embodiment of the present invention. The figure which shows the display of the calculus score corresponding to an original image and a calcification area | region. FIG. 6 is a diagram illustrating an example of an image and a calculus score display used for diagnosis support according to the first embodiment of the present invention. Explanatory drawing of the color gradation used for the color display of the image of a calcification area | region, and a calculus score. The XYZ chromaticity diagram of the XYZ color system used for the color display of the image of a calcification area | region and a calculus score. The figure which shows an example of the display of the image used for the diagnosis assistance by Example 2 of this invention, and a calculus score. The figure which shows the image which extracted the shadow (lesion candidate shadow) made into a lung cancer candidate from a chest CT image. FIG. 9 is a flowchart for executing Example 4 of the present invention. The figure which shows the display of a lesion candidate shadow and a lesion certainty factor. FIG. 10 is a view showing an example of an image used for diagnosis support according to Example 4 of the present invention and a display of lesion certainty factor. FIG. 10 is a diagram showing an example of an image used for diagnosis support according to Example 5 of the present invention and a display of a lesion certainty value.

Explanation of symbols

  1 Central processing unit (CPU), 2 main memory, 3 magnetic disk, 4 display memory, 5 CRT color display, 6 controller, 7 mouse, 8 keyboard

Claims (13)

  An abnormal region extraction unit that performs predetermined image processing on the medical image to extract an abnormal region that is a candidate for abnormality, and detects a degree of abnormality severity from the abnormal region image extracted by the abnormal region extraction unit Seriousness detection means, and a display means for identifying and displaying the abnormal area extracted by the abnormal area extraction means in the medical image and displaying the severity detected by the severity detection means. The image diagnosis support apparatus is provided, wherein the display means designates one of a plurality of seriousness or abnormal areas displayed on the display means, and the designated severity is assigned to another weight. Identify and display the severity and display the abnormal area corresponding to the specified severity as another abnormal area, or identify the specified abnormal area from the other abnormal area Display and the specified error Image diagnosis support device and displaying identifying the severity corresponding to a region other severity.   2. The display unit according to claim 1, wherein the display unit displays at least one of an abnormal region corresponding to the specified severity in color hatching or color translucent, or surrounds the abnormal region with a solid line or a broken line. An image diagnosis support apparatus characterized in that one of them is selected and displayed.   In claim 2, color gradation or RGB system, XYZ system obtained by any one of hue, brightness, saturation, or any combination thereof, which does not include an achromatic color, the color displayed by color hatching or color translucent. An image diagnosis support apparatus that is assigned from one color system of UVW system and LAB system.   In Claim 2 or 3, the color of solid line or broken line surrounding the abnormal region, color gradation obtained by any one of hue, brightness, saturation including an achromatic color, or any combination thereof, RGB system, XYZ system, An image diagnosis support apparatus that is assigned from one color system of UVW system and LAB system.   2. The display device according to claim 1, wherein when the severity display mode is an achromatic display, the display of the designated severity is displayed in reverse by distinguishing it from the other severity. An image diagnosis support apparatus characterized by that.   5. The image diagnosis support according to claim 2, wherein the display means displays the designated severity in the same color as a color for displaying an abnormal region corresponding to the severity. apparatus.   2. The medical image according to claim 1, wherein the medical image is a tomographic image of the heart taken by an X-ray CT apparatus, the abnormal region is a calcified region of a cardiac coronary artery, and the severity is a calculus score. An image diagnosis support apparatus.   In Claim 7, The said display means displays the inside of the calcification area | region corresponding to the said designated calculus score by color hatching or color translucent, or displays the said calcification area | region enclosed with a continuous line or a broken line. An image diagnosis support apparatus, wherein at least one is selected and displayed.   The color gradation or RGB system, XYZ system, or color gradation obtained by any one of hue, brightness, saturation, or any combination thereof, which does not include an achromatic color, as the color hatched or color translucent color displayed in claim 8 An image diagnosis support apparatus that is assigned from one color system of UVW system and LAB system.   9. The color gradation or RGB system, XYZ system, UVW obtained by using a solid line or a broken line color surrounding the calcified region in any one of hue, brightness, saturation including an achromatic color, or any combination thereof. An image diagnosis support apparatus, which is assigned from one of the color system of LAB or LAB.   8. The display unit according to claim 7, wherein when the display mode of the calculus score is an achromatic display, the display of the designated calculus score is displayed in a reversed manner so as to be distinguished from other calculus scores. An image diagnosis support apparatus.   11. The image diagnosis support apparatus according to claim 8, wherein the display unit displays the designated calculus score in the same color as a color for displaying a calcified region corresponding to the calculus score. .   2. The medical image according to claim 1, wherein the medical image is an image that can extract a lesion candidate shadow region that seems to be a lesion candidate from the image, and the abnormal region is the lesion candidate shadow region, and the severity Is a lesion certainty factor indicating a probability that the candidate shadow is a lesion.

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