JP2006149560A - Nuclear magnetic resonance imaging apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an MRI apparatus with an operation supporting function which enables the operation to be executed along a safe path by feeding back the result of the preoperative simulation during the operation. <P>SOLUTION: A control means of the MRI apparatus with an ISC function is equipped with a recording means to register and record a path of a surgical tool to an objective region and a prescribed range from a three-dimensional image of a subject displayed on a display means, and makes the relative position of the path to the objective region recorded by the recording means and/or the prescribed range recorded by the recording means and the position of the surgical tool detected by a position of the surgical tool detecting means to be displayed. The position of the surgical tool can be superposed and displayed as a virtual surgical tool on the image of the subject captured and displayed on real time. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a technique using a nuclear magnetic resonance imaging apparatus (hereinafter referred to as an MRI apparatus) for surgical support, and more particularly to an MRI apparatus having a guide function during surgery.

  In recent years, a technique called I-MRI (Interventional MRI or Intraoperative MRI) that uses an image (MR image) captured by an MRI apparatus for puncture monitoring at the time of surgery or percutaneous treatment has been put into practical use. One of them is a technique for arbitrarily setting a cross-section to be imaged in real time, taking an image by a high-speed imaging method, and displaying the obtained cross-sectional image, and is called an interactive scan ISC. In the interactive scan, a 3D position detection device is combined with an MRI apparatus, a part of a patient laid in an imaging space is designated by a predetermined pointer that can be detected by the 3D position detection apparatus, and this position information is sent to the MRI apparatus. The cross section including the designated position is imaged.

  In addition, as another technique for surgical support using MRI images, a plurality of cross-sectional images centered on the points specified by the pointers sequentially as the surgery progresses are created using previously acquired 3D MR image data of the patient. There is also a technique (surgical navigation system) for navigating the operation by displaying it, and it is applied to high-precision surgery such as neurosurgery. For detecting the position of the pointer, a mechanical method, an optical method, an ultrasonic method, or the like is employed.

  Furthermore, a surgical simulation function has been developed for the purpose of improving surgical treatment accuracy. For example, Patent Document 1 has a function of evaluating a surgical route to a surgical target based on a slice image captured by an X-ray CT apparatus or an MRI apparatus, and automatically calculating candidate paths. Devices for surgical support have been proposed. In Patent Document 2, a cost image taking into account the risk of contact or excision with a surgical tool is created based on the patient's three-dimensional image data, and the least invasive surgical route is automatically determined from this cost image. Techniques for searching have been proposed.

These techniques are effective means for planning an operation because the access route of the surgical tool can be calculated and depicted before the operation. However, with these techniques, it is not possible to confirm how the surgical tool moves during the operation based on the preoperative simulation results. During surgery, it may be necessary to select a route that is different from the route set in the preoperative simulation. However, it only takes time to capture the 3D image and start planning again. There is also a problem that the burden on the patient and the operator increases.
Japanese Patent Laid-Open No. 2001-113086 JP 2003-30624 A

  An object of the present invention is to provide an MRI apparatus with an operation support function capable of feeding back a result of a preoperative simulation during an operation and performing an operation along a safe route. Another object of the present invention is to provide an MRI apparatus capable of improving the safety of surgery by warning that a surgical instrument has approached a dangerous site (for example, an organ or an important blood vessel). . A further object of the present invention is to provide an MRI apparatus capable of replanning and presenting a safe route during surgery without significantly extending the operation time.

  The MRI apparatus of the present invention that achieves the above object includes an imaging unit that performs imaging by nuclear magnetic resonance on a subject placed in a static magnetic field, a display unit that displays an image captured by the imaging unit, and the static unit. An imaging position instruction means for instructing the imaging means at an arbitrary position in an imaging space in a magnetic field, and the imaging means and the display means for capturing and displaying an image including the position instructed by the imaging position instruction means And a surgical instrument position detection means for detecting the position of the surgical instrument used in the imaging space, the control means from the three-dimensional image of the subject displayed on the display means A storage means for registering and storing a route to the target site of the surgical instrument and a predetermined region, and displaying an image of the subject imaged and displayed in real time according to an instruction from the imaging position instruction means And displaying the relative position between the path to the target site stored in the storage means and / or the predetermined region stored in the storage means and the position of the surgical tool detected by the surgical tool position detection means. It is characterized by making it.

  The position of the surgical instrument can be displayed in a superimposed manner on a subject image captured and displayed in real time. In this case, for example, the surgical instrument is displayed as a virtual surgical instrument schematically showing the shape of the surgical instrument.

In the MRI apparatus of the present invention, for example, the predetermined area stored in the storage means is a part that should be prevented from entering by the surgical instrument, and the control means determines that the distance between the surgical instrument and the predetermined area is a predetermined interval. Alert when it becomes smaller.
Furthermore, in the MRI apparatus of the present invention, the control means newly receives the registration of the surgical instrument path from the image of the subject imaged and displayed in real time, and updates the path to the target site stored in the storage means. .

  According to the present invention, the result of the preoperative simulation is displayed during the operation, and the position of the surgical instrument that changes from moment to moment is captured in real time, together with or displayed superimposed on the displayed subject image, Surgery can be performed reliably along the simulated safety path. In addition, it is possible to improve the safety of the operation by previously registering dangerous parts such as organs and important blood vessels when the surgical tool comes in contact and warning that the surgical tool has approached those dangerous parts. In addition, according to the present invention, since a safe route during an operation can be re-planned using a screen imaged in real time, it is possible to reduce an increase in operation time associated with the route change.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a diagram showing an overall outline of an MRI apparatus to which the present invention is applied. This MRI apparatus 10 is a vertical magnetic field type open MRI apparatus in which a pair of static magnetic field magnets 11 and 12 are arranged on the upper and lower sides. The static magnetic field magnets 11 and 12 are supported by a support column 13 with a predetermined space. A uniform static magnetic field necessary for imaging is generated in (imaging space). The subject 14 is carried to the imaging space while being laid down on the bed 15, where an operation or the like is performed by the operator 16 together with imaging by the MRI apparatus.

  As the static magnetic field magnets 11 and 12, a magnet of a normal conducting system, a superconducting system, or a permanent magnet system is employed. Although not shown in the drawing, facing the imaging space, three sets of gradient magnetic field coils that apply magnetic field gradients in three orthogonal directions to the static magnetic field, and a high-frequency magnetic field having a magnetic resonance frequency are applied to the subject 14 and the subject 14 And a high-frequency coil for receiving the NMR signal generated from the. The high-frequency coil may be a dual-purpose coil for transmission and reception, or may have a dedicated coil for each. The operations of these gradient coil and high frequency coil are controlled by the control unit 17 in accordance with a pulse sequence determined by the imaging method.

  The MRI apparatus 10 also includes a signal processing system (not shown) that performs signal processing on the NMR signal received by the receiving coil, an image creation unit 18 that creates an MR image by performing image reconstruction operation on the signal-processed data, and the like. An input / output unit 19 for displaying the received image and inputting instructions for causing the control unit 17 to select and execute various functions necessary for imaging and surgery support functions, and various parameters and programs necessary for the control and calculation in progress And a storage unit 20 for storing the data. In the illustrated MRI apparatus, a display device (monitor) for displaying an image is provided in the input / output unit 19 and is also attached to the upper static magnetic field magnet 11 via a support unit. Surgery can be performed while confirming the image of the subject displayed in '.

  The MRI apparatus 10 also has an ISC function and a surgical navigation function as a surgical support function. For this reason, two infrared cameras 21 for detecting the position indicated by the pointer and a light emitting element for emitting infrared light are mounted. The position detecting device 22 is attached to the upper static magnetic field magnet 11 via an arm 23. The position detection device 22 is connected to a dedicated computer (personal computer) 24.

  The pointer is a predetermined arrangement of three reflecting spheres that reflect infrared rays emitted from the position detection device 22, and is fixed to the distal end of the surgical instrument 27 or the distal end of the pointing instrument. The positional relationship between the positions of the three reflecting spheres and the surgical tool or the tip of the pointing tool is registered in the computer 24 in advance, and the positions of these three reflecting spheres are captured by the two infrared cameras 21. The direction of the axis of the tool or the pointing tool and the position of the tip can be detected. In order to associate the direction and position in the camera coordinates captured by these infrared cameras 21 with the apparatus coordinates of the MRI apparatus, a reference tool 25 in which three reflecting spheres 26 are arranged like a pointer is fixed at a predetermined position of the MRI apparatus. Has been. In the illustrated example, the reference tool 25 is fixed to a gantry that covers the upper static magnetic field magnet 11.

  The ISC function and the navigation function are stored as programs in the storage unit 20 of the control unit 17, and are selected and executed via the input / output unit 19. When the ISC function is executed, for example, the position of the surgical instrument 27 with a pointer attached to one end is detected by the position detection device 22, and the detected position is correlated with the device coordinates of the MRI apparatus 10 by the reference tool 25. An imaging cross section in the apparatus 10 is determined. For example, when a cross section including the distal end of the surgical instrument 27 and the axis of the surgical instrument is set as an imaging cross section, a gradient magnetic field is determined so as to select the cross section, and real-time imaging is performed according to a preselected pulse sequence. . The obtained image is immediately displayed on the monitor 19 '.

  When the navigation function is executed, for example, when a desired position of the subject is indicated by an indicator attached with a pointer, the 3D image data of the subject that has already been acquired is centered on the indicated point. Create and display two orthogonal cross-sectional images. A 3D image such as a volume rendering image may be displayed together with these three orthogonal sections.

  In an operation using an MRI apparatus having such an operation support function, an image apparatus other than the MRI, such as an endoscope or a microscope, is further used depending on the surgical site. In such a case, the video from these video devices is displayed on a dedicated monitor installed in the vicinity of the monitor 19 'and is also taken into the storage unit 20 of the MRI apparatus 10, and if necessary, an image is displayed. The superimposed image is displayed on the MR image created by the creating unit 18.

Next, the operation support function using the MRI apparatus having such a configuration will be described.
The surgical support function is roughly divided into registration of the optimal surgical route before surgery and update / display of the relative position information of the surgical tool and the target position at any time during surgery. Includes warning and route change registration when approaching dangerous area. Although a technique for simulating and registering a surgical route before surgery is known, the present invention updates the relationship between the surgical tool and the target position that change from moment to moment during surgery, together with the simulation results before surgery. It is characterized by displaying and feeding back, so that it is possible to confirm whether or not the operation is being performed as simulated, thereby reducing the time required for the operation and improving the treatment accuracy.

  Hereinafter, the procedure of the preoperative simulation and the support function during the operation will be described based on the embodiment shown in FIG.

  First, a patient is placed in an imaging space, and imaging for acquiring three-dimensional image data is performed by the MRI apparatus 10 (step 101). The pulse sequence for imaging is not particularly limited. For example, imaging is performed using a gradient echo short TR three-dimensional imaging pulse sequence. Based on the three-dimensional image data obtained in this way, three orthogonal cross-sectional images (MPR: Multi Planar Reconstruction) and a volume rendering image are created and displayed (step 102). Next, based on the displayed screen, the surgical route is simulated and registered (steps 103 to 106).

  FIG. 3 shows a screen display example for preoperative simulation. In the illustrated example, in addition to the slice including the puncture target point, a total of three images 302 are displayed, and the operator designates the puncture target point on these three images. Also, if necessary, specify the area where the puncture needle should not touch or be damaged (inaccessible area) such as blood vessels or organs, or the area of the tissue where the puncture needle can pass (accessible area). And register (steps 103 and 104). Registration of the inaccessible area / accessible area may not be performed, for example, when it is clear that there is no problem blood vessel or organ between the puncture start point and the puncture target point. Just do. The designation and registration of the puncture target point and the inaccessible area / accessible area is performed by designating a part or area displayed on the screen by the input / output unit, and image coordinates (or device coordinates) corresponding to the part or area. This is done by storing the value in the storage unit.

  On the other hand, a surgical instrument used for the surgery is registered (step 105). When a pointer that can be detected by the position detection device 22 is fixed to one end of the surgical instrument, the registration of the surgical instrument is the relationship between the three reflecting spheres fixed to the pointer and the surgical instrument (in the surgical instrument coordinate system). The coordinates of each reflection sphere, the direction of the axis of the surgical instrument, the position of the tip, etc.) are registered, and the position of the reflection sphere in the apparatus coordinates is registered. When a plurality of surgical tools are registered in advance, a surgical tool actually used for surgery is selected from the registered plurality of surgical tools. The selection of the surgical tool is realized by, for example, displaying a selection GUI (selection box) on the display device of the input / output unit 19. As a result, the type of the surgical instrument and the position of the distal end of the surgical instrument in the apparatus coordinate system are grasped.

  The control unit 17 automatically routes the puncture target point to the puncture target point (surgical route) based on the puncture target point, the inaccessible area / accessible area and the type of surgical instrument registered in steps 103 to 105. Is calculated and displayed (step 106). A known method can be used as a method for automatically calculating a surgical route. For example, a line connecting an puncture target point and an arbitrary point on the outer skin of a subject, not passing through an inaccessible region, and having a short distance 1 Or select multiple lines as surgical path. The surgical route is displayed on the screen together with a mark (virtual surgical tool) schematically showing the shape of the registered surgical tool. In the embodiment shown in FIG. 3, the puncture start point and the image of the virtual surgical instrument inserted therefrom are superimposed on the 3D volume image 301 and displayed.

  Instead of automatically calculating the surgical route, the surgeon moves the virtual surgical tool displayed on the screen via the GUI and searches for the optimal route while accessing the puncture target point from any direction. You may do it. In this way, virtual surgery is performed by passing the virtual surgical tool through the 3D volume image, and it is examined whether or not the route is optimal (step 108). The simulation can be repeated until a safe path is secured, and the results of each simulation are saved as necessary. As a result, an optimal surgical route can be selected from the plurality of surgical routes calculated in step 106 (step 109).

  If the optimal operation route is selected by the simulation, the operation is started (step 110). An example of the GUI displayed on the display device at the start of surgery is shown in FIG.

  In the illustrated example, a surgical navigation image display unit 401, an ISC image display unit 402, input buttons 403 and 404 for instructing the start of imaging, a navigation and ISC start button 405, and data recording from other video devices A start button 406, an operation button 407 for displaying the presence / absence of pointer detection by the infrared camera 22, and the like are displayed. The navigation image display unit 401 displays three cross-sectional images (MPR: Multi Planar Reconstruction) and volume rendering images created from three-dimensional image data acquired before surgery. In addition, the ISC image display unit 402 displays a preoperative simulation result (301 in FIG. 3) 409 along with a real-time 2D image 408 captured by executing the ISC function. Although not shown in FIG. 4, information on the surgical tool registered in step 105 and information on the relative position between the surgical tool and the registered part are displayed together with other registration information such as imaging parameters (step 111).

  The surgeon 16 guides the surgical tool toward the puncture target point while confirming the result of the preoperative simulation (safe surgical route) displayed on the monitor 19 '. At this time, if a pointer is attached to the surgical instrument, information on the position of the distal end of the surgical instrument detected by the position detection device 22 is sent from the PC 24 to the control unit 17, and the control unit 17 uses the positional information as a basis. Then, the imaging section is determined, real-time imaging is started, and the obtained image is displayed as the ISC image 408 on the display device 19 and the monitor 19 ′. When the navigation function is executed as the operation progresses, three orthogonal sectional views centered on an arbitrary point designated during the operation are created using the three-dimensional image data acquired before the operation. The already displayed cross-sectional view is updated.

  Further, the control unit 17 uses the position information from the position detection device 22 to obtain relative position information with respect to the registered site (puncture target point). The relative position information between the surgical tool and the registered site is calculated by calculating the distance from the surgical tool tip to the registered site (puncture target point), for example, a message such as “Tumor inside-cm has surgical tool tip”. Display as. In addition to such display, the virtual surgical tool is displayed superimposed on a predetermined position on the ISC image or the navigation image corresponding to the movement of the surgical tool (step 112). Such relative position information is updated at any time as the surgical instrument moves, and the display is also updated. Further, when an inaccessible area is registered, it is possible to display this area by color-coding on the ISC image or the navigation image.

  Further, when the inaccessible area is registered, the control unit 17 determines, based on the position information of the surgical tool tip input from the position detection device 24, between the inaccessible area and the surgical tool tip existing in the advancing direction of the surgical tool. Calculate and display the distance. The distance between the surgical tool and the inaccessible area may be displayed as a numerical value together with the relative position information of the surgical tool and the registered site, or visually displayed by superimposing the virtual surgical tool on the subject image as described above. May be. The ISC imaging and the display / update of the relative position information are continued until an end instruction (step 115) or an operation plan change instruction (step 116) is given.

  On the other hand, when the distance between the surgical instrument and the inaccessible area is equal to or less than a preset threshold value, an alarm and / or message warning is issued (step 114). The surgeon who receives the warning may confirm the relationship between the virtual surgical tool displayed on the ISC screen and the inaccessible area, for example, and may advance the surgical tool by shifting the progress angle of the surgical tool. To do. Such a judgment may be made by the surgeon by looking at the monitor screen, but the control unit 17 makes a judgment based on the information on the registered inaccessible area / accessible area, and in which direction the surgical tool is advanced in the future. Can also be displayed on the screen. In this case, for example, a plurality of surgical routes registered by the preoperative simulation may be displayed, and a route other than the already performed surgical route may be selectable, or the calculation of the surgical route may be selected again. May be.

  When it is determined that the operation route needs to be changed (step 116) and it is selected to calculate the operation route again, the operation route is calculated using the multi-slice ISC image captured in real time (step 117). . The calculation of the surgical route performed during the operation can be performed in substantially the same manner as the preoperative simulation. However, in many cases, during the operation, the position of the organ or blood vessel is used to acquire a 3D volume image used for the preoperative simulation. Since it is different from the time, the latest ISC image acquired in real time is used. FIG. 5 shows how the surgical route is calculated during surgery. When the operation path change is selected, as shown in the figure, a slice including the surgical instrument and a plurality of slices parallel to the slice are imaged and displayed. The surgeon sets a puncture start point and a puncture target point in these displayed cross sections. If there is no inaccessible area between the two points, the direction of the surgical tool is determined from these two points, and the surgical route is determined. The surgeon guides the surgical tool along the new surgical path and starts the operation again.

  As described above, according to the present embodiment, the surgical route obtained by the preoperative simulation is displayed, and the position information of the surgical instrument that changes with the progress of the operation is imaged during the operation and / or the operation. By displaying with the navigation image updated inside or superimposed on the image, it is possible to confirm whether the surgery is proceeding as simulated. In addition, by registering areas that should avoid the invasion of surgical tools in advance, it is possible to notify the surgeon that the surgical tools have approached such areas, and the treatment accuracy can be greatly improved without damaging normal organs. . Furthermore, according to the present embodiment, since the operation route can be reset based on the ISC image acquired in real time during the operation, the treatment accuracy is greatly improved without extending the operation time and damaging the normal organ. It can be improved.

  In the above embodiment, the case where the pointer is fixed to the surgical instrument and the position of the pointer is detected by the position detection device equipped with two infrared cameras to grasp the direction and the distal end position of the surgical instrument has been described. As the position detection device, a device using an infrared camera, a mechanical device, a device using ultrasonic waves, or the like can be used. Also, the present invention can be applied to a case where a surgical tool is not operated by a surgeon but is operated by a manipulator (robot). In this case, position information of the manipulator can be used as position information of the surgical tool. Hereinafter, an MRI apparatus using a manipulator will be described.

  FIG. 6 shows an overall outline of an MRI apparatus provided with a manipulator. Similar to the MRI apparatus shown in FIG. 1, this MRI apparatus is also a vertical magnetic field type apparatus in which magnets are arranged above and below, and is provided with a gradient magnetic field coil, a high-frequency coil, etc. (not shown). The same elements as those in FIG. 1 are denoted by the same reference numerals.

  In this MRI apparatus, as a mechanism for driving the manipulator 61, a rail 62 fixed to the side of the top plate of the bed 15 and an arc-shaped arm 63 movable along the rail 62 are provided. Is fixed so as to be movable along the arc of the arm 63. The subject 14 is inserted into the arc of the arm 63. The arm 63 is also equipped with a receiving coil 60 for acquiring MR images in real time. In an MRI apparatus using a manipulator, an image device 64 such as an endoscope or a microscope is installed in the vicinity of a surgical site, and images from these image devices are displayed on a monitor 641 arranged in the vicinity of the display device 19. It has been projected.

  As shown in FIG. 7, the manipulator 61 includes a plurality of members 61a, 61b, and 61c that are rotatably connected to each other. By changing the connecting angle of these members, the surgical instrument 27 fixed to the distal end of the manipulator 61 is arbitrarily set. It can be moved and rotated by any amount in the direction. In order to drive the manipulator 61 and its driving mechanism, a manipulator driving unit 65, a manipulator control unit 66, and an operation console 67 are provided. When the operator (operator) operates the console 67 while viewing the image of the treatment site displayed on the monitor 19, the movement amount of each mechanism portion corresponding to the operation is input to the manipulator control unit 66, and the manipulator The movement of the arm 63 along the rail 62, the movement of the manipulator 61 along the arc of the arm 63, and the movement / rotation between the members of the manipulator 61 are performed by being transmitted to the driving unit 65. That is, the manipulator 61 can be positioned at a desired position of the subject 14 by moving the arm 63 along the rail 62 and moving the manipulator 61 along the arm 63.

  As described above, the manipulator control unit 66 has information regarding the position of the manipulator 61, and this position information is used in the same manner as the position information detected by the position detection device 22 of the MRI apparatus in FIG. 1 to perform ISC imaging. It is. That is, the preoperative simulation is performed using the pre-acquired 3D volume image to determine the surgical route and the registration of the puncture start point and the inaccessible / accessible area is the same as in the embodiment of FIGS. is there. However, in I-MRI using a manipulator, when surgery is started, the control unit 17 takes in position information of the surgical tool from the manipulator, selects a cross section including the surgical tool, and starts imaging in real time. At the same time, the position of the surgical tool is displayed as a virtual surgical tool on the obtained ISC image. The imaging cross section changes following the movement of the manipulator (the surgical tool fixed to the manipulator), and the ISC image and the virtual surgical tool superimposed thereon are updated.

  In addition, for example, since an image from an endoscope that moves together with the surgical instrument is simultaneously displayed on the monitor 641, the operation can be performed while confirming these ISC images and images of the endoscope and the like. Here, it is also possible to display the cross-sectional image acquired by ISC by superimposing it on an image of an endoscope or the like, thereby moving the surgical tool and proceeding with the operation while keeping the correspondence between the two.

  During the operation, the relative positional relationship between the surgical instrument tip and the registered puncture start point and inaccessible area is also updated and displayed as needed. The warning is issued when the distance between the distal end of the surgical instrument and the inaccessible area in the traveling direction becomes smaller than a predetermined value, and the operation path is changed accordingly, as in the above-described embodiment.

  When changing the operation route, for example, when the puncture start point and the puncture target point are set on the display screen of the ISC image as shown in FIG. 5, the control unit 17 automatically determines the direction vector from these two points. And the position information is sent to the manipulator control unit 66. In response to a command from the manipulator control unit 66, the manipulator driving unit 65 automatically resets the manipulator arm 63 to the puncture start point along the direction vector. In this way, the operation route can be changed in real time without interrupting the operation, and the treatment accuracy can be greatly improved.

  According to the present invention, information on surgical tools and inaccessible / accessible areas registered in the preoperative simulation is displayed side by side or superimposed on the display screen of the ISC image captured during the operation. By updating and displaying the position of the surgical instrument that changes with progress, it is possible to contribute to improvement in treatment accuracy. Further, according to the present invention, the operation time can be shortened by providing the function of changing the operation route as appropriate during the operation, and the burden on the operator and the patient can be reduced.

The figure which shows the whole outline | summary of the MRI apparatus of one embodiment of this invention The figure which shows the procedure of the surgery assistance function by the MRI apparatus of this invention The figure explaining the preoperative simulation using the MRI apparatus of this invention The figure which shows an example of the display screen of the MRI apparatus of this invention The figure explaining the simulation in operation using the MRI apparatus of this invention The figure which shows the whole outline | summary of the MRI apparatus of other embodiment of this invention. The figure which shows the principal part of the MRI apparatus of FIG.

Explanation of symbols

11, 12 ... Static magnetic field magnet, 14 ... Subject, 17 ... Control unit, 18 ... Image creation unit, 19 ... Input / output unit (display device), 19 '... Monitor , 20 ... storage unit, 22 ... position detection device, 27 ... surgical instrument

Claims (4)

An imaging unit that performs imaging by nuclear magnetic resonance on a subject placed in a static magnetic field, a display unit that displays an image captured by the imaging unit, and an arbitrary position in an imaging space in the static magnetic field An imaging position instruction means for instructing the means; a control means for controlling the imaging means and the display means to capture and display an image including the position instructed by the imaging position instruction means; and used in the imaging space In a nuclear magnetic resonance imaging apparatus comprising a surgical instrument position detecting means for detecting the position of a surgical instrument to be performed,
The control means includes storage means for registering and storing a route to a target site of the surgical tool and a predetermined region from the three-dimensional image of the subject displayed on the display means, and from the imaging position instruction means The image of the subject imaged and displayed in real time according to the instruction is displayed, and the path to the target site stored in the storage unit and / or the predetermined region stored in the storage unit and the surgical tool position detection A nuclear magnetic resonance imaging apparatus for displaying a relative position with respect to a position of a surgical instrument detected by means.   2. The nuclear magnetic resonance according to claim 1, wherein the control unit displays the position of the surgical tool as a virtual surgical tool schematically showing the shape of the surgical tool, superimposed on the image of the subject. Imaging device.   The predetermined area stored in the storage means is a part to be prevented from entering by the surgical instrument, and the control means has a distance between the surgical instrument and the predetermined area smaller than a predetermined interval. The nuclear magnetic resonance imaging apparatus according to claim 1, wherein a warning is sometimes issued. The control means receives a new registration of a surgical instrument path from an image of a subject imaged and displayed in real time, and updates the path to a target site stored in the storage means. Item 4. The nuclear magnetic resonance imaging apparatus according to any one of Items 1 to 3.