JP2006180926A - Medical display device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical display device which manages photography using only one photographing means and is incorporated appropriately into an operating microscope or the like. <P>SOLUTION: The medical display device takes photographs of a bright field (visible light) and a dark field (fluorescence) of a visual field using only one CCD camera 13. A dark field image is processed by chromakey to extract only a fluorescence image (an affected area), and the fluorescence image is superimposed and displayed on a bright field image. Because the bright field and the dark field are the same visual field, the fluorescence image of the dark field matches with the affected area in the bright field image. By displaying the fluorescent affected area on the bright field image in real time, the device is used not only for observation but also for an operation using an operation microscope 1 by incorporating the device into the microscope. Because the device uses only one CCD camera 13, the device can be incorporated into the operating microscope 1 easily. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a medical display device used when performing an operation or the like for surgically removing an affected part (for example, a tumor) having fluorescent substance accumulation.

  For example, in brain surgery, a fluorescent substance is administered to a patient, and at the stage where accumulation in an affected area such as a tumor has progressed, the illumination in the operating room is turned off to darken, and excitation light having a wavelength capable of exciting the fluorescent substance is irradiated. Then, since the fluorescence is emitted only from the affected part where the fluorescent substance is accumulated, the affected part that has emitted the fluorescence in the dark field is photographed by the fluorescent camera. The fluorescence camera has an optical filter that allows only the fluorescence wavelength to pass through, captures only the fluorescence, and records the information.

Next, the irradiation of the excitation light to the affected area is stopped, and the operating room illumination is turned on to make it brighter. Then, the affected part is photographed with a normal visible light camera. The image of the affected area captured by the visible light camera and the image previously captured and recorded by the fluorescence camera are displayed side by side on a display device to assist in the surgical operation (see, for example, Patent Document 1).
JP 2004-89533 A

  However, such a conventional technique requires two cameras, a fluorescent camera and a visible light camera, so that the apparatus is large and unsuitable for incorporation into, for example, a surgical microscope for surgery. .

  The present invention has been made paying attention to such a conventional technique, and provides a medical display device that requires only one imaging means and is suitable for incorporation into a surgical microscope or the like.

  The invention described in claim 1 is a single field of view that captures a bright-field image of a single field including an affected area where fluorescent substances are accumulated, and a dark-field image that irradiates the affected area with excitation light to emit fluorescence. Chroma key processing means that obtains a still image with a transparent background by cutting out only the fluorescent image from the dark field video at a predetermined threshold value, and the still image obtained by the chroma key processing means is superimposed on the bright field video and displayed. Display means.

  The invention described in claim 2 is characterized in that the photographing means automatically performs photographing of the dark field after the change every time the visual field is changed in conjunction with a switch related to the visual field change of the surgical microscope. To do.

  According to a third aspect of the present invention, there is provided one photographing means for photographing a bright field image including fluorescence emitted by irradiating an affected part with excitation light in one visual field including the affected part in which fluorescent substances are accumulated, and a bright field image. A chroma key processing means for obtaining a still image with a transparent background by cutting out only a fluorescent image with a predetermined threshold, and a still image obtained by the chroma key processing means superimposed on a bright field image not subjected to chroma key processing. Display means.

  In the invention according to claim 4, the chroma key processing means automatically obtains a still image of the fluorescent image in the bright field image every time the field of view is changed in conjunction with the switch related to the change of the field of view of the surgical microscope. It is characterized by doing.

  The invention described in claim 5 is characterized in that the photographing means and the display means are provided in the optical path of the surgical microscope.

  The invention according to claim 6 is characterized in that the switch related to the visual field change is any one of a focus variable switch, a zoom variable switch, a visual field XY movement switch, and a clutch release switch of a support mechanism for supporting the surgical microscope. And

  According to the first aspect of the present invention, only one photographing means is used, and the same visual field is photographed with a bright field (visible light) and a dark field (fluorescence). ) Is extracted and superimposed on the bright field image. Since the bright field and the dark field are the same field, the fluorescent image in the dark field coincides with the affected part in the bright field image. Therefore, since the affected part which is fluorescent in the bright field image can be displayed in real time, it can be used not only for observation but also directly in the operation using it by being incorporated in a surgical microscope or the like. Since there is one imaging means, it can be easily incorporated into a surgical microscope or the like.

  According to the invention of claim 2, every time the field of view of the surgical microscope is changed, it is necessary to take a dark field, but in conjunction with the switch related to the field of view change provided in the surgical microscope, The dark field was automatically taken when the field of view changed. Therefore, it is not necessary to operate the photographing means every time the field of view is changed, and the operability is good.

  According to the third aspect of the present invention, only a bright field is photographed by one photographing means. Depending on the type of fluorescent material and excitation light, or the sensitivity and performance of the imaging means, it is possible to capture the weak fluorescence in the bright field only. Accordingly, a bright-field image is subjected to chroma key processing to extract only a fluorescent image (affected area), and is superimposed and displayed on a bright-field image not subjected to chroma key processing. Since the chroma key processed image and the unprocessed video have the same visual field, the chroma key processed fluorescent image matches the affected area in the bright field video.

  According to the invention described in claim 4, every time the field of view of the surgical microscope is changed, it is necessary to obtain a still image of the fluorescent image in the bright field image by the chroma key processing means. In conjunction with the switch related to the field of view change, the acquisition of the still image of the fluorescent image accompanying the change of the field of view is automatically performed. Therefore, it is not necessary to operate the chroma key processing means each time the field of view is changed, and the operability is good.

  According to the fifth aspect of the present invention, since the photographing means and the display means are provided in the optical path of the surgical microscope, they can be incorporated into the surgical microscope without greatly changing the basic structure of the surgical microscope.

  According to the sixth aspect of the present invention, the switch related to the visual field change is any one of the focus variable switch, the zoom variable switch, the visual field XY movement switch, and the clutch release switch of the support mechanism that supports the surgical microscope. In accordance with the corresponding visual field changing operation, it is possible to reliably perform dark field imaging or chroma key processing.

  For the purpose of providing a medical display device suitable for incorporation into a surgical microscope or the like with only one imaging means, a single-field bright-field image including an affected area on which fluorescent substances are integrated, and excitation light on the affected area And a chroma key processing means for obtaining a still image with a transparent background by cutting out only the fluorescent image of the dark field image with a predetermined threshold value. And display means for displaying the still image obtained by the chroma key processing means superimposed on the bright field video. Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  1 to 3 are views showing a first embodiment of the present invention. The surgical microscope 1 is supported at the tip of a stand device or other support mechanism 2 in the operating room. The support mechanism 2 can freely change the position and orientation of the surgical microscope 1 by operating the clutch release switch 4 of the controller 3 provided in the surgical microscope 1 to free the clutch means (not shown). .

  The surgical microscope 1 is supported by the support mechanism 2 via the XY drive unit 5 and can move the entire surgical microscope 1 in four directions orthogonal in the horizontal direction. The XY drive unit 5 can also move the visual field of the surgical microscope 1 in the XY direction by operating a joystick type visual field XY movement switch 6 provided in the controller 3.

  The surgical microscope 1 is a stereoscopic microscope having two eyepieces 7, and as shown in FIG. 2, a focus lens 8 is installed in the vertical direction and a zoom lens 9 is installed in the horizontal direction. The focus lens 8 can move in the vertical direction to perform focus adjustment. The zoom lens 6 can move in the horizontal direction to perform zoom adjustment.

  Focus adjustment by the focus lens 8 can be performed by operating a focus variable switch 10 provided in the controller 3. Zoom adjustment by the zoom lens 9 can be performed by operating a zoom variable switch 11 provided in the controller 3. In this embodiment, the clutch release switch 4, the visual field XY movement switch 6, the focus variable switch 10, and the zoom variable switch 11 described above are “switches related to visual field change”.

  A beam splitter 12 is provided on one side of the two left and right optical paths K between the zoom lens 9 and the eyepiece 7 in the surgical microscope 1 to branch a part of the light in the horizontal direction. Then, the branched light beam can be photographed by one CCD camera (imaging means) 13 installed beside the surgical microscope 1. In FIG. 2, for convenience of description of the structure, the light beam is illustrated as being branched upward (actually, it is branched horizontally).

  A small liquid crystal panel (display unit) 14 is installed on the eyepiece 7 side of the beam splitter 12. The liquid crystal panel 14 is rotatable about the upper end. By rotating, the display screen can be seen from the eyepiece unit 7 by projecting into the optical path K. When the liquid crystal panel 14 is stored outside the optical path K, normal visual observation with the operation microscope 1 can be performed.

  Since the CCD camera 13 and the liquid crystal panel 14 are provided in the optical path K of the surgical microscope 1 as described above, they can be incorporated in the surgical microscope 1 without greatly changing the basic structure of the surgical microscope 1.

  The patient P observed by the surgical microscope 1 is preliminarily administered with a fluorescent dye 5-ALA as a fluorescent substance that accumulates in the affected area T such as a tumor. Since this accumulates in the cells of the affected area T, excitation light L having a wavelength region of 370 nm to 380 nm is irradiated to the affected area T after accumulation. The excitation light L is guided from the light source 15 to the affected part T by the optical fiber 16 and irradiated.

  Since the fluorescence from the affected part T is difficult to confirm in the bright field, when photographing with the CCD camera 13, the room illumination in the operating room is turned off and performed in the dark field.

  The CCD camera 13 installed in the surgical microscope 1 is connected to a chroma key device (chroma key processing means) 18 via a control unit 17. The chroma key device 18 receives a visible light image in the vicinity of the normal affected area T in the bright field and a fluorescent image of the affected area T in the dark field irradiated with the excitation light L, which is captured by the CCD camera 13. The bright field and dark field are completely the same field, and the field range, orientation, focus, zoom, etc. are completely the same.

  The bright field image and the dark field image captured by the CCD camera 13 are input to the chroma key device 18. In the chroma key device 18, a chroma key process 18a for obtaining a still image with a transparent background by cutting out only a fluorescent image from a dark field image, and a still image memory process 18b for storing the still image, An image synthesis process 18c is performed to superimpose a still image that has been subjected to the chroma key process 18a on a bright field image that is not subjected to the chroma key process 18a. The bright field image subjected to the image synthesis process can be displayed on the liquid crystal panel 14 and the external monitor 19 in the surgical microscope 1.

  Therefore, when the doctor performs an operation, first, the clutch release switch 4 provided in the controller 3 is operated to set the operation microscope 1 to a desired position and orientation, and then the focus variable switch 10 and the zoom are operated. The focus and zoom of the visual field can be adjusted with the variable switch 11, and the visual field XY movement switch 6 can be operated when necessary to move the visual field in the XY direction.

  When the visual field to be observed is determined, the main switch 20 and the display switch 21 of the chroma key device 18 are turned on. When the display switch 21 is turned on, the liquid crystal panel 14 protrudes into the optical path K in the surgical microscope 1. When the main switch 20 is turned on, the illumination in the operating room is automatically turned off and darkened, and the affected part T is irradiated with the excitation light L.

  Since fluorescence is emitted from the affected part T, the fluorescence image is taken by the CCD camera 13. After the fluorescent image is captured, the irradiation of the excitation light L is stopped, the illumination in the operating room is automatically turned on, and a bright field image can be captured. The captured dark field image is subjected to chroma key processing 18a, and the still image subjected to the chroma key processing 18a is superimposed on the bright field image not subjected to chroma key processing 18a and displayed on the liquid crystal panel 14 and the external monitor 19 in the surgical microscope 1.

  Since the dark field fluorescent image based on the same visual field is superimposed on the bright field image, the fluorescent image of the affected part T completely coincides with the affected part T in the bright field. Therefore, the doctor can completely grasp the position of the affected part T in the bright field image and can perform an accurate operation.

  Then, if any one of the switches 4, 6, 10, 11 related to the visual field change is operated during the operation, the bright field image changes, so that the operation is performed while the main switch 20 is on. Each time the operation is performed, the operating room is automatically darkened and the excitation light L is irradiated, and the dark field image is captured and the chroma key processing 18a is performed in the same manner as described above. It is acquired again and superimposed on the bright field image after the field of view is changed. Therefore, the fluorescent image of the affected part T can be displayed in real time in the bright field image that is always being observed. When the display of the fluorescent image is not performed, the display switch 21 is turned off, the liquid crystal panel 14 is accommodated outside the optical path K, and normal visual observation with the surgical microscope 1 can be performed.

  4 and 5 are views showing a second embodiment of the present invention. This embodiment shows an example in which the affected part T is displayed in a bright field image without darkening the operating room. That is, when performing fluorescence imaging of the affected area T, the affected area can be irradiated with the excitation light L without darkening the operating room depending on the fluorescent substance to be used, the type of excitation light, the performance of the CCD camera 13, or the like. In some cases, fluorescence from T can be photographed.

  Accordingly, in such a case, the bright field image captured by the CCD camera 13 is subjected to the chroma key processing 18a as it is, and the still image of the fluorescent image of the affected part T is taken out, and the bright key image 18a is not processed. It is displayed superimposed on the visual field image.

  Also in this case, when any one of the switches 4, 6, 10, and 11 related to the visual field change is operated, the bright field image changes, so that the operation is performed while the main switch 20 is on. Each time it is performed, the excitation light L is irradiated and the chroma key processing 18a of the bright field image is performed, and the acquired still image of the fluorescent image of the affected part T is superimposed and displayed in the bright field image. Other configurations and operational effects are the same as those of the first embodiment, and common parts are denoted by the same reference numerals, and redundant description is omitted.

  The CCD camera 13 may be provided with an optical filter that makes fluorescent photographing clearer in a range that does not interfere with visible light photographing.

Explanatory drawing which shows the surgical microscope incorporating the medical display apparatus which concerns on 1st Example of this invention. Schematic which shows the structure of the surgical microscope which concerns on 1st Example. Explanatory drawing which shows the image composition which concerns on 1st Example. Explanatory drawing which shows the surgery microscope incorporating the medical display apparatus which concerns on 2nd Example. Explanatory drawing which shows the image composition which concerns on 2nd Example.

Explanation of symbols

1 Surgical microscope 2 Support mechanism 4 Clutch release switch (switch related to visual field change)
6 Field of view XY movement switch (switch related to field of view change)
10 Focus variable switch (switch related to field of view change)
11 Zoom variable switch (switch related to field of view change)
13 CCD camera (photographing means)
14 Liquid crystal panel (display means)
18 Chroma key device (chroma key processing means)
19 External monitor (display means)
K optical path P patient T affected area L excitation light

Claims (6)

One imaging means for capturing a bright field image of a visual field including an affected area where fluorescent substances are accumulated, and a dark field image in which fluorescence is emitted by irradiating the affected area with excitation light;
Chroma key processing means for obtaining a still image in which only the fluorescent image of the dark field image is cut out at a predetermined threshold and the background is made transparent,
Display means for superimposing and displaying the still image obtained by the chroma key processing means on the bright field image;
A medical display device comprising: The medical display device according to claim 1,
A medical display device characterized in that an imaging unit automatically performs imaging of a dark field after change every time the field of view is changed in conjunction with a switch related to change of field of view of a surgical microscope. One imaging means for imaging a bright field image including fluorescence emitted by irradiating the affected area with excitation light in one visual field including the affected area where the fluorescent substance is accumulated;
Chroma key processing means for acquiring a still image with a transparent background by cutting out only a fluorescent image of the bright field video at a predetermined threshold;
Display means for displaying a still image obtained by the chroma key processing means superimposed on a bright field image not subjected to chroma key processing;
A medical display device comprising: The medical display device according to claim 3,
The chroma key processing means automatically obtains a still image of a fluorescent image in a bright field image every time the field of view is changed in conjunction with a switch related to the field of view change of a surgical microscope. Display device. The medical display device according to any one of claims 1 to 4,
A medical display device comprising an imaging means and a display means in an optical path of a surgical microscope. The medical display device according to claim 5,
A medical display device, wherein the switch related to the visual field change is any one of a focus variable switch, a zoom variable switch, a visual field XY movement switch, and a clutch release switch of a support mechanism for supporting a surgical microscope.

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