JP2008253605A - Ultrasonic diagnostic equipment and heart rate synchronizing signal generator - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To accurately generate a heart rate synchronizing signal and a warning signal based on the electrocardiographic waveform on which a pacemaker waveform is superposed. <P>SOLUTION: A waveform detecting part 61 of a heart rate synchronizing signal generating part 6 provided in an ultrasonic diagnostic equipment detects QRS wave and a pacemaker waveform separately from the electrocardiographic waveform of a subject on which the pacemaker waveform is superposed. A synchronizing signal generating part 62 generates a heart rate synchronizing signal for determining the time phase of heart rate synchronizing image data based on the detected QRS wave. On the other hand, a warning signal generating part 63 generates a warning signal for stopping the operation of a medical device having the possibility of giving interference noise to the heart pacemaker based on the pacemaker waveform detected by the waveform detecting part 61. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an ultrasonic diagnostic apparatus and a heartbeat synchronization signal generation apparatus that collect and display image data based on a heartbeat synchronization signal generated based on an electrocardiogram waveform.

  The ultrasonic diagnostic apparatus radiates an ultrasonic pulse generated from a vibration element built in an ultrasonic probe into a subject and receives an ultrasonic reflected wave generated by a difference in acoustic impedance of the subject tissue by the vibration element. Thus, various biological information is collected.

  This diagnostic method is widely used for functional diagnosis and morphological diagnosis of living organs because a real-time two-dimensional image can be easily observed with a simple operation by simply bringing an ultrasonic probe into contact with the body surface. Ultrasound diagnostic methods for obtaining biological information from reflected waves from tissues or blood cells in a living body have made rapid progress with the development of two major technologies, the ultrasonic pulse reflection method and the ultrasonic Doppler method. The obtained B-mode image and color Doppler image are indispensable in today's ultrasonic image diagnosis.

  By the way, ultrasonic image data (hereinafter referred to as image data) such as B-mode image data and color Doppler image data in the circulatory region is usually synchronized with a biological signal such as an electrocardiographic waveform obtained from the same subject. Generated or displayed. For example, a method of measuring a heartbeat time phase based on an electrocardiographic waveform in parallel with generation of time-series image data for a subject and storing the heartbeat time phase as incidental information of the image data when storing the image data Has been proposed (see, for example, Patent Document 1). According to this method, when displaying the above-mentioned image data, the image data can be read based on the heartbeat time phase information, so that the image data in the desired heartbeat time phase can be displayed in a short time and accurately. It becomes.

  In particular, when comparing multiple pieces of image data obtained from different sections of the same subject, or image data of the same diagnosis target part before and after drug load or exercise load, the heart rate added to each image data By using the synchronization signal, it is possible to compare and observe time-series image data in a desired heartbeat time phase, and generation and display of time-series image data in a desired heartbeat time phase based on the heartbeat synchronization signal. Can also be performed in real time.

  When generating a heartbeat synchronization signal from an electrocardiogram waveform having a different amplitude or shape depending on the subject, various devices have been made to detect the timing of the heartbeat synchronization signal stably and accurately. A method of generating a heartbeat synchronization signal based on the QRS wave having the largest amplitude is generally performed. In this case, the heartbeat synchronization signal generation unit included in the ultrasonic diagnostic apparatus compares a preset threshold value with the amplitude of the QRS wave, and generates a heartbeat synchronization signal at a timing when the QRS wave exceeds the threshold value.

  However, according to this method, when the amplitude of the T wave following the QRS wave is also larger than the threshold value, a new heartbeat synchronization signal is generated at a timing when the amplitude of the T wave exceeds the threshold value. In order to suppress the generation of a heartbeat synchronization signal based on such a T wave, a method of setting a mask period can be considered. By setting this mask period longer than the interval from the QRS wave to the T wave (RT interval) and shorter than the interval from the QRS wave to the next QRS wave (RR interval: heartbeat cycle), QRS It is possible to obtain only the heartbeat synchronization signal based on the wave.

On the other hand, a method of continuously monitoring the respiratory waveform measured in parallel with the measurement of the electrocardiographic waveform for the purpose of collecting the heartbeat synchronization signal and observing the electrocardiographic waveform as described above is performed in an emergency medical field or the like. In this case, the respiratory waveform is measured from a temporal change in impedance of the breast tissue obtained by applying a weak alternating voltage between a plurality of electrodes mounted on the subject's chest.
JP 2004-305453 A

  By the way, when a cardiac pacemaker with low resistance to electromagnetic interference noise from an external device, such as a rate-applied cardiac pacemaker, measures the respiratory waveform by impedance measurement as described above for a subject mounted in the body. The cardiac pacemaker has a risk of malfunction due to interference noise caused by the applied AC voltage being mixed from the sensor unit. In such a case, the operator of the apparatus checks whether or not a cardiac pacemaker having low resistance to interference noise is attached to the subject by reporting from the subject, and if so, breathing is performed. A method of manually stopping the operation of the waveform measurement unit has been taken.

  However, it is usually difficult to obtain information on the type and function of the cardiac pacemaker, and whether or not it is resistant to interference noise directly from the subject. It is impossible to obtain information. For this reason, when performing an ultrasound diagnosis using the heart rate synchronization method on a subject equipped with a cardiac pacemaker that has low resistance to interference noise, such as a rate-applied cardiac pacemaker, the operation of the respiratory waveform measurement unit is ensured. There was always a risk that it would be difficult to stop and the cardiac pacemaker would malfunction.

  On the other hand, an impulse-like trigger waveform (hereinafter referred to as a pacemaker waveform) output from the cardiac pacemaker is superimposed on the electrocardiographic waveform of the subject on which the cardiac pacemaker is attached, and the amplitude of this pacemaker waveform is If the predetermined threshold is exceeded, an erroneous heartbeat synchronization signal is generated. When image data in an incorrect time phase is collected based on the heartbeat synchronization signal, image data needs to be collected again, which not only lowers diagnostic efficiency but also increases the burden on the operator. Further, in the case of ultrasonic examination on a subject to which a contrast medium or a drug has been administered, there is a problem in that the burden on the subject increases because re-administration of these is necessary.

  The present invention has been made in view of such conventional problems, and a first object thereof is to generate a heartbeat synchronization signal generated based on an electrocardiographic waveform obtained from a subject to which a cardiac pacemaker is attached. An ultrasonic diagnostic apparatus capable of generating an accurate heartbeat synchronization signal using an electrocardiogram waveform of the subject on which a pacemaker waveform is superimposed when collecting image data at a desired heartbeat time phase of the subject using And providing a heartbeat synchronization signal generating apparatus.

  Furthermore, a second object of the present invention is to provide image data and breathing in a desired heartbeat time phase of the subject using a heartbeat synchronization signal generated based on an electrocardiographic waveform obtained from the subject wearing a cardiac pacemaker. An ultrasonic diagnostic apparatus and a heartbeat synchronization signal generation apparatus capable of generating a warning signal for the purpose of stopping the operation of a respiratory waveform measurement unit that may give interference noise to the cardiac pacemaker when collecting waveforms It is to provide.

  In order to solve the above-described problem, a heartbeat synchronization signal generation apparatus according to the present invention according to claim 1 generates a heartbeat synchronization signal that generates a heartbeat synchronization signal based on an electrocardiogram waveform obtained from a subject to which a cardiac pacemaker is attached. A waveform detecting means for separating and detecting the QRS wave and the pacemaker waveform in the electrocardiographic waveform on which the pacemaker waveform of the cardiac pacemaker is superimposed, and the QRS wave detected by the waveform detecting means A heartbeat synchronization signal generating means for generating a heartbeat synchronization signal based on the signal and a warning signal generating means for generating a warning signal based on the pacemaker waveform detected by the waveform detecting means are provided.

  The ultrasonic diagnostic apparatus of the present invention according to claim 8 is an ultrasonic diagnostic apparatus that generates image data in a desired heartbeat time phase based on a received signal obtained by transmitting and receiving ultrasonic waves to a subject, The heartbeat synchronization signal generation device according to any one of claims 1 to 7 is provided as a heartbeat synchronization signal generation unit, and the heartbeat synchronization signal is generated based on the heartbeat synchronization signal of the subject generated by the heartbeat synchronization signal generation unit. Image data in a desired heartbeat time phase is generated.

  According to the present invention, image data and a respiratory waveform in a desired heartbeat time phase of the subject are collected using a heartbeat synchronization signal generated based on an electrocardiographic waveform obtained from the subject with a cardiac pacemaker. At this time, it is possible to reliably stop the operation of the respiratory waveform measurement unit that may give interference noise to the cardiac pacemaker.

  Embodiments of the present invention will be described below with reference to the drawings.

  The heart rate synchronization signal generation unit of the ultrasonic diagnostic apparatus according to the first embodiment of the present invention described below generates a heart rate synchronization signal based on an electrocardiogram waveform obtained from the subject, and the transmission / reception unit is a system control unit. Drives a plurality of vibration elements provided in the ultrasonic probe according to a time-series frame trigger signal in a desired heartbeat time phase generated based on the heartbeat synchronization signal, and transmits / receives ultrasonic waves to / from the subject. Next, the image data generation unit performs signal processing on reception signals collected from a plurality of directions of the subject to generate image data in the heartbeat time phase, and the display unit generates in synchronization with each of the frame trigger signals The time-series image data thus displayed are sequentially displayed.

  At this time, the heartbeat synchronization signal generator separates and detects the QRS wave and the pacemaker waveform in the electrocardiogram waveform of the subject on which the pacemaker waveform is superimposed, and based on the detected QRS wave, the heartbeat synchronization signal described above And a warning signal based on the pacemaker waveform. And the said system control part controls the respiration waveform measurement unit which may give interference noise with respect to the said cardiac pacemaker according to the said warning signal, and stops the operation | movement.

  In this embodiment, moving image data is collected and displayed on a subject before drug administration, and further, time-series image data (hereinafter referred to as “time-series image data”) in the desired heartbeat time phase of the subject after drug administration. Is referred to as heart rate synchronization image data), but is not limited to this. For example, image data generation / display before and after exercise load and before and after contrast agent administration Good. In the following embodiments, a case where B-mode image data before and after drug administration is generated based on B-mode data collected in a desired heartbeat time phase will be described. Color Doppler image data or TDI based on color Doppler data is described. (Tissue Doppler Imaging) Image data, and also other image data such as THI (Tissue Harmonic Imaging) using harmonic components of received ultrasonic waves may be used.

(Device configuration)
The configuration of the ultrasonic diagnostic apparatus according to the first embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a block diagram showing the overall configuration of the ultrasonic diagnostic apparatus according to this embodiment. 2 and 4 show the configuration of the transmission / reception unit and the image data generation unit and the configuration of the heartbeat synchronization signal generation unit provided in the ultrasonic diagnostic apparatus.

  The ultrasonic diagnostic apparatus 100 of the present embodiment shown in FIG. 1 transmits an ultrasonic pulse (transmission ultrasonic wave) to a subject to which a cardiac pacemaker is attached, and an ultrasonic reflected wave (reception) obtained by this transmission. An ultrasonic probe 3 having a plurality of vibration elements for converting ultrasonic waves into electrical signals (reception signals), and a drive signal for transmitting ultrasonic pulses in a predetermined direction of the subject. The transmission / reception unit 2 that performs phasing addition of the reception signals of a plurality of channels obtained from these vibration elements, and performs signal processing on the reception signal after the phasing addition, thereby moving image data or an image in a desired heartbeat time phase. An image data generation unit 4 that generates data (heart rate synchronized image data), an electrocardiogram waveform measurement unit 5 that measures an electrocardiogram waveform of the subject, and the pacemaker waveform of the cardiac pacemaker superimposed thereon The purpose is to generate a heartbeat synchronization signal that determines the time phase of heartbeat synchronization image data based on the electrocardiogram waveform of the specimen and to stop the operation of a later-described respiratory waveform measurement unit 7 that may give interference noise to the cardiac pacemaker. Is provided with a heartbeat synchronization signal generator 6 for generating a warning signal.

  Further, the ultrasonic diagnostic apparatus 100 uses the electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 5 and the respiration waveform supplied from the respiration waveform measurement unit 7 as moving image data supplied from the image data generation unit 4 or heartbeat synchronization. The display unit 8 that is displayed by being superimposed on the image data, the input unit 9 for inputting subject information, setting image data generation conditions, and inputting various command signals, etc., and the above-described in the ultrasonic diagnostic apparatus 100 A system control unit 10 that controls each unit in an integrated manner is provided.

  The ultrasonic probe 3 transmits and receives ultrasonic waves to and from the body by bringing a tip having N vibration elements (not shown) into contact with the body surface of the subject. Each of the vibration elements is connected to the transmission / reception unit 2 via an N-channel multi-core cable (not shown). The vibration element is an electroacoustic transducer, which converts an electric pulse (driving signal) into an ultrasonic pulse (transmitting ultrasonic wave) during transmission and converts an ultrasonic reflected wave (received ultrasonic wave) into an electrical reception signal during reception. It has a function. The ultrasonic probe 3 has a sector scan support, a linear scan support, a convex scan support, and the like. In this embodiment, a case where the sector scan ultrasonic probe 3 is used will be described. A corresponding ultrasonic probe may be used.

  Next, specific configurations of the transmission / reception unit 2 and the image data generation unit 4 will be described with reference to the block diagram of FIG. The transmission / reception unit 2 illustrated in FIG. 2 includes a transmission unit 21 that supplies a drive signal to N vibration elements in the ultrasonic probe 3 and reception that performs phasing addition of N-channel reception signals obtained from the vibration elements. A portion 22 is provided.

  The transmission unit 21 transmits a rate pulse generator 211 that generates a rate pulse for determining a repetition period of the transmission ultrasonic wave, a delay time for focusing the transmission ultrasonic wave to a predetermined depth, and a predetermined direction. A transmission delay circuit 212 that gives a delay time to the rate pulse, and a drive circuit 213 that generates a drive pulse based on the delay time of the rate pulse and drives the N vibration elements built in the ultrasonic probe 3. Have.

  On the other hand, the receiving unit 22 includes an A / D converter 221 that performs A / D conversion on the N-channel received signal supplied from the vibration element, a delay time for focusing the received ultrasonic wave from a predetermined depth, and a predetermined time. A reception delay circuit 222 that gives a delay time for setting the reception directivity to the direction to each of the N-channel reception signals subjected to A / D conversion, and an N-channel reception signal output from the reception delay circuit 222 An adder 223 for adding and synthesizing is provided, and the reception signal obtained from a predetermined direction of the subject is phased and added by the reception delay circuit 222 and the adder 223.

  Next, the image data generation unit 4 performs an ultrasonic signal generation unit 41 that performs predetermined signal processing on the reception signal after the phasing addition output from the reception unit 22 of the transmission / reception unit 2 to generate B-mode data. The B-mode data is stored in correspondence with the ultrasonic wave transmission / reception direction with respect to the subject, and an ultrasonic data storage unit 42 for generating B-mode image data is provided. Then, the ultrasonic data generation unit 41 performs logarithmic conversion on the amplitude of the envelope detector 411 that performs envelope detection on the received signal supplied from the adder 223 of the reception unit 22 and the B mode A logarithmic converter 412 for generating data is provided. However, the envelope detector 411 and the logarithmic converter 412 may be configured by changing the order.

  Returning to FIG. 1, the electrocardiogram waveform measurement unit 5 uses a measurement electrode mounted on the body surface of the subject for the purpose of detecting the electrocardiogram waveform, and an electrocardiogram waveform detected by the measurement electrode as a predetermined value. An amplifying circuit for amplifying the amplitude and an A / D converter (none of which is shown) for converting the amplified electrocardiographic waveform into a digital signal are provided.

  FIG. 3 shows, for example, an electrocardiographic waveform of the subject in which a rate-adaptive cardiac pacemaker is mounted in the body and the pacemaker waveform of the cardiac pacemaker superimposed on the electrocardiographic waveform. An impulse-like pacemaker waveform Pm repeatedly generated at a predetermined period Tr is superimposed on an electrocardiographic waveform Ec having a P wave, a QRS wave, and a T wave generated from the myocardial tissue of the subject by stimulation of the pacemaker waveform Pm. Output from the radio wave measuring unit 5.

  The pacemaker waveform Pm that precedes the P wave, QRS wave, and T wave of the electrocardiographic waveform Ec has a frequency component that is extremely wide compared to the P wave, QRS wave, and T wave. In the following, detection of a QRS wave that is normally used for generating a heartbeat synchronization signal because it has the largest amplitude among P waves, QRS waves, and T waves generated according to the pacemaker waveform Pm will be described, but the present invention is not limited to this. It is not a thing.

  Next, the configuration of the heartbeat synchronization signal generator 6 will be described with reference to FIG. The heartbeat synchronization signal generating unit 6 generates a QRS wave in the electrocardiographic waveform of the subject supplied in time series from the electrocardiographic waveform measurement unit 5 of FIG. 1 and a pacemaker waveform superimposed on the electrocardiographic waveform. A waveform detection unit 61 that detects the waveform separately, a synchronization signal generation unit 62 that generates a heartbeat synchronization signal based on the QRS wave detected by the waveform detection unit 61, and a pacemaker waveform detected by the waveform detection unit 61. A warning signal generator 63 for generating a warning signal based on the warning signal is provided.

  The waveform detector 61 described above emphasizes the QRS wave from the electrocardiogram waveform Ec of the subject supplied from the electrocardiogram waveform measurement unit 5 in a state where the pacemaker waveform is superimposed as shown in FIG. A QRS wave detection unit 611 for detecting and a pacemaker waveform detection unit 612 for detecting only the pacemaker waveform from the electrocardiogram waveform Ec are provided. Each of the QRS wave detection unit 611 and the pacemaker waveform detection unit 612 is provided with a filter circuit (not shown) having a predetermined band or cutoff frequency, for example.

  FIG. 5 shows the frequency component Fr of the QRS wave, the frequency component Fp of the pacemaker waveform, the frequency characteristic Hr of the filter circuit (first filter circuit) included in the QRS wave detection unit 611, and the filter circuit (first filter circuit included in the pacemaker waveform detection unit 612). 2 shows a specific example of frequency characteristics Hr and Hp, and the pacemaker waveform has a signal band wider than the signal band of a QRS wave having a frequency component Fr of 10 Hz to 20 Hz, for example. . For such QRS wave of frequency component Fr and pacemaker waveform of frequency component Fp, the filter circuit of QRS wave detector 611 having filter characteristic Hr (first filter characteristic) selectively selects frequency component Fr of QRS wave. The filter circuit of the pacemaker waveform detector 612 having the filter characteristic Hp (second filter characteristic) extracts the high frequency component of the pacemaker waveform by removing the frequency component Fr of the QRS wave.

  FIG. 6 shows an electrocardiogram waveform of the subject on which the pacemaker waveform supplied from the electrocardiogram waveform measurement unit 5 and input to the QRS wave detector 611 and the pacemaker waveform detector 612 of the waveform detector 61 is superimposed (FIG. 6 ( a)), and the output waveform of the QRS wave detector 611 (FIG. 6B) and the output waveform of the pacemaker waveform detector 612 (FIG. 6C) are schematically shown in FIG. The amplitude of the pacemaker waveform Pm is greatly reduced in the output waveform of the QRS wave detector 611 shown in FIG. On the other hand, the QRS waveform is deleted from the output waveform of the pacemaker waveform detection unit 612 shown in FIG. 6C, and only the component (particularly, the high frequency component) of the pacemaker waveform Pm is output.

  Returning to FIG. 4, the synchronization signal generation unit 62 of the heartbeat synchronization signal generation unit 6 outputs an output waveform of the QRS wave detection unit 611 in which the QRS wave is relatively emphasized relative to the pacemaker waveform, and a preset threshold value α (first For example, when the output waveform exceeds the threshold value α, a trigger signal is generated as a heartbeat synchronization signal.

  On the other hand, the warning signal generation unit 63 determines whether or not a cardiac pacemaker is mounted in the body of the subject based on the output waveform of the pacemaker waveform detection unit 612 consisting only of the high frequency components of the pacemaker waveform from which the QRS wave component is eliminated. And generating a warning signal for stopping the operation of the respiratory waveform measurement unit 7 which has a risk of giving harmful interference noise to the cardiac pacemaker based on the determination result. Specifically, the output waveform of the pacemaker waveform detector 612 is compared with a preset threshold value β (second threshold value), and a warning signal is generated when the output waveform exceeds the threshold value β a predetermined number of times.

  Returning to FIG. 1, the respiratory waveform measurement unit 7 accompanies the measurement electrode disposed on the body surface of the subject for the purpose of impedance measurement of the breast tissue and the AC voltage applied to the measurement electrode. A respiratory waveform estimation unit that estimates a respiratory waveform based on the impedance of the breast tissue obtained by measuring an alternating current, and an A / D converter (none of which is shown) that converts the respiratory waveform into a digital signal are provided. ing. However, the above-described impedance measurement for the breast tissue is usually performed using measurement electrodes provided in the electrocardiogram waveform measurement unit 5 for the purpose of measuring the electrocardiogram waveform.

  On the other hand, the display unit 8 includes a display data generation unit 81, a data conversion unit 82, and a monitor 83. The display data generation unit 81 is, for example, the moving image data of the subject before the drug administration generated by the image data generation unit 4, the heartbeat synchronization image data in the desired heartbeat phase after the drug administration, and the electrocardiographic waveform measurement unit 5 The display unit generates the display data by synthesizing the electrocardiogram waveform measured by and the respiration waveform measured by the respiration waveform measurement unit. The data converter 82 performs D / A conversion and display format conversion on the display data to generate a video signal and display it on the monitor 83. Further, each unit of the display unit 8 has a warning message or warning information indicating that “a cardiac pacemaker is mounted in the subject” based on the warning signal generated by the warning signal generation unit 63 of the heartbeat synchronization signal generation unit 6. Is displayed (notified).

  On the other hand, the input unit 9 includes input devices such as a display panel, a keyboard, a trackball, a mouse, a selection button, and an input button on the operation panel, and inputs object information, an observation mode, and an image data collection mode. The image data collection condition and the image data display condition are set, the threshold value α and the threshold value β are set, and various command signals are input. The observation mode includes a moving image observation mode and a heartbeat synchronization image observation mode, and the image data collection mode includes an image data collection mode based on B-mode data and an image data collection mode based on color Doppler data.

  The system control unit 10 includes a CPU and a storage circuit (not shown), and the above-described various information input or set by the input unit 9 is stored in the storage circuit. Then, the CPU controls the transmission / reception unit 2 and the image data generation unit 4 of the ultrasonic diagnostic apparatus 100 based on the input / setting information described above, performs sector scanning on the subject, and generates moving image data in real time. To do. Further, a frame trigger signal corresponding to a desired heartbeat time phase is generated based on the heartbeat synchronization signal supplied from the heartbeat synchronization signal generation unit 6, and the transmission / reception unit 2 and the image data generation unit 4 are controlled by this frame trigger signal. Then, time-sequential heartbeat synchronized image data in the heartbeat time phase is generated.

  Furthermore, the system control unit 10 has a function of controlling the respiratory waveform measurement unit 7 based on the warning signal supplied from the warning signal generation unit 63 of the heartbeat synchronization signal generation unit 6 and stopping its operation.

(Heart rate synchronization image data collection procedure)
Next, the collection procedure of heartbeat synchronization image data in the present embodiment will be described with reference to the flowchart of FIG.

  Prior to the collection of image data for the subject, the operator of the ultrasound diagnostic apparatus 100 attaches the measurement electrodes of the electrocardiogram waveform measurement unit 5 and the respiratory waveform measurement unit 7 to the surface of the chest body of the subject, and then inputs The unit 9 inputs subject information, sets image data collection conditions, sets image data display conditions, and sets threshold values α and β. The input / setting information is stored in the storage circuit of the system control unit 10 (step S1 in FIG. 7).

  When the above initial setting is completed, the operator selects the moving image data observation mode in the input unit 9 and then makes the input unit 9 in a state where the ultrasonic probe 3 is in contact with the surface of the subject body before drug administration. Enter the image data collection start command. Then, when this command signal is supplied to the system control unit 10, collection of moving image data for the subject is started (step S2 in FIG. 7).

  When collecting moving image data, the rate pulse generator 211 of the transmission unit 21 illustrated in FIG. 2 generates a rate pulse according to the control signal supplied from the system control unit 10 and supplies the rate pulse to the transmission delay circuit 212. The transmission delay circuit 212 determines a delay time for focusing the ultrasonic wave to a predetermined depth in order to obtain a narrow beam width in transmission and a delay time for transmitting the ultrasonic wave in the first transmission / reception direction θ1. The rate pulse is supplied to the N-channel driving circuit 213. Next, the drive circuit 213 generates a drive signal having a predetermined delay time based on the rate pulse supplied from the transmission delay circuit 212, and supplies this drive signal to the N vibration elements in the ultrasonic probe 3. The transmitted ultrasonic wave is emitted into the subject.

  A part of the radiated transmission ultrasonic wave is reflected by an organ boundary surface or tissue having different acoustic impedance, received by the vibration element, and converted into an N-channel electrical reception signal. The received signal is converted into a digital signal by the A / D converter 221 of the receiving unit 22, and then the delay time and the transmission / reception for converging the received ultrasonic wave from a predetermined depth in the N-channel reception delay circuit 222. A delay time for setting a strong reception directivity with respect to the reception ultrasonic wave from the direction θ1 is given, and phasing addition is performed by the adder 223.

  The envelope detector 411 and the logarithmic converter 412 in the ultrasonic data generation unit 41 of the image data generation unit 4 to which the reception signal after the phasing addition is supplied perform envelope detection and logarithmic conversion on the reception signal. B mode data is generated and stored in the ultrasonic data storage unit 42.

  When the generation and storage of the B mode data for the transmission / reception direction θ1 is completed, ultrasonic waves are transmitted / received in the same procedure for each of the transmission / reception directions θ2 to θP, and the B mode data obtained at this time is also the ultrasonic data. It is stored in the storage unit 42. That is, in the ultrasonic data storage unit 42, B-mode data generated based on ultrasonic transmission / reception with respect to the transmission / reception directions θ1 to θP is stored corresponding to the transmission / reception direction, and image data is generated. Then, the generated image data is supplied to the display data generation unit 81 of the display unit 8.

  On the other hand, in parallel with the generation of the image data described above, the electrocardiogram waveform measurement unit 5 and the respiration waveform measurement unit 7 amplify the electrocardiogram waveform and the respiration waveform measured for the subject to a predetermined size A / D-converted and supplied to the display data generation unit 81 of the display unit 8. The display data generation unit 81 superimposes the electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 5 on the image data supplied from the image data generation unit 4 and the respiration waveform supplied from the respiration waveform measurement unit 7 to display data. Is displayed on the monitor 83 via the data converter 82.

  Further, by repeating ultrasonic transmission / reception in the transmission / reception directions θ1 to θP, a plurality of time-series image data on which the electrocardiogram waveform and the respiration waveform in the same time phase are superimposed are displayed as moving image data on the monitor 83 of the display unit 8. Displayed in real time (step S3 in FIG. 7).

  At this time, the pacemaker waveform detector 612 in the waveform detector 61 of the heartbeat synchronization signal generator 6 performs a filtering process on the electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 5 and is superimposed on the electrocardiogram waveform. When the presence or absence of a waveform is detected (step S4 in FIG. 7) and a pacemaker waveform is detected, the warning signal generator 63 generates a warning signal based on the detection result (step S5 in FIG. 7). Next, the system control unit 10 that has received this warning signal controls the display unit 8 to display (notify) a warning message or warning information that “a cardiac pacemaker is mounted in the subject” (FIG. 7). Step S6). Furthermore, the system control unit 10 supplies the control signal (operation stop signal) generated based on the warning signal to the respiratory waveform measurement unit 7 to stop the operation (step S7 in FIG. 7).

  On the other hand, the operator determines a suitable imaging position by adjusting the position and direction of the ultrasonic probe 3 under the observation of the moving image data displayed in real time in step S3, and then administers the drug to the subject. (Step S8 in FIG. 7), and the heartbeat synchronization image observation mode is selected in the input unit 9 (Step S9 in FIG. 7).

  At this time, the QRS wave detection unit 611 in the waveform detection unit 61 of the heartbeat synchronization signal generation unit 6 that has been supplied with the electrocardiogram waveform from the electrocardiogram waveform measurement unit 5 filters the electrocardiogram waveform and extracts the QRS wave. Then, the synchronization signal generation unit 62 generates a trigger signal as a heartbeat synchronization signal by comparing the QRS wave extracted by the QRS wave detection unit 611 with a preset threshold value α (step S10 in FIG. 7). .

  Next, the system control unit 10 that has received the heartbeat synchronization signal from the heartbeat synchronization signal generation unit 6 generates a frame trigger signal at the same timing as the heartbeat synchronization signal or at a timing delayed by a predetermined time from the heartbeat synchronization signal ( Step S11 in FIG.

  Next, the system control unit 10 controls the transmission / reception unit 2 and the image data generation unit 4 using the frame trigger signal, and the image data (beat-synchronized image data) synchronized with the frame trigger signal by the same procedure as in step S3 described above. ) Is generated. On the other hand, the display data generation unit 81 of the display unit 8 supplies the electrocardiogram waveform supplied from the electrocardiogram waveform measurement unit 5 or the respiration waveform supplied from the electrocardiogram waveform and the respiration waveform measurement unit 7 from the system control unit 10. The timing information of the frame trigger signal thus synthesized is combined, and further, the display data is generated by superimposing the combined electrocardiogram waveform or the electrocardiogram waveform and the respiratory waveform on the above-mentioned heartbeat synchronization image data. Then, the data conversion unit 82 performs D / A conversion and display format conversion on the display data and displays them on the monitor 83 (step S12 in FIG. 7).

  Further, by repeating the above steps S10 to S12, the monitor 83 of the display unit 8 has an electrocardiogram waveform having timing information of the frame trigger signal or an electrocardiogram waveform and a respiratory waveform superimposed on a desired heartbeat time phase. Time-series heartbeat synchronized image data is displayed (steps S10 to S12 in FIG. 7).

  According to the first embodiment described above, a heartbeat synchronization signal is generated based on an electrocardiogram waveform obtained from a subject on which a cardiac pacemaker is attached, and the subject's desired heartbeat time is generated using this heartbeat synchronization signal. When collecting image data in a phase, a QRS wave of an electrocardiographic waveform and a pacemaker waveform superimposed on the electrocardiographic waveform are separately detected and a heartbeat synchronization signal is generated based on the detected QRS wave This makes it possible to generate an accurate heartbeat synchronization signal. For this reason, image data in a desired heartbeat time phase can be easily and accurately collected even for a subject to which a cardiac pacemaker is attached, and ultrasonic diagnosis with high accuracy can be efficiently performed.

  Furthermore, according to the above-described embodiment, a heartbeat synchronization signal is generated based on an electrocardiogram waveform obtained from a subject to which a cardiac pacemaker is attached, and the subject is in a desired heartbeat time phase using the heartbeat synchronization signal. When collecting the image data and the respiratory waveform, the QRS wave of the electrocardiogram waveform and the pacemaker waveform superimposed on the electrocardiogram waveform are separately detected and detected according to the warning signal generated based on the detection result of the pacemaker waveform. By controlling the operation of the respiratory waveform measurement unit, it is possible to reliably stop the operation of the respiratory waveform measurement unit that may give interference noise to the cardiac pacemaker. For this reason, the malfunction of the cardiac pacemaker due to the interference noise of the respiratory waveform measurement unit can be prevented in advance, and the safety in the ultrasonic examination is greatly improved.

  Next, a heartbeat synchronization signal generating apparatus according to the second embodiment of the present invention will be described. The heartbeat synchronization signal generating apparatus in the present embodiment separately detects and detects a QRS wave of an electrocardiogram waveform measured from a subject on which a cardiac pacemaker is attached and a pacemaker waveform superimposed on the electrocardiogram waveform. A respiration waveform measurement unit that generates a heartbeat synchronization signal that determines the time phase of the heartbeat synchronization image data based on the QRS wave and that may cause interference noise to the heart pacemaker based on the detected pacemaker waveform A warning signal for stopping the operation is generated.

(Device configuration)
The configuration of the heartbeat synchronization signal generation apparatus according to the second embodiment of the present invention will be described with reference to the block diagram of FIG. However, in FIG. 8, units having the same configuration and function as each unit of the heart rate synchronization signal generation unit 6 shown in FIG.

  The heartbeat synchronization signal generating apparatus 200 of the present embodiment shown in FIG. 8 includes a QRS wave of an electrocardiogram waveform measured by an electrocardiogram waveform measurement unit separately installed on a subject to which a cardiac pacemaker is attached, and the electrocardiogram waveform. A waveform detector 61 for separating and detecting a pacemaker waveform superimposed on the signal, a synchronization signal generator 62 for generating a heartbeat synchronization signal based on the QRS wave detected by the waveform detector 61, and the waveform detection A warning signal generating unit 63 that generates a warning signal based on the pacemaker waveform detected by the unit 61, an input unit 64, and a control unit 65 are provided.

  The waveform detector 61 includes a QRS wave detector 611 that detects a QRS wave from the electrocardiogram waveform of the subject supplied from the electrocardiogram waveform measurement unit in a state where the pacemaker waveform is superimposed, and a pacemaker waveform from the electrocardiogram waveform. A pacemaker waveform detection unit 612 is provided. Each of the QRS wave detection unit 611 and the pacemaker waveform detection unit 612 is provided with a filter circuit (not shown) having a predetermined band and cutoff frequency.

  Next, the synchronization signal generation unit 62 compares the output waveform of the QRS wave detection unit 611 in which the QRS wave is relatively emphasized with respect to the pacemaker waveform with a preset threshold value α. A trigger signal is generated as a heartbeat synchronization signal at a time exceeding

  On the other hand, the warning signal generation unit 63 determines whether or not a cardiac pacemaker is mounted in the body of the subject based on the output waveform of the pacemaker waveform detection unit 612 consisting only of the high frequency components of the pacemaker waveform from which the QRS wave component is eliminated. And generating a warning signal for stopping the operation of a biological signal measuring device such as a respiratory waveform measuring unit or a treatment device that has a risk of giving harmful interference noise to the cardiac pacemaker based on the determination result . Specifically, the output waveform of the pacemaker waveform detector 612 is compared with a preset threshold value β, and a warning signal is generated when the output waveform exceeds the threshold value β a predetermined number of times.

  The input unit 64 has a function of setting various constants in each of the above-described units. For example, setting of filter constants or filter characteristics of filter circuits provided in each of the QRS wave detection unit 611 and the pacemaker waveform detection unit 612, The threshold α in the synchronization signal generator 62 and the threshold β in the warning signal generator 63 are set. Then, the control unit 65 comprehensively controls each of the above-described units, and generates a heartbeat synchronization signal and a warning signal based on an electrocardiogram waveform measured from the subject on which the cardiac pacemaker is attached.

  According to the second embodiment described above, when generating a heartbeat synchronization signal based on an electrocardiogram waveform obtained from a subject on which a cardiac pacemaker is worn, the QRS wave of the electrocardiogram waveform and this ECG waveform are superimposed. The detected pacemaker waveform is separately detected, and a heartbeat synchronization signal is generated based on the detected QRS wave, whereby an accurate heartbeat synchronization signal can be generated.

  In addition, according to the above-described embodiment, when generating a heartbeat synchronization signal based on an electrocardiogram waveform obtained from a subject on which a cardiac pacemaker is worn, the QRS wave of the electrocardiogram waveform and the ECG waveform are superimposed. By detecting the pacemaker waveform separately and controlling the operation of the medical device used simultaneously according to the warning signal generated based on the detection result of the pacemaker waveform, interference noise can be given to the cardiac pacemaker It is possible to reliably stop the operation of the medical device. For this reason, the malfunction of the cardiac pacemaker due to the interference noise of the medical device can be prevented in advance, and the safety in diagnosis and treatment is greatly improved.

  Furthermore, since the heartbeat synchronization signal generation device in the above-described embodiment is configured independently of a medical image diagnosis device such as an ultrasonic diagnosis device, any device can be used by being connected to these medical image diagnosis devices. The generation and supply of the heartbeat synchronization signal and the warning signal can be easily and stably performed for the medical image diagnostic apparatus.

  As mentioned above, although the Example of this invention has been described, this invention is not limited to the above-mentioned Example, It can change and implement. For example, the heartbeat synchronization signal generator 6 in the first embodiment described above or the heartbeat synchronization signal generator in the second embodiment generates a heartbeat synchronization signal based on the QRS wave of the electrocardiogram waveform obtained from the subject. Although the case has been described, it may be generated based on a P wave or a T wave.

  The heartbeat synchronization signal generator 6 in the first embodiment or the waveform detector 61 of the heartbeat synchronization signal generator in the second embodiment detects a QRS wave from an electrocardiogram waveform on which a pacemaker waveform is superimposed. The QRS wave detection unit 611 having the filter circuit and the pacemaker waveform detection unit 612 having the filter circuit for detecting the pacemaker waveform have been described independently. However, the present invention is not limited to this. Absent. For example, it is possible to detect a QRS wave and a pacemaker waveform in a time series by one filter circuit whose filter characteristics can be arbitrarily set. In this case, it can be easily realized by switching the QRS wave detection filter characteristic to the pacemaker waveform detection filter characteristic within a predetermined period after the QRS wave or T wave detection time.

  On the other hand, in the first embodiment described above, the case where warning words and warning information such as “a cardiac pacemaker is mounted in the subject” is displayed on the display unit 8 is described. You may display (notify | report) in the alerting | reporting part which is provided separately and which is not shown in figure.

  In the first embodiment, the case of generating / displaying time-series image data in a desired heartbeat time phase based on the heartbeat synchronization signal has been described. Further, heartbeat time phase data based on the heartbeat synchronization signal may be added and stored, and image data in a desired heartbeat time phase may be read and displayed based on the heartbeat time phase data. In this case, as described above, it may be a comparison display of image data generated under other conditions such as image data before and after exercise load, or image data in different scanning sections of the same subject, The display at this time may be either a still image display or a moving image display.

  Furthermore, in the first embodiment, moving image data is collected and displayed on a subject before drug administration, and further, time-sequential heartbeat synchronization images in a desired heartbeat time phase of the subject after drug administration. Although the case of generating and displaying data has been described, the present invention is not limited to this. For example, image data may be generated / displayed before and after exercise load. In this embodiment, the case where B-mode image data is generated based on B-mode data collected at a desired heartbeat time phase has been described. However, color Doppler image data based on color Doppler data or TDI (Tissue Doppler Imaging) ) Image data, and other image data such as THI (Tissue Harmonic Imaging) using harmonic components of received ultrasonic waves may be used.

1 is a block diagram showing the overall configuration of an ultrasonic diagnostic apparatus according to a first embodiment of the present invention. The block diagram which shows the specific structure of the transmission / reception part with which the ultrasonic diagnostic apparatus of the Example is provided, and an image data generation part. The figure which shows the electrocardiogram waveform with which the pacemaker waveform measured by the electrocardiogram waveform measurement unit of the Example was superimposed. The block diagram which shows the structure of the heart rate synchronizing signal generation part with which the ultrasonic diagnostic apparatus of the Example is provided. The figure which shows the frequency characteristic of the filter circuit with which each of the QRS wave and the frequency component of a pacemaker waveform and the QRS wave detection part and pacemaker waveform detection part in the Example is provided. The figure for demonstrating the input-output waveform of the waveform detection part with which the heart-rate-synchronization signal generation part of the Example is provided. The flowchart which shows the collection procedure of the heartbeat synchronous image data in the Example. The block diagram which shows the whole structure of the heart rate synchronizing signal generation apparatus in 2nd Example of this invention.

Explanation of symbols

2. Transmission / reception unit 21 ... Transmission unit 211 ... Rate pulse generator 212 ... Transmission delay circuit 213 ... Drive circuit 22 ... Reception unit 221 ... A / D converter 222 ... Reception delay circuit 223 ... Adder 3 ... Ultrasonic probe 4 ... Image data generation unit 41 ... Ultrasonic data generation unit 411 ... Envelope detector 412 ... Logarithmic converter 42 ... Ultrasound data storage unit 5 ... Electrocardiogram waveform measurement unit 6 ... Heartbeat synchronization signal generation unit 61 ... Waveform detection unit 611 ... QRS wave detection unit 612 ... pacemaker waveform detection unit 62 ... synchronization signal generation unit 63 ... warning signal generation unit 64 ... input unit 65 ... control unit 7 ... respiratory waveform measurement unit 8 ... display unit 81 ... display data generation unit 82 ... data conversion Unit 83 ... monitor 9 ... input unit 10 ... system control unit 100 ... ultrasonic diagnostic apparatus 200 ... heartbeat synchronization signal generation apparatus

Claims (10)

A heartbeat synchronization signal generating device that generates a heartbeat synchronization signal based on an electrocardiogram waveform obtained from a subject to which a cardiac pacemaker is attached,
Waveform detecting means for separately detecting a QRS wave and the pacemaker waveform in the electrocardiographic waveform on which the pacemaker waveform of the cardiac pacemaker is superimposed;
A heartbeat synchronization signal generating means for generating a heartbeat synchronization signal based on the QRS wave detected by the waveform detection means;
An apparatus for generating a heartbeat synchronization signal, comprising: warning signal generation means for generating a warning signal based on the pacemaker waveform detected by the waveform detection means.   The waveform detecting means includes QRS wave detecting means having a first filter circuit for extracting the QRS wave and pacemaker waveform detecting means having a second filter circuit for extracting the pacemaker waveform. The heartbeat synchronization signal generation apparatus according to claim 1, wherein   The first filter circuit has a band-pass filter characteristic that emphasizes and extracts the signal component of the QRS wave, and the second filter circuit eliminates the signal component of the QRS wave and increases the height of the pacemaker waveform. 3. The heartbeat synchronization signal generating apparatus according to claim 2, wherein the apparatus has a high-pass filter characteristic for extracting a band component.   The synchronization signal generation means sets the generation timing of the heartbeat synchronization signal by comparing the amplitude of the QRS wave detected by the waveform detection means with a preset first threshold value. The heartbeat synchronization signal generation device according to claim 1.   2. The heartbeat synchronization signal generation according to claim 1, wherein the warning signal generation means detects the presence or absence of the pacemaker waveform detected by the waveform detection means, and generates the warning signal based on the detection result. apparatus.   The warning signal generation means detects the presence or absence of the pacemaker waveform by comparing the amplitude of the pacemaker waveform detected by the waveform detection means with a preset second threshold value. 6. The heartbeat synchronization signal generating device according to 5.   The waveform detecting means detects the QRS wave and the pacemaker waveform by repeating in time series a first filter characteristic for extracting the QRS wave and a second filter characteristic for extracting the pacemaker waveform. The heartbeat synchronization signal generating apparatus according to claim 1, wherein An ultrasonic diagnostic apparatus that generates image data at a desired heartbeat time phase based on a reception signal obtained by transmitting and receiving ultrasonic waves to a subject,
The heartbeat synchronization signal generation device according to any one of claims 1 to 7 is provided as a heartbeat synchronization signal generation unit, and the heartbeat synchronization signal is generated based on the heartbeat synchronization signal of the subject generated by the heartbeat synchronization signal generation unit. An ultrasonic diagnostic apparatus that generates image data in a desired heartbeat time phase.   9. The ultrasonic diagnostic apparatus according to claim 8, further comprising a respiratory waveform measurement unit, and the respiratory waveform measurement unit stops its operation based on a warning signal generated by the heartbeat synchronization signal generation unit.   9. The supervising device according to claim 8, further comprising notifying means for notifying warning information, wherein the notifying means notifies warning information that a cardiac pacemaker is attached to the subject based on the warning signal. Ultrasonic diagnostic equipment.

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