JP2009160235A - Medical image processor, medical image diagnostic apparatus, and x-ray ct system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image processor which displays an image expressing the connection between the abnormal section of a wall motion and a narrowed portion of a blood vessel on the basis of an ultrasonic tomogram of the heart generated by an ultrasonic diagnostic apparatus and a three-dimensional image of the heart and the arteria coronaria generated by an X-ray CT device or an MRI. <P>SOLUTION: The processor is provided with an abnormal section extraction part 101 which obtains coordinate information on the abnormal section of the wall motion of the heart; an arteria coronaria extraction part 102 which obtains coordinate information on the arteria coronaria; a mapping part 103 which expresses the coordinate information on the abnormal section and the coordinate information on the arteria coronaria at the same three-dimensional coordinates; a distance calculation part 105 which calculates distances from respective points of the arteria coronaria to the abnormal section; a blood vessel cross section calculation part 106 which calculates cross-section areas at the respective points of the arteria coronaria; and an image generation part 107 which generates a graph which associates the arteria coronaria, the distances to the abnormal section from the respective points of the arteria coronaria, and the cross section area at the respective points of the arteria coronaria with each other. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical image processing apparatus and a medical image diagnostic apparatus that display a relationship between a wall motion on the myocardial intima side of a heart and a coronary artery. More specifically, the present invention relates to a medical image processing apparatus that extracts a blood vessel portion having a high stenosis rate based on wall motion, and a medical image diagnostic apparatus using the medical image processing apparatus, particularly an X-ray CT apparatus.

  Regarding the diagnosis of an abnormal site of wall motion on the myocardial intima side of the heart (hereinafter simply referred to as “wall motion”), an ultrasonic image in a state where no load is applied to the patient using an ultrasonic diagnostic apparatus, In addition, an ultrasound image is collected in a state where the patient is loaded. Then, the motion of the wall motion is observed based on this ultrasonic image, and an abnormal part of the heart is extracted.

  As for diagnosis of a stenosis site in a coronary artery, an image such as a cross-sectional view of a blood vessel is collected by an X-ray CT apparatus or an MRI apparatus, and diagnosis is performed using a stenosis analysis algorithm. For example, Patent Document 1 discloses an invention for extracting a coronary artery based on a CT image or an MRI image. In this invention, the image area of the coronary artery is extracted by analyzing the luminance and color of the heart image. Then, abnormal points of the heart are detected by extracting feature points such as the extracted branch point and tip of the coronary artery and following the movement of the feature points for each time phase.

  Conventionally, as in Patent Document 1 described above, the position of each coronary artery is extracted for each phase, and the coronary artery image generated by the X-ray CT apparatus is mapped to the heart image generated by the same X-ray CT apparatus. By doing so, it has been performed to grasp abnormalities in the operation of the heart. In addition, using the ultrasonic tomographic image of the heart generated by a medical diagnostic apparatus such as an ultrasonic diagnostic apparatus, the displacement or distortion of a specific tissue on the intima side of the heart for each time phase is obtained, and the obtained displacement or distortion is determined. A technique has been proposed in which an abnormal wall motion is obtained by comparing the value of the value with a reference value.

JP 2005-237555 A

  However, in the technique of Patent Document 1, an abnormality of the heart can be detected from the state of the coronary artery, but the relationship between the stenosis site of the coronary artery and the abnormality of the wall motion of the heart, in particular, the abnormality of the wall motion on the intima side of the heart The relationship between and is difficult to express. In addition, in the method of calculating the abnormality of the heart wall motion based on the displacement or distortion of the specific tissue on the intima side of the heart, it is only necessary to grasp the abnormal part of the heart wall motion based on the tomographic image of the heart, It is difficult to express the relationship between the abnormal part and the stenosis part of the coronary artery.

  The present invention has been made in view of such circumstances, and an ultrasonic tomographic image of the heart generated by an ultrasonic diagnostic apparatus and a three-dimensional image of the heart and coronary artery generated by an X-ray CT apparatus or MRI. Based on the above, a medical image processing apparatus, a medical image diagnostic apparatus, and an X-ray CT apparatus for displaying an image representing the relationship between an abnormal part of wall motion on the intima side of the heart and a stenotic part of a coronary artery are provided. It is an object.

  In order to achieve the above object, the medical image processing apparatus according to claim 1 is based on an ultrasonic tomogram generated by an ultrasonic diagnostic apparatus, and an abnormal site of wall motion on the intima side of the heart of a subject. The abnormal part extracting means for obtaining coordinate information on the three-dimensional coordinates on the ultrasonic tomographic image and the three-dimensional image of the heart generated by the medical image diagnostic apparatus other than the ultrasonic diagnostic apparatus Coronary artery extraction means for obtaining coordinate information on three-dimensional coordinates on the three-dimensional image, coordinate information on three-dimensional coordinates of the abnormal part, and coordinate information on three-dimensional coordinates of the coronary artery are set to the same three-dimensional coordinates. Mapping means for representing; distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery; cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery; and the extracted coronary artery When Image generation means for generating a graph in which the distance to the abnormal site at each point of the coronary artery is associated with the cross-sectional area at each point of the coronary artery, and display control for displaying the generated graph on the display means Means.

  The medical image processing apparatus according to claim 10, based on the ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus, on the ultrasonic tomographic image of the abnormal part of the wall motion on the intima side of the subject's heart. 3D on the 3D image of the coronary artery based on the 3D image of the heart generated by the abnormal part extracting means for obtaining coordinate information on the 3D coordinates and the medical image diagnostic apparatus other than the ultrasonic diagnostic apparatus Coronary artery extracting means for obtaining coordinate information on the coordinates, mapping means for representing the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery in the same three-dimensional coordinates, A distance calculating means for obtaining a distance to the abnormal part at each point, and a tomographic image of a predetermined distance including the coronary artery of the heart is generated, and a position in the length direction of the coronary artery based on the distance to the abnormal part is generated. Let me correspond And the image generation means for generating an image color the coronary artery of the tomographic image, it is characterized in that and a display control means for displaying the generated image on the display means.

  The medical image diagnostic apparatus according to claim 11 receives an ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus, and on the ultrasonic tomographic image of an abnormal site of wall motion on the intima side of the subject's heart. Abnormal part extraction means for obtaining coordinate information on three-dimensional coordinates, three-dimensional image generation means for generating a three-dimensional image of an external view of the heart based on data obtained by imaging the heart, and the three-dimensional image The coronary artery extracting means for obtaining coordinate information of the coronary artery on the three-dimensional image on the three-dimensional image, and the coordinate information of the abnormal part on the three-dimensional coordinate and the coordinate information of the coronary artery on the three-dimensional coordinate are the same. Mapping means represented by three-dimensional coordinates, distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery, cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery, Extracted Image generating means for generating a graph in which the coronary artery, the distance to the abnormal site at each point of the coronary artery, and the cross-sectional area at each point of the coronary artery are associated with each other, and the generated graph as display means Display control means for displaying.

  An X-ray CT apparatus according to a twelfth aspect of the present invention is based on three-dimensional image generation means for irradiating a subject with X-rays and generating a three-dimensional image of an external view of the heart of the subject, Based on the coronary artery extraction means for obtaining the coordinate information on the three-dimensional coordinates on the three-dimensional image of the coronary artery and the ultrasonic tomogram generated by the ultrasonic diagnostic apparatus, the wall motion of the intima side of the subject's heart is detected. The abnormal part extracting means for obtaining coordinate information on the three-dimensional coordinates on the ultrasonic tomographic image of the abnormal part, and the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery are the same. Mapping means represented by three-dimensional coordinates, distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery, cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery, The extracted coronary artery Image generating means for generating a graph in which the distance to the abnormal site at each point of the coronary artery is associated with the cross-sectional area at each point of the coronary artery, and a display for displaying the generated graph on the display means And a control means.

  According to the medical image processing apparatus according to claim 1, the medical image diagnosis apparatus according to claim 11, and the X-ray CT apparatus according to claim 12, the cross-sectional area of the coronary artery and the distance from the coronary artery to the abnormal site Can be displayed in correspondence (for example, side by side). Thereby, the operator can grasp | ascertain the constriction site | part of a coronary artery with a large change of the distance to an abnormal site | part. If the distance from the abnormal site changes greatly in the vicinity of the stenosis site of the coronary artery, it can be estimated that the stenosis site of the coronary artery is highly likely to cause an abnormality in the heart wall motion. Therefore, it becomes possible for the operator to extract coronary arteries that are estimated to be highly likely to cause abnormalities in the heart wall motion, and which coronary artery should be inserted to check for abnormal coronary arteries. It is possible to prioritize.

  In addition, according to the medical image processing apparatus of the tenth aspect, it is possible to display an image obtained by coloring the coronary artery image based on the distance to the abnormal part. As a result, the operator can intuitively grasp which part of the actual coronary artery has a stenosis part that has a great influence on the abnormality of the wall motion.

[First Embodiment]
A medical image processing apparatus according to the first embodiment of the present invention will be described below. FIG. 1 is a block diagram showing functions of the medical image processing apparatus 100 according to the present embodiment. The medical image processing apparatus 100 in this embodiment is connected to an external ultrasonic diagnostic apparatus 001 and an X-ray CT apparatus 002. This connection may be via a network or may be directly connected by a cable for performing information communication.

  The ultrasonic diagnostic apparatus 001 transmits an ultrasonic wave toward the subject's heart, receives an ultrasonic echo reflected by the heart, and generates an ultrasonic tomographic image of the heart based on the ultrasonic echo. Then, the ultrasonic diagnostic apparatus 001 outputs the generated ultrasonic tomogram to the abnormal part extraction unit 101 of the medical image processing apparatus 100. Furthermore, the ultrasound diagnostic apparatus 001 according to the present embodiment acquires tomographic image data representing the heart for each cardiac phase by scanning the subject's heart with ultrasound at regular intervals. That is, the ultrasonic diagnostic apparatus 001 acquires heart moving image data. For example, a plurality of tomographic image data (heart moving image data) over one period or more are acquired by scanning the heart of the subject with ultrasonic waves over one period or more. When an ECG signal is acquired, each tomographic image data is output to the abnormal part extraction unit 101 in association with the cardiac phase received at the timing when the tomographic image data is generated. Thereby, the cardiac time phase in which the tomographic image data is generated is associated with each of the plurality of tomographic image data and sent.

  The X-ray CT apparatus 002 rotates an X-ray irradiation unit and an X-ray detection unit (both not shown) in a direction perpendicular to the body axis of the subject, and further emits X-rays toward the heart while proceeding in the body axis direction. Then, X-rays passing through the heart are sensed. Then, the X-ray CT apparatus 002 generates an X-ray CT image that is a three-dimensional image of the heart based on the detected X-rays. Then, the X-ray CT apparatus outputs the generated X-ray CT image to the coronary artery extraction unit 102 of the medical image processing apparatus 100. The X-ray CT apparatus 002 acquires a plurality of X-ray CT images of the heart at a predetermined imaging interval (frame rate), thereby acquiring a three-dimensional image of the heart for each cardiac phase. That is, the X-ray CT apparatus 002 acquires heart moving image data. If an ECG signal is acquired, the cardiac time phase received at the timing when the tomographic image data is generated is associated with the X-ray CT image and output to the coronary artery extraction unit 102.

  FIG. 2 is a diagram schematically showing extraction of an abnormal part from an ultrasonic tomographic image. The abnormal part extraction unit 101 tracks the movement of each position of the heart wall with respect to the plurality of ultrasonic tomographic images 201 shown in FIG. 2 that form the moving image input from the ultrasonic diagnostic apparatus 001. Get the state of motion (displacement, displacement direction, displacement speed, etc.). Then, as shown in the graph 202, the abnormal part extraction unit 101 obtains an abnormal part 203 causing an abnormality in the heart wall motion based on the state of the heart wall motion, and coordinates the abnormal part 203 in the three-dimensional space. Ask for information. Here, the sphere represented by the dotted line in the graph 202 schematically represents the heart 204. In the graph 202, only the coordinate information of the abnormal part 203 is obtained, and the coordinates of the heart 204 are not particularly obtained, and are merely described for grasping the overall position. It is represented by a dotted line. Such extraction of the abnormal part 203 can be performed by applying any conventional technique. An outline of an example of a conventional method for extracting the abnormal portion 203 of the heart will be described. The abnormal part extraction unit 101 corresponds to the “abnormal part extraction unit” in the present invention.

  The abnormal part extraction unit 101 sets, as an initial contour, a contour designated on a tomographic image representing the heart based on the ultrasonic tomographic image 201, and a pattern between two acquired tomographic images having different cardiac phases. The position of each point constituting the contour in each cardiac time phase is obtained by matching. This contour designation designates the contour of the intima of the tomographic image of the heart such as the end diastole and the end diastole displayed on the monitor. Similarly, the operator designates the contour of the adventitia in the tomographic image of the heart. The contours of the intima and outer membrane in the tomographic image in which the intima and outer membrane are designated are set as the initial contour. When the two-dimensional contours of the intima and epicardium of a predetermined cardiac phase are designated by the operator, the abnormal site extraction unit 101 performs pattern matching between two images using a speckle pattern. For each ultrasonic tomographic image 201 acquired in the cardiac phase, the position of each point constituting the two-dimensional contour of the intima and outer membrane designated by the initial contour is obtained. Then, the abnormal part extraction unit 101 temporally tracks each point constituting the two-dimensional contour of the intima and outer membrane. Then, the abnormal part extraction unit 101 generates tomographic image data that draws a movement vector at each point constituting the intima and epicardium contours set as the initial contour by pattern matching using the speckle pattern. It is obtained for each time phase, and the movement vector at each point constituting the contours of the intima and epicardium is traced in time. In this way, the abnormal part extraction unit 101 obtains the coordinates of each point constituting the two-dimensional contour of the inner curtain and outer membrane in each cardiac phase. Then, the abnormal part extraction unit 101 calculates the displacement of the intima and epicardium in each cardiac phase based on the coordinate information of each point constituting the two-dimensional contours of the intima and epicardium in each cardiac phase. Ask. Then, the abnormal part extraction unit 101 obtains the myocardial distortion in each cardiac phase based on the displacement of the intima and epicardium in each cardiac phase. The abnormal part extraction unit 101 obtains a distortion rate representing a temporal change rate of distortion for each cardiac phase by differentiating temporally the myocardial distortion at each location in each cardiac phase. Then, the abnormal part extraction unit 101 extracts a part equal to or greater than a predetermined threshold as an abnormal part causing abnormal wall motion based on the distortion rate normalized by the maximum distortion value (maximum distortion) at each part. To do. The abnormal part extraction unit 101 uses the graph 202 corresponding to the ultrasonic tomographic image 201 based on the scanning information such as the scanning direction and the depth for the point of the abnormal part on the two-dimensional ultrasonic tomographic image 201 obtained in this way. It is expressed as coordinate information of the abnormal part 203 represented on the three-dimensional coordinate space represented by As described above, the abnormal part extraction unit 101 obtains the coordinate information of the abnormal part 203 in the three-dimensional coordinate space corresponding to the ultrasonic tomographic image 201. Here, the number of abnormal sites 203 is not limited to one, and a plurality of abnormal sites 203 may be detected. In that case, three-dimensional coordinate information of a plurality of abnormal sites 203 is obtained.

  In this embodiment, a threshold value of the strain rate is set in advance, and the portion having the strain rate exceeding the threshold value is used as the abnormal portion 203 of the wall motion. However, this may be another method. For example, a load is applied to the heart. The abnormal part 203 may be extracted by comparing the ultrasonic image in the case of the normal and the ultrasonic tomographic image in the case where no load is applied to the heart, or the normal ultrasonic tomogram and the abnormal ultrasonic tomogram. The configuration may be such that the abnormal part 203 is extracted by comparing with an image.

  The abnormal part extraction unit 101 outputs the coordinate information of the abnormal part 203 in the three-dimensional space corresponding to the obtained ultrasonic three-dimensional image to the mapping unit 103 and the image generation unit 107.

  FIG. 3 is a diagram schematically showing the extraction of the coronary artery from the X-ray CT image. The coronary artery extraction unit 102 analyzes the heart X-ray CT image 301 input from the X-ray CT apparatus in FIG. 3, extracts an image area of the coronary artery 304 as shown in the graph 303, and corresponds to the X-ray CT image 301. The coordinate information of the coronary artery 304 in the three-dimensional space to be acquired is acquired. Here, the sphere in the X-ray CT image 301 schematically represents the heart 302. Such calculation of the coordinate information of the coronary artery 304 can be performed by applying any conventional method. Therefore, an outline of an example of a method for extracting the coordinate information of the coronary artery 304 by the coronary artery extracting unit 102 will be described below. The coronary artery extraction unit 102 corresponds to “coronary artery extraction means” in the present invention.

  In the X-ray CT image 301 of the heart, the image area of the coronary artery 304 is represented by a different brightness and color from other image areas of the heart 302 (particularly the peripheral area of the coronary artery). The coronary artery extraction unit 102 extracts the image area of the coronary artery 304 by analyzing the luminance and color of the X-ray CT image 301 of the heart. For example, the coronary artery extraction unit 102 first determines the root position of the coronary artery in the image region of the coronary artery 304. The coronary artery 304 is a blood vessel that branches from the base and stretches around the surface layer, and supplies blood to the myocardium. The coronary artery extraction unit 102 specifies the root position of the aorta (the operator may specify it manually), and extracts a pixel value (pixel value) in the vicinity of the specified position. Then, the coronary artery extraction unit 102 extracts an image region of the coronary artery 304 by selecting a pixel having a pixel value substantially equal to the root position of the coronary artery 304 from pixels forming a three-dimensional image of the heart 302. Then, the coronary artery extraction unit 102 acquires coordinate information of the coronary artery 304 in a three-dimensional space corresponding to the X-ray CT image 301 generated by the X-ray CT apparatus based on the extracted image area of the coronary artery 304.

  Further, the coronary artery extraction unit 102 can obtain the direction of blood flow of the coronary artery 304 by tracing (tracing) pixels of the extracted image area of the coronary artery 304.

  The coronary artery extraction unit 102 outputs the coordinate information of the coronary artery 304 in the three-dimensional space corresponding to the X-ray CT image 301 generated by the acquired X-ray CT apparatus to the mapping unit 103 and the centerline extraction unit 104.

  Further, the coronary artery extraction unit 102 outputs the coordinate information of the coronary artery 304 and the blood flow direction of the coronary artery 304 to the blood vessel cross-sectional area calculation unit 106.

  FIG. 4 is a diagram schematically showing the mapping between the abnormal site 203 and the coronary artery 304 by the mapping unit 103. The mapping unit 103 includes the coordinate information of the abnormal part 203 and the coordinate information of the heart 204 in the three-dimensional space corresponding to the ultrasonic tomographic image 201 input from the abnormal part extraction unit 101, and the three-dimensional corresponding to the X-ray CT image 301. Based on the space, an abnormal site 203 is synthesized on the heart 302 represented by the X-ray CT image 301 as shown by a graph 401. Further, the mapping unit 103 is based on the coordinate information of the coronary artery 304 in the three-dimensional space corresponding to the X-ray CT image 301 in which the abnormal part 203 is synthesized and the X-ray CT image 301 input from the coronary artery extraction unit 102. As shown in the graph 402, the abnormal part 203 and the coronary artery 304 are represented on the same three-dimensional coordinate space. Hereinafter, expressing two different three-dimensional coordinate spaces as the same three-dimensional coordinate space is referred to as “mapping”. The mapping between the three-dimensional space corresponding to the ultrasonic tomographic image 201 and the three-dimensional space corresponding to the X-ray CT image 301 can be performed by applying any conventional method. Therefore, an outline of an example of a mapping method between the three-dimensional space corresponding to the ultrasonic tomographic image 201 and the three-dimensional space corresponding to the X-ray CT image 301 by the mapping unit 103 will be described below. Hereinafter, the coordinate system of the three-dimensional space defined by the ultrasonic tomographic image 201 is referred to as a first coordinate system, and the coordinate system of the three-dimensional space defined by the X-ray CT image 301 is referred to as a second coordinate system. This mapping unit 103 corresponds to “mapping means” in the present invention.

  When the coordinate conversion parameter is given in advance between the first coordinate system and the second coordinate system to the mapping unit 103, the mapping unit 103 uses the coordinate conversion parameter of the mapping unit 103 in the first coordinate system. By converting the value into a value in the second coordinate system, the coordinate information of the abnormal part 203 of the heart wall motion is expressed by the second coordinate value. Accordingly, the mapping unit 103 represents the abnormal portion 203 of the heart wall motion and the coronary artery 304 of the heart in the same coordinate system (here, the second coordinate system).

  On the contrary, it is possible to process the coordinate information of the coronary artery 304 to be expressed in the first coordinate system. Further, the coordinate information of the abnormal region 203 and the coordinate information of the coronary artery 304 may be expressed by a third coordinate system that can be converted with both the first and second coordinate systems.

  Next, a case where no coordinate conversion parameter is given in advance between the first coordinate system and the second coordinate system in the mapping unit 103 will be described. When several reference points are commonly found in the first coordinate system and the second coordinate system, the mapping unit 103 sets a coordinate conversion parameter for converting the coordinates of these reference points from one to the other. Ask. Thereby, an image represented by one coordinate system can be represented as an image of the other coordinate system. If the reference point is not clear, it is represented in a different coordinate system by detecting which region in the image in the second coordinate system is most similar to the small region of the image in the first coordinate system 2. A coordinate conversion parameter capable of converting between images is obtained. Basically, it is effective when two images are overlapped by translation. Although it can be applied even if there is a slight distortion, for example, when the sizes are different, as described above, image features are extracted and matching between feature descriptions is performed. For example, in both the ultrasonic three-dimensional image and the three-dimensional image obtained by the X-ray CT apparatus, the septum of the heart is expressed in each coordinate system. Therefore, the heart septum is extracted as a feature, and coordinate conversion parameters that can be converted from one to the other are obtained. The above coordinate conversion parameters are generated by a combination of matrices such as parallel movement on three-dimensional coordinates, rotation enlargement / reduction, and the like.

  The mapping unit 103 outputs the coordinate information of the abnormal part 203 of the heart wall motion and the coordinate information of the coronary artery 304 to which the coordinate systems are matched to the distance calculation unit 105.

  The center line extraction unit 104 extracts a center line that is a curve passing through the center of the coronary artery based on the coordinate information of the coronary artery in the three-dimensional space corresponding to the X-ray CT image input from the coronary artery extraction unit 102. The method for extracting the center line of the coronary artery from the coordinate information of the coronary artery can be performed by applying any conventional method. For example, as an example of the centerline extraction method, the center of gravity of the inner wall in each cross section when the coronary artery is cut at regular intervals (for example, every 0.1 mm) is calculated, and spline interpolation (specifically, calculated) The center of gravity is connected by a cubic function or the like to create a curve. In the present embodiment, a straight line connecting the centroids of the coronary artery cross sections is used as the center line. The centerline extraction unit 104 corresponds to “centerline extraction means” in the present invention.

  Further, the center line extraction unit 104 extracts points on the center line of the coronary artery at specific intervals. If the interval is narrowed, more detailed information can be obtained, and if the interval is widened, the process for obtaining the distance to the abnormal site described below is accelerated. In this embodiment, points are extracted at intervals of 0.1 mm along the center line of the coronary artery in order to suppress variations in the interval between the points to be extracted. For example, by obtaining the distance between two points on the center line and extracting points at regular intervals, it is possible to extract points at approximately equal intervals on the center line. In addition, other criteria may be used to extract this point. For example, points may be extracted at intervals of 0.1 mm between the X coordinate, the Y coordinate, or the Z coordinate. In the present embodiment, the centerline extraction unit 104 extracts points on the centerline again after obtaining the centerline, but when the interval change is not necessary, the centerline extraction unit 104 extracts the centerline. The center of gravity may be used as a point on the center line.

  The center line extraction unit 104 outputs the obtained coordinate information of the points on the center line to the distance calculation unit 105 and the blood vessel cross-sectional area calculation unit 106. In this embodiment, since the abnormal part is mapped in the coordinate system defined by the X-ray CT image in the mapping, the coordinate information of the point on the center line obtained by the center line extraction unit 104 is transmitted to the distance calculation unit 105 as it is. However, when another coordinate system is used in the mapping, the coordinate information of the point on the center line obtained by the center line extraction unit 104 is also converted into coordinates corresponding to the coordinate system mapped by the mapping unit 103. The coordinate information obtained by the conversion needs to be output to the distance calculation unit 105.

  FIG. 5 is a diagram for explaining the calculation of the distance from each point on the center line to the abnormal part using the shortest distance by the distance calculation unit 105. The distance calculation unit 105 extracts a point on the abnormal part 501 from the coordinate information of the abnormal part 501 input from the mapping unit 103. A point on the intima represented by the coordinate information in the three-dimensional space corresponding to the ultrasonic tomographic image 201 used when the abnormal part extraction unit 101 extracts the abnormal part 501 of the wall motion is subjected to coordinate conversion by the mapping unit 103. Are converted into points expressed in a three-dimensional space corresponding to the X-ray CT image 301. Therefore, for example, the distance calculation unit 105 can extract points on the abnormal part 501 by extracting points on the intima of the heart converted by the mapping unit 103. This distance calculation unit 105 corresponds to “distance calculation means” in the present invention.

  The distance calculation unit 105 obtains the distance from the point 504 on the center line 503 of the coronary artery 502 input from the center line extraction unit 104 to each extracted point on the abnormal part 501. Then, the distance calculation unit 105 sets the shortest distance among the obtained distances as the distance from the point 504 on the center line 503 to the abnormal part 501. The distance calculation unit 105 calculates the distance to the abnormal part 501 for all the points 504 on the extracted center line 503 on the coronary artery. Here, there may be a plurality of abnormal sites 501 as described above. Even in that case, the distance calculation unit 105 may calculate the distances for all the points on the abnormal part 501 and set the shortest distance among them as the distance from the point 504 on the center line 503 to the abnormal part 501. Even if the abnormal part 501 exists in a plurality of places and the distance from each point 504 on the center line 503 of the coronary artery 502 extends over the plurality of abnormal parts 501, the distance should change smoothly. Therefore, when a change in distance is displayed on the display unit 109, which will be described later, even if the abnormal part 501 from which the distance from each point 504 is calculated is different, the operator has a relationship between the stenosis part and the distance. This is because it is considered that there is very little influence on grasping.

  The distance calculation unit 105 outputs the coordinate information of each point 504 on the center line 503 and the calculated distance from each point 504 to the abnormal part 501 to the image generation unit 107.

  The blood vessel cross-sectional area calculation unit 106 obtains a cut surface obtained by cutting the blood vessel image input from the coronary artery extraction unit 102 in a direction perpendicular to the blood vessels at points on the center line input from the center line extraction unit 104. More specifically, first, the blood vessel cross-sectional area calculation unit 102 acquires the blood flow direction of the coronary artery obtained by the coronary artery extraction unit 102 at a point on a certain center line. Then, the blood vessel cross-sectional area calculation unit 102 obtains an expression of a plane orthogonal to the blood flow direction at the point on the center line. Then, the blood vessel cross-sectional area calculation unit 106 obtains an intersection area between the expression of this plane and the blood vessel wall of the coronary artery. This is because the coordinate information of the lumen of the blood vessel is obtained by searching for a portion where the luminance on the tomographic screen cut at the plane described above changes extremely. Thereby, the blood vessel cross-sectional area calculation unit 106 acquires coordinate information of the blood vessel cross-section at the position of the point. The blood vessel cross-sectional area calculation unit 106 calculates the cross-sectional area of the blood vessel (the area of the lumen) based on the obtained coordinate information of the blood vessel cross-section. This blood vessel cross-sectional area calculation unit 106 corresponds to “cross-sectional area calculation means” in the present invention.

  The blood vessel cross-sectional area calculation unit 106 detects a blood vessel cross-section at each point on the center line input from the center line extraction unit 104, and calculates an area. In the present embodiment, the point on the center line input from the center line extraction unit 104 is used in order to match the position obtained by the distance calculation unit 006 with the distance to the abnormal site. Since it is sufficient to know the approximate relationship between the stenosis site and the distance from each point on the center line of the coronary artery to the abnormal site, the points on the center line used by the blood vessel cross-sectional area calculation unit 106 and the distance calculation unit 105 are different. May be. In other words, the blood vessel cross-sectional area calculation unit 106 may independently extract the coordinates of points on the center line of the coronary artery. For example, the blood vessel cross-sectional area calculation unit 106 may set the interval between extracted points to 0.1 mm, and the distance calculation unit 105 may set the interval between extracted points to 0.2 mm.

  The blood vessel cross-sectional area calculation unit 106 inputs the calculated blood vessel cross-sectional area at each point on the center line of the coronary artery to the image generation unit 107.

  The image generation unit 107 inputs the coordinate information of the coronary artery and the coordinate information of the heart expressed in the three-dimensional space corresponding to the X-ray CT image from the coronary artery extraction unit 102, and 3 corresponding to the X-ray CT image from the mapping unit 103. Input of coordinate information of an abnormal part of the heart wall motion represented in a three-dimensional space, input of distance information from each point on the center line of the coronary artery from the distance calculation unit 105 to a blood vessel cross-sectional area calculation unit The blood vessel cross-sectional area at each point on the center line of the coronary artery is input from 106. This image generation unit 107 corresponds to “image generation means” in the present invention.

  The image generation unit 107 has a function of MPR (Multi Planar Information). MPR is a function that can generate a cross-sectional image to be referred to based on volume data generated by an X-ray CT apparatus.

  The image generation unit 107 stretches the blood vessel straight along the center line acquired from the center line extraction unit 104, and cuts the heart along a plane including the center line, and the coronary artery 601 and its vicinity as shown in FIG. A tomographic image (hereinafter referred to as “MPR image 600”) representing the tomographic portion 602 of the heart at a predetermined distance is generated. Here, FIG. 6 is a diagram illustrating an example of an MPR image generated by the image generation unit 107. The MPR image 600 can be created by applying any conventional method. For example, first, the image generation unit 107 cuts an X-ray CT image at a cross section perpendicular to the center line of the coronary artery 601 at each point on the center line acquired from the center line extraction unit 104, and on the center line on the cut surface. Pixels in one direction including these points are extracted within a predetermined distance including the coronary artery 601. Hereinafter, this collection of extracted pixels is referred to as a cutting straight line. Furthermore, the image generation unit 107 uses a cutting straight line at a specific point as a reference straight line, and acquires an angle between the cutting straight line at another point and the reference straight line. Then, the image generation unit 107 arranges the extracted points on the pixel center line so that they are arranged in a straight line, and further displays the image by inclining it by an angle formed with the reference line. As a result, the image generation unit 107 generates an MPR image 600 of the tomographic part 602 of the heart at a predetermined distance including a blood vessel obtained by extending the coronary artery 601 straight along the center line of the coronary artery 601 as shown in FIG. Further, although there are some branches in the coronary artery 601, the image generation unit 107 ignores the branch and displays a tomographic image of the coronary artery 601. That is, when the coronary artery 601 is branched, the image generation unit 107 displays the coronary artery 601 through which these two center lines pass as separate coronary arteries 601.

As shown in FIG. 7, the image generation unit 107 normalizes the cross-sectional area of the coronary artery 601 input from the blood vessel cross-sectional area calculation unit 106 so that the maximum value of the cross-sectional area enters the screen, and performs spline interpolation on each point. The graph 701 created by connecting with a smooth curve is displayed side by side with the coronary artery 601 of the MPR image 600 generated corresponding to each point on the center line. FIG. 7 is a diagram showing an example of a relationship display image 700 representing the relationship between the stenosis site of the coronary artery generated by the image generation unit 107 and the abnormal site of the heart wall motion. More specifically, generation of a graph representing the cross-sectional area of the coronary artery on the relevance display image by the image generation unit 107 will be described. The image generation unit 107 sets the vertical direction represented by the relationship display image 700 in FIG. 7 as the length direction of the coronary artery 601. Then, the image generation unit 107 uses the vertical direction of the relevance display image 700 in FIG. 7 as a coordinate axis representing the position of a point on the center line. Further, the image generation unit 107 sets the center line of the coronary artery 601 as a point 0 serving as a reference for the cross-sectional area coordinates, and sets the direction orthogonal to the coronary artery 601 as the coordinate axis representing the cross-sectional area (mm ² ). In the present embodiment, the image generation unit 107 sets the cross-sectional area to increase as it proceeds in the left direction in FIG. However, the reference line for the coordinates of the cross-sectional area may be another line parallel to the center line. Then, the image generation unit 107 arranges the normalized cross-sectional area values by associating the position in the length direction of the coronary artery 601 with the position of the point on the center line for which the cross-sectional area is obtained. Then, as shown in FIG. 7, the values of the cross-sectional areas arranged so as to correspond to the respective points on the center line are connected by a smooth curve using spline interpolation or the like to create a graph 701. This graph 701 corresponds to the “cross-sectional area graph” in the present invention.

  The image generation unit 107 normalizes the distance to the abnormal part at each point on the center line input from the distance calculation unit 105 so that the maximum value of the distance enters the screen, and further indicates the distance to the abnormal part. The points are connected by a smooth curve using spline interpolation or the like, and a graph 702 of the distance to the abnormal part is created and displayed side by side with the blood vessel of the tomographic image 500 generated corresponding to each point on the center line. More specifically, generation of a graph representing the distance to the abnormal part at each point on the center line on the relevance display image by the image generation unit 107 will be described. Similarly to the case of the cross-sectional area graph, the image generation unit 107 sets the vertical direction represented by the relationship display image 700 in FIG. 7 as the length direction of the coronary artery 601. Then, the image generation unit 107 uses the vertical direction of the relevance display image 700 in FIG. 7 as a coordinate axis representing the position of a point on the center line. Further, the image generation unit 107 sets the center line of the coronary artery 601 as 0 as a reference for the coordinates of the cross-sectional area, and sets the direction orthogonal to the coronary artery 601 as the coordinate axis representing the distance (mm) to the abnormal site. In the present embodiment, the image generation unit 107 sets the distance to the abnormal part to increase as it proceeds in the right direction in FIG. However, the line used as the reference for the coordinates of the distance to the abnormal part may be another line parallel to the center line. Then, the image generation unit 107 arranges the standardized distance values to the abnormal site by associating the position in the length direction of the coronary artery 601 with the position of each point on the center line for which the distance to the abnormal site was obtained. I will do it. Then, as shown in FIG. 7, a graph 702 is created by connecting the values of the distances to the abnormal parts arranged corresponding to the respective points on the center line with a smooth curve using spline interpolation or the like. This graph 701 corresponds to the “distance graph” in the present invention.

  In addition, when there is a coordinate that coincides with the coordinate information of the abnormal part in the coordinates of the cutting line, the image generation unit 107 colors the pixel in another color. Thereby, when there is an abnormal part on the tomographic image 500, it is displayed as an abnormal part 603 as shown in FIG.

  As described above, the image generation unit 107 arranges the cross-sectional area graph 701 of the blood vessel and the graph 702 of the distance to the abnormal part on the tomographic image 500, and colors the abnormal part 603, thereby moving the wall motion. An image representing the relationship between the abnormal region and the stenosis region of the coronary artery (hereinafter referred to as “relevance display image 700”) is created. Then, the image generation unit 107 outputs the created relevance display image 700 to the display control unit 108.

  The display control unit 108 causes the display unit 109 to display the relevance display image 700 input from the image generation unit 107. Here, when the entire coronary artery 601 is displayed, the image generation unit 107 displays the entire coronary artery 601 by reducing the enlargement ratio when the coronary artery 601 is long. The display control unit 108 corresponds to “display control means” in the present invention.

  Here, referring to the relevance display image 700 generated by the medical image processing apparatus 100 according to the present embodiment, it becomes possible to grasp at a glance each point on the coronary artery and the distance to the abnormal site at that point. . When the distance to the abnormal site in the stenotic region of the coronary artery changes abruptly, it is estimated from experience that the stenotic region is likely to cause abnormal motion of the heart wall motion. Therefore, when an operator inserts a catheter into the coronary artery to check for stenosis of the blood vessel, the operator can determine that the catheter should be inserted into the blood vessel that causes abnormal motion of the heart wall motion. .

  Next, a flow of generation and display of the relevance display image 700 in the medical image processing apparatus 100 according to the present embodiment will be described with reference to FIG. Here, FIG. 8 is a flowchart of generation and display of the relevance display image 700 in the medical image processing apparatus 100 according to the present embodiment.

  Step S001: The ultrasonic diagnostic apparatus 001 generates an ultrasonic tomographic image and outputs the generated ultrasonic tomographic image to the abnormal part extracting unit 101 of the medical image processing apparatus 100.

  Step S002: The X-ray CT apparatus 002 generates an X-ray CT image and outputs the generated X-ray CT image to the coronary artery extraction unit 102 of the medical image processing apparatus 100.

  Step S003: The abnormal part extraction unit 101 obtains displacement amounts of the intima and adventitia in each cardiac phase based on the ultrasonic tomogram input from the ultrasonic diagnostic apparatus 001, and calculates a distortion rate from the displacement amount. The coordinate information in the three-dimensional space corresponding to the ultrasonic tomographic image of the abnormal part is obtained by calculating and setting a part having the distortion rate equal to or greater than a predetermined threshold as an abnormal part causing abnormal wall motion.

  Step S004: The coronary artery extraction unit 102 extracts a point having the same luminance from the specified root position of the coronary artery based on the X-ray CT image input from the X-ray CT apparatus 002, so that the X-ray of the coronary artery Coordinate information in a three-dimensional space corresponding to the CT image is obtained.

  Step S005: The mapping unit 103 converts the coordinate information in the three-dimensional space corresponding to the ultrasonic tomogram of the abnormal part input from the abnormal part extraction unit 101 and the X-ray CT image of the coronary artery input from the coronary artery extraction unit 102. Based on the coordinate information in the corresponding three-dimensional space, mapping is performed by matching the coordinate spaces of the two coordinate systems using the coordinate conversion parameters. Here, the coordinate conversion parameter is a conversion formula that is given in advance or is a combination of translation, rotation, and enlargement matrices calculated by the mapping unit 103 using the septum of the heart as a reference point.

  Step S006: The center line extraction unit 104 cuts the coronary artery along a plane orthogonal at regular intervals based on the coordinate information in the three-dimensional space corresponding to the X-ray CT image of the coronary artery input from the coronary artery extraction unit 102, A center line is extracted by connecting the centroids of the cut surfaces using spline interpolation or the like. Further, the center line extraction unit 104 extracts points on the center line of the coronary artery at specific intervals from the root position.

  Step S007: The distance calculation unit 105 obtains the shortest distance from each point on the center line extracted by the center line extraction unit 104 to the abnormal part.

  Step S008: The blood vessel cross-sectional area calculation unit 106 performs processing on the center line input from the center line extraction unit 104 based on the coordinate information in the three-dimensional space corresponding to the X-ray CT image of the coronary artery input from the coronary artery extraction unit 102. The blood vessel cross-sectional area is obtained by cutting at each point in a direction perpendicular to the blood vessel, searching for a position where the luminance changes to a predetermined value or more, and obtaining coordinate information of the lumen of the coronary artery.

  Step S009: The image generation unit 107 obtains a cutting straight line based on a cross section cut at a plane perpendicular to the blood vessel at each point on the center line, and adjusts the angle so that each point on the center line is aligned straight. Then, the MPR image is generated.

  Step S010: The image generation unit 107 creates a blood vessel cross-sectional area graph based on the cross-sectional area of the blood vessel at each point on the center line of the coronary artery input from the blood vessel cross-sectional area calculation unit 106, and synthesizes it with the MPR image. In addition, the image generation unit 107 creates a graph of the shortest distance to the abnormal site based on the shortest distance from each point on the center line of the coronary artery input from the distance calculation unit 105 to the abnormal site, and synthesizes the graph with the MPR image. . Furthermore, the image generation unit 107 obtains an abnormal part appearing on the MPR image based on the coordinate information of the abnormal part input from the mapping unit 103, and colors the abnormal part. As described above, the image generation unit 107 generates the relevance display image 700.

  Step S011: The display control unit 108 causes the display unit 109 to display the relevance display image 700 generated by the image generation unit 107. Here, when the entire coronary artery does not fit on the screen, the display control unit 108 displays the entire coronary artery by reducing the enlargement ratio of the image.

  As described above, in the medical image processing apparatus according to the present embodiment, the cross-sectional area of the coronary artery and the distance from the point on the center line of the coronary artery to the abnormal part of the heart wall motion can be displayed side by side corresponding to each other. it can. As a result, the operator can easily detect the stenotic site of the coronary artery that is presumed to have a strong influence on the abnormality of the heart wall motion. Therefore, the operator can easily determine which coronary artery to insert the catheter for performing the examination.

  In the present embodiment, a plurality of coronary arteries are extracted as shown in FIG. 3, but only one coronary artery may be extracted. When one coronary artery is extracted, the operator can only determine whether or not the stenosis portion of the coronary artery causes a wall motion abnormality by referring to the posterior relation display image. On the other hand, when a plurality of coronary arteries are extracted, it becomes easy to determine which stenotic site in each coronary artery has a great influence on the abnormality of the heart wall motion.

  In addition, the medical image processing apparatus described above can be incorporated into a medical image diagnostic apparatus such as an X-ray CT apparatus or an MRI. In this manner, a stenosis site detected from an ultrasonic tomographic image using a medical image diagnostic apparatus without preparing a special medical image processing apparatus by being incorporated in a medical image diagnostic apparatus such as an X-ray CT apparatus or an MRI. It is possible to generate a relationship display image that represents the relationship between the distance from the coronary artery to the abnormal site obtained from the X-ray CT image or MRI image.

[Second Embodiment]
A medical image processing apparatus according to the second embodiment of the present invention will be described below. FIG. 9 is a block diagram showing functions of the medical image processing apparatus 100 according to the present embodiment. The medical image processing apparatus according to the present embodiment is configured to extract a stenosis site and display an image in a certain range including the stenosis site in the medical image processing apparatus according to the first embodiment. In FIG. 9, blocks with the same numbers as those in FIG. 1 have the same functions. As shown in FIG. 9, the medical image processing apparatus according to this embodiment is obtained by adding a stenosis site extraction unit 112 to the first embodiment. Therefore, in the following, extraction of a stenosis site and generation and display of a related display image will be mainly described.

  The blood vessel cross-sectional area calculation unit 106 outputs the coordinate information of each point on the center line of the coronary artery and the cross-sectional area of the blood vessel corresponding to each point to the stenosis region extraction unit 112.

  The stenosis region extracting unit 112 performs blood vessel operation from the root position of the coronary artery along the center line based on the coordinate information of each point on the center line of the coronary artery input from the blood vessel cross-sectional area calculating unit 106 and the cross-sectional area of the corresponding blood vessel. Follow the cross-sectional area. Then, the stenosis part extraction unit 112 extracts the coordinate information of the point on the center line of the cross section as the stenosis part, with a place where the change amount of the adjacent cross section is larger than a predetermined value as a stenosis part. This stenosis region extraction unit 112 corresponds to the “stenosis region extraction means” in the present invention.

  The stenosis site extraction unit 112 outputs the obtained coordinate information of the points on the center line in the stenosis site to the image generation unit 107.

  Further, when the image generation unit 107 receives an instruction from the operator to display a region at a certain distance including the stenosis site, the coronary artery at the stenosis site input from the blood vessel cross-sectional area calculation unit 106 (stenosis site extraction unit). Based on the coordinate information of the point on the center line, an MPR image of an area of a certain distance above and below the point is generated. Further, the image generation unit 107 combines the generated MPR image with a graph of the cross-sectional area of the blood vessel at each point on the center line of the coronary artery and a graph of the shortest distance from the point on the center line of the coronary artery to the abnormal site. A relevance display image is generated.

  The display control unit 108 causes the display unit 109 to display a relevance display image that displays only a region of a certain distance including the stenosis portion of the coronary artery input from the image generation unit 107.

  As described above, in the medical image processing apparatus according to the present embodiment, it is possible to display a relevance display image obtained by enlarging a certain distance in the stenosis of the coronary artery. Thereby, the operator can refer only to the correspondence between the stenosis site and the distance to the abnormal site of the heart wall motion in the stenosis site. This allows the operator to refer to the relationship display image that makes it easier to grasp the relationship between the stenosis part and the distance to the abnormal part than the enlarged stenosis part without searching for the stenosis part from the entire coronary artery. Is possible.

[Third Embodiment]
A medical image processing apparatus according to the third embodiment of the present invention will be described below. In the medical image processing apparatus according to the present embodiment, the method for calculating the distance from each point on the center line of the coronary artery to the abnormal part of the heart wall motion is the medical image processing apparatus according to the first embodiment or the second embodiment. Is different. The block diagram showing the function of the medical image processing apparatus according to the present embodiment is the same as FIG. 1 or FIG. Hereinafter, calculation of the distance from each point on the center line of the coronary artery by the distance calculation unit 105 to the abnormal part of the heart wall motion will be mainly described.

  The distance calculation unit 105 obtains the center of gravity G1 of the abnormal part 901 based on the coordinate information of the abnormal part of the heart wall motion input from the mapping unit 103 as shown in FIG. Here, when there are a plurality (n) of abnormal parts 901, the centers of gravity G2, G3,. Here, FIG. 10 is a diagram for explaining the calculation of the distance to the abnormal part in the medical image processing apparatus according to the present embodiment.

  The distance calculation unit 105 calculates the distance from each point 904 on the center line 903 of the coronary artery 902 to the center of gravity G1. The distance calculation unit 105 sets this distance as the distance from the point 904 to the abnormal part 901. Here, when there are a plurality (n places) of abnormal parts 901, the distance calculation unit 105 obtains the distances from the point 904 to the centers of gravity G2, G3,..., Gn in all the abnormal parts 901. And the distance calculation part 105 makes the shortest distance among the distance to each gravity center G1, G2, G3, ..., Gn the distance from the point 904 to the abnormal region 901.

  The distance calculation unit 105 outputs the obtained distance from the point 904 to the abnormal part 901 to the image generation unit 107.

  The image generation unit 107 uses the distance from each point 904 to the abnormal part 901 obtained from the center of gravity of the abnormal part 901 input from the distance calculation part 105 to use the distance from each point 904 to the abnormal part. Create a graph. Then, the image generation unit 107 synthesizes a graph of the distance from each point 904 to the abnormal part to the MPR image generated by itself. In addition, the image generation unit 107 creates a blood vessel cross-sectional area graph, and synthesizes the blood vessel cross-sectional area graph with the aforementioned MPR image. Furthermore, the image generation unit 107 colors the abnormal part of the MPR image described above to generate a relevance display image.

  The display control unit 108 causes the display unit 109 to display the relevance display image generated by the image generation unit 107.

  As described above, in the medical image processing apparatus according to the present embodiment, the distance from the point on the center line of the coronary artery to the center of gravity of the abnormal part is used as the distance to the abnormal part. Thereby, there is no need to obtain distances for all points on the abnormal part, and the process for obtaining the distance to the abnormal part can be accelerated.

[Fourth Embodiment]
A medical image processing apparatus according to the fourth embodiment of the present invention will be described below. The medical image processing apparatus according to the present embodiment is different from the medical image processing apparatus according to the first to third embodiments in the relevance display image generated by the image generation unit. Therefore, hereinafter, the generation of the relevance display image in the image generation unit will be mainly described. The block diagram of the medical image processing apparatus according to this embodiment is the same as the block diagram shown in FIG. 1 or FIG.

  The image generation unit 107 inputs the coordinate information of the coronary artery and the coordinate information of the heart expressed in the three-dimensional space corresponding to the X-ray CT image from the coronary artery extraction unit 102, and 3 corresponding to the X-ray CT image from the mapping unit 103. Input of coordinate information of an abnormal part of the heart wall motion represented in a three-dimensional space, input of distance information from each point on the center line of the coronary artery from the distance calculation unit 105 to a blood vessel cross-sectional area calculation unit The blood vessel cross-sectional area at each point on the center line of the coronary artery is input from 106.

  FIG. 11 is a diagram showing an example of a relevance display image created by the medical image processing apparatus according to this embodiment. The image generation unit 107 projects each of these parts on the XY plane based on the input coronary artery coordinate information, abnormal part coordinate information, and heart coordinate information. At this time, as a projection method, for example, the projection can be performed by simply setting the Z coordinate to 0 and representing each part only by the XY coordinate. Here, in the present embodiment, the projection is performed on the XY plane, but the projected plane may be any plane in the three-dimensional space. Further, as shown in FIG. 11, the image generation unit 107 places the projected image of the heart within a certain distance of the coronary artery 111 in the projected image at the bottom, and superimposes the projected image of the coronary artery 111 thereon, A projection image of the abnormal part 115 is overlaid thereon. Furthermore, as shown in FIG. 11, the image generation unit 107 darkens a place where the distance from each point on the center line of the coronary artery 111 to the abnormal part 115 is close, and thins the place where the distance is far, and adjusts the coronary artery according to the distance. 111 is colored. However, this color scheme may use a change in color or use another color. In this embodiment, the region 113 of the coronary artery 111 is thin and the distance is long, and the region 114 of the coronary artery 111 is dark and thus the distance is close. The image generation unit 107 outputs the generated relevance display image 700 to the display control unit 108.

  The display control unit 108 causes the display unit 109 to display the input relationship display image 700.

  As described above, the medical image processing apparatus according to the present embodiment uses an image projected on a plane as a relevance display image. This makes it possible to grasp the relationship between the stenosis site and the abnormal site with an image close to the actual heart state.

Block diagram of a medical image processing apparatus according to the first, third, and fourth embodiments Diagram showing extraction of abnormal site from ultrasonic tomogram A diagram schematically showing coronary artery extraction from X-ray CT images Diagram showing mapping between abnormal site and coronary artery The figure for explaining the calculation of the distance to the abnormal part using the shortest distance FIG. 4 is a diagram illustrating an example of an MPR image according to the first embodiment. The figure of an example of the relevance display image in a 1st embodiment FIG. 4 is a flowchart of relevance display image generation and display in the medical image processing apparatus according to the first embodiment. Block diagram of medical image processing apparatus according to second, third, and fourth embodiments The figure for explaining the calculation of the distance to the abnormal part using the center of gravity The figure of an example of the relevance display image in 4th Embodiment

Explanation of symbols

001 Ultrasound diagnostic apparatus 002 X-ray CT apparatus 100 Medical image processing apparatus 101 Abnormal part extraction unit 102 Coronary artery extraction unit 103 Mapping unit 104 Centerline extraction unit 105 Distance calculation unit 106 Blood vessel cross-sectional area calculation unit 107 Image generation unit 108 Display control unit 109 Display

Claims (12)

Abnormal part extraction for obtaining coordinate information on three-dimensional coordinates on the ultrasonic tomographic image of the abnormal part of the wall motion on the intima side of the heart of the subject based on the ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus Means,
Coronary artery extraction means for obtaining coordinate information on three-dimensional coordinates on the three-dimensional image of the coronary artery based on the three-dimensional image of the heart generated by a medical image diagnostic apparatus other than the ultrasonic diagnostic apparatus;
Mapping means for representing the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery in the same three-dimensional coordinates;
Distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery;
A cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery;
Image generating means for generating a graph in which the extracted coronary artery, a distance to the abnormal site at each point of the coronary artery, and a cross-sectional area at each point of the coronary artery are associated with each other;
Display control means for displaying the generated graph on a display means;
A medical image processing apparatus comprising: A center line extracting means for extracting the center line of the coronary artery;
The distance calculation means obtains the distance to the abnormal site at each point on the center line of the coronary artery,
The cross-sectional area calculating means calculates the cross-sectional area of the coronary artery at each point on the center line of the coronary artery;
The medical image processing apparatus according to claim 1.   The medical image processing apparatus according to claim 1, wherein the distance calculation unit sets a shortest distance to the abnormal part at each point of the coronary artery as a distance to the abnormal part.   The distance calculating means calculates the center of gravity of the abnormal part, and sets the distance from the point on the center line on the coronary artery to the center of gravity of the abnormal part as the distance to the abnormal part. The medical image processing apparatus according to claim 2.   5. The medical image according to claim 4, wherein, when there are a plurality of the abnormal parts, the distance calculating unit sets a distance to the nearest center of gravity among the abnormal parts as a distance to the abnormal part. 6. Processing equipment. The coronary artery extracting means extracts a plurality of coronary arteries,
The medical image processing apparatus according to claim 1, wherein the display control unit displays a graph in which cross-sectional areas of the plurality of coronary arteries are associated with distances to abnormal sites side by side. . Further comprising a stenosis site extracting means for extracting, as a stenosis site, a place where a change amount of the cross-sectional area of the coronary artery in the three-dimensional image is large
The image generating means displays an enlarged predetermined range including the stenotic site in the coronary artery,
The medical image processing apparatus according to claim 1, wherein the medical image processing apparatus is a medical image processing apparatus.   The image generation means includes a distance graph of the distance to the abnormal site using the position in the length direction of the coronary artery and the distance to the abnormal site as a coordinate system, and the position in the length direction of the coronary artery and the coronary artery. A cross-sectional area graph of the cross-sectional area of the coronary artery with a cross-sectional area as a coordinate system is generated, and the distance graph and the cross-sectional area graph are displayed on one screen in association with the position in the length direction of the coronary artery. The medical image processing apparatus according to claim 1, wherein a graph is generated.   The image generation means generates a tomogram of a predetermined distance including the coronary artery of the heart, and generates an image in which the graph is superimposed on the tomogram based on the position in the length direction. The medical image processing apparatus according to any one of claims 1 to 8, wherein Abnormal part extraction for obtaining coordinate information on three-dimensional coordinates on the ultrasonic tomographic image of the abnormal part of the wall motion on the intima side of the heart of the subject based on the ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus Means,
Coronary artery extraction means for obtaining coordinate information on three-dimensional coordinates on the three-dimensional image of the coronary artery based on the three-dimensional image of the heart generated by a medical image diagnostic apparatus other than the ultrasonic diagnostic apparatus;
Mapping means for representing the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery in the same three-dimensional coordinates;
Distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery;
A tomogram of a predetermined distance including the coronary artery of the heart is generated, and an image in which the coronary artery of the tomogram is colored based on the distance to the abnormal site and corresponding to the position in the length direction of the coronary artery is generated. The image generating means;
Display control means for displaying the generated image on a display means;
A medical image processing apparatus comprising: Abnormal part extraction for obtaining coordinate information on three-dimensional coordinates on the ultrasonic tomographic image of the abnormal part of the wall motion on the intima side of the subject's heart in response to the ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus Means,
Three-dimensional image generation means for generating a three-dimensional image of an external view of the heart based on data obtained by imaging the heart;
Coronary artery extraction means for obtaining coordinate information on three-dimensional coordinates on the three-dimensional image of the coronary artery based on the three-dimensional image;
Mapping means for representing the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery in the same three-dimensional coordinates;
Distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery;
A cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery;
Image generating means for generating a graph in which the extracted coronary artery, a distance to the abnormal site at each point of the coronary artery, and a cross-sectional area at each point of the coronary artery are associated with each other;
Display control means for displaying the generated graph on a display means;
A medical image diagnostic apparatus comprising: A three-dimensional image generating means for irradiating the subject with X-rays and generating a three-dimensional image of an external view of the heart of the subject;
Coronary artery extraction means for obtaining coordinate information on three-dimensional coordinates on the three-dimensional image of the coronary artery based on the three-dimensional image;
Abnormal part extraction for obtaining coordinate information on three-dimensional coordinates on the ultrasonic tomographic image of the abnormal part of the wall motion on the intima side of the heart of the subject based on the ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus Means,
Mapping means for representing the coordinate information on the three-dimensional coordinates of the abnormal part and the coordinate information on the three-dimensional coordinates of the coronary artery in the same three-dimensional coordinates;
Distance calculating means for obtaining a distance to the abnormal site at each point of the coronary artery;
A cross-sectional area calculating means for calculating a cross-sectional area of the coronary artery at each point of the coronary artery;
Image generating means for generating a graph in which the extracted coronary artery, a distance to the abnormal site at each point of the coronary artery, and a cross-sectional area at each point of the coronary artery are associated with each other;
Display control means for displaying the generated graph on a display means;
An X-ray CT apparatus comprising: