JP2009183508A - Diagnostic image support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To calculate a thickened part of a chest wall where efficiency of diagnostic reading is considered. <P>SOLUTION: A CPU 11 generates additional menu information in order to adding an area to be analyzed, when differentiating the display gradation of a displayed image, controls the generated additional menu information to be displayed on a monitor 115 as an additional instruction switch, displays and controls a mouse 17 to set an area to be analyzed of the image of a different display gradation according to setting of the additional instruction switch by the mouse 17, calculates the size of the thickened part of the chest wall or a lung wall included in the set area to be analyzed, and controls the calculated size of the thickened part to be displayed on the monitor 15. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention measures image data including a lung field of a subject, calculates a portion whose shape has changed in the image data due to an action such as a lung disease or a sign thereof, and performs image diagnosis performed by a doctor on the calculated information. The present invention relates to an image diagnosis support apparatus presented as support information.

  A user such as an interpreting physician operates the information display means as follows. In the list of the plurality of examination information displayed on the information display means, the examination information next to the line below the predetermined examination information corresponding to the diagnostic target medical image displayed on the image display means Displays the next corresponding image. Prior to this display, at least a part of the next image is first read from the image storage means and temporarily stored, and the rest of the next image is not read by the end of the input of the diagnosis result. If there is, read the rest. In parallel with this reading, or after that, the diagnosis target image displayed on the image display means is controlled to be switched to the next image that has been read first and displayed. As a result, the examination information to be interpreted in advance is automatically displayed in a list, and the examination information displayed in the list is displayed at a high speed with a simple key operation in order to display medical diagnostic images to be examined continuously. can do. There has been proposed a medical image diagnostic system capable of efficiently performing interpretation work without imposing a burden on a user such as an interpretation doctor (for example, Patent Document 1).

JP 2006-178773 A.

  In recent years, medical workers are well aware that accumulation of asbestos inhaled by a subject in the lungs appears as an abnormality in the thickness of the chest wall (also referred to as lung wall) in diagnostic imaging. Medical workers are also well known to progress from asbestos accumulation to malignant cancers such as mesothelioma. An abnormality in the thickness of the chest wall is thicker than a normal chest wall (referred to as “thickened part”). For medical professionals, early detection of a thickened portion of the chest wall is diagnostic information useful for image diagnosis from the viewpoint of prevention and progression monitoring.

  However, asbestos is inhaled by human breathing and accumulates in the lung like a thorn, causing the following unresolved problems.

(1) Problems with one tomographic image
Even for one identical tomographic image, the thickened portion cannot be calculated accurately unless the gradation of the image is appropriate. Therefore, for example, the operator needs to manually adjust the display gradation so that the chest wall can be extracted, and to select the gradation condition for properly displaying the chest wall by the operator's interpretation. This selection may hinder the improvement of diagnostic efficiency.

(2) Problems with multiple tomographic images Not only one tomographic image is measured, but usually multiple images. Unless the proper display of the chest wall made with a single tomographic image can be expanded to multiple images, the operation of one tomographic image must be performed for multiple images, which hinders the improvement of diagnostic efficiency. Sometimes it becomes.

  An object of the present invention is to provide an image diagnosis support apparatus capable of calculating a thickened portion of the chest wall in consideration of the interpretation efficiency.

  The object is to set an image acquisition unit for acquiring a tomographic image including a lung region of a subject, an image display unit for displaying the acquired tomographic image, and an analysis target region for the displayed image by an input device. Analysis target region setting means, thickened portion calculating means for calculating the size of the thickened portion of the chest wall or lung wall existing in the set analysis target region, and display control of the calculated thickened portion size on the image display means A medical image diagnosis support apparatus comprising: a control unit configured to generate additional menu information for adding the analysis target region when the display gradation of the displayed image is changed. The generated additional menu information is displayed on the image display means as an additional command switch, and the additional command switch is set by the input device. Therefore, the analysis target region setting unit sets the analysis target region of the image having the different display gradation, and the thickening unit calculating unit calculates the size of the thickened portion of the chest wall or the lung wall existing in the set analysis target region. This is achieved by controlling display of the calculated size of the thickened portion on the image display means.

  According to the present invention, it is possible to provide an image diagnosis support apparatus capable of calculating a thickened portion of the chest wall in consideration of the interpretation efficiency.

  The best mode for carrying out the present invention will be described below with reference to the accompanying drawings. Note that components having the same function are denoted by the same reference symbols throughout the drawings for describing the embodiment of the invention, and the repetitive description thereof is omitted.

  FIG. 1 is a hardware configuration diagram showing a configuration example of the entire diagnostic imaging support apparatus according to the present invention.

  The diagnostic imaging support apparatus 10 is connected to a medical imaging apparatus 2 that captures an image of a subject through a network such as a LAN 3. The medical image capturing apparatus 2 is described as an X-ray CT apparatus as an example, but is configured by an apparatus capable of capturing an image of a subject (preferably a three-dimensional image) such as an MR apparatus or an ultrasonic imaging apparatus.

  The diagnostic imaging support apparatus 10 is mainly a central processing unit (CPU) 11 as a control device that controls the operation of each component, and a main memory 12 that stores a control program for the device and serves as a work area when the program is executed. And a magnetic disk 13 that stores various application software including programs for processing such as operating system (OS), peripheral device drive, chest wall thickness calculation, and display for temporarily storing display data A memory 14, a monitor 15 such as a CRT monitor or a liquid crystal monitor that displays an image based on data from the display memory 14, a mouse 17 as a position input device, and a mouse on the monitor 15 by detecting the state of the mouse 17 Consists of a controller 16 that outputs signals such as the pointer position and mouse 17 status to the CPU 11, a keyboard 18, and a bus 19 that connects the above components. It is.

The CPU 11 reads the program from the magnetic disk 13, loads it into the main memory 12, and executes it.
In FIG. 1, the magnetic disk 13 is connected as a storage device other than the main memory 12, but a hard disk drive or the like may be connected in addition thereto.

  FIG. 2 is a diagram showing a main flow of the first embodiment executed by the medical image diagnosis support apparatus of FIG. The CPU 11 in FIG. 1 operates according to this main flow. Hereinafter, details of the main flow will be described in the order of steps.

  First, the CPU 11 displays an ID input screen of the subject on the monitor 15 on the display 14 of the medical image diagnosis support apparatus. An operator such as a doctor inputs the patient ID number using the mouse 17 or the keyboard 18. The CPU 11 reads a tomographic image corresponding to the ID number of the patient to be diagnosed from the magnetic disk 12 from the tomographic images taken in advance by the medical image modality. When the reading is completed, the CPU 11 displays a tomographic image (current image) on the monitor 15.

[Step S20]
The operator selects the tomographic image to be measured by displaying on the monitor 15.

[Step S21]
As shown in FIG. 3 (a), the operator sets the measurement center on the screen of the selected tomographic image using a pointing device such as the mouse 17. As shown in FIG. 3B, this setting method may be a method in which a measurement range is set on the screen of the selected tomographic image and the center of gravity of the set range is set as the center.

[Step S22]
The CPU 11 causes the monitor 15 to display guide information for setting a measurement range as shown in FIG. 4 starting from the measurement center set in the previous step. That is, as shown in FIG. 4 (a), the measurement center is set on the right side of the drawing with the image center as a reference. Actually, the measurement range can be arbitrarily selected by the operator.

  In this case, in the measurement range 43a, the entire measurement range can be moved radially around the measurement center. When the moving radiuses 43b and 43c in the measurement range of FIG. 4 (b) are selected and moved, each can be set to an arbitrary angle. If the contour lines 43d and 43e of the measurement range are moved, the distance from the center can be changed. The contour lines 43d and 43e may be manually set by the operator using the mouse 17 or the like.

[Step S23]
After setting the measurement range in the previous step, the operator selects a soft switch on the “analysis” monitor on the screen. The CPU 11 measures the thickened portion included in the measurement range as shown in FIG. Specifically, the CPU 11 performs threshold processing on the regions on the contour lines 43d and 43e, and separates the lung field region and the region other than the lung field. The threshold used at this time may be, for example, an average value of the lung field region or an arbitrary value set by the operator. Then, the CPU 11 measures the length in the direction perpendicular to the contour line 43e, and calculates the average value. The CPU 11 also calculates an average pixel value (CT value) of the thickened portion.

[Step S24]
The CPU 11 displays the calculation result on the monitor 15 as shown in FIG.

[Step S25]
The CPU 11 stores the calculation result in the main memory 12.

[Step S26]
When the operator wants to add another area, the add menu is selected as shown in FIG. 7 (a).

[Step S27]
The operator adds a measurement range with the mouse 17 as shown in FIG.
CPU11 performs the process of step S21-step S25, and measures the added thickened part.

[Step S28]
The operator refers to the slice list and adds the next slice with the mouse 17.
The CPU 11 performs steps S20 to S25 and measures the added thickened portion.

  According to the present embodiment, the thickened portion of another region and the thickened portion of another slice can be set continuously, so that the thickened portion of the chest wall can be calculated in consideration of the interpretation efficiency.

  FIG. 8 (a) shows a screen example in which a plurality of thickened portions are measured. FIG. 8 (c) shows a screen example when attention is paid to one of the measurement results.

  FIG. 9 is a diagram showing a main flow of the second embodiment executed by the medical image diagnosis support apparatus of FIG. The CPU 11 in FIG. 1 operates according to this main flow. Hereinafter, only the main part of this main flow will be described in the order of steps.

[Step S90]
Each tomographic image of the input case is divided into a lung field and other areas by threshold processing. Then, the edge portion may be set as the lung wall region. Alternatively, threshold processing is performed using a pixel value that identifies air and a soft part region as a threshold value, and a high CT value portion in the soft part region is re-extracted as a bone region. High-order spline interpolation may be performed on the inside of this bone region to set a boundary, and this may be adopted as the lung wall region.

[Step S91]
The CPU 11 determines whether or not the lung wall region has been successfully extracted from all tomographic images of the input cases. If the determination result is successful, the CPU 11 proceeds to step S92. If the determination result is unsuccessful, the CPU 11 displays the unsuccessful image, and performs the processing from step S21 to step S26.

[Step S92]
The CPU 11 measures the thickness of the thickened part from the lung wall. In this case, the thickness is measured in the direction perpendicular to the chest wall.

[Step S93]
After calculating all the tomographic images of the input cases, the CPU 11 displays the calculation results as shown in FIG. 6 or FIG. 8 (a). Further, FIG. 10 shows a display example in which the measurement range and the thickened portion can be understood.

  According to the second embodiment, the thickened portion of another region and the thickened portion of another slice can be set continuously, so that the thickened portion of the chest wall can be calculated in consideration of the interpretation efficiency.

  Further, since the second embodiment refers to the bone region, the lung region is specified anatomically, and the extraction accuracy can be improved.

  The preferred embodiments of the medical image display apparatus according to the present invention have been described above, but the present invention is not limited to such examples. It will be apparent to those skilled in the art that various changes or modifications can be conceived within the scope of the technical idea disclosed in the present application, and these are naturally within the technical scope of the present invention. Understood.

1 is an overall configuration diagram of an image diagnostic system according to an embodiment of the present invention. The flowchart which shows the execution program of 1st embodiment which concerns on this invention. The figure which shows the example of a screen display at the time of the measurement center setting (step S21) in the execution program of 1st embodiment. The figure which shows the example of a screen display at the time of the measurement range setting in the execution program of 1st embodiment (step S22). The figure which shows the example of a screen display at the time of thickening part measurement (step S23) in the execution program of 1st embodiment. The figure which shows the example of a screen display at the time of thickening part measurement result display in the execution program of 1st embodiment (step S24). The figure which shows the example of a screen display at the time of thickening part measurement result display (step S26) concerning this invention. The figure which shows another screen display example at the time of the thickening part measurement result display concerning this invention. The flowchart which shows the execution program of 2nd embodiment which concerns on this invention. The figure which shows another screen display example at the time of the thickening part measurement result display concerning this invention.

Explanation of symbols

  10 diagnostic imaging support device, 11 CPU, 12 main memory, 13 magnetic disk, 14 display memory, 15 monitor, 16 mouse controller, 17 mouse, 18 keyboard, 19 common bus

Claims (4)

Image acquisition means for acquiring a tomographic image including a lung region of the subject;
Image display means for displaying the acquired tomographic image;
Analysis target area setting means for setting an analysis target area with the input device for the displayed image;
A thickened part calculating means for calculating a size of a thickened part of the chest wall or lung wall existing in the set analysis target area;
A medical image diagnosis support apparatus comprising: a control unit that controls display of the calculated size of the thickened portion on the image display unit;
The control means generates additional menu information for adding the analysis target area when the display gradation of the displayed image is changed, and uses the generated additional menu information as an additional command switch to generate the image. While controlling the display on the display means,
As the additional command switch is set by the input device, the analysis target area of the image having the different display gradation is set in the analysis target area setting means, and the chest wall or lung wall existing in the set analysis target area is set. A medical image diagnosis support apparatus, characterized by causing the thickened part calculating means to calculate a size of the thickened part and controlling the display of the calculated thickened part size on the image display means. Image acquisition means for acquiring a tomographic image including a lung region of the subject;
Image display means for displaying the acquired tomographic image;
Analysis target area setting means for setting an analysis target area with the input device for the displayed image;
A thickened part calculating means for calculating a size of a thickened part of the chest wall or lung wall existing in the set analysis target area;
A medical image diagnosis support apparatus comprising: a control unit that controls display of the calculated size of the thickened portion on the image display unit;
The control means generates additional menu information for adding the setting of the analysis target region for an image at a slice position different from the displayed image, and uses the generated additional menu information as an additional command switch for the image. While controlling the display on the display means,
As the additional command switch is set by the input device, the analysis target region setting means sets the analysis target region of the image at the different slice position, and thickening of the chest wall or lung wall existing in the set analysis target region A medical image diagnosis support apparatus characterized by causing the thickened part calculating means to calculate the size of a part and controlling the display of the calculated thickened part size on the image display means. The thickened portion calculating means, a chest wall extracting means for extracting the inside of the bone included in the tomographic image as a chest wall;
Determining means for determining success or failure of extraction of the chest wall,
The image diagnosis support apparatus according to claim 1, wherein the control unit controls display information of the image display unit based on success or failure of extraction determined by the determination unit.   The control means controls the display information of the image display means to generate display information capable of setting the analysis target area by the input device when the success or failure of the extraction determined by the determination means is negative. The image diagnosis support apparatus according to claim 3.

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