JP2009230609A - Medical image diagnosis support device and medical image diagnosis support program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image diagnosis support device for referring to, on a digital image, a medical examination history about teeth designated on the digital image. <P>SOLUTION: A medical image diagnosis support device 1 acquires an image 49 for a dentist, and acquires tooth position information 50 showing the positions of teeth included in the image 49 for a dentist, and displays the acquired image 49 for a dentist and tooth position information 50. An operator sets coordinate positions in the image 49 for a dentist and the tooth position information 50. The medical image diagnosis support device 1 acquires site information showing the sites of the selected teeth from the coordinate positions set by the operator, and extracts a medical examination history including the sites of the teeth selected from electronic medical record information 100, and displays the extracted medical examination history for display. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical image diagnosis support apparatus that displays a medical image acquired by a medical image capturing apparatus such as an X-ray image capturing apparatus, an X-ray CT apparatus, an MRI apparatus, or an ultrasonic diagnostic apparatus and supports a diagnosis by a doctor. . Specifically, the present invention relates to a medical image diagnosis support apparatus that supports diagnosis by a dentist using a dentist image.

Generally, a medical image diagnosis support apparatus acquires a medical image from the medical image photographing apparatus, performs image processing on the medical image, and displays a diagnostic image.
As for dentist images, the patient dentist images are searched from the image database based on the patient code, the dentist image screen is displayed on a screen different from the chart input screen, and the chart is referred to while referring to the dentist image screen. There has been proposed a medical chart creation device that performs an input operation on an input screen (see, for example, Patent Document 1).
JP 2005-196660 A

  In order to refer to the treatment history of the treatment area, the oral condition on the chart input system is shown as an image, or the oral condition is displayed on the display where the dental formula is imaged on the screen dedicated to site input. Clicking on the tooth image, he referred to his past medical history. In addition, in order for a dentist to refer to a dentist image such as an X-ray image, when the dentist image is a digital image, it is necessary to start up image management software, and the dentist image is recorded on the film. In some cases, it was necessary to prepare a film.

  However, in order to refer to both the patient's medical history and dentist image at the time of medical treatment, it is necessary to prepare both an image viewer for dentist images and a medical record screen for medical history in the conventional medical chart creation device. However, there is a problem of misreading because there are many movements of the line of sight between the digital image and the medical history.

  The present invention has been made in view of the above-described problems, and an object thereof is to provide a medical image diagnosis support apparatus that can refer to a medical history of a tooth designated on a digital image on the digital image.

  According to a first aspect of the present invention for achieving the above object, in a medical image diagnosis support apparatus for supporting a diagnosis using a dentist image by a dentist, a dentist image acquisition means for acquiring the dentist image, and the dental Tooth position information acquisition means for acquiring tooth position information indicating the position of a tooth included in a medical image, display means for displaying the acquired dentist image and tooth position information, and the displayed dentist image and tooth Coordinate position setting means for setting a coordinate position in the position information, tooth selection means for detecting a tooth corresponding to the set coordinate position based on the tooth position information, and selecting or canceling the tooth, and From the part information acquisition means for acquiring the part information indicating the part of the tooth selected by the tooth selection means, and from the electronic medical record information, the acquired part information A display medical history creation means for creating a display medical history for a tooth that has been extracted and selected, and a display medical history display means for displaying the display medical history. Is a medical image diagnosis support apparatus characterized by the above.

  The medical image diagnosis support apparatus of the first invention acquires a dentist image, acquires tooth position information indicating a position of a tooth included in the dentist image, and displays the acquired dentist image and tooth position information. The coordinate position is set in the displayed dentist image and tooth position information, and the tooth corresponding to the coordinate position set based on the tooth position information is detected and selected or deselected, and the selected state Obtaining part information indicating the part of the tooth, extracting a medical history including the part information obtained from the electronic medical record information, creating a display medical history for the selected tooth, and displaying the display medical history The display item to be displayed is determined from a plurality of display items based on the selection of the operator to be displayed, and the determined display item to be displayed is superimposed on the dentist image.

  It is preferable that the coordinate position setting means sets a designated coordinate position of one point, and the tooth selection means changes a selection state of one tooth corresponding to the set coordinate position of one point.

  The second invention includes a dentist image acquisition step for acquiring the dentist image, a tooth position information acquisition step for acquiring tooth position information indicating a position of a tooth included in the dentist image, and the acquired dental The display step for displaying the medical image and the tooth position information, the coordinate position setting step for setting the coordinate position in the displayed dentist image and tooth position information, and the setting based on the coordinate position of the tooth position information. A selection step for detecting a tooth corresponding to the coordinate position and selecting or deselecting the tooth; a region information acquisition step for acquiring region information indicating a region of the tooth selected by the selection unit; and an electronic medical record A table for extracting the medical history including the acquired part information from the information and creating the medical history for display about the selected tooth And use medical history creation step, a medical image diagnosis assisting program to be executed and display medical history display step of displaying the display medical history, to the computer.

  The medical image diagnosis support program may be transmitted / received via a network, or may be recorded and distributed on a recording medium.

  ADVANTAGE OF THE INVENTION According to this invention, the medical image diagnosis assistance apparatus which can refer the medical treatment history about the tooth designated on the digital image on a digital image can be provided.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the following description and the accompanying drawings, the same reference numerals are given to the constituent elements having the same functional configuration, and the redundant description will be omitted.
In the following embodiments, description will be made on the assumption that X-ray CT images or X-ray CT images are used as medical images, but the present invention is not limited to this. A medical image taken by an MRI apparatus or an ultrasonic imaging apparatus may be used as the medical image.

(1. Configuration of medical image diagnosis support apparatus 1)
First, the configuration of the medical image diagnosis support apparatus 1 will be described with reference to FIG.
FIG. 1 is a hardware configuration diagram of the medical image diagnosis support apparatus 1.
The medical image diagnosis support apparatus 1 includes a CPU 10, a magnetic disk 13, a main memory 14, a mouse 16 and a keyboard 17 connected to a controller 15, a display memory 18, a display 19, an input memory 8, and a pen-type input device 9. The medical image diagnosis support apparatus 1 is connected to a medical image photographing apparatus 11 via a LAN 12.

  The medical image capturing apparatus 11 is an apparatus that captures a medical image such as a tomographic image of a subject. The medical imaging apparatus 11 is, for example, an X-ray CT apparatus, an MRI apparatus, or an ultrasonic imaging apparatus. The medical image diagnosis support apparatus 1 displays a medical image of a subject.

  The CPU 10 is a device that controls the operation of each connected component. The CPU 10 loads a program stored in the magnetic disk 13 and data necessary for program execution into the main memory 14 and executes the program. The magnetic disk 13 is a device that acquires and stores medical images such as tomographic images captured by the medical image capturing device 11 via a network such as the LAN 12. The magnetic disk 13 stores a program executed by the CPU 10 and data necessary for program execution. The main memory 14 stores programs executed by the CPU 10 and the progress of arithmetic processing. The mouse 16, the keyboard 17, and the pen-type input device 9 are operation devices for an operator to give an operation instruction to the medical image diagnosis support apparatus 1. The input memory 8 holds position information designated by the pen-type input device 9. The display memory 18 stores display data to be displayed on a display 19 such as a liquid crystal display or a CRT.

(2. Creation of tooth position information)
Next, the creation of tooth position information will be described with reference to FIGS.
The medical image diagnosis support apparatus 1 creates a tooth frame indicating a position for each tooth based on a dentist image.
FIG. 2 is a flowchart showing the operation of the medical image diagnosis support apparatus 1 in creating tooth position information.

(2-1. Reading image file: Step 1001)
The operator operates the mouse 16 and the keyboard 17 to select a dentist image to be diagnosed from among the dentist images photographed by the medical image photographing device 11. The CPU 10 of the medical image diagnosis support apparatus 1 reads out the dentist image selected by the operator from the magnetic disk 13 and holds it in the main memory 14 (step 1001). The dentist image is handled by an image file in JPEG format or BITMAP format.

(2-2. Determination of Image Analysis Area: Step 1002)
FIG. 3 is an explanatory diagram of determining an image analysis region.
The CPU 10 of the medical image diagnosis support apparatus 1 removes the margin 22 from the dentist image 21 held in the main memory 14 and determines the image analysis region 23 (step 1002). Thereby, analysis accuracy and processing speed can be improved.

(2-3. Outer tooth frame determination: Step 1003)
FIG. 4 is a diagram illustrating calculation of the tooth end 55.
The CPU 10 of the medical image diagnosis support apparatus 1 performs line scanning in the Y direction on the dentist image 40 that is the dentist image 21 in the image analysis region 23. The CPU 10 performs line scanning on the scanning lines 51 and 53 to measure the density distribution 52 and the density distribution 54. The horizontal axis of the density distribution 52 and the density distribution 54 indicates the scanning direction Y, and the vertical axis indicates the standard deviation of the density. The CPU 10 measures the density distribution in the same manner for the other scanning lines. The CPU 10 calculates a position where the standard deviation of the density changes abruptly as in the density distribution 54 and determines the position of the tooth end 55 (tooth number 7) in the dentist image 41.

FIG. 5 is a diagram illustrating calculation of the median line 57.
The CPU 10 of the medical image diagnosis support apparatus 1 sets a median line 57 at a position that internally divides the tooth ends 55 at both ends, for example, 1: 1 in the dentist image 42 in which the positions of the tooth ends 55 are determined. The CPU 10 sets a point 56 at a position that internally divides the tooth end 55 and the median line 57 into 1: 1. The CPU 10 determines the curvature of the curve 58 based on five points of the two tooth ends 55, the midline 57, and the two points 56. For calculating the curvature, for example, a quadratic polynomial indicating an ellipse is used. Here, the calculation of the median line 57 is exemplified, but the median line 57 is not limited as long as it is an index for specifying the dentition.

FIG. 6 is a diagram showing determination of the tooth outer frame 60.
The CPU 10 of the medical image diagnosis support apparatus 1 determines the external tooth frame 60 in the dentist image 43 by moving the curve 59 in the Y direction, and holds it in the main memory 14 (step 1003).

(2-4. Determination of tooth space: Step 1004)
FIG. 7 is a diagram illustrating the determination of the tooth gap line 62.
In the dentist image 44, the CPU 10 of the medical image diagnosis support apparatus 1 calculates the dividing line from the midline toward both tooth ends at a ratio sampled with the distance from the midline to the tooth end being 1. In the dentist image 44, the CPU 10 divides the scanning region at a position that internally divides the distance between the tooth ends, for example, approximately 1: 2: 1. Thereby, the exposure non-uniformity resulting from the tooth row being curved can be improved. The CPU 10 measures the density distribution on the curve 61 by moving and scanning the curve 61 in the Y direction in the dentist image 44. In the dentist image 45, the CPU 10 moves the position of the dividing line to a position that matches the density distribution measured in the regions on both sides in the X direction of the dividing line, and determines the tooth gap line 62 (step 1004). Thereby, the position of the gap line 62 can be determined as an appropriate position even when the teeth are arranged unevenly. The CPU 10 determines a tooth frame 63 indicating a position for each tooth based on the gap line 62.

  When the CPU 10 of the medical image diagnosis support apparatus 1 scans the region from the tooth end to the gingiva in the oral cavity to measure the density distribution and detects a position where the density difference between the tooth and the gap is significant, The wisdom tooth frame 64 is determined at this position. When the tooth is not detected in the scanned area, the CPU 10 determines the tooth frame 65 at the position.

(2-5. Tooth state display: Step 1005)
FIG. 8 is a diagram illustrating size conversion of a dentist image.
The CPU 10 of the medical image diagnosis support apparatus 1 converts the dentist image 46 having the image analysis size into a dentist image 47 having the display size, and develops the dentist image 47 so that the tooth frames are arranged in a straight line. A medical image 48 is created. In the dentist image 47, the rectangular tooth frame 66 is arranged in a curved shape, but in the dentist image 48, it is converted into a rectangular tooth frame 67 and arranged in a straight line.
The CPU 10 superimposes the dentist image and the tooth frame on the display 19.

(3. Display of medical history of specified part)
Next, referring to FIG. 9 to FIG. 16, the medical history display of the designated site will be described.
As shown in FIG. 9, a dentist image 49, tooth position information 50, tooth frame coordinate information 80, tooth information 90 and electronic medical record information 100 are stored on the magnetic disk 13 of the medical image diagnosis support apparatus 1. These pieces of information may be stored in a storage device or database system other than the magnetic disk 13 and acquired via a network. The tooth position information 50 includes tooth frame coordinate information 80 and is tooth position information such as a tooth frame created by the processing of FIG.

FIG. 10 is a diagram showing the tooth frame coordinate information 80.
In the tooth frame coordinate information 80, four-point coordinates 82 are recorded for each tooth number 81 of the tooth frame. For example, in the example of FIG. 10, (100, 100), (110, 100), (100, 120), and (110, 120) are recorded for “upper right 1” of the tooth number 81. These four-point coordinates 82 are the four vertex coordinates of the tooth frame indicating “upper right 1” of the tooth number 81.

FIG. 11 is a diagram showing the tooth information 90.
The tooth information 90 is recorded in association with a tooth number 91, a tooth type 92 (anterior tooth, premolar, molar), a root canal number 93, an abutment tooth 94, and a missing tooth 95. In the example of FIG. 11, the data of the tooth number 91 “upper right 1” has the abutment tooth 94 “−”. This indicates that “upper right 1” is not an abutment tooth.

(3-1. Treatment history display processing of designated part)
FIG. 12 is a flowchart showing the operation of the medical image diagnosis support apparatus 1 in the medical history display processing for the designated part.
As shown in FIG. 12, the CPU 10 of the medical image diagnosis support apparatus 1 is based on dentist image information 49 and tooth position information 50 read from the magnetic disk 13, and tooth position information such as dentist image information 49 and a tooth frame. 50 is displayed on the display 19 (step 2001). Thereafter, the operator designates a site for which the medical history is desired to be referred to (step 2002), and the CPU 10 of the medical image diagnosis support apparatus 1 creates a display medical history relating to the designated site (step 2003). The medical history is displayed (step 2004).

(3-2. Site designation processing: Step 2002)
The part designation process will be described in more detail using FIG.
FIG. 13 is a flowchart showing the operation of the medical image diagnosis support apparatus 1 in the part designation process (step 2002).
FIG. 14 is a diagram for explaining a tooth site designation process in the dentist image 49.
The CPU 10 of the medical image diagnosis support apparatus 1 reads the tooth frame coordinate information 80 from the magnetic disk 13 and stores it in the main memory 14. The CPU 10 of the medical image diagnosis support apparatus 1 reads the coordinate position of the place where the operator has clicked with the mouse 16, holds it in the main memory 14, compares it with the tooth frame coordinate information 80, and the coordinate position of the click place is the tooth frame. (Step 2011). When the CPU 10 of the medical image diagnosis support apparatus 1 determines that the inside of the tooth frame has been clicked (Yes in step 2011), the tooth number corresponding to the clicked tooth frame is selected (step 2012). . When the CPU 10 of the medical image diagnosis support apparatus 1 determines that the inside of the tooth frame has not been clicked (No in step 2011), the tooth designation process ends.

  In the tooth designation process (step 2002), when the inside of the tooth frame corresponding to the already selected tooth is clicked, the selected state may be changed to the deselected state.

  In addition to specifying a tooth by clicking one point, a plurality of tooth numbers corresponding to a tooth including a part of the drag and drop locus of the mouse 16 in the tooth frame may be selected by one operation, or the mouse. A plurality of tooth numbers corresponding to teeth in which all tooth frames are included in the rectangular range designation by 16 drag-and-drop operations may be selected in one operation.

  In FIG. 14, a tooth frame 68 is displayed so as to overlap the dentist image 49, and when the operator clicks the mouse 16 at the position of the cursor 70, the lower left sixth tooth is selected, and the tooth frame is displayed. The selected state is shown.

(3-3. Displaying medical history creation processing: step 2003)
The display medical history creation process will be described in more detail with reference to FIG.
FIG. 15 is a flowchart showing the operation of the medical image diagnosis support apparatus 1 in the display medical history creation process (step 2003).
The CPU 10 of the medical image diagnosis support apparatus 1 reads the medical history such as the electronic medical record information 100 of the magnetic disk 13 and stores it in the main memory 14 (step 2020), and performs steps 2022 to 2024 for the number of medical history. Repeat (step 2021). The CPU 10 of the medical image diagnosis support apparatus 1 acquires a certain medical history on the main memory 14 (step 2022), and determines whether the site information of the medical history includes the designated site (step 2023). When the CPU 10 of the medical image diagnosis support apparatus 1 determines that the medical history includes the designated part (Yes in Step 2023), the medical history is added to the medical history for display on the main memory 14 (Step 2024). ), The process returns to step 2022. If the CPU 10 of the medical image diagnosis support apparatus 1 determines that the designated part is not included in the medical history (No in Step 2023), the CPU 10 returns to Step 2022 without performing any particular processing.

FIG. 16 is a diagram for explaining the display processing of the medical history of the designated part on the screen 71.
In FIG. 16, as shown in FIG. 16A, on the screen 71 in which the tooth frame 68 and the tooth number button 72 are displayed on the dentist image 49, the operator moves the lower right 1 to No. 3 is selected.

  The medical history such as the electronic medical record information 100 is searched for the lower right 1 to 3 designated in FIG. 16A, and the designated lower right is displayed in the medical history window 73 as shown in FIG. The medical history about Nos. 1-3 is displayed. For example, in the medical history window 73, a treatment 76 and an insurance score 77 are displayed for each designated date 75 for each date 74.

  Further, not the medical history but the tooth information 90 for the designated part may be displayed.

(4. Effect)
In this embodiment, while referring to the tooth state of the actual dentist image, the medical history can be confirmed for the tooth specified on the dentist image, and the current state and treatment content are integrated and imaged. Can do.

  The preferred embodiments of the medical image diagnosis support 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.

Hardware configuration diagram of medical image diagnosis support apparatus 1 The flowchart which shows operation | movement of the medical image diagnosis assistance apparatus 1 in preparation of tooth position information Illustration of determining the image analysis area The figure which shows calculation of the tooth end 55 The figure which shows calculation of the median line 57 The figure which shows the determination of the tooth outer frame 60 The figure which shows determination of the tooth space line 62 Diagram showing dentistry image size conversion The figure which shows the information preserve | saved at the magnetic disc 13 The figure which shows tooth frame coordinate information 80 The figure which shows the tooth information 90 The flowchart which shows operation | movement of the medical image diagnosis assistance apparatus 1 in the medical treatment history display process of the designated site | part. The flowchart which shows operation | movement of the medical image diagnosis assistance apparatus 1 in a site | part designation | designated process. The figure explaining the site | part specification process of the tooth in the dentist image 49 The flowchart which shows operation | movement of the medical image diagnosis assistance apparatus 1 in the medical treatment history preparation process for a display. The figure explaining the display processing of the medical history for display of the designated part on screen 71

Explanation of symbols

1 ... Medical image diagnosis support apparatus 10 ... CPU
11 ... Medical imaging device 12 ... LAN
13 ......... Magnetic disk 14 ......... Main memory 15 ......... Controller 16 ......... Mouse 17 ......... Keyboard 18 ......... Display memory 19 ......... Display 21, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 ......... Dentist image 22 ......... Margin 23 ......... Image analysis area 50 ......... Tooth position information 51, 53 ......... Scan line 52, 54 ......... Density distribution 55 ......... End of tooth 57 ......... Medium line 58, 59, 61 ......... Curve 60 ......... Outer tooth frame 62 ......... Gap space 63, 64, 65, 66, 67, 68 ......... Tooth Frame 70 ……… Cursor 71 ……… Screen 72 ……… Tooth number button 73 ……… Medical history window 74 ……… Date 75 ……… Part 76 ……… Action 77 ……… Insurance points 90 ……… Tooth information 100 ……… Electronic medical record information

Claims (3)

In a medical image diagnosis support apparatus for supporting diagnosis by a dentist using a dentist image,
A dentist image acquiring means for acquiring the dentist image;
Tooth position information acquisition means for acquiring tooth position information indicating the position of a tooth included in the dentist image;
Display means for displaying the acquired dentist image and tooth position information;
Coordinate position setting means for setting a coordinate position in the displayed dentist image and tooth position information;
Tooth selection means for detecting a tooth corresponding to the set coordinate position based on the tooth position information and making it a selected state or a deselected state;
Part information acquisition means for acquiring part information indicating a part of the tooth selected by the tooth selection means;
From the electronic medical record information, a medical treatment history creation means for display that creates a medical treatment history for display about a tooth that has been selected and extracted from the medical treatment history including the acquired part information;
Display medical history display means for displaying the display medical history;
A medical image diagnosis support apparatus comprising:   The coordinate position setting means sets a designated coordinate position of one point, and the tooth selection means changes a selection state of one tooth corresponding to the set coordinate position of one point. The medical image diagnosis support apparatus according to claim 1. A dentist image obtaining step for obtaining the dentist image;
Tooth position information acquisition step for acquiring tooth position information indicating the position of the tooth included in the dentist image;
A display step for displaying the acquired dentist image and tooth position information;
A coordinate position setting step for setting a coordinate position in the displayed dentist image and tooth position information;
Based on the coordinate position of the tooth position information, a selection step of detecting a tooth corresponding to the set coordinate position and selecting or deselecting the tooth;
A part information acquisition step for acquiring part information indicating a part of a tooth selected by the selection unit;
From the electronic medical record information, a medical treatment history creation step for display that creates a medical treatment history for display about a tooth that has been selected and extracted from the medical treatment history including the acquired part information;
A display medical history display step for displaying the display medical history;
Medical image diagnosis support program for causing a computer to execute the program.

Images