JP2009254904A - Ultrasonic image diagnostic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic image diagnostic apparatus which has high temporal efficiency in electrocardiographic measurement operation, facilitates a measurement operation, and has high operability. <P>SOLUTION: The ultrasonic image diagnostic apparatus includes a T/R waves display position movement means 19, and detects a display trigger position in an electrocardiogram by a reference signal detector 11 to use it as the measurement standard position to display a measurement cursor at a position of T wave/R wave. The measurement cursor can be switched to both sides to display. The T wave/R wave can be respectively displayed as measurement cursor 4 of CH1 and measurement cursor 5 of CH2 and both cursors can be moved to the measurement cursor 4 of CH1 (and measurement cursor 5 of CH2). <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

The present invention relates to an electrocardiogram that displays the cardiac potential of the heart, and more particularly to an ultrasonic diagnostic imaging apparatus having a measurement function on the electrocardiogram.

In the prior art, in order to obtain image information for diagnosing a region of interest in a patient's body tissue as a subject, an ultrasonic diagnostic imaging apparatus is widely used because of its low invasiveness and ease of operation. For the image information transmission function provided by these ultrasonic image diagnostic apparatuses, further improvements in convenience and operability are demanded by doctors and clinical technologists who are users.

In response to these demands from the user side, various techniques have been applied in conventional ultrasonic diagnostic imaging apparatuses. In particular, when an image of the circulatory system is imaged during an ultrasound image scan, when an examination is performed based on the pulsation of the heart and the dynamics of the valve under the ultrasonic tomogram, a technical means capable of simultaneously rendering an electrocardiogram Has been taken. (For example, refer to Patent Document 1.)
The heart is subject to dual antagonistic control of the autonomic nervous system, the sympathetic nervous system that promotes its activity and the depressing para-switching nervous system. An electrocardiogram (ECG) is a display or recording of the electrocardiogram associated with the action of the heart. The pulsation of the heart is performed by transmitting electrical impulses generated by the regulator in the order of the atrium, atrioventricle, nodule, hiss end, left and right legs, Purkinje fibrils, and ventricular muscle. Since the RR interval of the electrocardiogram forms a constant sinus rhythm, the fluctuation of the RR interval (heart rate variability) is used to evaluate the function of the autonomic nervous system, mental stress, work load, etc. ing.

One cycle of the electrocardiogram consists of P, Q, R, S, and T waves. The P to Q waves represent atrial excitement, and the Q to T waves represent ventricular excitement. From the end of the T wave to the beginning of the P wave represents the relaxation period of the heart. In addition to the function of the autonomic nervous system, fluctuations in the RR interval are said to be affected by baroreceptors on the blood vessel wall, blood pressure fluctuations, respiration, and body temperature regulation.

Thus, by measuring the appearance position and interval of each characteristic wave represented by the electrocardiogram on the electrocardiogram and observing the shape thereof, a lesion such as a heart disease can be diagnosed. In particular, in today's ultrasonic diagnostic apparatuses, products having an ultrasonic Doppler scanning function that can visualize blood flow information and movement information such as valves have been widely used. In addition, diagnostic methods for heart diseases, for example, using these ultrasonic Doppler scanning functions have been established, and are highly evaluated as accurate and non-invasive diagnostic methods.

  FIG. 4 is an example of a display screen of a conventional ultrasonic diagnostic imaging apparatus.

In an ultrasonic diagnostic imaging apparatus having a function capable of electrically detecting a change in electrocardiographic potential obtained from a subject and rendering it as an electrocardiogram, for example, an electrocardiogram is simultaneously displayed on a monitor screen on which an ultrasonic tomographic image is rendered. There are some which can display the electrocardiogram display screen 1. In such a device, initial setting on the waveform of the electrocardiogram 2 is performed by operating a measurement function switch on the operation panel for the electrocardiogram 2 of the subject displayed on the electrocardiogram display screen 1. A measurement cursor 20 according to the prior art is displayed at the center position. By displaying the measurement cursor 20 according to the conventional technique, the operator can designate a measurement start point on the electrocardiogram 2. In this location designation, the operator observes the waveform of the electrocardiogram 2 and finds a waveform shape and position that are significant in diagnosis, and positions the measurement cursor 20 at the found location via an input means such as a trackball.

The operator uses the positioned measurement cursor 20 as a reference line for starting measurement. For example, when PQ time is measured on the electrocardiogram 2 and used as a diagnostic material, P
The measurement result of the time interval from the rising position of the wave to the apex of the Q wave is used. The PQ time is a time from when the excitement started from the sinoatrial node is transmitted to the ventricle via the atrioventricular node and starts to excite the ventricle, and is about 120 to 200 ms as a normal value. The operator moves the measurement cursor 20 to P
Set to the rising position of the wave and read the time to the top of the Q wave with reference to this measurement cursor. By comparing the read measurement time with a normal value, the result can be used as a diagnostic material.

Further, by displaying two measurement cursors 20, it is possible to position two positions, a measurement start position and a measurement end position. In this way, for example, when the above-mentioned PQ time is measured, there is no need to visually read the time from the electrocardiogram 2 displayed on the screen to the top of the Q wave, and the time between the two measurement cursors. The length is displayed as a number on the screen. This display is realized by measurement software built in the ultrasonic diagnostic imaging apparatus.

JP-A-9-56717

In the conventional ultrasonic diagnostic imaging apparatus having the above-described configuration, the measurement cursor for measurement used for electrocardiogram measurement is set in advance so as to be displayed at the center of the screen display when the measurement function is activated. It was displayed. For this reason, the operator needs to move the displayed measurement cursor every time measurement is started using a trackball on the operation panel for measurement.

This movement operation complicates the measurement operation, and particularly when performing electrocardiogram measurement on a large number of subjects, the movement operation of the measurement cursor becomes troublesome, which in turn causes a decrease in time efficiency. It was.

In addition, if the operator is not familiar with the operation of the ultrasonic image diagnostic apparatus provided in the ultrasonic image diagnostic apparatus or the operation of the ultrasonic image diagnostic apparatus, a relatively long time is required for the positioning operation of the measurement cursor. It will hang. For this reason, time efficiency is lowered, and it cannot be said that it is easy to move the measurement cursor to the intended position on the electrocardiogram, and the intended measurement operation may be difficult.

In view of the above problems, an object of the present invention is to provide an ultrasonic diagnostic imaging apparatus that has good time efficiency in an electrocardiogram measurement operation, can be easily performed, and has good operability.

In order to solve the above-described problem, an ultrasonic diagnostic imaging apparatus according to claim 1 transmits an ultrasonic wave to a subject, receives an obtained reflected wave, and outputs it as an ultrasonic echo signal. An ultrasonic probe, and an ultrasonic image generating means for forming an ultrasonic image based on the ultrasonic echo signal;
A phase detection unit for detecting a plurality of phase positions in an electrocardiogram waveform; a measurement cursor setting unit for setting a measurement cursor to a predetermined phase position of the electrocardiogram waveform based on a detection result of the phase detection unit; A display image generating unit that generates a display image based on a sound wave image; and a calculation unit that performs a calculation related to medical information based on the ultrasonic image information corresponding to the detection result of the phase detecting unit. And

As described above in detail, according to the present invention, by drawing a circular marker so as to be inscribed in the wall of the tissue, the maximum diameter portion is searched for the tissue.
It can be recognized very easily visually, and since the operation is easier compared to searching for the maximum diameter portion linearly, the burden on the operator can be reduced. In addition, since the measurement accuracy is improved, it is possible to achieve a great effect such as being able to contribute to an appropriate diagnosis.

It is the schematic for demonstrating the signal processing of the ultrasonic image diagnostic apparatus which concerns on embodiment of this invention. It is a block diagram for demonstrating the signal processing of the ultrasonic diagnostic imaging apparatus which concerns on embodiment of this invention. It is an example of the display screen by the ultrasound diagnostic imaging apparatus which concerns on other embodiment of this invention, (a) is a display screen after a measurement cursor movement, (b) is a display screen after a movement. It is an example of the display screen of the ultrasonic image diagnostic apparatus by a prior art. (A) is an example of display of an electrocardiogram according to the embodiment of the present invention, and (b) is an example of menu display of measurement and calculation.

FIG. 1 is a schematic diagram for explaining signal processing of the ultrasonic diagnostic imaging apparatus according to the embodiment of the present invention.

The ultrasound diagnostic imaging apparatus according to the embodiment of the present invention will be described by taking as an example a configuration that is provided in the ultrasound diagnostic imaging apparatus and that can capture the waveform change of the cardiac potential in synchronization with the ultrasound tomographic image. In this configuration, at least the electrocardiogram display screen 1 and the electrocardiogram display screen 1
2, and an R wave detection circuit 3 for detecting an R wave in the electrocardiogram 2,
It consists of In addition to the R wave, the T wave may be detected by providing other T wave detection means, for example. Further, by providing this detection means for the purpose of detecting a plurality of types of waveforms, it is possible to detect not only a single waveform but also a plurality of types of waveforms at the same time.

The electrocardiogram 2 displayed on the electrocardiogram display screen 1 shows a characteristic waveform shape in synchronization with the heartbeat. Among these characteristic waveform shapes, the position of the R wave on the electrocardiogram 2 showing a particularly remarkable waveform shape is detected by the R wave detection circuit 3. Reference is now made to FIG.

FIG. 2 is a configuration diagram for explaining signal processing of the ultrasonic diagnostic imaging apparatus according to the embodiment of the present invention.

The R wave detection circuit 3 shown in FIG. 1 for detecting the R wave is configured to be included in the reference signal detector 11 shown in FIG. 2, and receives a cardiac potential signal from the ECG 21. The R wave is detected. Next, after a predetermined delay time is added via the delay circuit 22, the R wave is sent to the cursor display means 19 at the next stage.

The cursor display means 19 according to the present invention includes a non-fade (NF) processing circuit 12 for displaying a stable electrocardiogram 2 not attenuated on the display monitor 14, and this non-fade (
NF) The CPU 1 which takes in the ECG time phase signal 17 output from the processing circuit 12 and outputs the display position instruction data 18 which is data of the initial position and end position of the measurement based on this signal.
6 and a graphic plane 15 that generates image data to be displayed on the display monitor 14 simultaneously with the measurement cursor superimposed on the electrocardiogram based on the display position instruction data 18.

Upon receiving the image data output from the graphic plane 15, the DSC 13 synthesizes an electrocardiographic waveform, a menu display for measurement, and the like with the ultrasonic image. CPU 16 is DSC1.
Data is exchanged with 3.

The ultrasonic reception signal output from the T & R 10 is subjected to signal processing by the ultrasonic signal processing means 23. In the ultrasonic signal processing means 23, signal processing as a basis for image display such as B mode, M mode, and Doppler mode is performed and sent to the DSC 13.

An operator gives a measurement instruction to an electrocardiogram displayed on the display monitor 14 from an operation panel (not shown) in order to perform electrocardiogram measurement. In response to this instruction, the above-described reference signal detector 11 and cursor display means 19 operate to detect, for example, an R wave on the electrocardiogram. The position of the detected R wave on the time axis is specified by the graphic plane 15 and the CPU 16, and the measurement cursor is displayed at the R wave position on the electrocardiogram 2 on the display monitor 14. The operator simply selects the measurement function on the operation panel, and a measurement cursor is displayed on the R wave, for example, without using input instruction means such as a trackball.

Here, referring again to FIG. 1, in order to display the measurement cursor on the electrocardiogram 2, the position of the R wave detected by the R wave detection circuit 3 on the time axis in the electrocardiogram is specified. Based on the specified position information on the time axis, a measurement cursor is displayed at the position of the R wave. For example,
The measurement cursors shown in FIG. 1 are examples displayed in pairs.

According to this example, the measurement cursor 4 of CH1 is displayed at the position of the R wave. On the other hand, C
A measurement cursor 5 of H2 is displayed at a position on the time axis of the T wave. Here, in order to specify the position of the T wave on the time axis, the entire waveform shape of the electrocardiogram 2 is recognized as a pattern, and the position of the T wave is compared with the pattern of the electrocardiogram stored in the apparatus in advance. This can be realized by detecting.

Further, the waveform of the electrocardiogram 2 is sampled at a predetermined time interval, and the inclination at the sampling instant is detected by using a differentiation circuit or the like. By comparing this detected value with a slope value input in advance, a significant waveform can be detected on the R wave, T wave, and other electrocardiogram diagnosis.

Furthermore, in combination with the ultrasonic diagnostic imaging apparatus, a heart beat or the like is displayed on the B-mode image, and the electrocardiogram 2 is also displayed in synchronization with this beat. In order to display the electrocardiogram 2 in accordance with the movement of the B-mode image of the pulsation or the ultrasonic Doppler image display, a synchronization means using a delay is provided as shown in FIG. . In particular, in order to display the electrocardiogram 2 while drawing blood flow information by the ultrasonic Doppler method, the frame rate by ultrasonic scanning of the ultrasonic tomographic image becomes low, so a relatively large delay time is generated. There is a need to.

Further, a CH1 position display 6 and a CH2 position display 7 are displayed on the image to distinguish both channels. If there is another R (wave or T) wave on ECG 2 at the same time, this R
Both the CH1 measurement cursor 4 (and the CH2 measurement cursor 5) can be displayed at the position of the (wave or T) wave. The position detection of the R (wave and T) wave is realized by the same procedure as the conventional R wave and T wave detection method.

Note that the method of writing to the graphic plane 15 is one means for transmitting to the CPU 16, and if the CPU 16 can read it, the same effect can be obtained by writing to a frame memory (not shown) for displaying an ultrasonic image.

FIG. 3 is an example of a display screen by an ultrasonic diagnostic imaging apparatus according to another embodiment of the present invention.

FIG. 3A shows that the measurement cursor 4 for CH1 and the measurement cursor 5 for CH2 are displayed in the electrocardiogram 2. Further, (b) is a display after the CH1 measurement cursor 4 and the CH2 measurement cursor 5 are moved to another designated position as a set. When an electrocardiogram 2 is displayed on one electrocardiogram display screen 1 and there are two or more waveform changes that require measurement on the electrocardiogram, for example, the operator can instruct to move the measurement cursor from the operation panel to perform the first measurement. It is possible to move from the display position of the measurement cursor 4 of CH1 and the measurement cursor 5 of CH2, which are positions, to a waveform position requiring another measurement as a set. CH1 position display 6 (and CH
The two-position display 7) shows the CH1 measurement cursor 4 (and the CH2 measurement cursor 5) after movement, and two measurements can be performed on one screen.

This movement of the measurement cursor can be realized by capturing all the waveforms to be measured displayed on the electrocardiogram 2 on the graphic plane 15 and recognizing their positions using the cursor display means 19 described with reference to FIGS. . All the positions on the time axis, such as T waves and R waves, which are measured waveforms in this case, are all stored in the graphic plane 15. When measuring other T-waves or R-waves according to the operator's instruction, the measurement cursor is displayed at the position of the other T-waves or R-waves according to the operator's instructions or sequentially.

According to the ultrasonic diagnostic imaging apparatus according to the present invention described above, the throughput for diagnosis is improved because the measurement cursor position is automatically calculated. Moreover, it is possible to provide correct information to an operator who has little knowledge of ultrasonic image diagnosis and who cannot fully understand the relationship between the initial position and end position on the electrocardiogram and the time phase on the time axis on the ECG. .

In addition, since the measurement start position can be displayed on the ECG waveform in advance when measuring the ECG,
The operation of moving the measurement cursor position indicating the measurement start position can be omitted.

Further, the position of the measurement cursor displayed first can be switched to either T wave or R wave, and the two measurement cursors displayed for measurement are moved to other T wave and R wave positions. be able to.

Further, at the same time as displaying the measurement cursor position, the position data on the time axis for this display is used in measurement and calculation by the measurement function. For this reason, the measurement cursor position is automatically calculated without the operator pointing the position on the screen, and the cursor is displayed at a predetermined position. At the same time, the position information is automatically used as a setting condition for measurement and calculation.

FIG. 5 shows a display example of the electrocardiogram display and measurement function of the ultrasonic diagnostic imaging apparatus according to the embodiment of the present invention. FIG. 5A shows an example of the electrocardiogram display 24, and various predetermined calculation and measurement functions are displayed on the displayed electrocardiogram waveform so as to be selectable. (B)
Is an example of display of the measurement menu 25. Here, items that can be measured and items that can be calculated are displayed to the operator at the same time.

For example, when the calculation menu of the left atrial aorta ratio LAD / AOD is selected by the operator arbitrarily, the measurement cursor position is automatically displayed in the ultrasonic diagnostic imaging apparatus of the present invention. Specifically, the measurement cursor 4 is set at a position where the R wave is detected, and the measurement cursor 5 is set at a position delayed by a predetermined time from the R wave. The delay time at this time is set in advance so that the measurement cursor 5 is set near the position where the left atrial diameter is maximum. Since the AOD can be detected from the ultrasonic image near the R wave, the CPU 16 obtains the AOD measurement value from the ultrasonic image at the position of the measurement cursor 4, and the CPU 16 measures the LAD from the ultrasonic image at the position of the measurement cursor 5. Find the value.

The CPU 16 obtains the left atrial aortic ratio as a measurement value by dividing the obtained LAD by AOD.

Thus, by calculating the information of the measurement start position as a set value for medical information calculation such as the left atrial aorta ratio LAD / AOD, it is automatically performed without the need to set numerical values or positions. The operability of measurement / calculation is improved.

The embodiment described above is described in order to facilitate understanding of the present invention, and is not described in order to limit the present invention. Therefore, each element disclosed in the above embodiment includes all design changes and equivalents belonging to the technical scope of the present invention.

Here, ECG is taken as an example, but PCG can also have a similar measurement function for blood pressure waveforms and the like. Furthermore, the PCG waveform linked with the ultrasonic tomographic image can be measured by the configuration combined with the ultrasonic diagnostic imaging apparatus.

1 ... ECG display screen, 2 ... ECG, 4 ... CH1 measurement cursor, 5 ... CH2 measurement cursor, 6 ... CH1 position display, 7 ... CH2 position display, 12 ... Non-fade processing, 15 ... Graphic plane, 13 ... DSC 19 ... Measurement cursor display means, 20 ... Measurement cursor according to the prior art

Claims (4)

An ultrasonic probe that transmits an ultrasonic wave to a subject, receives an obtained reflected wave, and outputs an ultrasonic echo signal;
An ultrasonic image generating means for forming an ultrasonic image based on the ultrasonic echo signal;
Phase detection means for detecting a plurality of phase positions in an electrocardiogram waveform;
Measurement cursor setting means for setting a measurement cursor to a predetermined phase position of the electrocardiogram waveform based on the detection result of the phase detection means;
Display image generating means for generating a display image based on the ultrasonic image;
A calculation means for calculating medical information based on the ultrasonic image information corresponding to the detection result of the phase detection means;
An ultrasonic diagnostic imaging apparatus comprising: 2. The ultrasonic image according to claim 1, wherein the calculation means performs calculation using at least one of a right ventricular outflow tract diameter, an aortic diameter, a left atrial diameter, an aortic valve diameter, and an ejection time. Diagnostic device. 2. The ultrasonic diagnostic imaging apparatus according to claim 1, further comprising means for displaying a measurement menu related to the calculation means and selecting a desired item from the displayed measurement menu. When the measurement cursor setting means selects a desired item from the measurement menu by the selection means, a plurality of phase positions that require measurement in the electrocardiogram waveform based on the detection result of the phase detection means. And a different measurement cursor different from the measurement cursor is set at a position separated by a predetermined interval with respect to the predetermined phase position. 4. The method according to claim 3, wherein a dimension of the tissue in the subject is measured based on the ultrasonic image information corresponding to the phase position where the cursor is set, and calculation is performed using the measurement result. Ultrasonic diagnostic imaging equipment.

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