JP2010051726A - Medical image diagnostic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To automatically judge the insertion direction of a subject to a photography part. <P>SOLUTION: Whether the insertion direction of a subject P into the photography part 13 of a medical image diagnostic apparatus body 10 is from the vertex direction or from the leg direction is automatically discriminated by performing image processing of an appearance image, a scanogram image, a tomographic image of the subject photographed by a camera 100, etc. to extract a feature point of a body. Thus, since the insertion direction or the photographic direction of the subject is automatically judged without depending on manual input by an operator, burdens of the operator are alleviated, erroneous input is surely prevented, and misdiagnosis due to erroneous recognition of the direction of the image is prevented from being caused when the photographed tomographic image is read. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical image diagnostic apparatus capable of sequentially obtaining a plurality of tomographic images of a subject in the body axis direction, and in particular, whether the subject's insertion direction into the imaging unit is from the top or leg direction. The present invention relates to a medical image diagnostic apparatus capable of discriminating or automatically discriminating whether a tomographic image is obtained sequentially from the top of a subject or from a leg direction.

  In medical image diagnostic apparatuses such as an X-ray CT apparatus, a magnetic resonance imaging apparatus, and a PET apparatus, a large number of tomographic images are obtained along the body axis direction of a subject and used for diagnosis. At that time, a tomographic image can be obtained by sending the subject who is resting on the top of the bed from any direction, either from the top of the head or from the leg, to the imaging unit of the medical image diagnostic apparatus. Therefore, if a tomographic image of a plurality of slices is obtained at a predetermined interval for a certain diagnostic region and these images are interpreted by an interpreting physician, it is misunderstood as if images taken sequentially from the top of the head were taken sequentially from the leg direction. There is a risk that the direction of the actual image may be determined in the opposite direction, which may lead to misdiagnosis.

In order to eliminate such a problem, the insertion direction as a part of the subject information is conventionally included in the taken tomographic image so that the direction of the subject inserted into the imaging unit can be understood as the parietal direction or the leg direction. (For example, refer to Patent Document 1). As a result, it is clarified whether the obtained tomographic image is taken sequentially with the subject inserted into the imaging unit from the top of the head or inserted into the imaging unit from the leg direction and sequentially taken. Consideration was made so as not to cause misunderstandings during interpretation. As an input method, an operator inputs to the medical diagnostic imaging apparatus by selecting a design or an arrow from the dialogue screen of the operation unit, or selecting characters such as Head First and Foot First. The contents are used by the control unit as a part of the subject information.
JP 2007-167634 A

  However, the characters and marks indicating the direction in which the subject is inserted displayed in the acquired tomographic image are the result of manual input by the operator to the medical image diagnostic apparatus, and the operator's inadvertent mistakes are completely eliminated. I couldn't. For example, it is expected that Head First will be set as Foot First, and vice versa, Foot First will be set as Head First. In such a case, the incidental information displayed in the obtained tomographic image is the actual direction. Therefore, there was a risk that misdiagnosis might be caused if the incidental information was interpreted and interpreted.

  In order to solve such a problem, the present invention automatically determines the insertion direction of the subject into the imaging unit using the image processing means without the manual input of the operator, and the result Is recorded as incidental information, or a medical image diagnostic apparatus that allows an operator to check whether there is any mistake is provided.

  In order to solve the above-mentioned problem, the invention described in claim 1 is configured such that a subject placed on the top plate of the bed apparatus is inserted into the imaging unit along the body axis direction and sequentially along the body axis direction. In the medical image diagnostic apparatus for obtaining a plurality of tomographic images, it is determined whether the insertion direction of the subject into the imaging unit is from the top direction or the leg direction, or the obtained tomographic image is the subject And a discriminating means for discriminating whether it is sequentially obtained from the top direction or the leg direction.

  According to a second aspect of the present invention, in the medical image diagnostic apparatus according to the first aspect, the determination unit is configured to perform image processing based on a video of a camera that has photographed a subject positioned in the photographing unit. It is characterized by extracting body feature points.

  According to a third aspect of the present invention, in the medical image diagnostic apparatus according to the first aspect of the present invention, the discrimination means is a feature point of the body by image processing based on scanogram data obtained separately from the tomographic image. Is extracted.

  According to a fourth aspect of the present invention, in the medical image diagnostic apparatus according to the first aspect, the discrimination means extracts a body contour by image processing based on the plurality of tomographic images. It is characterized by that.

  Further, the invention according to claim 5 is the medical image diagnostic apparatus according to claim 1, wherein the discriminating means performs organ processing by image processing based on radiation detection data from a radiopharmaceutical administered to the subject. It is characterized by extracting the positional relationship such as.

  As shown in the section of the means for solving the above problems, according to the invention of each claim described in the claims of the present invention, the following effects can be obtained.

  According to the first aspect of the present invention, it is automatically determined whether the insertion direction or the imaging direction of the subject to the imaging unit is from the top of the head or the leg side without the manual input of the operator. Thus, it is possible to reduce the burden on the operator and reliably prevent an input error. Therefore, it is possible to prevent misdiagnosis by misidentifying the direction of the image when interpreting the captured tomographic image.

  According to the second aspect of the present invention, the state of the subject at the time of insertion into the photographing unit is photographed by the camera, and the insertion direction or photographing direction is judged based on the video, so the judgment result is reliable. Become. In addition, the operator can observe the state of the subject with the camera, which can contribute to the improvement of safety in photographing.

  According to the third aspect of the present invention, since the scanogram image obtained prior to the start of tomography is used for setting the imaging range and imaging conditions with an X-ray CT apparatus or the like, no special incidental work is required. It does not put a burden on the operator.

  According to the invention described in claim 4, since the tomographic image taken as the original purpose is used to determine the insertion direction or photographing direction of the subject to the photographing unit, the certainty can be further increased. .

  According to the invention described in claim 5, since the positional relationship of the organ is determined from the density pattern of the image obtained by the PET apparatus, it is possible to easily recognize the insertion direction or the imaging direction of the subject to the imaging unit. Is possible.

  Hereinafter, embodiments of a medical image diagnostic apparatus according to the present invention will be described in detail with reference to FIGS.

  First, as an example of a medical image diagnostic apparatus according to the present invention, an outline of an apparatus in which an X-ray CT apparatus and a PET (single photon emission computer tomography) apparatus are integrated will be described.

  FIG. 1 is a schematic system diagram of an example of such a medical image diagnostic apparatus. The medical image diagnostic apparatus main body 10 includes an X-ray CT apparatus 20 and a PET apparatus 30 with a common base. The medical image diagnostic apparatus main body 10 includes an imaging unit 13 that shares the X-ray CT apparatus 20 and the PET apparatus 30, and the imaging unit 13 is provided with a display unit 40 and an illumination unit 50. The medical image diagnostic apparatus includes a bed apparatus 60 for sending the subject to the imaging unit 13. Further, the X-ray CT apparatus 20, the PET apparatus 30, and the bed apparatus 60 are controlled, the scan control unit 70 for processing the acquired image data, and the display unit 40 under the control of the scan control unit 70. A navigation control unit 80 for controlling the illumination unit 50 is provided. In addition, an operation unit 90 in which an operator appropriately inputs instructions and setting values to the scan control unit 70, or a test that is placed on the bed device 60 and sent to the imaging unit 13 of the medical image diagnostic apparatus body 10 The camera 100 etc. which image | photograph a person's state and send out the image | photographed data to the scan control part 70 are also provided.

  Next, the structure of the medical image diagnostic apparatus will be described with reference to FIG.

  FIG. 2 is a longitudinal sectional view of the medical image diagnostic apparatus as viewed from the side, and shows the positional relationship between the X-ray CT apparatus 20 and the PET apparatus 30 arranged in the medical image diagnostic apparatus body 10 and the imaging unit 13. The relationship is schematically shown.

  That is, the medical diagnostic imaging apparatus main body 10 is installed on the floor, and an X-ray CT apparatus 20 and a PET apparatus 30 are arranged in series in the longitudinal direction with the imaging unit 13 in common. The surface of the medical diagnostic imaging apparatus main body 10 is covered with a cover, and the hollow cylindrical imaging unit 13 is formed at a substantially central portion of the medical diagnostic imaging apparatus main body 10 so as to penetrate between the front cover 11 and the rear cover 12. Is formed. A top plate 61 of the bed apparatus 60 on which the subject P is placed is inserted into the imaging unit 13 so as to be able to advance and retract from the outside of the front cover 11 as indicated by an arrow 62.

  The front cover 11 is provided with a camera 100 above the photographing unit 13. The camera 100 is placed on a top plate 61 of the bed apparatus 60 and takes a substantially whole body image of the subject P introduced into the imaging unit 13. The imaging unit 13 is surrounded by a cover 14 (hereinafter referred to as a dome cover) made of mylar or the like, and is formed in a hollow cylindrical shape. By this dome cover 14, the inside of the medical image diagnostic apparatus main body 10 is connected. The imaging unit 13 is partitioned.

  The X-ray CT apparatus 20 includes an X-ray tube and an X-ray detector that rotate around the imaging unit 13 (not shown), and a circumferential range indicated by reference numeral 21 is an X-ray range. Thus, the X-ray tube and the X-ray detector rotate in the hatched portion.

  On the other hand, in the PET apparatus 30, a circumferential range indicated by reference numeral 31 is released from the subject P based on a radiopharmaceutical (for example, FDG: F-18 fluorodeoxyglucose) previously administered to the subject P. A gamma ray detector (not shown) is arranged so as to surround the photographing unit 13 at a position where the oblique line of the position 31 is given.

  Now, in the tomographic image capturing by the medical diagnostic imaging apparatus shown in FIGS. 1 and 2, whether the subject was photographed by inserting the subject into the imaging unit 13 from the top of the head, or by inserting from the leg direction. A means for determining whether the image has been taken before the tomographic image is taken or a means for judging after the tomographic image is taken. First, means for determining before taking a tomographic image will be described as a first embodiment.

  The subject P to be inserted into the imaging unit 13 of the medical image diagnostic apparatus main body 10 is placed on the top plate 61 of the bed apparatus 60 and sent from the front cover 11 side. A camera 100 is installed on the front cover 11 at a position above the photographing unit 13, and a substantially whole body image of the subject P is photographed by the camera 100. The captured image is sent to the scan control unit 70, where image processing is performed to extract body feature points such as a body contour.

  As a result, when the subject P is inserted into the imaging unit 13 from the top of the head, the head is positioned on the leading end side of the image captured by the camera 100. When this image is processed, for example, FIG. The contour image is as shown in (a). Therefore, by recognizing that the extracted tip R of the body contour is an arc shape as indicated by a thick black line, the scan control unit 70 inserts the subject P into the imaging unit 13 from the head direction. Judge that. On the other hand, when the subject P is inserted into the imaging unit 13 from the leg side, the leg portion is located on the leading end side of the image. Therefore, when this image is processed, the image is thin as shown in FIG. Two contour images F1 and F2 are obtained. Therefore, by recognizing such an image, the scan control unit 70 determines that the subject P has been inserted into the imaging unit 13 from the leg direction. This determination result is recorded as incidental information of a tomographic image to be taken later.

  Further, a contour image is obtained by performing image processing on the whole body image of the subject, and by plotting the center of the width direction along the body axis direction sequentially with respect to the contour image, as shown in FIG. A branch can be recognized. That is, in the contour image of FIG. 4, the upper side is the leg side and the lower side is the torso side, whereas the upper limb side from the head to the torso is plotted with one point (T1) in the center in the width direction. Since there are two legs on the side, two points (T2) are plotted at the center in the contour image. Therefore, the position where the center point changes from 1 point (T1) to 2 points (T2) is the leg branch point, and it becomes easy to distinguish between the upper limb side and the lower limb side. Accordingly, it is easy to recognize the insertion direction of the subject P inserted into the imaging unit 13, that is, the imaging direction. Based on this result, the subject P inserted into the imaging unit 13 is inserted from the head direction. Whether it is inserted from the leg direction or not, and the determination result is recorded as incidental information of a tomographic image to be photographed thereafter.

  Even if the whole body image of the subject P is not photographed by the camera 100, depending on the type of medical image diagnostic apparatus (referred to as modality), the sensor image unique to the modality is used to the photographing unit 13. The direction of the inserted subject P can be recognized.

  That is, in the X-ray CT apparatus, scanogram data (also referred to as a positioning image) is imaged prior to the start of tomography in order to set the imaging range and imaging conditions of the tomographic image. Is well known (for example, see Japanese Patent Application Laid-Open No. 9-313476). Therefore, based on the scanogram data, the body contour of the subject, the arrangement of ribs and spine, the shape of the organ, and the like are pattern-recognized, and the feature points of the body are extracted from the results, and these are sent to the imaging unit 13. The insertion direction of the inserted subject P can be determined.

  For example, when the scanogram M1 of the head or the scanogram M2 of the waist as shown in FIG. 5 is obtained, the relationship between the position of the top M11 and the eye M12 on the arc, With respect to, the imaging direction of the scanogram data, that is, the insertion direction of the subject P into the imaging unit 13 can be determined based on a predetermined criterion such as the positional relationship between the lumbar spine M21 and the pelvis M22. This determination result is recorded as incidental information of a tomographic image to be taken later, or displayed on, for example, a dialogue screen of the operation unit 90 as a caution text for allowing the operator to confirm the insertion direction of the subject P. Let

  Next, a means for determining after photographing whether the photographed tomographic image is photographed by inserting the subject P into the photographing unit 13 from the top of the head or by photographing from the leg direction. This will be described as Example 2.

  As means for determining the insertion direction of the subject P after such imaging, body contours are extracted based on a large number of tomographic images obtained by respective modalities such as an X-ray CT apparatus and a magnetic resonance imaging apparatus. It is also possible to determine the insertion direction (imaging direction) in a three-dimensional manner by combining the position information of the bed top plate on which the subject P is placed and recognizing the pattern. Further, in the case where the whole body image can be acquired in addition to the acquisition of the tomographic image like the PET apparatus 30, it is particularly easy to determine the insertion direction of the subject P into the imaging unit 13 after the tomographic image is acquired. .

  In the PET apparatus 30, for example, FDG is often administered to the subject P and a whole body image is photographed. For example, the photographed image is schematically shown in FIG. 6, but the FDG administered to the subject P is often shown. The degree of accumulation varies from organ to organ. In FIG. 6, symbol P1 indicates the head (brain) of the subject P, symbol P2 indicates the torso, symbol P3 indicates the chest, and symbol P4 indicates the arm. The urinary bladder is indicated by the symbol P21.

  Now, since FDG is mainly composed of glucose, it has a high degree of integration in the head (brain) P1 and bladder P21. Therefore, the integrated FDG is displayed as a large black sphere on the image. . However, since the head (brain) P1 is large, the black sphere is also displayed larger, and since the bladder P21 is smaller than the head (brain) P1, the black sphere is displayed smaller. Therefore, the positional relationship between the head (brain) P1 and the bladder P21 is determined from the magnitude of the density pattern of such an image, and based on this result, the subject P to be inserted into the imaging unit 13 is in the parietal direction. Therefore, it is possible to easily recognize the insertion direction, that is, the imaging direction, whether the lens is inserted from the leg or from the leg direction. The determination result is recorded as incidental information on the photographed tomographic image.

  As described above, in the medical image diagnostic apparatus according to the present invention, when tomographic images are taken, it is taken whether the subject is inserted into the photographing unit 13 from the top of the head or from the direction of the legs. The means for determining before shooting and the means for determining after shooting have been described. Here, when the insertion direction of the subject P into the imaging unit 13, that is, the imaging direction cannot be determined before the tomographic image is acquired, the medical image diagnostic apparatus according to the present invention is determined after the tomographic image is acquired. A flow of a series of operations will be described based on the flowcharts shown in FIGS.

  FIG. 7 shows the flow of operations when determining the direction of insertion of the subject P into the imaging unit 13 before tomography.

  As step 1, immediately before the appearance image, that is, the whole body image or the upper body image of the subject P placed on the top plate 61 of the bed 60 is inserted into the imaging unit 13 of the medical image diagnostic apparatus body 10, the front cover 11 Images are taken by the camera 100 attached to the camera. Next, as Step 2, it is determined whether or not the appearance photograph of the subject P has been acquired. If it has been acquired, the process proceeds to Step 3, where the acquired appearance photograph is subjected to image processing to extract a body contour. To recognize whether the subject P is inserted into the imaging unit 13 from the direction of the head or the direction of the legs. If the insertion direction of the subject P into the imaging unit 13 is identified here, the process proceeds to step 6 and the insertion direction as the identification result is recorded in the scan control unit 70 as incidental information.

  Based on the recording result, each tomographic image is displayed as, for example, Head First, Foot First, or the like, and the insertion direction of the subject P, that is, the imaging direction is clarified for each tomographic image. Further, in the case of an apparatus in which an operator manually inputs the insertion direction as before, based on the identification result in step 5, if there is an error in the operator's input in step 6, that fact is notified, and the insertion direction is correct. It is also possible to call attention so that it can be corrected.

  On the other hand, if the appearance photograph of the subject P cannot be acquired for some reason in step 2, the process proceeds to step 4 and the subject P inserted into the imaging unit 13 using the sensor image unique to the modality. It is determined whether or not the direction can be recognized. As a result, if it is possible to make a determination based on the sensor image, the process proceeds to step 5, for example, based on a scanogram image in an X-ray CT apparatus, using a well-known image recognition technique, body contour, arrangement of ribs, spine, etc., organ The shape and the like are recognized, and the body feature points are extracted from the result to identify the insertion direction. Thereafter, the process proceeds to step 6, and the insertion direction of the identification result is recorded in the scan control unit 70 as supplementary information.

  If it is determined in step 4 that a modality-specific sensor image cannot be used, the process proceeds to step 11 shown in FIG.

  FIG. 8 shows the flow of operation when determining the insertion direction of the subject P into the imaging unit 13 after tomography, and this case will be described next.

  First, in step 11, it is determined whether or not it is possible to determine the insertion direction (imaging direction) of the subject P into the imaging unit 13 from the tomographic images collected by each modality. If it can be determined here, the process proceeds to step 12 where a body contour is extracted based on a large number of tomographic images collected by each modality, and the bed top plate on which the subject P is placed while recognizing these patterns. The insertion direction (imaging direction) is identified three-dimensionally in combination with the position information.

  If the insertion direction of the subject P into the imaging unit 13 is identified in step 12, the process proceeds to step 15 and the insertion direction as the identification result is recorded in the scan control unit 70 as incidental information. Based on the recording result, each tomographic image can be displayed, for example, Head First, Foot First, etc., and the insertion direction of the subject P, that is, the imaging direction is clarified for each tomographic image.

  On the other hand, if it is determined in step 11 that the direction of insertion of the subject P into the imaging unit 13 (imaging direction) cannot be determined from the collected tomographic images, the process proceeds to step 13 and the whole body is acquired after the tomographic images are collected. Determine whether images can be collected. As a result, if it can be determined, the process proceeds to step 14 where the pattern of the whole body image collected using a known 3D image recognition technique or the like is recognized, and the insertion direction (imaging direction) of the subject P into the imaging unit 13 is recognized. ).

  That is, if the modality is a PET device, the FDG accumulation degree differs for each organ such as the head (brain) P1 and the bladder P21 in the whole body image taken by administering FDG to the subject P. The positional relationship between the head (brain) P1 and the bladder P21 can be determined from the size (pattern) of the black sphere as shown. Therefore, based on this result, it is possible to identify whether the subject P inserted into the imaging unit 13 is inserted from the head direction or from the leg direction, or the insertion direction, that is, the imaging direction. It is.

  If the insertion direction of the subject P into the imaging unit 13 is identified in step 14, the process proceeds to step 15, and the insertion direction as the identification result is recorded in the scan control unit 70 as incidental information. If it is determined in step 13 that collection of a whole body image is impossible after tomographic image collection, it is difficult to automatically identify the insertion direction of the subject P into the imaging unit 13 only at this time. Become.

  As described above in detail, according to the present invention, when a tomographic image of the subject P is captured by the medical image diagnostic apparatus, the insertion direction of the subject P into the imaging unit 13 of the medical image diagnostic apparatus main body 10, That is, an image of the camera that has actually photographed the subject P that has been manually input by the operator, indicating whether the subject P has been inserted from the head side or the leg side. Or a sensor image acquired by a medical image diagnostic apparatus, or a whole body image obtained after collecting a tomographic image or a tomographic image acquired by a medical image diagnostic apparatus. Since the determination can be made automatically after the tomographic image is acquired, the burden on the operator can be reduced and input errors can be prevented. It is also possible to make the operator check whether there is an error in the input or to call attention.

  In addition, this invention can be implemented with a various form within the range of a summary, without being limited to the above-mentioned Example. For example, although an almost whole body image of the subject P is taken by the camera 100, only the tip portion of the subject P approaching the front cover 11 may be taken. The camera 100 may be either for still image shooting or for moving image shooting, and may be a video camera.

1 is a schematic system diagram of an example of a medical image diagnostic apparatus according to the present invention. It is the longitudinal cross-sectional view which looked at the medical image diagnostic apparatus from the side surface side. It is explanatory drawing of the subject's outline image illustrated in order to demonstrate the effect | action of one Example of this invention. It is explanatory drawing of the other outline image illustrated in order to demonstrate the effect | action of this invention. It is explanatory drawing of the scanogram image illustrated in order to demonstrate the effect | action of the other Example of this invention. It is explanatory drawing which showed typically the image image | photographed with the PET apparatus. It is the flowchart explaining the flow of operation | movement of one Example of this invention. It is the flowchart explaining the flow of operation | movement of the other Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Medical diagnostic imaging apparatus main body 11 Front cover 13 Imaging | photography part 20 X-ray CT apparatus 30 PET apparatus 60 Bed apparatus 61 Top plate 70 Scan control part 80 Navigation control part 90 Operation part 100 Camera

Claims (5)

In the medical image diagnostic apparatus for inserting the subject placed on the top plate of the bed apparatus into the imaging unit along the body axis direction and sequentially obtaining a plurality of tomographic images along the body axis direction,
It is determined whether the direction of insertion of the subject into the imaging unit is from the top or leg direction, or the obtained tomographic images are sequentially obtained from the top direction of the subject or sequentially from the leg direction. A medical image diagnostic apparatus comprising: a determination unit that determines whether the image is obtained. 2. The medical image according to claim 1, wherein the determination unit extracts a feature point of the body by image processing based on an image of a camera that has photographed the subject positioned in the photographing unit. Diagnostic device. The medical image diagnostic apparatus according to claim 1, wherein the determination unit extracts a feature point of the body by image processing based on scanogram data obtained separately from the tomographic image. The medical image diagnostic apparatus according to claim 1, wherein the discriminating unit extracts a body contour by image processing based on the plurality of tomographic images. 2. The medical image according to claim 1, wherein the determination unit extracts a positional relationship of an organ or the like by image processing based on radiation detection data from a radiopharmaceutical administered to the subject. Diagnostic device.

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