JP2010213863A - X-ray diagnostic device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To easily detect a nonperfusion image, when observing a perfusion situation over the whole cardiac muscle. <P>SOLUTION: A perfusion image preparing part 11c prepares a cardiac muscle perfusion image of expressing the perfusion situation of the cardiac muscle in each of a left circumflex, a left anterior descending coronary and a right coronary, when shadowing those. A perfusion image superposing part 11f prepares a perfusion superposed image superposed with the respective cardiac muscle images prepared by the perfusion image preparing part 11c. A perfusion superposed image display control part 11h displays the perfusion superposed image prepared by the perfusion image superposing part 11f, on a display part 9. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an X-ray diagnostic apparatus that generates an X-ray image by irradiating a subject with X-rays, detecting X-rays transmitted through the subject, and in particular, creating a myocardial perfusion image representing a myocardial perfusion state. Regarding technology.

  Conventionally, a technique for imaging myocardial perfusion has been proposed in X-ray cine imaging in which X-ray imaging is performed continuously after injecting a contrast medium into the coronary artery of the heart (see, for example, Patent Document 1). This technique estimates perfusion from the concentration change of the contrast agent in the myocardium, and is attracting attention as a means for knowing the perfusion status to the myocardium before and after catheter treatment.

  Such technology focuses on imaging a portion with perfusion. However, in an actual clinical site, there are many cases where it is confirmed whether or not there is a non-perfusion region throughout the myocardium. In such a case, after the X-ray cine radiographing was performed using the above-mentioned technique, the three coronary arteries of the left anterior descending branch, the left circumflex branch, and the right coronary artery, which are the main pathways to the myocardium, were respectively contrasted. In addition, a perfusion image of the myocardium is created for each coronary artery into which the contrast medium has been injected.

  FIG. 17 is an explanatory diagram for explaining a conventional technique related to imaging of myocardial perfusion. FIGS. 17A, 17B, and 17C show the myocardial perfusion region P when the contrast medium C is injected by inserting the catheter K into the left circumflex branch, the left anterior descending branch, and the right coronary artery, respectively. Yes. In the myocardium, the region where blood is supplied for each coronary artery is different. Therefore, as shown in FIG. 17, the position of the myocardial perfusion region P to be imaged is different for each coronary artery into which the contrast medium has been injected.

JP 2008-136800 A

  However, as described above, in the conventional technique, the myocardial perfusion region is separately imaged for each coronary artery infused with the contrast agent, so that the examiner can perform a plurality of perfusions generated for each coronary artery infused with the contrast agent. It was necessary to compare the images. Therefore, it was very difficult to detect a non-perfusion region over the entire myocardium.

  The present invention has been made in view of the above, and an object of the present invention is to provide an X-ray diagnostic apparatus capable of easily detecting a non-perfusion region when observing a perfusion state over the entire myocardium. And

  In order to solve the above-described problems and achieve the object, the present invention according to claim 1 is a myocardium representing a perfusion state of the myocardium in the case where at least the first coronary artery is imaged and the second coronary artery is imaged. Perfusion image creating means for creating a perfusion image, perfusion image superimposing means for creating a perfusion superimposed image by superimposing each myocardial perfusion image created by the perfusion image creating means, and perfusion created by the perfusion image superimposing means Perfusion superimposed image display control means for displaying a superimposed image on a display unit is provided.

  According to the first aspect of the present invention, when the perfusion state is observed over the entire myocardium, it is possible to easily detect a non-perfusion region of the myocardium.

FIG. 1 is a block diagram illustrating the configuration of the X-ray diagnostic apparatus according to the first embodiment. FIG. 2 is a functional block diagram illustrating the configuration of the image calculation / storage unit according to the first embodiment. FIG. 3 is a diagram illustrating an example of X-ray image extraction by the X-ray image extraction unit. FIG. 4 is a diagram illustrating an example of perfusion image creation by the perfusion image creation unit. FIG. 5 is a diagram illustrating an example of peak hold image creation by the peak hold image creation unit. FIG. 6 is a diagram illustrating an example of creating a perfusion superimposed image by the perfusion image superimposing unit. It is a figure which shows an example of X-ray superimposition image creation by an X-ray image superimposition part. FIG. 8 is a diagram illustrating an example of perfusion superimposed image display by the perfusion superimposed image display control unit. FIG. 9 is a flowchart illustrating a processing procedure of processing performed by the image calculation / storage unit according to the first embodiment. FIG. 10 is a functional block diagram of the configuration of the image calculation / storage unit according to the second embodiment. FIG. 11 is a diagram illustrating an example of difference image creation by the X-ray difference image creation unit. FIG. 12 is a diagram illustrating an example of non-perfusion region extraction by the non-perfusion region extraction unit. FIG. 13 is a diagram illustrating an example of heart region extraction by the heart region extraction unit. FIG. 14 is a diagram illustrating an example of non-perfusion region image display by the non-perfusion image display control unit. FIG. 15 is a flowchart illustrating a processing procedure of processing performed by the image calculation / storage unit according to the second embodiment. FIG. 16 is a perspective view illustrating the configuration of the X-ray diagnostic apparatus according to the third embodiment. FIG. 17 is an explanatory diagram for explaining a conventional technique related to imaging of myocardial perfusion.

  Embodiments of an X-ray diagnostic apparatus according to the present invention will be described below in detail with reference to the drawings. In the embodiment described below, a case where a myocardial perfusion image representing a myocardial perfusion state is created for each case where the left circumflex branch, the left anterior descending branch, and the right coronary artery are imaged will be described.

  First, before describing the embodiments of the X-ray diagnostic apparatus according to the present invention, terms used in the following embodiments will be described.

  First, the “myocardial perfusion image” is an image representing the perfusion state of the myocardium. For example, a myocardial perfusion image is obtained by injecting a contrast medium into the coronary artery and estimating the perfusion rate according to a change in the concentration of the contrast medium in the myocardium. Based on the estimated perfusion rate, the myocardial perfusion image Generated by setting the pixel value.

  In addition, “X-ray cine imaging” is to perform X-ray imaging of a region to be imaged of a subject continuously in time series. The “cine radiographed image” is an X-ray image taken by X-ray cine radiography. A “peak hold image” is created by selecting the maximum pixel value within a predetermined period for each pixel at the same position based on a plurality of cine-photographed X-ray images. It is an image.

  Next, Example 1 will be described. The X-ray diagnostic apparatus according to the first embodiment creates a myocardial perfusion image representing the myocardial perfusion state for each case where the left circumflex branch, the left anterior descending branch, and the right coronary artery are imaged. Then, the X-ray diagnostic apparatus according to the first embodiment creates a perfusion superimposed image obtained by superimposing the created myocardial perfusion images, and displays the created perfusion superimposed image on the display unit.

  In this way, by displaying the myocardial perfusion images in an overlapping manner, the examiner can easily confirm whether or not there is a non-perfusion region over the entire myocardium. That is, according to the X-ray diagnostic apparatus according to the first embodiment, it is possible to easily detect the non-perfusion region of the myocardium when observing the perfusion situation over the entire myocardium. Hereinafter, such an X-ray diagnostic apparatus will be specifically described.

  First, the configuration of the X-ray diagnostic apparatus according to the first embodiment will be described. FIG. 1 is a block diagram illustrating the configuration of the X-ray diagnostic apparatus 100 according to the first embodiment. As shown in the figure, the X-ray diagnostic apparatus 100 includes an X-ray tube 1, an X-ray detection unit 2, a C arm 3, a mechanism control unit 4, a high voltage generation unit 5, a high voltage control unit 6, a bed 7, It has a gantry unit 8, a display unit 9, an operation unit 10, an image calculation / storage unit 11, and a system control unit 12.

  The X-ray tube 1 generates X-rays using the high voltage supplied from the high voltage generator 5 and irradiates the subject P with the generated X-rays. The X-ray detection unit 2 detects X-rays that have passed through the subject P. The X-ray detection unit 2 is, for example, an FPD (X-ray flat panel detector) or I.D. I. (Image Intensifier).

  The C arm 3 holds the X-ray tube 1 and the X-ray detector 2. Specifically, the C arm 3 is formed in a C shape, and supports the X-ray tube 1 at one end and supports the X-ray detection unit 2 at the other end. Here, the C arm 3 supports the X-ray tube 1 and the X-ray detector 2 so as to face each other with the subject P interposed therebetween.

  The mechanism control unit 4 supports the C arm 3 so as to be rotatable and movable. The mechanism control unit 4 rotates or moves the C arm 3 under the control of the system control unit 12. The high voltage generator 5 supplies a high voltage required for the X-ray tube 1 to generate X-rays. The high voltage control unit 6 controls generation of a high voltage by the high voltage generation unit 5 under the control of the system control unit 12.

  The bed 7 has a top plate on which the subject P is placed and a leg portion that supports the top plate. The couch 7 moves the top plate in the vertical direction or the horizontal direction under the control of the system control unit 12. The gantry unit 8 is installed on the floor and supports the mechanism control unit 4 and the bed 7 from below.

  The display unit 9 displays various images generated by the image calculation / storage unit 11. The display unit 9 is configured by, for example, an FPD (Flat Panel Display) or a CRT (Cathode Ray Tube) display.

  The operation unit 10 receives various operations from the operator. The operation unit 10 includes an operation monitor 10a, a photographing hand switch 10b, and a switch holder 10c. The operation monitor 10a displays information related to the operation of the X-ray diagnostic apparatus 100 such as patient information, imaging conditions, and imaging protocol. The photographing hand switch 10b is used when the operator instructs the photographing start and photographing end. The switch holder 10c detachably fixes the photographing hand switch 10b to the console on which the operation monitor 10a and the like are placed.

  The image calculation / storage unit 11 generates various images by performing various image processing based on the X-rays detected by the X-ray detection unit 2. The image calculation / storage unit 11 stores various generated images.

  The system control unit 12 controls the entire X-ray diagnostic apparatus 100 by controlling the functional units based on various operations received through the operation unit 10. The system control unit 12 can control the X-ray diagnostic apparatus 100 so that various parts of the subject are imaged by various imaging methods. For example, the system control unit 12 can control the imaging of the subject's heart continuously in time series. In this manner, capturing a part to be imaged continuously in time series is hereinafter referred to as “cine imaging”.

  Next, the configuration of the image calculation / storage unit 11 according to the first embodiment will be described. FIG. 2 is a functional block diagram illustrating the configuration of the image calculation / storage unit 11 according to the first embodiment. As shown in FIG. 2, the image calculation / storage unit 11 includes an image data storage unit 11a, an X-ray image extraction unit 11b, a perfusion image creation unit 11c, a peak hold image creation unit 11d, an image registration unit 11e, and a perfusion image superposition. A unit 11f, an X-ray image superimposing unit 11g, and a perfusion superimposed image display control unit 11h.

  The image data storage unit 11 a stores various images generated based on the X-rays detected by the X-ray detection unit 2. The image data storage unit 11a is configured by a storage device such as an HDD (Hard Disk Drive). For example, in the image data storage unit 11a, a cine-captured image of the heart that is imaged in the case of imaging the left circumflex branch, imaging the left anterior descending branch, and imaging the right coronary artery is stored. .

  The X-ray image extraction unit 11b extracts an X-ray image of a specific cardiac phase from a cine-captured image of the heart that has been imaged after imaging the coronary artery. Specifically, the X-ray image extraction unit 11b specifies a cine-captured image of the heart related to the subject to be diagnosed from the X-ray images stored in the image data storage unit 11a. In addition, the X-ray image extraction unit 11b extracts an X-ray image at a specific cardiac phase (for example, an X-ray image in a diastole) from the specified cine-photographed image.

  FIG. 3 is a diagram illustrating an example of X-ray image extraction by the X-ray image extraction unit 11b. As shown in FIG. 3, for example, the X-ray image extraction unit 11b extracts an X-ray image X1 of a specific cardiac phase from a plurality of X-ray images taken in time series after contrasting the left convolution. In addition, the X-ray image extraction unit 11b extracts an X-ray image X2 having a specific cardiac phase from a plurality of X-ray images taken in time series after contrasting the left front descending branch. Further, the X-ray image extraction unit 11b extracts an X-ray image X3 having a specific cardiac phase from a plurality of X-ray images taken in time series after contrasting the right coronary artery.

  The perfusion image creation unit 11c creates a myocardial perfusion image for each of a plurality of coronary arteries. Specifically, the perfusion image creation unit 11c creates a myocardial perfusion image based on each X-ray image extracted by the X-ray image extraction unit 11b. Here, when creating a myocardial perfusion image, the perfusion image creation unit 11c sets pixel values of pixels included in a region representing the myocardium in accordance with perfusion conditions in each part of the myocardium.

  More specifically, the perfusion image creation unit 11c obtains a differential coefficient representing the concentration change rate of the contrast agent for each part of the myocardium based on each X-ray image extracted by the X-ray image extraction unit 11b. Then, the perfusion image creation unit 11c creates a perfusion image by calculating a perfusion value according to the obtained differential coefficient and setting a pixel value of a pixel included in a region representing the myocardium according to the calculated perfusion value. To do. Note that the method for generating the myocardial perfusion image is not limited to this, and various generally known techniques can be used.

  FIG. 4 is a diagram illustrating an example of perfusion image creation by the perfusion image creation unit 11c. As shown in FIG. 4, for example, the perfusion image creation unit 11c, based on the X-ray images X1, X2, and X3 of the specific cardiac phase extracted by the X-ray image extraction unit 11b, Myocardial perfusion images P1, P2, and P3 when the right coronary artery is contrasted are created.

  The peak hold image creation unit 11d creates a peak hold image by selecting the maximum pixel value for each pixel at the same position for each X-ray image extracted by the X-ray image extraction unit 11b. Specifically, the peak hold image creation unit 11d creates a peak hold image for each X-ray image obtained by contrasting the same coronary artery for each X-ray image extracted by the X-ray image extraction unit 11b. To do.

  FIG. 5 is a diagram illustrating an example of peak hold image creation by the peak hold image creation unit 11d. As shown in FIG. 5, for example, the peak hold image creation unit 11d has a left convolution branch and a left front descending branch based on the X-ray images X1, X2, and X3 of the specific cardiac phase extracted by the X-ray image extraction unit 11b. Peak hold images H1, H2, and H3 are created when the right coronary artery and the right coronary artery are respectively contrasted.

  The image alignment unit 11e aligns the myocardial perfusion image and the peak hold image. Specifically, the image alignment unit 11e aligns each myocardial perfusion image created by the perfusion image creation unit 11c and the peak hold image created by the peak hold image creation unit 11d (position, magnification, Image angle etc.).

  Here, when performing alignment of each image, the image alignment unit 11e corrects the shift amount related to the position of each image based on the movement amount of the top plate on which the subject P is placed at the time of imaging. Note that the image alignment unit 11e acquires information about the amount of movement of the top board from the system control unit 12 or the bed 7.

  Further, for example, the image alignment unit 11e is configured to irradiate the subject P at the time of imaging with an X-ray irradiation range (FOV) and / or between the X-ray tube 1 and the X-ray detection unit 2. The enlargement ratio of each image may be corrected based on the distance (SID: Source Image Distance).

  Alternatively, the image alignment unit 11e may correct the position and / or the enlargement ratio of each myocardial perfusion image based on the shape of a portion (for example, a bone) having a low X-ray transmittance.

  The perfusion image superimposing unit 11f creates a perfusion superimposed image obtained by superimposing the myocardial perfusion images created by the perfusion image creating unit 11c. Specifically, the perfusion image superimposing unit 11f creates a perfusion superimposed image by superimposing each myocardial perfusion image created by the perfusion image creating unit 11c and then aligned by the image registration unit 11e. To do.

  Here, when creating the perfusion superimposed image, the perfusion image superimposing unit 11f selects the maximum pixel value for each pixel at the same position for each myocardial perfusion image created by the perfusion image creating unit 11c. To overlay each myocardial perfusion image.

  Alternatively, the perfusion image superimposing unit 11f may superimpose the myocardial perfusion images by obtaining the sum of pixel values for each pixel at the same position for each myocardial perfusion image created by the perfusion image creation unit 11c.

  FIG. 6 is a diagram illustrating an example of creating a perfusion superimposed image by the perfusion image superimposing unit 11f. As shown in FIG. 6, for example, the perfusion image superimposing unit 11f superimposes the myocardial perfusion images P1, P2, and P3 created by the perfusion image creating unit 11c, thereby creating a left circumflex branch, a left anterior descending branch, and a right coronary artery. A perfusion superimposed image PS representing the myocardial perfusion situation when contrasted is created.

  The X-ray image superimposing unit 11g creates an X-ray superimposed image by superimposing the X-ray images extracted by the X-ray image extracting unit 11b. Specifically, the X-ray image superimposing unit 11g superimposes each peak hold image that has been created by the peak hold image creating unit 11d and then aligned by the image positioning unit 11e. Create a superimposed image.

  For example, the X-ray image superimposing unit 11g may extract a blood vessel region representing a region occupied by a blood vessel from each X-ray image and create an X-ray superimposed image by superimposing the extracted blood vessel regions. .

  FIG. 7 is a diagram illustrating an example of an X-ray superimposed image created by the X-ray image superimposed unit 11g. As shown in FIG. 7, the X-ray image superimposing unit 11g superimposes the peak hold images H1, H2, and H3 created by the peak hold image creating unit 11d, respectively, so that the left circumflex branch, the left anterior descending branch, and the right coronary artery X-ray superimposed images HS each of which is drawn.

  The perfusion superimposed image display control unit 11h causes the display unit 9 to display the perfusion superimposed image created by the perfusion image superimposing unit 11f. Specifically, the perfusion superimposed image display control unit 11h overlays the X-ray superimposed image created by the X-ray image superimposed unit 11g, and then displays the perfusion superimposed image created by the perfusion image superimposed unit 11f. 9 is displayed.

  For example, the perfusion superimposed image display control unit 11h may transmit the perfusion superimposed image when displaying the perfusion superimposed image superimposed on the X-ray superimposed image.

  FIG. 8 is a diagram illustrating an example of perfusion superimposed image display by the perfusion superimposed image display control unit 11h. As shown in FIG. 8, for example, the perfusion superimposed image display control unit 11h superimposes the perfusion superimposed image PS created by the perfusion image superimposing unit 11f on the X-ray superimposed image HS created by the X-ray image superimposing unit 11g. The displayed image PI is displayed.

  FIG. 9 is a flowchart illustrating a processing procedure of processing performed by the image calculation / storage unit 11 according to the first embodiment. As illustrated in FIG. 9, the image calculation / storage unit 11 according to the present embodiment executes the following process when a process start instruction is received from the operator via the operation unit 10 (step S101, Yes). ).

  Specifically, first, the X-ray image extracting unit 11b refers to the X-ray image stored in the image data storage unit 11a, contrasts the coronary artery, and then images a plurality of cine images of the heart. An X-ray image of a specific cardiac phase is extracted from (step S102).

  Subsequently, the perfusion image creation unit 11c creates a myocardial perfusion image in each case where a plurality of coronary arteries are imaged (step S103). The peak hold image creation unit 11d creates a peak hold image by selecting the maximum pixel value for each pixel at the same position for each X-ray image extracted by the X-ray image extraction unit 11b ( Step S104).

  Subsequently, the image alignment unit 11e corrects the position, magnification, and image angle of each myocardial perfusion image created by the perfusion image creation unit 11c and the peak hold image created by the peak hold image creation unit 11d. (Step S105).

  Thereafter, the perfusion image superimposing unit 11f creates a perfusion superimposed image obtained by superimposing the myocardial perfusion images created by the perfusion image creating unit 11c (step S106). Also, the X-ray image superimposing unit 11g creates an X-ray superimposed image by superimposing the peak hold images created by the peak hold image creating unit 11d (step S107).

  Then, the perfusion superimposed image display control unit 11h causes the display unit 9 to display the perfusion superimposed image created by the perfusion image superimposing unit 11f on the X-ray superimposed image created by the X-ray image superimposing unit 11g (Step S11). S108).

  As described above, in the first embodiment, the perfusion image creation unit 11c creates a myocardial perfusion image representing the myocardial perfusion situation when the left circumflex branch, the left anterior descending branch, and the right coronary artery are imaged. Further, the perfusion image superimposing unit 11f creates a perfusion superimposed image obtained by superimposing the myocardial perfusion images created by the perfusion image creating unit 11c. Then, the perfusion superimposed image display control unit 11h causes the display unit 9 to display the perfusion superimposed image created by the perfusion image superimposing unit 11f.

  In this way, by displaying the myocardial perfusion images in an overlapping manner, the examiner can easily confirm whether or not there is a non-perfusion region over the entire myocardium. Therefore, according to the first embodiment, it is possible to easily detect the non-perfusion region of the myocardium when observing the perfusion situation over the entire myocardium.

  In the first embodiment, the X-ray image extraction unit 11b contrasts the left circumflex branch, the left anterior descending branch, and the right coronary artery, and then X-ray images of a specific cardiac phase are respectively obtained from the X-ray images taken in time series. To extract. Then, the perfusion image creation unit 11c creates a myocardial perfusion image based on each X-ray image extracted by the X-ray image extraction unit 11b. Therefore, according to the first embodiment, by using an X-ray image of a specific cardiac phase, the size of the heart on the image can be made uniform, and a clear myocardial perfusion image can be created.

  In the first embodiment, the perfusion image creation unit 11c creates a myocardial perfusion image by setting pixel values of pixels included in a region representing the myocardium in accordance with the perfusion situation in each part of the myocardium. Then, when creating the perfusion superimposed image, the perfusion image superimposing unit 11f superimposes each myocardial perfusion image by selecting the maximum pixel value for each pixel at the same position. Therefore, according to the first embodiment, it is possible to clearly represent a region where there is perfusion.

  In the first embodiment, the perfusion image creation unit 11c creates a myocardial perfusion image by setting pixel values of pixels included in a region representing the myocardium in accordance with the perfusion situation in each part of the myocardium. Then, the perfusion image superimposing unit 11f superimposes each myocardial perfusion image by obtaining the sum of pixel values for each pixel at the same position when creating the perfusion superimposed image. Therefore, according to the first embodiment, when there is a portion where blood is supplied from a plurality of coronary arteries in the myocardium, it is possible to collectively represent the perfusion situation in that portion.

  In the first embodiment, the image alignment unit 11e aligns each myocardial perfusion image created by the perfusion image creation unit 11c. Then, the perfusion image superimposing unit 11f creates a perfusion superimposed image using each myocardial perfusion image that has been aligned by the image registration unit 11e. Therefore, according to the first embodiment, since the shift of the perfusion region in the myocardial perfusion image can be prevented, it is possible to accurately grasp the relative positional relationship of the perfusion region.

  In the first embodiment, the image alignment unit 11e corrects the position of each myocardial perfusion image based on the amount of movement of the top plate on which the subject is placed during imaging when performing the alignment. Therefore, according to the first embodiment, it is possible to prevent the position of the perfusion region from being shifted in the myocardial superimposed image, so that the perfusion region in the myocardial superimposed image can be more accurately aligned.

  In the first embodiment, when the image alignment unit 11e performs alignment, the X-ray irradiation range irradiated to the subject during imaging and / or the subject is irradiated with X-rays. The magnification of each myocardial perfusion image is corrected based on the distance between the X-ray tube and the X-ray detector that detects X-rays transmitted through the subject. Therefore, according to the first embodiment, it is possible to prevent the enlargement rate position of the perfusion region from being shifted in the myocardial superimposed image, and thus it is possible to more accurately align the perfusion region in the myocardial superimposed image.

  In the first embodiment, the image alignment unit 11e corrects the position and / or the enlargement rate of each myocardial perfusion image based on the shape of the region with low X-ray transmittance when performing alignment. Therefore, according to the first embodiment, the position and / or the enlargement ratio are corrected based on the actually captured X-ray image, so that the perfusion region in the myocardial superimposed image can be more accurately aligned. become.

  In the first embodiment, the X-ray image superimposing unit 11g creates an X-ray superimposed image obtained by superimposing the X-ray images extracted by the X-ray image extracting unit 11b. Then, the perfusion superimposed image display control unit 11h displays the perfusion superimposed image superimposed on the X-ray superimposed image created by the X-ray image superimposing unit 11g. Therefore, according to the first embodiment, it is possible to easily grasp the positional relationship between the perfusion region or the non-perfusion region and each part of the heart based on the X-ray image that is the basis of the perfusion image.

  In the first embodiment, the peak hold image creation unit 11d selects the maximum pixel value for each pixel at the same position for each X-ray image extracted by the X-ray image extraction unit 11b. Generate a hold image. Then, the X-ray image superimposing unit 11g creates an X-ray superimposed image by superimposing the peak hold images created by the peak hold image creating unit 11d. Therefore, according to the first embodiment, it is possible to easily grasp the positional relationship between the perfusion region or the non-perfusion region and the blood vessel based on the X-ray image in which the shape of the blood vessel including the coronary artery is clearly depicted. .

  In the first embodiment, the X-ray image superimposing unit 11g extracts a blood vessel region representing a region occupied by a blood vessel from each X-ray image extracted by the X-ray image extracting unit 11b, and each extracted blood vessel region is extracted. An X-ray superimposed image is created by superimposing. Therefore, according to the first embodiment, the positional relationship between the perfusion region or the non-perfusion region and the blood vessel can be grasped more accurately.

  In the first embodiment, the perfusion superimposed image display control unit 11h transmits the perfusion superimposed image when displaying the perfusion superimposed image on the X-ray superimposed image. Therefore, according to the first embodiment, when the coronary artery and the perfusion region overlap each other in the X-ray irradiation direction, it is possible to simultaneously confirm the respective states.

  In the first embodiment, the perfusion superimposed image display control unit 11h displays the perfusion superimposed image after being superimposed on the X-ray superimposed image, but the present invention is not limited to this. For example, the perfusion superimposed image display control unit 11h may display each perfusion image and the perfusion superimposed image before being superimposed side by side.

  Next, Example 2 will be described. In the first embodiment, the X-ray diagnostic apparatus 100 superimposes and displays the myocardial perfusion image. However, the X-ray diagnostic apparatus according to the second embodiment uses the perfusion superimposed image as a region where the perfusion state of the myocardium is poor. Is extracted as a non-perfusion region, and a non-perfusion region image representing the extracted non-perfusion region is displayed on the display unit.

  In this way, by displaying a region where the perfusion state of the myocardium is poor as a non-perfusion region, the operator can instantly confirm whether or not there is a non-perfusion region over the entire myocardium. That is, according to the X-ray diagnostic apparatus according to the second embodiment, it is possible to instantaneously detect a non-perfusion region of the myocardium when observing the perfusion situation over the entire myocardium. Hereinafter, such an X-ray diagnostic apparatus will be specifically described.

  The configuration of the X-ray diagnostic apparatus according to the second embodiment is basically the same as that shown in FIG. 1 except for the function of the image calculation / storage unit. Therefore, the function of the image calculation / storage unit according to the second embodiment will be described below.

  First, the configuration of the image calculation / storage unit 21 according to the second embodiment will be described. FIG. 10 is a functional block diagram illustrating the configuration of the image calculation / storage unit 21 according to the second embodiment. Here, for convenience of explanation, functional units that play the same functions as the respective units shown in FIG. 2 will be given the same reference numerals, and detailed description thereof will be omitted.

  As shown in FIG. 10, the image calculation / storage unit 21 includes an image data storage unit 11a, an X-ray image extraction unit 11b, a perfusion image creation unit 11c, an X-ray difference image creation unit 21i, an image registration unit 21e, and a perfusion image. It has a superimposing unit 11f, a non-perfusion region extraction unit 21j, a heart region extraction unit 21k, and a non-perfusion image display control unit 21h.

  The X-ray difference image creation unit 21i creates a difference image between each X-ray image extracted by the X-ray image extraction unit 11b and an image immediately before or after one frame. Specifically, when an X-ray image is extracted by the X-ray image extraction unit 11b, the X-ray difference image creation unit 21i stores image data immediately before or immediately after one frame of the extracted X-ray image as image data. Read from the unit 11a. Then, the X-ray difference image creation unit 21i creates a difference image.

  FIG. 11 is a diagram illustrating an example of difference image creation by the X-ray difference image creation unit 21i. As shown in FIG. 11, for example, the X-ray difference image creation unit 21 i first performs, for each X-ray image obtained by contrasting the same coronary artery among the X-ray images extracted by the X-ray image extraction unit 11 b. X-ray images H1, H2 and H3 photographed at 1 are respectively acquired. Further, the X-ray difference image creation unit 21i acquires X-ray images taken immediately after one frame of the X-ray images H1, H2, and H3, and creates difference images S1, S2, and S3 using each image. .

  The image alignment unit 21e aligns each myocardial perfusion image created by the perfusion image creation unit 11c and each difference image created by the X-ray difference image creation unit 21i. Note that a specific method of alignment performed by the image alignment unit 21e is the same as that of the image alignment unit 11e described in the first embodiment, and thus description thereof is omitted here.

  The non-perfusion region extraction unit 21j extracts a non-perfusion region representing a region where the myocardial perfusion state is poor. Specifically, the non-perfusion region extraction unit 21j extracts a region having a poor myocardial perfusion state from the perfusion superimposed image created by the perfusion image superimposing unit 11f as a non-perfusion region.

  More specifically, the non-perfusion region extraction unit 21j sets a region where a perfusion value indicating a myocardial perfusion state is equal to or less than a predetermined threshold as a region having a poor perfusion state. Further, the non-perfusion region extraction unit 21j extracts only a region having an area of a predetermined size or more as a non-perfusion region among regions having poor perfusion conditions.

  FIG. 12 is a diagram illustrating an example of non-perfusion region extraction by the non-perfusion region extraction unit 21j. As illustrated in FIG. 12, for example, the non-perfusion region extraction unit 21j extracts the non-perfusion region NP from the PS created by the perfusion image superimposing unit 11f.

  The heart region extraction unit 21k extracts a region representing the heart from each X-ray image extracted by the X-ray image extraction unit 11b as a heart region. Specifically, the heart region extraction unit 21k extracts a heart region by extracting a common region in each difference image created by the X-ray difference image creation unit 21i.

  For example, the heart region extraction unit 21k receives an operation for setting a region for at least one of the X-ray images extracted by the X-ray image extraction unit 11b from the operator via the operation unit 10, The received region may be extracted as a heart region.

  The heart region extraction unit 21k may extract a heart region using, for example, an energy subtraction method. The “energy subtraction method” referred to here is an imaging method in which X-rays having different energies are alternately irradiated onto a region to be imaged, and the X-ray image obtained thereby is subjected to subtraction processing. According to this dual energy subtraction, it is possible to obtain an image in which a part unnecessary for diagnosis is deleted, an image in which a contrast medium or a stent is emphasized, and the like.

  FIG. 13 is a diagram illustrating an example of heart region extraction by the heart region extraction unit 21k. As shown in FIG. 13, for example, the heart region extraction unit 21k extracts the heart region RH by extracting common regions in the difference images S1, S2, and S3 created by the X-ray difference image creation unit 21i. .

  The non-perfusion image display control unit 21h causes the display unit 9 to display a non-perfusion region image representing the non-perfusion region extracted by the non-perfusion region extraction unit 21j. Specifically, the non-perfusion image display control unit 21h extracts only the region included in the heart region extracted by the heart region extraction unit 21k from the non-perfusion region extracted by the non-perfusion region extraction unit 21j. Display as an image.

  Here, when displaying the non-perfusion region image, the non-perfusion image display control unit 21h measures the area of the non-perfusion region and further displays the measured area.

  The non-perfusion image display control unit 21h may change the pixel values of the pixels included in the non-perfusion region according to the perfusion value indicating the perfusion state of the myocardium when displaying the non-perfusion region image. For example, the non-perfusion image display control unit 21h uses a plurality of threshold values and changes the color information of the pixel every time the perfusion value exceeds each threshold value. Alternatively, the non-perfusion image display control unit 21h may display the non-perfusion area in a blinking manner.

  FIG. 14 is a diagram illustrating an example of non-perfusion region image display by the non-perfusion image display control unit 21h. As illustrated in FIG. 14, for example, the non-perfusion image display control unit 21 h includes a region included in the heart region extracted by the heart region extraction unit 21 k out of the non-perfusion region NP extracted by the non-perfusion region extraction unit 21 j. A non-perfusion region image NI showing only the image is displayed.

  FIG. 15 is a flowchart illustrating a processing procedure of processing performed by the image calculation / storage unit 21 according to the second embodiment. As illustrated in FIG. 15, the image calculation / storage unit 21 according to the present embodiment executes the following process when receiving a process start instruction from the operator via the operation unit 10 (step S201, Yes). ).

  Specifically, first, the X-ray image extracting unit 11b refers to the X-ray image stored in the image data storage unit 11a, contrasts the coronary artery, and then images a plurality of cine images of the heart. An X-ray image of a specific cardiac phase is extracted from (step S202).

  Subsequently, the perfusion image creation unit 11c creates a myocardial perfusion image in each case where a plurality of coronary arteries are imaged (step S203). In addition, the X-ray difference image creation unit 21i reads an image immediately before or immediately after one frame of the X-ray image extracted by the X-ray image extraction unit 11b from the image data storage unit 11a (step S204). A difference image is created (step S205).

  Subsequently, the image alignment unit 21e aligns each myocardial perfusion image created by the perfusion image creation unit 11c and each difference image created by the X-ray difference image creation unit 21i (step S206).

  Thereafter, the perfusion image superimposing unit 11f creates a perfusion superimposed image obtained by superimposing the myocardial perfusion images created by the perfusion image creating unit 11c (step S207). Further, the non-perfusion region extraction unit 21j extracts a region having a poor myocardial perfusion state as a non-perfusion region from the perfusion superimposed image created by the perfusion image superimposing unit 11f (step S208).

  Further, the heart region extraction unit 21k extracts a region representing the heart from each X-ray image extracted by the X-ray image extraction unit 11b as a heart region (step S209).

  Then, the non-perfusion image display control unit 21h causes the display unit 9 to display a non-perfusion region image representing the non-perfusion region extracted by the non-perfusion region extraction unit 21j (step S210).

  As described above, in the second embodiment, the non-perfusion region extraction unit 21j extracts a region having a poor myocardial perfusion state from the perfusion superimposed image created by the perfusion image superimposing unit 11f as a non-perfusion region. Then, the non-perfusion image display control unit 21h causes the display unit 9 to display the non-perfusion region extracted by the non-perfusion region extraction unit 21j as a non-perfusion region image.

  In this way, by displaying a region where the perfusion state of the myocardium is poor as a non-perfusion region, the operator can instantly confirm whether or not there is a non-perfusion region over the entire myocardium. Therefore, according to the X-ray diagnostic apparatus according to the second embodiment, it is possible to instantaneously detect a non-perfusion region of the myocardium when observing the perfusion situation over the entire myocardium.

  In the second embodiment, the non-perfusion region extraction unit 21j extracts only a region having an area of a predetermined size or more as a non-perfusion region among regions having poor perfusion conditions. Therefore, according to the second embodiment, even when a portion without perfusion is imaged as a perfusion region due to the influence of noise or the like, such an unnecessary portion can be removed. Can be increased.

  In the second embodiment, the non-perfusion region extraction unit 21j sets a region where the perfusion value indicating the myocardial perfusion state is equal to or less than a predetermined threshold as the region where the perfusion state is poor. Therefore, according to the second embodiment, it is possible to appropriately adjust the degree of removing the influence of noise and the like by adjusting the threshold value.

  In the second embodiment, when the non-perfusion image display control unit 21h displays the non-perfusion region image, the color information of the pixels included in the non-perfusion region is changed according to the perfusion value representing the myocardial perfusion state. . Therefore, according to the second embodiment, when there is a slight perfusion in the non-perfusion region, it is possible to easily grasp the degree of perfusion.

  In the second embodiment, when the non-perfusion image display control unit 21h displays the non-perfusion region image, the non-perfusion region is displayed in a blinking manner. Therefore, according to the second embodiment, since the non-perfusion region can be highlighted and displayed by blinking display, the non-perfusion region can be detected more easily.

  In the second embodiment, when the non-perfusion image display control unit 21h displays the non-perfusion region image, it measures the area of the non-perfusion region and further displays the measured area. Therefore, according to the second embodiment, it is possible to easily grasp the size of the non-perfusion region in the entire myocardium.

  In the second embodiment, the heart region extraction unit 21k extracts a region representing the heart from each X-ray image extracted by the X-ray image extraction unit 11b as a heart region. Then, the non-perfusion image display control unit 21h displays only the region included in the heart region extracted by the heart region extraction unit 21k as the non-perfusion region image among the non-perfusion regions extracted by the non-perfusion region extraction unit 21j. Let Therefore, according to the second embodiment, it is possible to prevent a portion other than the heart from being displayed as a non-perfusion region, so that the non-perfusion region can be detected more accurately.

  In the second embodiment, the heart region extraction unit 21k extracts a region set by the operator for at least one of the X-ray images extracted by the X-ray image extraction unit 11b as a heart region. Therefore, according to the second embodiment, since the operator can set an arbitrary range as the heart region, it is possible to easily detect the specific perfusion region in the specific part of the myocardium.

  In the second embodiment, the X-ray difference image creation unit 21i creates a difference image with respect to each X-ray image extracted by the X-ray image extraction unit 11b from an image immediately before one frame or immediately after one frame. Then, the heart region extraction unit 21k extracts a heart region by extracting a common region in each of the difference images created by the X-ray difference image creation unit 21i. Therefore, according to the second embodiment, the heart region can be accurately extracted.

  In the second embodiment, the heart region extraction unit 21k extracts the heart region using an energy subtraction method. Therefore, according to the second embodiment, the heart region can be extracted more accurately.

  Next, Example 3 will be described. In the third embodiment, a biplane type X-ray diagnostic apparatus will be described. FIG. 16 is a perspective view illustrating the configuration of the X-ray diagnostic apparatus 300 according to the third embodiment. As shown in FIG. 16, the X-ray diagnostic apparatus 300 is a biplane X-ray diagnostic apparatus, which includes a front X-ray imaging system (hereinafter referred to as “first imaging system”), a side system An X-ray imaging system (hereinafter referred to as “second imaging system”) is equipped, and the subject placed on the top 50 can be imaged simultaneously from two directions.

  The first imaging system includes a first X-ray tube 31, a first X-ray detector 32, and a first support 33. The X-ray tube 31 is attached to one end of the first supporter 33, and the X-ray detector 32 is attached to the other end of the first supporter 33. CA1 indicates the imaging center axis of the first imaging system that connects the center of the image receiving surface of the X-ray detector 32, the focal point of the X-ray tube 31, and a fixed point IC called an isocenter. The first support device 33 is formed in a C shape and is supported by a stand 35 installed on the floor via an arm holder 34. The arm holder 34 and the stand 35 constitute a first supporter support mechanism that rotatably supports the first supporter 33.

  Here, in the first imaging system, in addition to the three-axis rotation mechanism of the first support 33, the main rotation, the slide rotation, and the support column rotation, two axes of the floor rotation and the flat detector / X-ray aperture rotation are added. Equipped with a 5-axis rotation mechanism. Specifically, first, the stand 35 has a structure capable of rotating the arm holder 34 along the arrow A (A2). Further, the arm holder 34 has a structure capable of slidingly rotating the first supporter 33 along the arrow B. Further, the stand 35 has a structure capable of rotating (turning) the column along the arrow C. Further, the stand 35 has a structure capable of rotating the floor along the arrow D. The first X-ray detector 32 and the first X-ray tube 31 attached to the first supporter 33 have a structure that can rotate along the arrow E.

  With such a structure, the first photographing system can arbitrarily tilt the photographing angle with respect to arrows A (A2) and B. The first imaging system can move between the imaging position located inside the second supporter 43 and the standby position by turning with respect to the arrows C and D. Further, the first imaging system can arbitrarily rotate the image receiving surface by turning with respect to the arrow E.

  On the other hand, the second imaging system includes a second X-ray tube 41, a second X-ray detector 42, and a second support 43. The second X-ray tube 41 is attached to one end of the second support device 43 via the first lifting mechanism 44, and the second X-ray detector 42 is connected to the second support device via the second lifting mechanism 45. 43 is attached to the other end. CA2 represents the second imaging central axis of the second imaging system that connects the center of the image receiving surface of the second X-ray detector 42, the focal point of the second X-ray tube 41, and a fixed point IC called an isocenter. The second supporter 43 is formed in a Ω shape and is suspended from the slider base 47 via the arm holder 46.

  The arm holder 46 holds the second supporter 43 so as to be slidable in the direction of arrow F along the arc. The slider base 47 holds the arm holder 46 so as to be capable of rotating along the arrow G. A first elevating mechanism 44 and a second elevating mechanism 45 extending downward are provided at both ends of the second support device 43. A second X-ray tube 41 is held at the lower end of the first lifting mechanism 44. A second X-ray detector 42 is held at the lower end of the second lifting mechanism 45.

  Here, the second X-ray tube 41 and the second X-ray detector 42 face each other on the second imaging center axis CA2. The first elevating mechanism 44 and the second elevating mechanism 45 elevate and lower the second X-ray tube 41 and the second X-ray detector 42 in the vertical direction along the arrow H while maintaining this facing. The slider base 47 is supported so as to be movable vertically and horizontally by engaging with a traveling rail (not shown) provided on the ceiling surface. The arm holder 46 and the slider base 47 constitute a second supporter support mechanism that rotatably supports the second supporter 43.

  The first imaging center axis CA1 of the first imaging system and the second imaging center axis CA2 of the second imaging system intersect at an isocenter IC. The first imaging system and the second imaging system having such a configuration are configured by a mechanism control unit (not shown), for example, a first imaging central axis corresponding to the first X-ray tube 31 and the first X-ray detector 32, for example. The movement is controlled so that the intersection of CA1 and the second imaging center axis CA2 corresponding to the second X-ray tube 41 and the second X-ray detector 42 coincides with the region of interest of the subject, and the imaging operation is performed. .

  With this configuration, in the third embodiment, the X-ray diagnostic apparatus 300 generates a myocardial perfusion image in the same manner as in the first or second embodiment based on the X-ray image captured by the first imaging system. create. On the other hand, the second imaging system can be freely used by the operator for treatment. For example, the second imaging system is used when a catheter is inserted into a subject.

  As described above, in the third embodiment, the X-ray diagnostic apparatus 300 uses the first X-ray tube 31 and the first X-ray detector 32 to capture an X-ray image and the second X-ray tube. 41 and a second imaging system that captures an X-ray image by the second X-ray detector 42. Then, the X-ray diagnostic apparatus 300 creates each myocardial perfusion image based on the X-ray image captured by the first imaging system.

  As a result, the examiner can easily confirm the perfusion status over the entire myocardium while operating the catheter at an optimal angle. That is, according to the third embodiment, the convenience of the X-ray diagnostic apparatus can be improved.

  In the third embodiment, the case where the myocardial perfusion image is created using the first imaging system has been described. However, the myocardial perfusion image may be created using the second imaging system.

  As mentioned above, although Example 1, 2 and 3 were demonstrated, this invention may be implemented with various different forms other than the Example mentioned above.

  For example, the various image displays described in the first and second embodiments may be appropriately switched according to a request from the operator. In that case, for example, in the first embodiment, when the perfusion superimposed image display control unit 11h contrasts each coronary artery in response to a request from the operator, one of the myocardial perfusion images is displayed. Switch the display.

  Similarly, in the first embodiment, the perfusion superimposed image display control unit 11h switches the display so that either the perfusion superimposed image or the X-ray superimposed image is displayed in response to a request from the operator. Similarly, in the first embodiment, the perfusion superimposed image display control unit 11h switches the display so that either the perfusion image before superposition or the perfusion superimposed image is displayed according to a request from the operator.

  Alternatively, in Example 2, the non-perfusion image display control unit 21h switches the display so that either the perfusion superimposed image or the non-perfusion region image is displayed in response to a request from the operator.

  In this way, the perfusion superimposed image display control unit 11h or the non-perfusion image display control unit 21h switches various image displays in response to a request from the operator, so that the operator switches images as necessary. However, it becomes possible to detect the non-perfusion region efficiently.

  It should be noted that various means can be used as means for accepting a request for switching various image displays from the operator. For example, hardware means such as buttons and switches of the operation unit 10 or software means such as GUI (Graphical User Interface) realized by executing a predetermined program can be used.

  Further, in each of the above-described embodiments, the case where the myocardial perfusion image representing the myocardial perfusion state is created for each case where the left circumflex branch, the left anterior descending branch and the right coronary artery are imaged has been described. Is not something In other words, the present invention can be similarly applied even when creating a myocardial perfusion image in the case of imaging other types of coronary arteries.

  Further, according to each of the above-described embodiments, the non-perfusion region can be easily detected over the entire myocardium, so that the examination time and diagnosis time can be shortened.

  In each of the above-described embodiments, the case where a myocardial perfusion image representing the myocardial perfusion state is created has been described. However, the present invention is not limited to this, and the same applies when creating a perfusion image of another part. Can be applied to. For example, the present invention can be similarly applied to the case of creating a perfusion image of the head.

  As described above, the X-ray diagnostic apparatus according to the present invention is useful when observing the perfusion situation of the myocardium, and particularly when grasping the perfusion situation over the entire myocardium after imaging a plurality of coronary arteries. Is suitable.

DESCRIPTION OF SYMBOLS 100,300 X-ray diagnostic apparatus 1 X-ray tube 2 X-ray detection part 3 C arm 4 Mechanism control part 5 High voltage generation part 6 High voltage control part 7 Sleeper 8 Mounting part 9 Display part 10 Operation part 10a Operation monitor 10b For imaging | photography Hand switch 10c Switch holder 11, 21 Image calculation / storage unit 11a Image data storage unit 11b X-ray image extraction unit 11c Perfusion image creation unit 11d Peak hold image creation unit 11e, 21e Image alignment unit 11f Perfusion image superimposition unit 11g X-ray Image superimposing unit 11h Perfusion superimposed image display control unit 21h Non-perfusion image display control unit 21i X-ray difference image creation unit 21j Non-perfusion region extraction unit 21k Heart region extraction unit 12 System control unit 31 First X-ray tube 32 First X-ray Detector 33 First support device 34 Arm holder 35 Stand 41 Second X-ray tube 42 Second X-ray detector 4 3 Second Support Unit 44 First Elevating Mechanism 45 Second Elevating Mechanism 46 Arm Holder 47 Slider Base 50 Top Plate

Claims (11)

A perfusion image creating means for creating a perfusion image representing a perfusion situation of a predetermined site in each of the case where the first blood vessel is imaged and the second blood vessel is imaged;
Perfusion image superimposing means for creating a perfusion superimposed image obtained by superimposing the perfusion images created by the perfusion image creating means;
An X-ray diagnostic apparatus comprising: a perfusion superimposed image display control unit that displays a perfusion superimposed image created by the perfusion image superimposing unit on a display unit. An X-ray image of a specific time phase from an X-ray image taken in time series after imaging the first blood vessel and an X-ray image taken in time series after imaging the second blood vessel X-ray image extraction means for extracting
The X-ray diagnostic apparatus according to claim 1, wherein the perfusion image creation unit creates the perfusion image based on each X-ray image extracted by the X-ray image extraction unit. The perfusion image creating means creates the perfusion image by setting a pixel value of a pixel included in a region representing the predetermined part according to a perfusion situation in each part of the predetermined part,
The perfusion image superimposing means superimposes the perfusion image by selecting a maximum value of pixel values or obtaining a sum for each pixel at the same position when creating the perfusion superimposed image. The X-ray diagnostic apparatus according to claim 1 or 2. Image alignment means for aligning the perfusion image created by the perfusion image creation means,
4. The X-ray diagnosis apparatus according to claim 1, wherein the perfusion image superimposing unit creates the perfusion superimposed image using the perfusion image that has been aligned by the image alignment unit. . An X-ray image superimposing unit that creates an X-ray superimposed image obtained by superimposing the X-ray images extracted by the X-ray image extracting unit;
5. The X perfusion superimposed image display unit according to claim 2, wherein the perfusion superimposed image display control unit displays the perfusion superimposed image superimposed on the X-ray superimposed image created by the X-ray image superimposing unit. Line diagnostic equipment. A non-perfusion region extracting means for extracting a region where the perfusion status of the predetermined part is poor as a non-perfusion region from the perfusion superimposed image created by the perfusion image superimposing means;
The non-perfusion image display control means for displaying the non-perfusion area extracted by the non-perfusion area extraction means on the display unit as a non-perfusion area image. X-ray diagnostic apparatus according to.   The X-ray according to claim 6, wherein the non-perfusion image display control unit measures the area of the non-perfusion region and further displays the measured area when displaying the non-perfusion region image. Diagnostic device. A part region extracting unit that extracts a region representing a predetermined part from each X-ray image extracted by the X-ray image extracting unit as a part region;
The non-perfusion image display control means displays, as the non-perfusion area image, only the area included in the part area extracted by the part area extraction means among the non-perfusion areas extracted by the non-perfusion area extraction means. The X-ray diagnostic apparatus according to claim 6 or 7, wherein   The perfusion superimposed image display control means displays either a perfusion image when the first blood vessel is imaged or a perfusion image when the second blood vessel is imaged according to a request from the operator. The X-ray diagnostic apparatus according to claim 1, wherein the display is switched as described above.   The X-ray diagnosis apparatus according to claim 1, wherein the perfusion superimposed image display control unit displays each perfusion image before superposition and the perfusion superimposed image side by side. The X-ray diagnostic apparatus includes a first imaging system that captures an X-ray image by a first X-ray tube and a first X-ray detector, an X-ray by an X-ray detector and a second X-ray detector. A biplane type having a second imaging system for capturing a line image,
The perfusion image creating means creates the perfusion image based on an X-ray image taken by the first imaging system,
The X-ray diagnostic apparatus according to claim 1, wherein the second imaging system is used for a surgical operation on a subject.

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