JP2010274043A - Ultrasonic diagnostic apparatus and ultrasonic image processing program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic diagnostic apparatus and an ultrasonic image processing program, quantitatively and quickly acquiring the three-dimensional position relationship between target regions to be compared on a three-dimensional image. <P>SOLUTION: When radio wave cauterization treatment (RFA: Radiofrequency Ablation) is performed for a diseased part (a medical treatment target) using a puncture needle, spatial position associating between different volume data is performed in the respective scenes of pre-examination for the RFA treatment, the process of the RFA treatment and post-examination for the RFA treatment, thereby providing support information to quantitatively and quickly acquire the three-dimensional position relationship between the target regions to be compared using the position associated volume data group. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  In the ultrasonic diagnosis, in order to facilitate the comparison of the distance between the boundary surfaces between the target regions to be compared, alignment between a plurality of volume data, setting of the boundary surface for the region of interest, and between the boundary surfaces The present invention relates to an ultrasonic diagnostic apparatus and an ultrasonic image processing program that perform distance measurement and parametric display of position information.

  Ultrasound diagnosis can be performed repeatedly by simply touching the ultrasound probe from the body surface, and the heart beats and fetal movements can be obtained in real time, and it is highly safe. . In addition, it can be said that this is a simple diagnostic method in which the scale of the system is smaller than other diagnostic devices such as X-rays, CT, and MRI, and inspection can be easily performed while moving to the bedside. Ultrasound diagnostic devices used in this ultrasound diagnosis vary depending on the types of functions that they have, but small ones that can be carried with one hand have been developed. Thus, there is no influence of exposure, and it can be used in obstetrics and home medical care.

  In recent years, a two-dimensional array probe (a probe in which a plurality of ultrasonic transducers are arranged in a two-dimensional matrix), a mechanical 4D probe (mechanically arranged in a direction orthogonal to the arrangement direction of the ultrasonic transducer array). It is possible to acquire a volume data group of time-series ultrasonic images using a probe capable of performing ultrasonic scanning while turning and generate and display a three-dimensional ultrasonic image in real time. Furthermore, it is possible to perform alignment between a plurality of different volume data by a three-dimensional alignment technique. By using this registration technique between volume data, for example, it is possible to visually compare the tumor area in the volume data acquired before treatment with the treatment area in the volume data acquired after treatment. it can.

  However, the conventional ultrasonic diagnostic apparatus has the following problems, for example.

  First, it is impossible to quantitatively grasp the three-dimensional positional relationship between target regions to be compared on a three-dimensional image. In particular, when performing ultrasonic ablation treatment, it is necessary to secure a treatment area in which a margin area of 5 mm or more is maintained with respect to the tumor before treatment. With conventional devices, such a margin area can be secured. It cannot be judged objectively. Furthermore, in real-time monitoring using an ultrasonic diagnostic apparatus, body movement due to respiration and posture during image acquisition is likely to occur. Under such circumstances, it is difficult to determine a three-dimensional positional relationship between target regions to be compared without quantitative information.

  The present invention has been made in view of the above circumstances, and an ultrasonic diagnostic apparatus capable of quantitatively and quickly grasping a three-dimensional positional relationship between target regions to be compared on a three-dimensional image. It is another object of the present invention to provide an ultrasonic image processing program.

  In order to achieve the above object, the present invention takes the following measures.

  According to the first aspect of the present invention, the first volume data including the first comparison target acquired by the predetermined medical image diagnostic apparatus and the second volume including the second comparison target acquired by the ultrasonic diagnostic apparatus. Positioning means for spatially aligning the data, a first area based on the boundary surface of the first comparison object in the first volume data, and the first volume data in the second volume data Information generation for generating information relating to the positional relationship between the first area and the second area, and area specifying means for specifying the second area based on the second comparison target boundary surface Means, image generation means for generating an ultrasonic image including information on the positional relationship using the first volume data or the second volume data, and the generated ultrasonic image An ultrasonic diagnostic apparatus characterized by comprising display means for, the.

  According to the second aspect of the present invention, the first volume data including the first comparison target acquired by the predetermined medical image diagnostic apparatus and the second volume including the second comparison target acquired by the ultrasonic diagnostic apparatus. Alignment means for performing spatial alignment with data in real time, a first area based on the boundary surface of the first comparison object in the first volume data, and the second volume data A region specifying means for specifying and updating the second region based on the boundary surface of the second comparison target in real time, and a positional relationship between the first region and the second region An ultrasonic image including information relating to the positional relationship using information generation means for generating and updating information in real time and the first volume data or the second volume data Image generating means for generating realistic other free update, an ultrasonic diagnostic apparatus characterized by comprising a display means for displaying the ultrasound image the generated in real time.

  According to a twelfth aspect of the present invention, there is provided setting means for setting a first comparison target region and a second comparison target region in volume data acquired by ultrasonic scanning, and a boundary surface of the first comparison target. The region specifying means for specifying the first region based on the second region and the second region based on the boundary surface of the second comparison target, the boundary region of the first comparison target, and the second Information generating means for generating information on the positional relationship with the boundary region to be compared, image generating means for generating an ultrasound image including information on the positional relationship using the volume data, and the generated And a display means for displaying an ultrasonic image.

  According to a thirteenth aspect of the present invention, there is provided setting means for setting a first comparison target region and a second comparison target region in volume data acquired in real time by ultrasonic scanning, and the first comparison target A region specifying means for specifying and updating in real time a first region based on a boundary surface and a second region based on the boundary surface of the second comparison target; and the first comparison target An information generating means for generating and updating information relating to the positional relationship between the boundary region and the boundary region to be compared in real time; and an ultrasonic image including information relating to the positional relationship using the volume data. An ultrasonic diagnostic apparatus comprising: an image generation unit that generates and updates; and a display unit that displays the generated ultrasonic image.

  According to a fifteenth aspect of the present invention, a computer includes a first volume data including a first comparison object acquired by a predetermined medical image diagnostic apparatus, and a second volume including a second comparison object acquired by the ultrasonic diagnosis apparatus. An alignment function for executing spatial alignment of the second volume data, a first area based on the boundary surface of the first comparison object in the first volume data, and the second An area specifying function for specifying the second area based on the boundary surface of the second comparison target in the volume data, and information on the positional relationship between the first area and the second area; An image generation function for generating an ultrasonic image including information on the positional relationship using the information generation means to generate and the first volume data or the second volume data An ultrasonic image processing program for causing realize a display function of displaying an ultrasound image that is generated.

  According to a sixteenth aspect of the present invention, a computer includes a first volume data acquired by a predetermined medical image diagnostic apparatus and including a first comparison target, and a first volume data acquired by an ultrasonic diagnostic apparatus and including a second comparison target. An alignment function for executing real-time spatial alignment of the second volume data, a first area based on the boundary surface of the first comparison object in the first volume data, and the first An area specifying function for specifying and updating the second area based on the boundary surface of the second comparison target in the volume data of 2 in real time, and between the first area and the second area Using the information generation function for generating and updating information related to the positional relationship in real time and the first volume data or the second volume data. Ultrasonic image processing characterized by realizing an image generation function for generating and updating an ultrasonic image including information related to a person in real time and a display function for displaying the generated ultrasonic image in real time It is a program.

  According to a seventeenth aspect of the present invention, there is provided a setting function for causing a computer to set a first comparison target region and a second comparison target region in volume data acquired by ultrasonic scanning, and the first comparison target. A region specifying function for specifying the first region based on the boundary surface of the second region and the second region based on the boundary surface of the second comparison target; and the boundary region of the first comparison target; An information generation function for generating information on a positional relationship with the boundary region of the second comparison target, an image generation function for generating an ultrasound image including information on the positional relationship using the volume data, An ultrasonic image processing program that realizes a display function for displaying the generated ultrasonic image.

  According to an eighteenth aspect of the present invention, there is provided a setting function for causing a computer to set a first comparison target region and a second comparison target region in volume data acquired in real time by ultrasonic scanning; A region specifying function for specifying and updating in real time a first region based on a comparison target boundary surface and a second region based on the second comparison target boundary surface; An information generation function for generating and updating information on the positional relationship between the boundary region to be compared and the boundary region to be compared with the second comparison target in real time, and the information including the information on the positional relationship using the volume data An ultrasonic image processing program characterized by realizing an image generation function for generating and updating a sound wave image and a display function for displaying the generated ultrasonic image. That.

  As described above, according to the present invention, there is provided an ultrasonic diagnostic apparatus and an ultrasonic image processing program capable of quantitatively and quickly grasping a three-dimensional positional relationship between target regions to be compared on a three-dimensional image. Can be realized.

FIG. 1 is a diagram showing a block configuration of the ultrasonic diagnostic apparatus according to the present embodiment. FIG. 2 is a flowchart showing the flow of processing in the RFA pre-treatment examination using the ablation treatment support function. FIG. 3 is a conceptual diagram showing the contents of the processing in step 4 and step S5. FIG. 4 is a flowchart for explaining the flow of position association processing between different first volume data and second volume data. FIG. 5 shows a display example of an ultrasound image, an X-ray CT image, and the like corresponding to the same cross section displayed before the RFA treatment. FIG. 6 is a flowchart showing the flow of RFA treatment processing using the ablation treatment support function. FIG. 7 shows a display example of an ultrasonic image, an X-ray CT image, a volume rendering image, and the like corresponding to the same cross section displayed before the RFA treatment. FIG. 8 is a diagram for explaining an example of a method for calculating the distance between the boundary surface of the affected area and the boundary surface of the ablation region. FIGS. 9A and 9B are diagrams for explaining an example of a display form of an ultrasonic image that parametrically displays information related to the shortest distance between the boundary surfaces. FIG. 10 is a diagram showing a display example of information that is used to correct the puncture needle (tip position) generated using the distance between the center of the affected area and the center of the ablation area. FIG. 11 shows the examination of the therapeutic effect after a predetermined time (for example, 5 minutes) has elapsed from the completion of the puncture treatment using the ablation treatment support function, and the post-RFA treatment inspection after a predetermined period (for example, one month) since the completion of the puncture treatment. It is the flowchart which showed the flow of the process in the case of performing. FIG. 12 is a diagram showing a display example of an ultrasound image over a period before and after the treatment that is displayed when the treatment effect is examined using the ablation treatment support function.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

  FIG. 1 is a diagram showing a block configuration of the ultrasonic diagnostic apparatus according to the present embodiment. As shown in the figure, the ultrasonic diagnostic apparatus main body 11 includes an ultrasonic probe 12, an input device 13, a monitor 14, an ultrasonic transmission unit 21, an ultrasonic reception unit 22, a B-mode processing unit 23, and a Doppler processing unit 24. , An image generation unit 25, an image memory 26, an image composition unit 27, a control processor 28, an ablation treatment support information generation unit 29, an internal storage unit 31, and an interface unit 33.

  The ultrasonic transmission unit 21 and the reception unit 22 incorporated in the apparatus main body 11 may be configured by hardware such as an integrated circuit, but may be a software program modularized in software. Hereinafter, the function of each component will be described.

  The ultrasonic probe 12 generates ultrasonic waves based on a drive signal from the ultrasonic receiving unit 21 and converts a reflected wave from the subject into an electric signal, and a matching layer provided in the piezoelectric vibrator. And a backing material for preventing the propagation of ultrasonic waves from the piezoelectric vibrator to the rear. When ultrasonic waves are transmitted from the ultrasonic probe 12 to the subject P, the transmitted ultrasonic waves are successively reflected by the discontinuous surface of the acoustic impedance of the body tissue and received by the ultrasonic probe 12 as an echo signal. . The amplitude of this echo signal depends on the difference in acoustic impedance at the discontinuous surface that is supposed to be reflected. In addition, the echo when the transmitted ultrasonic pulse is reflected by the moving blood flow or the surface of the heart wall depends on the velocity component in the ultrasonic transmission direction of the moving body due to the Doppler effect, and the frequency Receive a shift.

  Note that the ultrasonic probe 12 according to the present embodiment can acquire volume data, and is a two-dimensional array probe (a probe in which a plurality of ultrasonic transducers are arranged in a two-dimensional matrix) or a mechanical 4D probe ( Assume that the probe is capable of performing ultrasonic scanning while mechanically rolling the ultrasonic transducer array in a direction orthogonal to the arrangement direction. However, without being limited to this example, it is also possible to acquire volume data by adopting, for example, a one-dimensional array probe as the ultrasound probe 12 and performing ultrasound scanning while manually swinging the probe.

  The input device 13 is connected to the device main body 11, and includes various switches, buttons, tracks for incorporating various instructions, conditions, region of interest (ROI) setting instructions, various image quality condition setting instructions, etc. from the operator into the device main body 11. In addition to the ball, it has a mouse, a keyboard, and the like.

  The monitor 14 displays in vivo morphological information and blood flow information as an image based on the video signal from the image generation circuit 25. Further, the three-dimensional image displayed on the monitor 14 can change the cross-sectional position, the display format, the observation direction, and the like according to a predetermined instruction from the input device 13.

  The ultrasonic transmission unit 21 includes a pulse generator 21A, a transmission delay unit 21B, and a pulsar 21C. In the pulsar circuit, a rate pulse for forming a transmission ultrasonic wave is repeatedly generated at a predetermined rate frequency fr Hz (period: 1 / fr second). Further, in the delay circuit, a delay time necessary for focusing the ultrasonic wave into a beam shape for each channel and determining the transmission directivity is given to each rate pulse. The pulse generator applies a drive pulse to the probe 12 at a timing based on this rate pulse.

  The ultrasonic transmission unit 22 includes a preamplifier 22A, an A / D converter, a reception delay unit, an adder, and the like. The preamplifier amplifies the echo signal captured via the probe 12 for each channel. The reception delay unit gives a delay time necessary for determining the reception directivity to the amplified echo signal, and thereafter performs an addition process in an adder. By this addition, the reflection component from the direction corresponding to the reception directivity of the echo signal is emphasized, and a comprehensive beam for ultrasonic transmission / reception is formed by the reception directivity and the transmission directivity.

  The B-mode processing unit 23 receives the echo signal from the receiving unit 22, performs logarithmic amplification, envelope detection processing, and the like, and generates data in which the signal intensity is expressed by brightness. This data is transmitted to the image generation circuit 24 and is displayed on the monitor 14 as a B-mode image in which the intensity of the reflected wave is represented by luminance.

  The Doppler processing unit 23 performs frequency analysis on velocity information from the echo signal received from the receiving unit 22, extracts blood flow, tissue, and contrast agent echo components due to the Doppler effect, and obtains blood flow information such as average velocity, dispersion, and power. Ask for multiple points. The obtained blood flow information is sent to the image generation unit 25 and displayed in color on the monitor 14 as an average velocity image, a dispersion image, a power image, and a combination image thereof.

  The image generation unit 25 converts the scan line signal sequence of the ultrasonic scan into a scan line signal sequence of a general video format represented by a television or the like, and generates an ultrasonic diagnostic image as a display image. The image generation unit 25 is equipped with a storage memory for storing image data. For example, an operator can call up an image recorded during an examination after diagnosis. Note that data before entering the image generation unit 25 may be referred to as “raw data”. Further, the image generation unit 25 generates time-series volume data using a plurality of sequentially acquired ultrasonic data.

  The image memory 26 includes a storage memory that stores image data received from the image generation unit 25. This image data can be called by an operator after diagnosis, for example, and can be reproduced as a still image or as a moving image using a plurality of images.

  The internal storage unit 31 is a dedicated program for realizing a later-described ablation treatment support function, a control program for executing image generation / display processing, diagnostic information (patient ID, doctor's findings, etc.), diagnostic protocol, transmission / reception Conditions, ultrasonic image data, image data acquired in other modalities, and other data groups are stored. Further, it is also used for storing images in the image memory 26 as necessary. Data in the internal storage unit 31 can also be transferred to an external peripheral device via the interface unit 33.

  The control processor 28 has a function as an information processing apparatus (computer) and is a control means for controlling the operation of the main body of the ultrasonic diagnostic apparatus. The control processor 28 reads out a dedicated program or the like for realizing a later-described ablation treatment support function from the internal storage unit 31, develops it on the memory, and executes arithmetic / control related to various processes.

  The ablation treatment support information generation unit 29 executes processing according to a later-described ablation treatment support function, and generates support information. Various processes executed by the ablation treatment support information generation unit 29 will be described in detail later.

  The interface unit 33 is an interface related to the input device 13, a network, and a new external storage device (not shown). Data such as ultrasonic images and analysis results obtained by the apparatus can be transferred to other apparatuses via the network by the interface unit 33. In addition, image data acquired by other modalities such as an X-ray computed tomography apparatus, a magnetic resonance imaging apparatus, and a nuclear medicine diagnostic apparatus can be taken into the ultrasonic diagnostic apparatus via the network by the interface unit 33. .

(Cautery treatment support function)
Next, the ablation treatment support function provided in the ultrasonic diagnostic apparatus will be described. This function is different in each of the scenes before the RFA treatment, during the RFA treatment, and after the RFA treatment when the affected part (treatment target) is treated by radiofrequency ablation (RFA) using a puncture needle. Support for spatially associating data with each other, and using a volume data group that has been associated with each other to quantitatively and quickly grasp the three-dimensional positional relationship between target areas to be compared Information is provided. In the following, for the sake of specific explanation, a case where liver cancer is treated with RFA is taken as an example. However, it is only an example that the affected area is liver cancer, and the technical idea of the present invention is not limited to the case where the affected area is liver cancer. For example, in preoperative chemotherapy for breast cancer, It is also effective for quantitative grasp of changes.

(RFA pre-treatment examination)
FIG. 2 is a flowchart showing the flow of processing in the RFA pre-treatment examination using the ablation treatment support function. As shown in the figure, first, volume data related to the liver is acquired by contrast CT imaging (dynamic CT, CTA, CTAP, etc.), magnetic resonance imaging, etc. in order to confirm the position of liver cancer and make a treatment plan. (Step S1).

  Next, an MPR image, a volume rendering image, and the like are generated and displayed using the acquired volume data (step S2). While observing the displayed image, an area corresponding to the affected part (liver cancer) is automatically specified by an artificial or boundary detection process and the boundary surface is set (step S3).

  Next, in order to determine the approach position of the ultrasound probe in RFA treatment, tissue harmonic imaging (THI), four-dimensional ultrasound scanning using a contrast agent, etc. are executed to obtain volume data relating to the liver (step S4). ). Subsequently, an MPR image, a volume rendering image, and the like are generated and displayed using the acquired volume data (step S5). FIG. 3 conceptually shows the contents of the processing in step 4 and step S5.

  Next, the ablation treatment support information generation unit 29 associates the position of volume data (CT volume data, etc.) acquired by contrast CT imaging with volume data (ultrasound volume data) acquired by ultrasound scanning. Is executed (step S6). The ablation treatment support information generation unit 29 includes, for example, a GPU (Graphics Processing Unit), an FPGA (Field Programmable Gate Array), an SIC (Application Specific Integrated Circuit), etc. Can be adopted.

  FIG. 4 is a flowchart for explaining the flow of position association processing between different first volume data and second volume data (CT volume data or the like and ultrasonic volume data in the example of step S6). is there. As shown in the figure, first, the ablation treatment support information generation unit 29 uses the coordinate system of one volume data (second volume data: volume2 in the example of the figure) of the two volume data as the other volume data. Coordinate conversion for matching with the coordinate system of the first volume data (in the example of FIG. 4) is executed (step S61).

  Next, the ablation treatment support information generation unit 29 uses the first volume data and the second volume data to calculate a feature amount (index) related to the degree of similarity for each volume data (step S62). An evaluation function for evaluating the positional deviation between the first volume data and the second volume data is calculated using the feature amount corresponding to the volume data (step S63). As the feature amount related to the similarity, mutual information amount, entropy, cross-correlation amount, and volume data calculated using the data in the region of interest (ROI) set to volume data or no book flow data are used. Difference values, combinations thereof, or the like.

  Next, the ablation treatment support information generation unit 29 determines whether or not the value of the evaluation function satisfies the optimum value criterion (step S64). If it is determined in step S74 that “the value of the evaluation function satisfies the optimum value criterion”, the ablation treatment support information generation unit 29 ends the position association processing. On the other hand, if it is determined that “the value of the evaluation function does not satisfy the optimum value criterion”, the ablation treatment support information generation unit 29 changes the conversion parameter until the value of the evaluation function satisfies the optimum value criterion, and step S61. Through S64 are repeated (step S65).

  Next, the image generation unit 25 uses the CT volume data associated with the position and the ultrasonic volume data to generate an ultrasonic image and an X-ray CT image for suitably observing the affected area before treatment. Generate. The generated ultrasonic image and X-ray CT image are displayed in a predetermined form on the monitor 14 (step S7).

  FIG. 5 shows a display example of an ultrasonic image, an X-ray CT image, an MRI image, etc., which are displayed in correspondence with each other and displayed before the RFA treatment. The ablation area size, the insertion position of the puncture needle, and the route are determined in accordance with the composite affected area image acquired by a plurality of modalities as shown in FIG. 5 (step 8). The ablation area size is set, for example, so as to allow a margin of 5 mm or more at the liver cancer boundary surface. Further, it is preferable that the margin value of such ablation area size is displayed on the image in a predetermined form. A volume rendering image including the CT volume data and ultrasonic volume data that are associated with each other, the determined cauterization region, the insertion position of the puncture needle, and the like are stored in the internal storage unit 31.

(During RFA treatment)
FIG. 6 is a flowchart showing the flow of RFA treatment processing using the ablation treatment support function. As shown in the figure, first, a volume rendering image including the ablation area determined in the RFA pre-treatment examination and the insertion position of the puncture needle is reproduced to determine the final approach position of the ultrasonic probe ( Step S10).

  Next, tissue harmonic imaging (THI), four-dimensional ultrasound scanning using a contrast agent, and the like are executed, and volume data regarding the affected area is acquired (step S11). Subsequently, an MPR image, a volume rendering image, and the like are sequentially generated and displayed using the acquired volume data (step S12).

  Next, the ablation treatment support information generation unit 29 positions the volume data (previous volume data) acquired by contrast CT imaging or the like in advance and the volume data (real time volume data) acquired in real time by ultrasonic scanning. The association is executed, and the result (correspondence) is stored (step S13). Specific contents of the position association processing are as described above.

  Next, an MPR image, a volume rendering image, and the like are generated and displayed using each associated volume data. For example, the surgeon displays various images with different cross-sectional positions, display formats, and observation directions using the associated real-time volume data, and is useful for intraoperative determination during RFA treatment and effect determination after RFA treatment. The image which seems to be is selected, and the cross section used for monitoring is determined (step S14).

  Next, in response to a predetermined operation, the control processor 28 updates the volume data in real time, and generates and displays an ultrasonic image corresponding to the cross section determined in step S14 in real time. The surgeon performs a puncture operation on the affected area while monitoring the position of the affected area and the puncture needle, the path of the puncture needle, and the like using the displayed ultrasonic image (step S15).

  Next, when the puncture needle reaches the affected area, the control processor 28, in response to a predetermined operation, ultrasonically scans the three-dimensional region including the affected area, acquires volume data relating to the affected area again, pre-volume data, An X-ray CT image and MR image for indicating the affected area before treatment after performing position matching with the real-time volume data, an ultrasound image for indicating the affected area during cauterization, and the affected area after cauterization Are displayed in a predetermined form (step S16).

  FIG. 7 is a diagram illustrating a display example of an ultrasound image, an X-ray CT image, and an MR image that are associated with each other during RFA treatment. In the left four-screen display, the upper left is an X-ray CT image before treatment, the upper right is a contrast-enhanced ultrasound image before treatment, the lower-left is an ultrasound image image during cauterization, and the lower-left is a contrast ultrasound image after cauterization. . Since these four images are associated with each other at the volume level, other images can be changed and displayed in conjunction with each other only by changing the orientation of one image. In the example of FIG. 7, the affected part (tumor) before cauterization is clearly visualized in the upper left X-ray CT image. The affected area after cauterization is clearly visualized in the lower right contrast-enhanced ultrasound image.

  Next, the ablation treatment support information generation unit 29 includes the boundary surface of the affected area set in advance, and the boundary surface of the ablation area set based on the current tip position of the puncture needle and a preset ablation area size. The distance between them (for example, the shortest distance) is calculated (step S17). The method for calculating the distance between the boundary surface of the affected area and the boundary surface of the ablation area is not particularly limited. For example, as shown in FIG. 8, the boundary surface of the ablation area is divided into a plurality of minute regions S1, and the boundary surface of the affected part is divided into a plurality of minute regions S2. Then, the distance between all the combinations of the minute region S1 and the minute region S2 is calculated, and the smallest one is the distance between the minute region S1 and the boundary surface of the affected area, and the distance between the minute region S2 and the boundary surface of the ablation region. The shortest distance.

  Next, the image generation unit 25 generates an ultrasonic image for parametrically displaying the shortest distance between the boundary surfaces using the calculated distances for each of the small regions S1 and S2. In other words, the image generation unit 25 uses one of the boundary surface of the affected area and the boundary surface of the ablation area (for example, the boundary surface of the ablation area) to assign an ultrasonic wave having a different color according to the distance calculated for each small area S1. Generate an image. The generated ultrasonic image is synthesized with predetermined information in the image synthesis unit 27 and displayed on the monitor 14 (step S18).

  FIGS. 9A and 9B are diagrams for explaining an example of a display form of an ultrasonic image that parametrically displays information related to the shortest distance between the boundary surfaces. In FIG. 9A, the boundary surface of the affected area and the boundary surface of the ablation area are displayed with different color wire frames. In FIG. 9B, the color corresponding to the distance to the boundary surface of the affected area, which is calculated in step S17, is assigned to each minute area S1 of the boundary surface of the ablated area. This is an example of parametric display of the shortest distance information between the boundary surface. In this example, an area where the distance between the boundary surfaces is short and the risk is high as treatment is displayed in red, for example, and an area where the distance between the boundary surfaces is large and the risk is low as treatment is displayed in blue, for example. By such parametric display, it is possible to list the shortest distance between each part of the affected area and the ablation area, and it is possible to overlook and grasp areas where the ablation margin is insufficient and the risk of recurrence is high. It is also possible to convert the distance information between the boundary surfaces into a color code according to the purpose and display it parametrically.

  Next, the ablation treatment support information generation unit 29 determines whether or not the current ablation area is set to sufficiently include the affected area + margin based on the calculated shortest distance between the affected area and the ablation area. Is determined (evaluated) (step S19). As a result, when it is determined that “the current ablation area is not set to sufficiently include the affected area + margin”, “the current ablation area is set to sufficiently include the affected area + margin”. Until it is determined as “”, the puncture needle is re-stabbed, and the processes of steps S15 to S19 are repeatedly executed.

  When it is determined that “the current ablation area is not set so as to sufficiently include the affected area + margin”, for example, the center of the affected area and the center of the ablation area are calculated, and the distance between the centers is calculated. Information for supporting correction of the puncture needle (the tip position thereof) may be generated and displayed, for example, as shown in FIG. In the example of the figure, the distance between the center positions of each region and the direction of changing the needle tip position where the risk decreases as RFA treatment are shown.

  In addition, the determination in step S18 exemplifies a case where the ablation treatment support information generation unit 29 automatically determines based on the calculated shortest distance between the affected area and the ablation area. However, the present invention is not limited to this example. For example, based on an ultrasonic image in which the shortest distance between each part of the affected area and the ablation area is parametrically displayed, the operator makes an artificial determination or fine adjustment. Also good.

  If it is determined in step S19 that “the current ablation area is set so as to sufficiently include the affected area + margin”, cauterization of the affected area is executed at a predetermined timing. While the cauterization is performed, the control processor 28 continuously performs ultrasonic scanning of the three-dimensional area including the cautery area in order to acquire a three-dimensional image that can monitor the cauterization status (step S20). The surgeon monitors the situation with the ultrasonic image displayed in real time, and uses the associated real-time volume data, for example, to complete the planned area (ie, the affected area + the area including the margin). It is determined whether or not it has been cauterized. As a result, if it is determined that cauterization is insufficient, additional cauterization treatment is performed.

(Examination after RFA treatment)
FIG. 11 shows the examination of the therapeutic effect after a lapse of a predetermined time (for example, 5 minutes) from the completion of the puncture treatment using the ablation treatment support function, or after the RFA treatment after the lapse of a predetermined time (for example, one month) It is the flowchart which showed the flow of the process in the case of performing test | inspection. As shown in the figure, first, a three-dimensional region including the affected part (cauterization completion region) is ultrasonically scanned, and volume data relating to the affected part is acquired again (step S21). The ablation treatment support information generation unit 29 acquires volume data (acquired by contrast CT imaging or the like) before ablation treatment, ultrasonic volume data obtained during ablation treatment, and is acquired in real time after treatment. Position matching with the existing volume data is executed (step S22). Then, an MPR image, a volume rendering image, and the like are generated and displayed using each associated volume data (step S23). For example, the surgeon displays various images having different cross-sectional positions, display formats, and observation directions using the associated real-time volume data, and from these, the RFA treatment which is considered to be useful for comparing the therapeutic effects on the affected area. A previous image, an image during RFA treatment, and an image after RFA treatment are each selected (step S24). The selected image is displayed on the monitor 14 in the form as shown in FIG. 12, for example.

  Next, the affected area before RFA treatment and the ablation completion area after RFA treatment are specified in the associated volume data while observing the displayed image, either artificially or automatically by boundary detection processing or the like. The boundary surface of each area is set (step S25).

  The ablation treatment support information generation unit 29 calculates, for example, the distance between the boundary surface of the affected area before RFA treatment and the boundary surface of the ablation completion region after RFA treatment using the associated volume data ( Step S26). The image generation unit 25 uses the calculated distance to generate an ultrasonic image for parametrically displaying the distance between the boundary surfaces. The generated ultrasonic image is combined with predetermined information in the image combining unit 27 and displayed on the monitor 14 in a predetermined form (step S27). The distance between the boundary surface of the affected area before the RFA treatment and the boundary surface of the cauterization completion region after the RFA treatment is indicated by a color code as support information by the displayed ultrasonic image. Accordingly, the surgeon observes a plurality of images over the period before and after the treatment shown in FIG. 12 and an image in which the boundary surface distance is color-coded, so that the presence or absence of an area where cauterization is not sufficient, RFA treatment The later progress can be judged objectively.

(effect)
According to the configuration described above, when RFA treatment is performed on an affected area (treatment target) using a puncture needle, the space between different volume data in each of the pre-RFA treatment inspection, the RFA treatment, and the post-RFA treatment inspection. 3D distance information between the boundary surface of the affected area and the boundary surface of the ablation area is obtained from the boundary surface of the affected area and Along with the boundary surface of the ablation area, for example, it is color-coded and displayed on the boundary surface of the ablation area. Therefore, the surgeon can quantitatively and quickly grasp the positional relationship between the boundary surface of the affected area and the boundary surface of the ablation area. At this time, by defining an ablation area with an appropriate margin added to the affected area to be ablated, it is only necessary to pay attention to the positional relationship between the boundary area of the affected area and the ablation area. It is possible to easily grasp whether or not the cauterization can be executed while maintaining a sufficient margin. Furthermore, it is possible to generate and provide support information for correcting the position of the puncture needle based on the three-dimensional distance information between the boundary surface of the affected area and the boundary surface of the ablation area. The surgeon corrects the position of the puncture needle according to the provided support information, thereby realizing a suitable cauterization treatment with an appropriate margin secured.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Specific examples of modifications are as follows.

  (1) Each function according to the present embodiment can also be realized by installing a program for executing the processing in a computer such as a workstation and developing the program on a memory. At this time, a program capable of causing the computer to execute the technique is stored in a recording medium such as a magnetic disk (floppy (registered trademark) disk, hard disk, etc.), an optical disk (CD-ROM, DVD, etc.), or a semiconductor memory. It can also be distributed.

  (2) In the above embodiment, an example in which RFA ablation using the ablation treatment support function is executed since the affected area is not monitored using the ultrasonic diagnostic apparatus during the puncture treatment has been described. However, the medical image diagnostic apparatus used for monitoring is not limited to the ultrasonic diagnostic apparatus, and other modalities such as an X-ray CT apparatus, a magnetic resonance imaging apparatus, an X-ray diagnostic apparatus, and a nuclear medicine diagnostic apparatus (PET, SPECT). May be used.

  (3) In the said embodiment, the ablation area | region defined as a spherical surface was illustrated. However, the cautery region can be defined using an elliptical sphere or any other shape. Further, when the affected area is large in the area that can be cauterized by one process, it is necessary to sequentially move the puncture needle to cauterize the entire ablation area. In such a case, it is preferable that different colors are assigned to the areas that have already been cauterized and the areas that have not yet been cauterized so that they can be distinguished.

  (4) The above embodiment exemplifies a case where a plurality of different volume data is associated, the distance between each comparison target area defined in each volume data is calculated, and the result is displayed, for example, in color code did. On the other hand, a plurality of comparison target regions may be defined in the same volume data, the distance between the regions may be calculated for these, and the result may be displayed, for example, with a color code. In such a case, the position association process is not necessary. Examples of the same volume data that can be acquired by the ultrasonic diagnostic apparatus include B-mode volume data and Doppler data acquired in color Doppler mode imaging.

  In addition, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

  As described above, according to the present invention, there is provided an ultrasonic diagnostic apparatus and an ultrasonic image processing program capable of quantitatively and quickly grasping a three-dimensional positional relationship between target regions to be compared on a three-dimensional image. Can be realized.

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic apparatus, 11 ... Apparatus main body, 12 ... Ultrasonic probe, 13 ... Input device, 14 ... Monitor, 21 ... Ultrasonic transmission unit, 22 ... Ultrasonic reception unit, 23 ... B mode processing unit, 24 ... Doppler processing unit, 25 ... image generation unit, 26 ... image memory, 27 ... image composition unit, 28 ... control processor (CPU), 29 ... cauterization treatment support information generation unit, 31 ... storage unit, 33 ... interface unit

Claims (18)

Spatial alignment of first volume data including a first comparison object acquired by a predetermined medical image diagnostic apparatus and second volume data including a second comparison object acquired by an ultrasound diagnostic apparatus Alignment means for performing
A first area based on the boundary surface of the first comparison object in the first volume data and a second area based on the boundary surface of the second comparison object in the second volume data And an area specifying means for specifying,
Information generating means for generating information relating to a positional relationship between the first region and the second region;
Using the first volume data or the second volume data, an image generation means for generating an ultrasound image including information on the positional relationship;
Display means for displaying the generated ultrasonic image;
An ultrasonic diagnostic apparatus comprising: Spatial alignment of first volume data including a first comparison object acquired by a predetermined medical image diagnostic apparatus and second volume data including a second comparison object acquired by an ultrasound diagnostic apparatus Positioning means for performing in real time;
A first area based on the boundary surface of the first comparison object in the first volume data and a second area based on the boundary surface of the second comparison object in the second volume data A region specifying means for specifying and updating in real time;
Information generating means for generating and updating information on a positional relationship between the first area and the second area in real time;
Image generation means for generating and updating an ultrasonic image including information on the positional relationship using the first volume data or the second volume data,
Display means for displaying the generated ultrasonic image in real time;
An ultrasonic diagnostic apparatus comprising: The first volume data is obtained by using a treatment target before cauterization treatment as the first comparison target,
The second volume data is obtained by using a treatment target after acupuncture treatment as the second comparison target;
The ultrasonic diagnostic apparatus according to claim 1 or 2. The first volume data is obtained by using a treatment target before ultrasonic ablation treatment as the first comparison target,
The second volume data is acquired in real time with an ablation area defined on the basis of a predetermined position of a puncture needle punctured as a reference during ultrasonic ablation treatment as the second comparison target. thing,
The ultrasonic diagnostic apparatus according to claim 1 or 2.   5. The method according to claim 1, wherein the region specifying unit specifies a region larger than the first comparison target interface by a predetermined amount as the first region. 6. Ultrasonic diagnostic equipment.   The image generation unit assigns information relating to each positional relationship converted into a color code in accordance with a distance to a corresponding position on the first region or the second region, thereby relating to the positional relationship. The ultrasonic diagnostic apparatus according to any one of claims 1 to 5, wherein the ultrasonic image including information is generated. The information generation means generates support information for supporting position correction of the puncture needle based on the information on the generated positional relationship,
The image generating means generates the ultrasonic image including the support information;
The ultrasonic diagnostic apparatus according to claim 4.   The medical image diagnostic apparatus is any one of an ultrasonic diagnostic apparatus, an X-ray computed tomography apparatus, a magnetic resonance imaging apparatus, and a nuclear medicine diagnostic apparatus. Ultrasound diagnostic equipment.   The alignment means uses at least one index of a mutual information amount, entropy, a cross-correlation amount, and a difference value using the volume data calculated using the first volume data and the second volume data. The ultrasonic diagnostic apparatus according to claim 1, wherein the alignment is performed based on the position alignment.   The ultrasonic diagnostic apparatus according to claim 9, wherein the alignment unit calculates the index for a region of interest set in each of the first volume data and the second volume data.   11. The alignment device according to claim 1, wherein the alignment unit is configured by any one of a graphics processing unit (GPU), a field programmable gate array (FPGA), and an application specific integrated circuit (SIC). The ultrasonic diagnostic apparatus according to one item. Setting means for setting the first comparison target region and the second comparison target region in the volume data acquired by ultrasonic scanning;
A region specifying means for specifying a first region based on the boundary surface of the first comparison target and a second region based on the boundary surface of the second comparison target;
Information generating means for generating information relating to a positional relationship between the boundary region of the first comparison target and the boundary region of the second comparison target;
Image generating means for generating an ultrasound image including information on the positional relationship using the volume data;
Display means for displaying the generated ultrasonic image;
An ultrasonic diagnostic apparatus comprising: Setting means for setting a first comparison target region and a second comparison target region in volume data acquired in real time by ultrasonic scanning;
A region specifying means for specifying and updating in real time a first region based on the boundary surface of the first comparison target and a second region based on the boundary surface of the second comparison target;
Information generating means for generating and updating information on the positional relationship between the first comparison target boundary region and the second comparison target boundary region in real time;
Image generation means for generating and updating an ultrasound image including information on the positional relationship using the volume data;
Display means for displaying the generated ultrasonic image;
An ultrasonic diagnostic apparatus comprising:   The ultrasonic diagnostic apparatus according to claim 1, wherein the region specifying unit detects the boundary surfaces by automatic boundary detection. On the computer,
Spatial alignment of first volume data including a first comparison object acquired by a predetermined medical image diagnostic apparatus and second volume data including a second comparison object acquired by an ultrasound diagnostic apparatus Alignment function to execute
A first area based on the boundary surface of the first comparison object in the first volume data and a second area based on the boundary surface of the second comparison object in the second volume data And an area specifying function for specifying
Information generating means for generating information relating to a positional relationship between the first region and the second region;
An image generation function for generating an ultrasonic image including information on the positional relationship using the first volume data or the second volume data;
A display function for displaying the generated ultrasonic image;
An ultrasonic image processing program characterized by realizing the above. On the computer,
Spatial alignment of first volume data including a first comparison object acquired by a predetermined medical image diagnostic apparatus and second volume data including a second comparison object acquired by an ultrasound diagnostic apparatus Alignment function to execute in real time,
A first area based on the boundary surface of the first comparison object in the first volume data and a second area based on the boundary surface of the second comparison object in the second volume data And an area specifying function for specifying and updating
An information generation function for generating and updating information on a positional relationship between the first area and the second area in real time;
An image generation function for generating and updating an ultrasonic image including information on the positional relationship using the first volume data or the second volume data,
A display function for displaying the generated ultrasonic image in real time;
An ultrasonic image processing program characterized by realizing the above. On the computer,
A setting function for setting the first comparison target region and the second comparison target region in the volume data acquired by ultrasonic scanning;
A region specifying function for specifying a first region based on the boundary surface of the first comparison target and a second region based on the boundary surface of the second comparison target;
An information generation function for generating information on a positional relationship between the first comparison target boundary region and the second comparison target boundary region;
An image generation function for generating an ultrasound image including information on the positional relationship using the volume data;
A display function for displaying the generated ultrasonic image;
An ultrasonic image processing program characterized by realizing the above. On the computer,
A setting function for setting a first comparison target region and a second comparison target region in volume data acquired in real time by ultrasonic scanning;
A region specifying function for specifying and updating in real time a first region based on the boundary surface of the first comparison target and a second region based on the boundary surface of the second comparison target;
An information generation function for generating and updating information on a positional relationship between the boundary region of the first comparison target and the boundary region of the second comparison target in real time;
An image generation function for generating and updating an ultrasound image including information on the positional relationship using the volume data;
A display function for displaying the generated ultrasonic image;
An ultrasonic image processing program characterized by realizing the above.

Images