JP2011015912A - X-ray diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray diagnostic apparatus which, when changing a part to be photographed, ensures an auto-positioning function considering a build of a subject, makes unnecessary for a health care attendant to manually adjust an arm or a top panel, and allows a position to be photographed to be moved to a desired position in a short time without exposing the subject to extra radiation.SOLUTION: The X-ray diagnostic apparatus capable of photographing at different positions by relatively moving the top panel where the subject is placed and a photography system including an X-ray tube and an X-ray detector includes: a calculation means (S115) for calculating a position by acquiring a relative position between the top panel and the photography system during photography of a first part to be photographed; an specification means (S105) for specifying a distance between a first photography part and a second photography part; and change means (S119, S121) for changing the relative position between the top panel and the photography system on the basis of the calculated position and the specified distance in changing the part to be photographed from the first part to be photographed to a second part to be photographed.

Description

  The present invention relates to an X-ray diagnostic apparatus capable of collecting and observing X-ray images. Specifically, the present invention relates to an auto that can easily reproduce the angle of a C-arm and the position of a top plate when changing a region to be imaged. The present invention relates to a circulatory X-ray diagnostic apparatus having a positioning function.

  In recent years, an X-ray diagnostic apparatus for circulatory organs has been used as an apparatus for supporting treatment using a catheter (IVR: Interventional Radiology) by utilizing real-time characteristics in addition to a routine examination for diagnosis as usual. In treatment (IVR) and examination for coronary stenosis disease, there is a possibility that stenosis disease of the lower limb arteries may occur. There are cases where In this lower limb arterial imaging, it is desirable to perform imaging over a wide range as much as possible with a single injection of contrast medium so that the amount of contrast medium can be reduced as much as possible. Therefore, the operator manually slides the couch top. A method of performing DA imaging (Sliding DA imaging) while largely translating the top plate in the longitudinal direction (in the direction of the subject's head and feet) is used.

  In such IVR and examinations, the circulatory organ X-ray diagnostic apparatus is required to be able to perform fluoroscopy and radiography from multiple directions of the flow of contrast medium injected into the blood vessel and various devices inserted into the blood vessel. Yes. For this reason, some cardiovascular X-ray diagnostic apparatuses pre-register the angle of the C-arm that holds the X-ray tube and the X-ray detector, the position of the top plate, etc. It is equipped with an auto-positioning function that can easily reproduce those positions by entering a registration number.

  For example, Patent Document 1 proposes an X-ray imaging apparatus in which the position and angle of a holding device that is optimal for observing a subject can be easily registered as an auto-positioning target, and the position and angle can be used during observation. ing. This X-ray imaging apparatus accepts pressing of the simple registration button by the operator, records the position / angle of the holding device together with a one-digit number, accepts pressing of the trigger button by the operator, and stores the stored number and The holding device is moved using the position and angle of the holding device.

JP 2008-230347 A

  When a medical worker makes a diagnosis using a circulatory organ X-ray diagnostic apparatus, the hemostasis situation near the puncture position where a guide wire or device is inserted after the intervention of the diagnosis target part such as the heart or the head is usually performed In order to confirm the image with X-rays, the C-arm or the top plate is moved to move the imaging target position to the vicinity of the puncture position and perform imaging. At this time, it takes time to move the imaging system having the imaging target position in the vicinity of the head and the chest so that the puncture position of the thigh of the lower limb becomes the imaging target position using the above-described auto-positioning function. There was a problem that. In addition, after being moved by the auto-positioning function, the medical staff has to make fine adjustments manually according to the physique of the subject. In addition, X-ray fluoroscopy may be performed for fine adjustment of the position. In this case, the exposure dose of the subject may increase.

  In recent years, floor-standing X-ray tube holding devices having a large number of drive shafts have been used in many facilities. Such a floor-standing X-ray tube holding device is advantageous in that it does not require a large-scale construction and installation space and can be cheaper than an overhead traveling X-ray tube holding device. In the floor-mounted multi-axis X-ray tube holding device, it is necessary to adjust a plurality of axes when manually positioning the lower limb region of the subject. For this reason, the fine adjustment operation to the hemostatic position by the floor-standing X-ray tube holding device is a work that is more time-consuming for the medical staff.

  The present invention has been made in view of the above-described problems. When changing the imaging target region, the present invention realizes an auto-positioning function in consideration of the physique of the subject, and a medical worker uses a C-arm, a top plate, and the like. It is an object of the present invention to provide a cardiovascular X-ray diagnostic apparatus that can move an imaging target position to a desired position in a short time without the need for fine adjustment manually and without unnecessary exposure of the subject. .

  In order to solve the above problems, an X-ray diagnostic apparatus for circulatory organs according to the present invention relatively moves between a top plate on which a subject is placed and an imaging system including an X-ray tube and an X-ray detector. In the X-ray diagnostic apparatus capable of performing imaging at different positions, a calculation unit that acquires a relative position between the top plate and the imaging system and calculates an average position during imaging of the first imaging region; A specifying unit that specifies a distance between the first imaging region and the second imaging region; and a calculation unit that calculates a region to be imaged from the first imaging region to the second imaging region. And changing means for changing the relative positions of the top plate and the photographing system based on the average position and the predetermined distance specified by the specifying means.

  According to the circulatory organ X-ray diagnostic apparatus according to the present invention, when changing a region to be imaged, an auto-positioning function considering the physique of a subject is realized, and a medical worker manually operates a C-arm, a top plate, etc. Thus, there is no need to make fine adjustments, and there is no extra exposure of the subject, and the imaging target position can be moved to a desired position in a short time.

The block diagram which shows the rough structure of the X-ray diagnostic apparatus for cardiovascular according to this invention. 1 is a block diagram showing a system configuration of a cardiovascular X-ray diagnostic apparatus according to the present invention. The figure which shows the imaging | photography object range at the time of coronary imaging in the X-ray diagnostic apparatus for circulatory organs concerning this invention, and the imaging position at the time of a puncture position imaging | photography. The flowchart which shows the procedure of the imaging | photography control processing in the case of performing auto-positioning using the average position at the time of coronary artery imaging | photography in the X-ray diagnostic apparatus for circulatory organs concerning this invention. The figure for demonstrating the imaging | photography control processing in the case of performing auto-positioning using the average position at the time of a coronary artery imaging | photography in the X-ray diagnostic apparatus for circulatory organs concerning this invention. The flowchart which shows the procedure of the imaging | photography control processing in the case of performing auto-positioning using the past test | inspection information in the X-ray diagnostic apparatus for circulatory organs concerning this invention. The figure for demonstrating the imaging | photography control processing in the case of performing auto-positioning using the past test | inspection information in the X-ray diagnostic apparatus for circulatory organs concerning this invention. 6 is a flowchart showing a procedure of imaging control processing when auto-positioning is performed using an average position of an image monitor or the like in the X-ray diagnostic apparatus for circulatory organs according to the present invention. The figure for demonstrating the imaging | photography control processing in the case of performing auto-positioning using average positions, such as an image monitor, in the X-ray diagnostic apparatus for circulatory organs concerning this invention. (A) is a perspective view showing an example of a floor-standing X-ray tube holding device having a large number of drive shafts, (B) is a front view showing this X-ray tube holding device, and (C) is this The figure which shows the rotation direction at the time of seeing an X-ray tube holding apparatus from upper direction.

  An embodiment of an X-ray diagnostic apparatus according to the present invention will be described in detail with reference to the accompanying drawings. As an X-ray diagnostic apparatus according to the present invention, a circulatory X-ray diagnostic apparatus 1 capable of displaying captured images in real time will be described as an example. FIG. 1 is a diagram schematically showing the overall configuration of a circulatory X-ray diagnostic apparatus 1 according to the present invention, and FIG. 2 is a block diagram showing the system configuration of the circulatory X-ray diagnostic apparatus 1 according to the present invention. It is.

  As shown in FIGS. 1 and 2, the circulatory X-ray diagnostic apparatus 1 detects and images an X-ray generator 11 for generating and irradiating X-rays and X-rays transmitted through a subject. An X-ray image receiving device 12 for converting into an electric signal, and a C arm 13 that holds the X-ray generating device 11 and the X-ray image receiving device 12 so as to face each other are provided.

  The X-ray generator 11 includes an X-ray tube, a diaphragm that limits the X-ray irradiation range, a high-voltage device that generates X-rays by applying a high voltage to the X-ray tube. The X-ray image receiving apparatus 12 includes an image intensifier that converts X-rays transmitted through the subject into an optical image. Note that a flat panel detector may be used instead of the image intensifier.

  The C arm 13 is moved and controlled by the arm driving device 13a so that various parts of the subject can be seen and photographed from various angles, and the mutual positional relationship with the subject (top plate 18) is adjusted. To be moved. The C-arm 13 includes a traveling carriage 14 that operates in the body axis direction of the subject and the left-right direction of the subject, and a ceiling rail 15 that guides the traveling carriage 14 to travel on the ceiling surface and holds the traveling carriage 14. And are guided and controlled by the traveling carriage 14 and the ceiling rail 15 based on the control of the arm driving device 13a. Further, the body axis direction position (X1) of the traveling carriage 14 (X-ray generator 11 or X-ray image receiving apparatus 12) is detected by the position detector 16, and the lateral position (Y1) of the traveling carriage 14 is detected by the position detector 17. Is detected. These position detectors 16 and 17 are, for example, potentiometers.

  Further, the cardiovascular X-ray diagnostic apparatus 1 includes a top plate 18 serving as a patient's bed between the X-ray generation apparatus 11 and the X-ray image receiving apparatus 12 while the subject is laid down. The top plate 18 is moved and controlled by a top plate driving device 18a so as to adjust the mutual positional relationship with respect to the X-ray generation device 11 and the X-ray image receiving device 12. That is, the top plate 18 is controlled to move by a moving mechanism that can move in the body axis direction of the subject (top plate 18) and in the left-right direction of the subject. The position (X2) of the top plate 18 (subject) in the direction of the opposite axis is detected by the position detector 19, and the position of the top plate 18 (subject) in the left-right direction (Y2) is detected by the position detector 20. These position detectors 19 and 20 are, for example, potentiometers.

  The cardiovascular X-ray diagnostic apparatus 1 acquires an analog video signal from the X-ray TV camera 21 and the X-ray TV camera 21 that convert an optical image received by the X-ray image receiving apparatus 12 into a video signal, and digitally converts this signal to the digital signal. A / D converter 22 for converting to a video signal, an image memory 23 for storing the digital video signal converted by the A / D converter 22, and a D for converting the digital video signal stored in the image memory 23 to an analog video signal A / A converter 24 and a monitor 25 for displaying the analog video signal converted by the D / A converter 24 are provided.

  The cardiovascular X-ray diagnostic apparatus 1 includes a CPU (Central Processing Unit) 26 that comprehensively controls the apparatus. The CPU 26 performs photographing control processing, which will be described later, and various other arithmetic processing and control processing. The cardiovascular X-ray diagnostic apparatus 1 also includes an image storage memory 27 for storing a large number of images received by the X-ray image receiving apparatus 12, an input / output device 28 for inputting / outputting patient information and examination information, and an angle setting for the C arm 13. And a position information storage memory 29 for storing position information such as the position in the body axis direction and the position of the top plate 18 in the body axis direction. As for the image stored in the image storage memory 27, for example, at the time of diagnosis, an arbitrary image is selected by an instruction from a medical staff, read out from the image storage memory 27 to the image memory 23, and then displayed on the monitor 25. Is displayed. Note that position information such as the current position and average position of the top board 18 and the C-arm 13 used in the imaging control process described later is stored in the position information storage memory 29.

  The X-ray irradiation control and the arm driving device 13a and the top plate driving device 18a are operated remotely from a console (not shown) by a medical worker, and are controlled by the CPU 26 according to the operation content. . The console includes an X-ray irradiation switch, an arm operation device, a top panel operation device, and means for inputting patient information and user information. In addition, the console has a foot switch for performing DA shooting operation, and when the foot switch is stepped on by a medical worker, shooting is started, and shooting is continued while being stepped on, Shooting is terminated when the foot switch is released. Further, the console, for example, a button or foot switch for automatically moving the C-arm 13 or the top 18 to the puncture position (auto-positioning) when performing X-ray fluoroscopy at the puncture position after imaging of the coronary artery. Etc. are provided.

  In recent years, an X-ray diagnostic apparatus for circulatory organs has been used as an apparatus that supports treatment using a catheter (IVR; Interventional Radiology) in addition to routine examinations for conventional diagnosis.

  When making a diagnosis with the circulatory organ X-ray diagnostic apparatus 1, usually, after performing an intervention on a target part such as the heart or the head, the hemostasis state near the puncture position where a guide wire or device is inserted is confirmed by X-ray. In order to do this, it is necessary to move the C arm 13 or the top board 18 so that the vicinity of the puncture position becomes the X-ray fluoroscopic target position.

  FIG. 3 is a diagram showing an imaging range and a puncture position when the cardiovascular X-ray diagnostic apparatus 1 images a coronary artery. As shown in FIG. 3, for example, after the coronary artery is treated with the subject's chest as an imaging target position, the imaging target position is moved to the subject's puncturing position, and then hemostasis near the puncture position is performed. X-ray fluoroscopy is performed to confirm the situation.

  At this time, when the imaging target position in the cardiovascular X-ray diagnostic apparatus is moved using the conventional auto-positioning function, the imaging target position is moved from, for example, the vicinity of the head or chest to the puncture position of the thigh of the lower limb. It took time to make it happen. In addition, after being moved by the auto-positioning function, it is necessary for the medical staff to make fine adjustments manually according to the physique of the subject. In addition, X-ray fluoroscopy may be performed for fine adjustment of the position. In this case, the exposure dose to the subject also increases. X-ray fluoroscopy is a technique for collecting a moving image with a relatively small dose of X-ray, and imaging is a technique for collecting an image with good image quality with a relatively large dose.

  Therefore, the X-ray diagnostic apparatus 1 for circulatory organs according to the present invention has a relative position (an angle of the C arm 13) between the imaging system (C arm 13) and the subject (top plate 18) when imaging the coronary artery. The position information storage memory 29 stores the position, body axis direction position, top plate 18 position, etc. in the position information storage memory 29. After the coronary artery is imaged, X-ray fluoroscopy is performed at the puncture position in order to confirm the hemostatic state, for example. When performing, it has an auto-positioning function that estimates the puncture position based on the stored imaging position of the coronary artery and moves the imaging target position to the puncture position.

In other words, in a normal examination for a coronary artery, each of the three segments of the left coronary artery (anterior descending branch and the convoluted branch) and the right coronary artery is photographed from an angle at which each artery can be easily observed. Therefore, the number of photographed images is generally over ten. The circulatory organ X-ray diagnostic apparatus 1 stores the angle of the C arm 13 and the position in the body axis direction or the position in the body axis direction of the top plate 18 when the coronary artery is imaged in the position information storage memory 29. To do. Further, the circulatory organ X-ray diagnostic apparatus 1 averages a plurality of imaging positions based on the stored position information, thereby sequentially calculating the average value of the positions in the body axis direction of the C-arm 13 and the top plate 18 (the imaging average of the coronary artery). The position P _M ) is calculated and stored together in the position information storage memory 29. The circulatory organ X-ray diagnostic apparatus 1 sets a distance from the photographing mean position P _M of the coronary arteries (e.g., restriction distance D) of the proceeds to the foot direction by position to the target position of the automatic positioning, the instruction of medical personnel Based on this, the C arm 13 or the top plate 18 is automatically moved.

  The limit distance D is the distance from the heart to the thigh of the lower limb. For example, the distance from the average heart of an adult male to the thigh of the lower limb is stored in the position information storage memory 29 as a default value. However, when height data is input as patient information at the start of the examination, a certain percentage (for example, 30%) of length is calculated as the limit distance D from the height data, and the calculated value is used. Or, for example, when a limit distance D corresponding to a subject of 170 cm is stored as a default value, for example, when the height of the subject is 160 cm, a value obtained by multiplying the default value by 0.9 is limited The distance D may be adopted.

  As described above, the cardiovascular X-ray diagnostic apparatus 1 performs imaging of the coronary artery while performing autopositioning based on the average position information in the longitudinal direction of the C-arm 13 or the couchtop 18 at the time of coronary artery imaging and the limit distance D. The procedure for performing the imaging control process for performing fluoroscopy of the puncture position will be described in detail based on the flowchart shown in FIG. Hereinafter, for example, “step S101” is described as “S101”, and the term “step” is omitted.

  First, the CPU 26 determines whether or not an examination is started in the circulatory X-ray diagnostic apparatus 1 (S101). At this time, the CPU 26 determines that the inspection has been started based on, for example, turning on the power or performing a predetermined operation. When the inspection is not started (No in S101), the CPU 26 stands by as it is.

  When the inspection is started (Yes in S101), the CPU 26 determines whether or not the height is set (S103). At this time, the CPU 26 determines that the height is set, for example, when the height is input from the input / output device 28. When the height is set (Yes in S103), the CPU 26 updates the limit distance D (S105). At this time, the CPU 26 sets, for example, a certain proportion of height (for example, 30%) as the limit distance D.

  The CPU 26 sets the number N of photographing times to “0” since photographing has not yet been performed (S107). Then, the CPU 26 determines whether or not all photographing has been completed (S109). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed.

  If all shooting has not been completed (No in S109), the CPU 26 determines whether shooting has been performed (S111). The medical worker instructs the start of imaging by, for example, stepping on a foot switch at the foot. In this case, the shooting is continued while the foot switch is being stepped on, and the shooting is ended when the foot switch is released. Therefore, the CPU 26 determines that shooting has started, for example, based on the foot switch being released. When photographing is not performed (No in S111), the process returns to step S109, and the CPU 26 determines whether or not the inspection is finished again.

When photographing is performed (Yes in S111), the CPU 26 adds 1 to the number N of photographing (S113). The CPU26 then updates the current position _{P N} is a body axis direction position of the current C-arm or top panel 18 (S115). At this time, CPU 26, from the position detector 16 or a position detector 18 to obtain the body-axis direction position of the C-arm 13 or top plate 18, and this position is the current position _{P N.}

  Then, the CPU 26 returns to step S109 and determines again whether or not all photographing has been completed. When all the photographing has been completed (Yes in S109), the CPU 26 determines whether or not auto-positioning to the hemostatic position is instructed (S117). The medical staff instructs the cardiovascular X-ray diagnostic apparatus 1 to perform auto-positioning, for example, by performing a predetermined operation using a console.

When auto positioning is instructed (Yes in S117), the CPU 26 calculates a target position P for moving the C-arm or the top plate 18 (S119). At this time, by using an average value of a plurality of shooting positions, the target position P is calculated based on, for example, the following equation (1).

  The CPU 26 moves the C arm or the top board 18 to the target position P calculated in step S119 (S121). The CPU 26 determines whether or not the inspection is finished (S123). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed. If the inspection has not been completed (No in S123), the CPU 26 waits until the inspection is completed. When the inspection is finished (Yes in S123), the CPU 26 finishes the photographing control process.

  In this way, the circulatory organ X-ray diagnostic apparatus 1 calculates the average position of the couch 18 during imaging of the coronary artery, and when the imaging of the coronary artery is completed, the medical staff instructs Based on the above, the target position P of the top plate 18 at the time of hemostasis is calculated from the average position of the top plate 18 using the limit distance D, and the C arm 13 or the top plate 18 is moved to the hemostatic position. Thereby, when changing the imaging target site in the circulatory organ X-ray diagnostic apparatus 1, the medical staff can easily adjust the imaging target position to a desired position without manually fine-tuning the C arm 13 or the top plate 18. Can be moved to.

  Next, when the circulatory X-ray diagnostic apparatus 1 images the puncture position after coronary artery imaging, instead of using the imaging position at the time of coronary artery imaging as described above, imaging at the time of past hemostasis of the subject is performed. A procedure for performing imaging control processing for imaging the coronary artery and the puncture position while performing auto-positioning based on the position will be described in detail based on the flowchart shown in FIG.

  The cardiovascular X-ray diagnostic apparatus 1 determines the angle of the C arm 13 and the position in the body axis direction, the position in the body axis direction of the top board 18 and the like when performing confirmation fluoroscopy for hemostasis after the end of the coronary artery imaging. Stored as inspection information. Alternatively, the inspection information may be output from the input / output device 28 at the end of imaging, and this inspection information may be input from the input / output device 28 at the start of the next imaging. In addition, the imaging position of the confirmation fluoroscopy for hemostasis may be automatically stored at the end of the imaging, or may be stored by operating a console by a medical worker.

  When retesting or treatment is performed on the same subject next time, location information for hemostasis confirmation is extracted from the examination information at the previous examination and used to obtain the location for hemostasis confirmation. Information used in the past by the same subject as information is set as a target position Pt for auto-positioning, and is used when the C-arm 13 or the top board 18 is moved.

  The position information storage unit 29 stores a predetermined default value as the target position Pt for auto positioning. Further, the position information storage unit 29 stores each height in association with a target position Pt for auto-positioning. Thus, for a subject to be examined for the first time, if the height of the subject is entered at the start of the examination, the height of another subject who has been examined in the past and has the same or closest height information as that height is entered. Location information for hemostasis confirmation can be used. Further, the auto-positioning target position Pt set as the default value is updated with the value used for shooting as the default value every time shooting is performed.

  First, the CPU 26 determines whether or not an examination is started in the circulatory organ X-ray diagnostic apparatus 1 (S201). At this time, the CPU 26 determines that the inspection has been started based on, for example, turning on the power or performing a predetermined operation. If the inspection has not been started (No in S201), the CPU 26 stands by as it is.

  When the examination is started (Yes in S201), the CPU 26 determines whether there is past examination information of the subject (S203). At this time, the CPU 26 determines that there is past inspection information when past inspection information is input from the external device such as RIS (Radiology Information System) by the input / output device 28.

  When there is past examination information (Yes in S203), the CPU 26 acquires the value of the target position Pt from the past examination information of the same subject and uses the target position used in the examination started in Step S201. Set as Pt (S205).

  When there is no past examination information (No in S203), the CPU 26 determines whether or not the subject's height is set in the past examination information (S207). When the height of the subject has been set (Yes in S207), the CPU 26 sets a default value corresponding to the height as the target position Pt (S209).

  If there is no past examination information and the height has not been set (No in S205), the CPU 26 sets a default target position value that does not depend on the height as the target position Pt (S211).

  The CPU 26 determines whether or not all photographing has been completed (S213). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed.

  If all photographing has not been completed (No in S213), the CPU 26 determines whether or not auto-positioning to the hemostatic position has been instructed (S215). At this time, the CPU 26 determines that auto-positioning has been instructed, for example, when an instruction operation is performed by an instruction means included in the console.

  When the auto positioning is instructed (Yes in S213), the CPU 26 moves the C arm or the top board 18 to the hemostatic position, that is, the target position Pt set in Step S205, S209, or S211 (S215). Thereby, the medical worker can move the C arm 13 or the top plate 18 to a desired position without manually moving the C arm 13 or the top plate 18. On the other hand, when auto-positioning is not instructed (No in S213), the CPU 26 does not move the C-arm 13 or the top 18 and the medical worker manually moves the C-arm 13 or the top 18 to the hemostatic position. Let

  CPU26 judges whether X-ray fluoroscopy was implemented by the medical worker (S219). For example, the medical worker instructs the start of fluoroscopy by stepping on a foot switch at the foot. In this case, X-ray fluoroscopy is continued while the foot switch is being stepped on, and X-ray fluoroscopy is terminated when the foot switch is released. Therefore, the CPU 26 determines that shooting has started based on the foot switch being released.

  When X-ray fluoroscopy is performed (Yes in S219), the CPU 26 determines whether or not the C arm 13 or the top plate 18 has been manually moved (S221). When auto-positioning is not performed in steps S215 and S217, when the position of the top 18 is finely adjusted by the medical staff after the C-arm 13 or the top 18 is moved by auto-positioning in step S217 For example, it is determined that the C-arm 13 or the top plate 18 has been manually moved. When the C-arm 13 or the top 18 is manually moved (Yes in S221), the CPU 26 adds the amount moved to the target position Pt and updates the value of the target position Pt (S223).

  The CPU 26 updates the value of the target position Pt in the inspection information whether or not the target position Pt is updated in step S223 (S225). Then, the CPU 26 determines whether or not the height is set (S227). At this time, the CPU 26 sets the height when there is past examination information in step S203 and the height is described in the examination information or when the height is set in step S207. Judge.

  When the height is set (Yes in S227), the CPU 26 updates the default target position Pt corresponding to the height (S229). Then, returning to step S219, the CPU 26 determines again whether or not X-ray fluoroscopy is performed. When X-ray fluoroscopy is not performed (Yes in S219), the CPU 26 determines whether or not the examination is finished (S231). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed. If the inspection has not been completed (No in S231), the process returns to step S219, and the CPU 26 determines whether or not X-ray fluoroscopy is performed. When the inspection is finished (Yes in S231), the CPU 26 finishes the photographing control process.

  Thus, when there is past examination information of the same subject, the cardiovascular X-ray diagnostic apparatus 1 sets the hemostatic target position Pt based on the examination information, and when there is no past examination information. The default hemostatic position corresponding to the height is set as the target position Pt for hemostasis, and when the height is not set, the default hemostatic position not depending on the height is set as the target position Pt for hemostasis. When is completed, the C-arm 13 or the top 18 is moved to the hemostasis target position Pt based on an instruction from the medical staff. Thereby, when changing the imaging target site in the circulatory organ X-ray diagnostic apparatus 1, the medical staff can easily adjust the imaging target position to a desired position without manually fine-tuning the C arm 13 or the top plate 18. Can be moved to.

  Next, when the cardiovascular X-ray diagnostic apparatus 1 performs imaging of the puncture position after coronary artery imaging, instead of using the average coronary imaging position and the past hemostatic position of the subject as described above, medical The target position P for hemostasis is set based on the standing position of the worker (operator or supporter), and when the coronary artery imaging is completed, the C arm 13 or the top plate 18 is hemostatic based on the instructions of the medical staff. A procedure for performing shooting control processing for shooting at a target position P will be described in detail with reference to the flowchart shown in FIG.

The cardiovascular X-ray diagnostic apparatus 1 estimates the operator's standing position P _{p based} on the positions in the body axis direction of a plurality of devices used by the medical staff at the time of diagnosis, and further punctures the operator from the standing position P _p. Is estimated. The circulatory organ X-ray diagnostic apparatus 1 has an auto-positioning function for setting the estimated puncture position as a target position P for auto-positioning and moving the C-arm 13 or the top board 18.

  The equipment used for estimating the puncture position includes a monitor 25 arranged obliquely above the operator standing beside the bed and displaying a photographed image, and placed at the operator's feet so that the operator can start and end photographing. A foot switch 31 for instructing, and a table side console (TSC) 32 installed on the side of the bed for instructing an autopositioning or the like by an operator or supporter can be considered. For example, an ultrasonic transmitter is installed in each of these devices and a receiver is installed on the bed, so that the circulatory X-ray diagnostic apparatus 1 can grasp the installation position of each device.

The cardiovascular X-ray diagnostic apparatus 1 calculates the standing position P _p of a medical worker (operator) based on the body axis direction position of these devices every time imaging is performed. Assuming that the TCS 32 is operated by a supporter other than the operator, for example, when the position P _{m of the} monitor 25, the position P _f of the foot switch 31, and the position P _{s of} the TSC 32 are set, the position P _{m of the} monitor 25 and the foot position P _f of the switch 31 is considered substantially the same as standing position of the operator, the position P _s head direction αcm of TCS32 (α is an arbitrary number) position of is estimated to standing position of the operator. Therefore, the average position of these devices can be set as the operator standing position P _p . That is, the operator's standing position P _p is calculated by the following equation (2).

The cardiovascular X-ray diagnostic apparatus 1 calculates the operator's standing position P _p every time imaging is performed, and further calculates the average value thereof to determine the operator's standing position = position for confirming hemostasis. . Thus, the circulatory X-ray diagnostic apparatus 1 sets the position information for hemostasis confirmation to the target position P for auto-positioning, and moves the C arm 13 or the top board 18.

  First, the CPU 26 determines whether or not the examination is started in the circulatory X-ray diagnostic apparatus 1 (S301). At this time, the CPU 26 determines that the inspection has been started based on, for example, turning on the power or performing a predetermined operation. When the inspection is not started (No in S301), the CPU 26 stands by as it is. The CPU 26 sets the number N of photographing times to “0” because photographing has not yet been performed (S303).

  The CPU 26 determines whether or not all shooting has been completed (S305). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed.

  If all shooting has not been completed (No in S305), the CPU 26 determines whether shooting has been performed (S307). A medical worker instructs the start of imaging by, for example, stepping on the foot switch 31 at the foot. In this case, the shooting is continued while the foot switch 31 is being stepped on, and the shooting is ended when the foot switch 31 is released. Therefore, for example, the CPU 26 determines that photographing has started based on the foot switch 31 being opened. If shooting has not been performed (No in S307), the process returns to step S305, and the CPU 26 determines again whether or not all shooting has been completed.

When photographing is performed (Yes in S307), the CPU 26 uses the position P _{m of the} monitor 25, the position P _f of the foot switch 31, and the position P _s of the TSC 32 to average the position P _{N of the} operator's standing position. Is updated (S309). At this time, CPU 26 updates the average value _{P N} of the standing position of the operator with the following equation (3). This equation (3) corresponds to the above-described equation (2).

  Then, the CPU 26 adds 1 to the number N of photographing (S311). The CPU 26 returns to step S305 and determines again whether or not all photographing has been completed. When all the imaging has been completed (Yes in S305), the CPU 26 determines whether or not auto-positioning to the hemostatic position is instructed (S307). The medical staff instructs the cardiovascular X-ray diagnostic apparatus 1 to perform auto-positioning by performing a predetermined operation using the input / output device 28, for example.

When the auto positioning is instructed (Yes in S307), the CPU 26 calculates a target position P for moving the C arm 13 (S315). Target position P at this time is based on the average position P _N of the standing position of the operator which has been updated in step S309, the calculated by the following equation (4).

  The CPU 26 moves the C arm 13 or the top board 18 to the target position P calculated in step S315 (S317). From this moved state, the medical staff can easily start imaging the lower limb artery of the subject. On the other hand, if auto-positioning is not instructed in step S313, the C arm 13 or the top board 18 is manually moved by a medical worker. The CPU 26 determines whether the inspection is finished (S319). At this time, the CPU 26 determines that the inspection has been completed based on, for example, the power being turned off or a predetermined operation being performed. If the inspection has not been completed (No in S319), the CPU 26 waits until the inspection is completed. When the inspection is ended (Yes in S319), the CPU 26 ends the photographing control process.

In this way, the circulatory organs X-ray diagnostic apparatus 1 calculates the middle of performing a photography of the coronary arteries, monitor 25, the average position P _N of the standing position of the operator with the position of the foot switch 31, TSC32 When the imaging of the coronary artery is completed, the target position P of the C-arm 13 or the top plate 18 at the time of lower-limb arterial imaging is calculated from this average position based on an instruction from the medical staff, The top plate 18 is moved to the calculated target position P. Thereby, when changing the imaging target site in the circulatory organ X-ray diagnostic apparatus 1, the medical staff can easily adjust the imaging target position to a desired position without manually fine-tuning the C arm 13 or the top plate 18. Can be moved to.

  In recent years, a floor-standing X-ray tube holding device having a large number of drive shafts has been used in many facilities. 10A is a view showing a floor-standing X-ray tube holding device 1A having a large number of drive shafts, and FIG. 10B is a front view showing the X-ray tube holding device 1A. FIG. 10C is a diagram showing the rotation direction when the X-ray tube holding device 1A is viewed from above.

  As shown in FIGS. 10A to 10C, the X-ray tube holding apparatus 1A can take images of any position from any direction by combining rotation of a plurality of C arms 13, support column rotation, and floor rotation. Can do. This is because such a floor-standing X-ray tube holding device 1A is advantageous in that it does not require a costly construction and installation space and can be cheaper than an overhead traveling X-ray tube holding device. In the floor-mounted multi-axis X-ray tube holding device, it is necessary to adjust a plurality of axes when manually positioning the lower limb region of the subject. For this reason, the fine adjustment operation to the hemostatic position is a work that is more troublesome for the medical staff. Therefore, the auto-positioning function as in the present invention is very useful in a floor-standing X-ray tube holding device having a large number of drive shafts.

  According to the circulatory organ X-ray diagnostic apparatus 1 according to the present invention, when changing a region to be imaged, an auto-positioning function considering the physique of the subject is realized, and a medical worker performs the C-arm 13 or the top plate 18. It is possible to move the imaging target position to a desired position in a short time without the need for fine adjustment manually.

  DESCRIPTION OF SYMBOLS 1 ... X-ray diagnostic apparatus for circulatory organs, 11 ... X-ray generator, 12 ... X-ray image receiver, 13 ... Arm, 14 ... Traveling trolley, 15 ... Ceiling rail, 16, 17, 19, 20 ... Position detector, 18 ... Top plate, 21 ... X-ray TV camera, 22 ... A / D converter, 23 ... Image memory, 24 ... D / A converter, 25 ... Monitor, 26 ... CPU, 27 ... Memory for image storage, 28 ... On Output device 29... Position information storage memory 31. Foot switch 32. Table side console (TSC).

Claims (7)

In an X-ray diagnostic apparatus capable of performing imaging at different positions by relatively moving a top plate on which a subject is placed and an imaging system including an X-ray tube and an X-ray detector,
Calculating means for acquiring a relative position between the top plate and the imaging system during imaging of the first imaging region and calculating the position;
Specifying means for specifying a distance between the first imaging region and the second imaging region;
When changing the imaging target region from the first imaging region to the second imaging region, based on the position calculated by the calculating unit and the distance specified by the specifying unit, the top plate and the imaging system Changing means for changing the relative position;
An X-ray diagnostic apparatus comprising:   The X-ray diagnostic apparatus according to claim 1, wherein the specifying unit specifies a distance between the first imaging region and the second imaging region based on a height of the subject. In an X-ray diagnostic apparatus capable of performing imaging at different positions by relatively moving a top plate on which a subject is placed and an imaging system including an X-ray tube and an X-ray detector,
When changing the imaging target part from the first part to the second part, the relative position of the top plate and the imaging system used in the previous examination of the second part from the previous examination information of the subject First acquisition means for acquiring
Changing means for changing the relative position of the top plate and the imaging system to the relative position acquired by the first acquisition means when changing the imaging target part from the first part to the second part;
An X-ray diagnostic apparatus comprising: Storage means for storing the height of the subject and the relative position of the top plate and the imaging system in association with each other;
The first acquisition unit acquires a relative position corresponding to the height of the subject from the storage unit based on the height of the subject when the previous examination information of the subject cannot be acquired. The X-ray diagnostic apparatus according to claim 3. The storage means stores a predetermined relative position of the top plate and the imaging system,
The X-ray diagnostic apparatus according to claim 4, wherein the first acquisition unit acquires the predetermined relative position from the storage unit when the height of the subject cannot be acquired. Comprising second acquisition means for acquiring the position of each of the devices installed around the top board;
The changing unit calculates a relative position of the top plate and the imaging system based on the position of each device acquired by the second acquiring unit when changing the imaging target region. The X-ray diagnostic apparatus according to claim 3, wherein the X-ray diagnostic apparatus is changed to a position.   The device installed around the top panel includes at least display means for displaying an image photographed by the photographing system, first operating means for instructing photographing by the photographing system, and the changing means. The X-ray diagnostic apparatus according to claim 6, further comprising second operation means for instructing a change by.

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