JP2012040220A - Medical imaging system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical imaging system which can easily determine entering route of a puncture needle.SOLUTION: The medical imaging device includes an input part for performing an input indication to an object to be punctured in an MRI image, and a puncture possible part setting part 54 for searching and setting a puncture possible part in which puncture is applicable from the indicated object to be punctured in the input part to a body surface side. In addition, a puncture guide display control part 55 for displaying a distance mark which shows the distance of the puncture possible part and a scanning surface by an ultrasonic probe is provided.

Description

  The present invention relates to a medical imaging apparatus that searches for a puncturable portion that can be punctured with a puncture needle.

  When a puncture needle is inserted into a subject and treatment or tissue sampling is performed, the puncture route is determined while observing an ultrasound image so that a thick blood vessel, bone, or other organ is not damaged by the puncture needle. . Specifically, as shown in Patent Document 1, for example, a blood vessel is scanned on an puncture line while displaying an ultrasonic image on which a puncture line indicating an entry path of a puncture needle is displayed by scanning with an ultrasonic probe. The path of entry of the puncture needle is specified by searching for a cross section where there is no puncture avoidance target such as bone, other organs, etc. that should avoid the passage of the puncture needle.

  Then, after specifying the entry path of the puncture needle in this way, the puncture needle is attached to the attachment attached to the ultrasonic probe and puncture is performed, so that the scan surface by the ultrasonic probe is at a specific position and angle. A puncture needle is inserted into the needle.

  Incidentally, medical images other than ultrasound images, such as X-ray CT (Computed Tomography) images and MRI (Magnetic Resonance Imaging) images, may be clearer than ultrasound images. Therefore, for example, as described in Patent Document 2, in a device that displays a real-time ultrasonic image and displays an X-ray CT image or an MRI image having the same cross section as the ultrasonic image, these X-ray CT images are displayed. In some cases, the entry path of the puncture needle may be specified by adjusting the position and angle of the ultrasonic probe while confirming the puncture avoidance target using the MRI image.

JP 2009-160013 A JP 2002-112998 A

  However, since it is necessary to change the position and angle of the ultrasonic probe over and over on the body surface before finding the cross section where the puncture avoidance target does not exist on the puncture line, it is very complicated. Met.

  The first aspect of the invention made to solve the above-described problem is that an ultrasound image or a medical image other than an ultrasound image has an input unit for performing an input indicating a puncture target, and a puncture that is a punctureable part A medical image apparatus comprising: a puncturable portion setting unit that searches and sets a possible portion from the puncture target instructed by the input unit toward the body surface side.

  The invention of the second aspect is characterized in that, in the invention of the first aspect, the puncturable portion setting unit searches for the puncturable portion based on the ultrasonic image data or the medical image data. A medical image apparatus.

  According to a third aspect of the present invention, in the first or second aspect of the invention, the puncturable portion setting unit converts the puncture avoidance target to be prevented from passing through the puncture needle into the ultrasonic image data or the medical image data. The medical image device is characterized in that the punctureable portion is searched based on the identification.

  According to a fourth aspect of the present invention, in the third aspect of the invention, the puncturable portion setting unit assumes a straight line from the puncture target toward the body surface and does not pass through the puncture avoidance target or the straight line In the medical image device, a region formed by a set is set as the puncturable portion.

  The invention of the fifth aspect is the invention of any one of the first to fourth aspects, showing the distance between the ultrasonic probe that performs scanning with ultrasonic waves, and the puncturable portion and the scanning surface by the ultrasonic probe. And a distance mark display control unit for displaying a distance mark.

  A sixth aspect of the invention is the third aspect of the invention of the fifth aspect, wherein a position sensor for detecting the position of the ultrasonic probe and a tertiary that has a predetermined point as the origin based on position detection information of the position sensor. A position calculation unit that calculates a position of echo data in a coordinate system of the original space, and the distance mark display control unit includes the position of the echo data calculated by the position calculation unit and the position of the puncturable portion. The medical image apparatus is characterized in that the distance mark is displayed on the basis thereof.

  A seventh aspect of the invention is the medical image according to the fifth or sixth aspect of the invention, wherein the distance mark indicates a distance between at least two points in the puncturable portion and the scan surface. Device.

  An eighth aspect of the invention is the medical image device according to any one of the first to seventh aspects, wherein the puncture target is a lesioned part in a subject.

  According to the invention of the above aspect, since the puncture possible portion from the puncture target indicated in the ultrasonic image or the medical image to the body surface side is searched and set, the entry path of the puncture needle can be easily determined. Can do. In addition, the search for the puncturable portion is performed from the puncture target, which is the target for puncturing the puncture needle, toward the body surface, so that the puncturable portion can be found relatively easily.

  Further, according to the invention of the above other aspect, since the distance mark indicating the distance between the puncturable portion and the scan surface is displayed, the current distance between the scan surface and the puncturable portion can be known. The position and angle of the ultrasonic probe can be easily adjusted so that the scan surface includes the puncturable portion.

  Further, according to another aspect of the invention, the distance mark indicates a distance between at least two points in the puncturable portion and the scan plane, so that the scan plane can be punctured in any direction It is possible to easily grasp the approach to the part.

It is a block diagram which shows an example of schematic structure of the ultrasonic diagnosing device in embodiment of this invention. It is a block diagram which shows the structure of the display control part in the ultrasonic diagnosing device shown in FIG. It is a flowchart which shows the effect | action at the time of determining a puncture position. It is a figure which shows an example of the display part on which the MRI image of the cross section of a lesioned part was displayed. It is a figure which shows an example of the display part on which the lesion part instruction | indication marker was displayed. It is a conceptual diagram of the search of the puncturable part in 3D data of an MRI image. It is a flowchart which shows an effect | action until it starts puncture by positioning an ultrasonic probe so that a scan surface may contain a puncture possible part. It is a figure which shows an example of the display part on which the B mode image and the MRI image were displayed in parallel. It is a figure which shows an example of the display part on which the puncture guide display was displayed. It is a conceptual diagram which shows a puncture possible part and a scanning surface. It is a figure which shows an example of the display part by which the B mode image and MRI image of the cross section which contain a lesion part but do not contain all the puncture possible parts are displayed. It is a figure which shows an example of the display part on which the B mode image and MRI image of the cross section containing a puncture possible part were displayed. In a 1st modification, it is a key map showing a predetermined reference plane containing a puncture part. In a 2nd modification, it is a conceptual diagram which shows the puncture possible part which consists of a conical area | region. In a 2nd modification, it is a figure which shows an example of the display part in case a scan surface has passed the punctureable part which consists of a conical area | region.

  Hereinafter, embodiments of the present invention will be described in detail with reference to FIGS. 1 includes an ultrasonic probe 2, a transmission / reception unit 3, an echo data processing unit 4, a display control unit 5, a display unit 6, an operation unit 7, a control unit 8, an HDD (Hard Disk Drive: hard disk). Drive) 9, a magnetic generator 10 and a magnetic sensor 11. The ultrasonic diagnostic apparatus 1 is an example of an embodiment of a medical image apparatus according to the present invention.

  The ultrasonic probe 2 includes a plurality of ultrasonic transducers (not shown) arranged in an array, and transmits ultrasonic waves to the subject through the ultrasonic transducers, and echo signals thereof. Receive. The ultrasonic probe 2 is an example of an embodiment of an ultrasonic probe in the present invention.

  The ultrasonic probe 2 is provided with the magnetic sensor 11 composed of, for example, a Hall element. The magnetic sensor 11 detects magnetism generated from the magnetism generating unit 10 composed of, for example, a magnetism generating coil. A detection signal in the magnetic sensor 11 is input to the display control unit 5. The detection signal in the magnetic sensor 11 may be input to the display control unit 5 via a cable (not shown), or may be input to the display control unit 5 wirelessly. The magnetism generator 10 and the magnetic sensor 11 are for detecting the position and inclination of the ultrasonic probe 2 as will be described later, and are an example of an embodiment of the position sensor in the present invention.

  The transmission / reception unit 3 drives the ultrasonic probe 2 under a predetermined transmission condition, and scans a scan surface in an acoustic ray sequence with an ultrasonic beam. The transmission / reception unit 3 drives the ultrasonic probe 2 according to a control signal from the control unit 8.

  In addition, the transmission / reception unit 3 performs signal processing such as phasing addition processing on the echo signal obtained by the ultrasonic probe 2 and outputs the echo data after the signal processing to the echo data processing unit 4.

  The echo data processing unit 4 performs predetermined processing such as logarithmic compression processing and envelope detection processing on the echo data output from the transmission / reception unit 3 to create B-mode data.

  As shown in FIG. 2, the display control unit 5 includes a position calculation unit 51, a memory 52, a display image control unit 53, a puncturable portion setting unit 54, and a puncture guide display control unit 55. Based on the magnetic detection signal from the magnetic sensor 11, the position calculation unit 51 is configured to obtain information on the position and inclination of the ultrasonic probe 2 in a coordinate system in a three-dimensional space with the magnetic generation unit 10 as an origin (hereinafter, referred to as the following). (Referred to as “probe position information”). Further, the position calculation unit 51 calculates position information of echo data in the coordinate system of the three-dimensional space based on the probe position information. The position calculation unit 51 calculates position information for each pixel. The position calculation unit 51 is an example of an embodiment of the position calculation unit in the present invention.

  The memory 52 is composed of, for example, a semiconductor memory (Memory) such as a RAM (Random Access Memory) and a ROM (Read Only Memory). The memory 52 stores, for example, B-mode data output from the echo data processing unit 4 and converted into B-mode image data by the display image control unit 53 as will be described later. The data before being converted into the B-mode image data is referred to as raw data. Raw data may be stored in the HDD 9.

  The memory 52 or the HDD 9 stores medical image data acquired by a medical image apparatus other than the ultrasonic diagnostic apparatus 1 as described later.

  The display image control unit 53 scan-converts the B-mode data processed by the echo data processing unit 4 into B-mode image data by a scan converter, and converts the B-mode image based on the B-mode image data. It is displayed on the display unit 6. A B-mode image is an example of an embodiment of an ultrasonic image in the present invention. Further, the display image control unit 53 causes the display unit 6 to display a medical image based on the medical image data. In this example, the medical image is an MRI image as will be described later.

  The display image control unit 53 includes a coordinate system in a three-dimensional space with the magnetic generation unit 10 as an origin, that is, a coordinate system of a B-mode image, and a coordinate system of an MRI image that is a medical image other than an ultrasound image. The B-mode image and the MRI image for the same cross section are displayed on the display unit 6. In this example, as will be described later, the B-mode image and the MRI image are displayed side by side on the display unit 6.

  The puncturable portion setting unit 54 searches and sets a puncturable portion, which is a portion that can be punctured with a puncture needle, from the puncture target toward the body surface side as will be described later. The puncturable part setting unit 54 is an example of an embodiment of the puncturable part setting unit in the present invention.

  The puncture guide display control unit 55 displays the puncture guide display Gu on the B mode image and the MRI image displayed on the display unit 6 as will be described later. The puncture guide display Gu includes a puncture line nl indicating a puncture route and a distance mark dm indicating a distance between the puncturable portion and the scan surface by the ultrasonic probe 2 (see FIG. 9). Details will be described later. The distance mark dm is an example of an embodiment of a distance mark in the present invention. The puncture guide display control unit 55 is an example of an embodiment of a distance mark display control unit in the present invention.

  The display unit 6 includes an LCD (Liquid Crystal Display), a CRT (Cathode Ray Tube), or the like. The operation unit 7 includes a keyboard and a pointing device (not shown) for an operator to input instructions and information. In the operation unit 7, for example, the operator performs input for instructing the puncture target as will be described later. The operation unit 7 is an example of an embodiment of an input unit in the present invention.

  The control unit 8 includes a CPU (Central Processing Unit). The control unit 8 reads a control program stored in the HDD 9 and executes functions in each unit of the ultrasonic diagnostic apparatus 1.

  Now, puncturing using the ultrasonic diagnostic apparatus 1 of this example will be described. The puncture target is, for example, a liver lesion. In performing puncture, first, a puncturable portion of the subject is set. The setting of the puncturable portion will be specifically described based on the flowchart of FIG. In step S <b> 1 of FIG. 3, the medical image data other than the ultrasonic image acquired in advance in the medical image apparatus other than the ultrasonic diagnostic apparatus 1 is stored in the HDD 9. Here, it is assumed that 3D data of an MRI image acquired in advance by an MRI apparatus (not shown) is stored as the medical image. In this example, the 3D data of the MRI image is 3D data of an MRI image obtained by extracting a puncture avoidance target, which will be described later, and 3D data of an MRI image including a tissue other than the puncture avoidance target.

  Next, in step S2, as shown in FIG. 4, the operator is an MRI image MG based on the data of the MRI image stored in the HDD 9, and the MRI image MG of the cross section of the lesion X as the puncture target. Is displayed on the display unit 6. The MRI image MG displayed at this time is an MRI image including tissues other than the puncture avoidance target. Incidentally, at the time of puncturing, a puncture needle is inserted with the lesion X as a target. That is, the lesion X is a puncture target.

  Next, in step S3, the operator operates the operation unit 7 to display a lesion site indication marker M for indicating the lesion site X at the position of the lesion site X in the MRI image MG as shown in FIG. . In this example, the lesion portion instruction marker M is displayed with a cross.

  When the lesion portion indicating marker M is displayed at the position of the lesion portion X in step S3, the puncturable portion setting unit 54 searches for a puncturable portion from the lesion portion X toward the body surface side in step S4. To set. Specifically, as shown in FIG. 6, the puncturable portion setting unit 54 assumes a straight line l from the lesion X to the body surface side in the 3D data Da of the MRI image, and the puncture needle is placed on the straight line l. It is determined whether there is a puncture avoidance target that should be avoided. The puncture avoidance target is specified based on the 3D data Da of the MRI image. Therefore, the 3D data of the MRI image used for searching for the puncturable portion is 3D data of the MRI image obtained by extracting the puncture avoidance target. The puncture avoidance target is, for example, a blood vessel, and 3D data of the MRI image from which the blood vessel is extracted is used as the 3D data of the MRI image from which the puncture avoidance target is extracted.

  If there is no puncture avoidance target on the straight line l, the straight line is set as a puncturable portion. The puncturable portion setting unit 54 determines whether or not there is a puncture avoidance target, assuming a straight line l radially from the lesion X at a predetermined angle. The straight line l may be assumed radially in a three-dimensional space instead of being assumed radially only in one plane.

  When there are a plurality of straight lines l where there is no puncture avoidance target, for example, the straight line l having the shortest distance from the lesion X to the body surface may be set as the puncturable portion, or any plurality of straight lines l may be punctured It may be set as a possible part.

  When the puncturable portion is set by the puncturable portion setting unit 54, the position coordinates of the puncturable portion in the 3D data of the MRI image are stored in the memory 52.

  When the puncturable portion is set as described above, the puncture is started after the ultrasonic probe 2 is positioned so that the scan surface of the ultrasonic probe 2 includes the puncturable portion. This will be specifically described based on the flowchart of FIG.

  First, in step S11, as shown in FIG. 8, the ultrasonic probe 2 scans the ultrasonic wave, and the display image control unit 53 displays the real-time B-mode image BG based on the obtained echo signal on the display unit 6. Display. Further, the display image control unit 53 displays the MRI image MG on the display unit 6 in parallel with the B-mode image BG. This MRI image MG is an MRI image including tissues other than the puncture avoidance target.

  Next, in step S12, alignment processing between the coordinate system of the B-mode image BG and the coordinate system of the MRI image MG is performed. Specifically, the operator moves the cross-section of one or both images while comparing the B-mode image BG displayed on the display unit 6 and the MRI image MG, and the B-mode image having the same cross-section. BG and MRI image MG are displayed. The cross section of the B-mode image BG is moved by changing the position of the ultrasonic probe 2. The cross section of the MRI image MG is moved by inputting an instruction to change the cross section by operating the operation unit 7.

  Whether the cross sections are the same or not is determined, for example, by referring to a characteristic part by the operator. Incidentally, it is assumed that the ultrasonic scanning surface of the ultrasonic probe 2 is parallel to the slice surface of the MRI image MG.

  When the B-mode image BG and the MRI image MG for the same cross section are displayed, the operator inputs an instruction indicating that the same cross section has been displayed. Thereby, coordinate conversion between the coordinate system of the B-mode image BG and the coordinate system of the MRI image MG becomes possible, and the alignment process is completed. After this alignment processing, the display image control unit 53 displays the MRI image MG having the same cross section as the B mode image BG so as to follow the B mode image BG displayed in real time.

  Next, in step S13, as shown in FIG. 9, the puncture guide display control unit 55 displays the puncture guide display Gu composed of the puncture line nl and the distance mark dm on the B-mode image BG and the MRI image MG.

  Two distance marks dm are displayed on the puncture line nl. As shown in FIG. 10, the distance mark dm has an area corresponding to the distances d1 and d2 between the two points P1 and P2 and the scan plane S in the puncturable portion N. It consists of figures that have. In this example, as the distance mark dm, when the distance is not zero, a square having an area corresponding to the distance is displayed, and when the distance is zero, a graphic “+” is displayed ( (See FIGS. 11 and 12).

  Incidentally, the position of the point P2 is the position of the lesion X.

  The puncture guide display control unit 55 displays the puncture line nl based on the position coordinates of the puncturable portion stored in the memory 52. Specifically, in the MRI image MG, when the MRI image MG that is not a cross section including the puncturable portion is displayed, the puncturable portion of the position coordinates stored in the memory 52 is displayed on the displayed cross section. Is projected to display the puncture line nl. Further, when the MRI image MG of the cross section including the puncturable portion is displayed, the puncture line nl is displayed on the puncturable portion.

  On the other hand, in the B mode image BG, when a B mode image BG that is not the same cross section as the cross section including the puncturable portion is displayed, the coordinates at which the puncturable portion is projected on the cross section of the displayed MRI image are The puncture line nl is displayed at coordinates obtained by coordinate conversion to the coordinate system of the B-mode image. Further, when the B-mode image BG having the same cross section as the cross-section including the puncturable portion is displayed, the coordinates of the puncturable portion in the MRI image MG are converted into coordinates obtained by coordinate conversion into the coordinate system of the B-mode image. The puncture line nl is displayed.

  Incidentally, when a plurality of puncturable portions are set, a plurality of puncture lines nl corresponding to these puncturable portions may be displayed. In this case, the distance mark dm is displayed for each puncture line nl. However, the number of puncture lines nl to be displayed is such that the puncture line nl and the distance mark dm, the B-mode image BG, and the MRI image MG are not easily seen.

  One end of the puncture line nl opposite to the body surface is the position of the lesion or the position where the lesion is projected. One of the distance marks dm is displayed at one end of the puncture line nl. Further, another of the distance marks dm is displayed around an arbitrary point on the puncture line nl. In this example, the distance mark dm is displayed at the positions of the points P1 and P2 in the puncturable portion or at the positions where these points P1 and P2 are projected.

  When the position information of the echo data calculated by the position calculation unit 51, that is, the position information of the scan plane is converted into the position information in the coordinate system of the MRI image, the puncture guide display control unit 55 coordinates the coordinates of the MRI image. Using the position information of the scan plane in the system and the position information of the puncturable portion, the distance between the scan plane and the points P1, P2 on the puncturable portion N is calculated, and the distance mark dm is displayed.

  Next, in step S14, the scanning surface of the ultrasonic probe 2 is adjusted to a cross section including a puncturable portion. In the state where the distance mark dm is “+”, the scanning surface by the ultrasonic probe 2 passes through the points P1 and P2 in the puncturable portion N shown in FIG. The cross section includes N. Therefore, the operator adjusts the position and angle of the ultrasonic probe 2 so that the distance mark dm becomes “+”, thereby matching the scan surface of the ultrasonic probe 2 with the cross section including the puncturable portion.

  For example, as shown in FIG. 11, when the B-mode image BG and the MRI image MG of a cross section that includes the lesion X but does not include all the puncturable portions are displayed, one of the distance marks dm becomes “+”. Become. In this state, in order to set the other distance mark dm made of a square to “+”, the angle of the ultrasonic probe 2 is adjusted by an amount corresponding to the area of the square. Thus, since the distance mark dm is displayed in an area corresponding to the distance, the position and angle of the ultrasonic probe 2 can be easily adjusted.

  When the operator confirms that both of the distance marks dm are “+” as shown in FIG. 12, the operator inserts the puncture needle in step S15. The puncture needle can be inserted into the scan surface by being attached to an attachment (not shown) attached to the ultrasonic probe 2 and inserted.

  Incidentally, the puncture needle may be inserted along the puncture line nl that coincides with the puncturable portion set by the puncturable portion setting unit 54 in the state of FIG. 12, but is not limited thereto. Absent. For example, with reference to the puncture line nl, the operator finds a portion where the puncture needle can be inserted without passing through the puncture avoidance target from the lesion to the body surface, and the puncture needle is inserted into this portion. Good. In this case, a straight line may be displayed on the path of the puncture needle that the operator has found.

  According to the ultrasonic diagnostic apparatus 1 of the present example described above, in step S3, a punctureable portion is searched assuming a straight line 1 from the lesion X instructed in the MRI image MG toward the body surface. Therefore, the entry path of the puncture needle can be easily determined. Moreover, the search for the puncturable portion is performed from the lesion X toward the body surface, so that the puncturable portion can be found relatively easily.

  Further, since the distance mark dm is displayed, it is possible to know the distance between the scan surface and the puncturable portion, so that the position and angle of the ultrasonic probe 2 are adjusted so that the scan surface includes the puncturable portion. Can be easily adjusted. Therefore, it is possible to easily identify the cross section through which the puncture needle is inserted. In addition, since the distance mark dm is displayed at two locations, it is possible to easily grasp in which direction the scan plane is inclined to approach the puncturable portion.

  According to the ultrasonic diagnostic apparatus 1 of this example, the puncturable part can be easily found as described above, and the distance mark dm guides the cross section including the puncturable part. Therefore, the conventional complexity can be eliminated.

  Next, a modification of the above embodiment will be described. First, the first modification will be described. As shown in FIG. 13, the distance mark is determined depending on which side the scanning surface by the ultrasonic probe 2 is located with respect to a predetermined reference surface SS including the puncturable portion N. You may make it change the color of dm. Thereby, when the scanning surface is adjusted to the cross section including the puncturable portion, it is possible to easily grasp which direction the ultrasonic probe 2 should be moved.

  Next, a second modification will be described. The puncturable portion may be a two-dimensional or three-dimensional region. Specifically, in step S3 described above, in the 3D data of the MRI image, a straight line l is assumed from the lesion X to the body surface side, and there is a puncture avoidance target on this straight line l that should avoid the passage of the puncture needle. Whether or not there is no puncture avoidance target is determined as a puncturable portion.

  In the second modified example, when the scan surface is not included in the puncturable portion, only the distance marker dm may be displayed as the puncture guide display Gu. When the scan surface is included in the puncturable portion, a display showing a cross section of the puncturable portion on the scan surface may be displayed on the B-mode image BG and the MRI image MG. For example, as shown in FIG. 14, when the puncturable portion N ′ is a conical region having the lesion X as a vertex, in the state where the scan surface passes through the conical region, as shown in FIG. The display r indicating the cross section of the conical region may be displayed on the B-mode image BG and the MRI image MG.

  As mentioned above, although this invention was demonstrated by the said embodiment, of course, this invention can be variously implemented in the range which does not change the main point. For example, in the above embodiment, the search for the puncturable portion is performed in the data of the MRI image, and the MRI image is displayed together with the real-time ultrasonic image. However, if the medical image is other than the ultrasonic image, the MRI is displayed. For example, an X-ray CT image may be used instead of the MRI image. Alternatively, in the ultrasonic image data acquired in advance, a puncture possible portion may be searched, and the ultrasonic image acquired in advance may be displayed together with the real-time ultrasonic image for puncturing.

  Further, the setting of the puncturable portion may be performed not by an ultrasonic diagnostic apparatus but by a medical image apparatus other than an ultrasonic diagnostic apparatus such as an MRI apparatus or an X-ray CT apparatus.

  Furthermore, the puncture avoidance target may include a bone or an organ other than the organ that performs puncture.

1 Ultrasonic diagnostic equipment (medical imaging equipment)
2 Ultrasonic probe 7 Operation part (input part)
10 Magnetic generator (position sensor)
11 Magnetic sensor (position sensor)
51 Position Calculation Unit 54 Puncturable Part Setting Unit 55 Puncture Guide Display Control Unit (Distance Mark Display Control Unit)
UG B-mode image (ultrasonic image)
MG MRI image (medical image)
dm Distance mark l Straight line N Punctable part X Lesion

Claims (8)

An input unit for performing an instruction to instruct a puncture target in an ultrasonic image or a medical image other than an ultrasonic image;
A puncturable part setting unit that searches and sets a puncturable part that is a puncturable part from the puncture target instructed in the input unit toward the body surface side, and
A medical image apparatus comprising:   The medical image apparatus according to claim 1, wherein the puncturable portion setting unit searches for the puncturable portion based on the data of the ultrasonic image or the data of the medical image.   The puncturable portion setting unit searches for the puncturable portion by specifying a puncture avoidance target that should avoid passage of a puncture needle based on the ultrasonic image data or the medical image data. The medical image apparatus according to claim 1 or 2.   The punctureable portion setting unit assumes a straight line from the puncture target to the body surface, and sets a straight line that does not pass through the puncture avoidance target or a region composed of a set of straight lines as the punctureable portion. The medical image apparatus according to claim 3. An ultrasonic probe that performs ultrasonic scanning;
A distance mark display control unit for displaying a distance mark indicating a distance between the puncturable portion and a scanning surface by the ultrasonic probe;
The medical image apparatus according to any one of claims 1 to 4, further comprising: A position sensor for detecting the position of the ultrasonic probe;
A position calculation unit that calculates a position of echo data in a coordinate system of a three-dimensional space having a predetermined point as an origin based on position detection information of the position sensor;
The distance mark display control unit displays the distance mark based on the position of the echo data calculated by the position calculation unit and the position of the puncturable part. Medical imaging device.   The medical image apparatus according to claim 5 or 6, wherein the distance mark indicates a distance between at least two points in the puncturable portion and the scan plane.   The medical image apparatus according to any one of claims 1 to 7, wherein the puncture target is a lesion in a subject.

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