JP2013146381A - X-ray ct apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray CT apparatus capable of providing an optimal tomographic image to simply and reliably securing a route for reaching an object in order to be treated while avoiding other organs.SOLUTION: An X-ray CT apparatus includes: a bed device 2 on which an object H lies down; a rack 3 for obtaining internal information of the object H by moving the bed device 2 including a top plate 2a to which the object H directly contacts and inserting the top plate 2a to the tunnel-like inside thereof to photograph the object H positioned in the inner part; and a control part 4 for controlling driving of the bed device 2 and the rack 3. The control part 4 includes an image generation part 4m generating medical images for each of a plurality of angles, obtained when the object H is photographed at a position where the rack 3 is inclined based on the obtained inner information, and a display part 4g for displaying the medical images generated at the image generation part 4m side by side for each of the angles of the rack 3.

Description

  Embodiments described herein relate generally to an X-ray CT apparatus.

  2. Description of the Related Art In recent years, medical image diagnostic apparatuses that collect information inside a subject and generate a medical image by imaging the inside of the subject based on the collected information have been used. An example of this medical image diagnostic apparatus is an X-ray CT apparatus (computed tomography).

  This X-ray CT apparatus has a display called CT fluoroscopy that reconstructs a tomographic image of the subject based on the obtained internal information (volume data) and displays it in real time in parallel with the collection of the internal information of the subject. it can. When the CT fluoroscopy is performed, the cross section perpendicular to the body axis of the subject is often displayed by, for example, three tomographic images because of the configuration of the X-ray CT apparatus. However, in this method, for example, when puncturing is performed, it may be difficult to grasp the state of insertion of the needle into the subject.

  For this inconvenience, in Patent Document 1 below, although it is a cross section perpendicular to the body axis with respect to the subject, 360 ° around the subject, for example, 0 °, 90 °, 180 °, 270 °, etc. The above inconvenience is dealt with by photographing from four directions.

JP 2006-141709 A

  However, in the invention disclosed in Patent Document 1, there are cases where the following cases cannot be handled.

  That is, there is no problem when it is possible to perform puncture sufficiently with a tomographic image perpendicular to the body axis of the displayed subject. However, for example, when puncturing is performed based on the tomographic image, there is a risk that the puncture may contact or penetrate other organs before reaching the treatment target on the path of the inserted needle. The tomogram that has been used cannot be used.

  On the other hand, it is possible to secure a route to reach the treatment target without touching any organ by generating a cross-section with a slight angle rather than a cross-section perpendicular to the body axis and displaying it as a medical image In some cases, it can be considered.

  However, even in this case, it is troublesome and time-consuming to shoot many times for each angle to determine which angle is appropriate for puncturing. This method cannot be used from the viewpoint of exposure.

  The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to obtain an optimal tomographic image for easily and surely securing a route to reach a treatment target while avoiding other organs. An object of the present invention is to provide an X-ray CT apparatus that can be provided.

  According to the first aspect of the present invention, in the X-ray CT apparatus, the bed apparatus on which the subject lies down, and the couch apparatus moves the top plate directly in contact with the object and inserts the inside into the tunnel shape, A gantry that acquires internal information of the subject by imaging a subject that is positioned, and a control device that controls the driving of the couch device and the gantry, and the control device uses the gantry based on the acquired internal information. An image generation unit that generates a medical image obtained when a subject is imaged at an inclined position for each of a plurality of angles, and a medical image generated by the image generation unit are displayed side by side for each angle of the gantry. A display unit.

1 is an overall view showing an overall configuration of an X-ray CT apparatus in an embodiment of the present invention. It is a block diagram which shows the internal structure of the control apparatus of the X-ray CT apparatus in embodiment of this invention. It is a flowchart which shows the flow from the production | generation of a tomogram to display in embodiment of this invention. It is an example of a screen which shows an example of the display of the tomographic image produced | generated in embodiment of this invention. It is an example of a screen which shows an example of the display of the tomographic image produced | generated in embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

  FIG. 1 is an overall view showing an overall configuration of an X-ray CT apparatus 1 according to an embodiment of the present invention. The X-ray CT apparatus 1 includes a bed apparatus 2 including a top plate 2 a on which a subject H is placed, a gantry 3, and a control apparatus 4 that controls the X-ray CT apparatus 1.

  In the embodiment of the present invention, the control of the X-ray CT apparatus 1 is based on a signal from the control device 4 on the assumption that the control device 4 is provided as, for example, the console shown in FIG. Will be described as being performed. However, the function of the control device may be provided in the gantry 3 and the control device of the gantry 3 may control the entire X-ray CT apparatus 1.

  The bed apparatus 2 includes a top board 2a, a bed 2b that supports the top board 2a, and a base 2c that supports the top board 2a and the bed 2b. When acquiring the internal information of the subject H using the X-ray CT apparatus 1, that is, when imaging, the subject H is in direct contact with the top 2a. When the subject H is in direct contact with the top board 2a, a posture other than lying down may be taken. The cross-sectional shape of the top plate 2a in the minor axis direction may be a horizontal shape or a shape curved toward the subject H lying on the side. Furthermore, in order to image the subject H lying down in the gantry 3, it is possible to advance and retreat in both directions (horizontal direction) indicated by an arrow A shown in FIG. 1.

  The bed 2b supports the top board 2a. Various devices such as a driving device when the top plate 2a moves in the direction of arrow A and an encoder that measures the inclination of the top plate 2a accompanying the movement of the top plate 2a are provided inside the bed 2b. Results measured by these various devices are transmitted to the control device 4. In addition, when the top plate 2a moves in the direction of arrow A, particularly when the top plate 2a moves toward the gantry 3, the bed 2b does not move, so the support position of the top plate 2a by the bed 2b is At the start of movement, the entire subject H moves along with the movement, such as the chest, trunk, legs, trunk, legs and legs.

The base 2c supports the top board 2a and the bed 2b. The base 2c is movable in the vertical direction, that is, in the direction of arrow B shown in FIG. 1 (vertical direction), and adjusts the height of the subject H and the top 2a entering the gantry 3. Can do. Further, the base 2c does not move like the bed 2b.

  In the case of an X-ray CT apparatus, for example, the gantry 3 irradiates the subject H with X-rays. Therefore, a tunnel-shaped opening 3 a is provided in the center of the gantry 3 in order to allow the subject H (top plate 2 a) to enter and leave. An X-ray irradiation unit (for example, an X-ray tube) and a light receiving unit (for example, an X-ray detector) (not shown) are housed in the gantry 3 to form a rotation unit, and rotate around the subject H. Shoot with. Along with the progress of imaging on the gantry 3, the top 2a on which the subject H is placed also moves in the direction of the arrow A by a necessary amount.

  The position (imaging position) at which the subject H is irradiated with X-rays in the gantry 3 is referred to as an “X-ray path”, for example, and is indicated by a dashed line (reference numeral 3b) in FIG. Further, the gantry 3 includes a tilt mechanism that tilts the rotating unit as indicated by an arrow C in FIG. 1, and can be tilted (tilt) toward the bed apparatus 2 side or the opposite side according to photographing. It is possible.

  A light source 3c is provided in the opening 3a at a position facing the bed apparatus 2 (the body surface of the subject H lying on the top 2a). The light source 3c is for irradiating the body surface of the subject H with light to indicate the position of puncture on the body surface of the subject H. As the light source 3c, for example, a laser is used, and is irradiated from a laser oscillator toward a predetermined position on the body surface of the subject H.

  In the embodiment of the present invention, the control device 4 is configured as a console as shown in FIG. Although the console (control device 4) is shown side by side with the couch device 2 and the gantry 3 in FIG. 1, it may be provided in a separate room from the examination room in which the couch device 2 and the gantry 3 are installed. good. When imaging the subject H, for example, the X-ray CT apparatus 1 (the bed apparatus 2 and the gantry 3) is drive-controlled based on a control signal generated by operating an operation console (control apparatus 4) by a laboratory technician. Is done.

  FIG. 2 is a block diagram showing an internal configuration of the control device 4 of the X-ray CT apparatus 1 in the embodiment of the present invention.

  In the control device 4, a central processing unit (CPU) 4a, a read only memory (ROM) 4b, a random access memory (RAM) 4c, and an input / output interface 4d are connected via a bus 4e. An input unit 4f, a display unit 4g, a communication control unit 4h, a storage unit 4i, a removable disk 4j, and a drive unit control unit 4k are connected to the input / output interface 4d. For example, the bed apparatus 2 and the gantry 3 that are the drive unit 41 of the X-ray CT apparatus 1 are controlled by the drive unit control unit 4k.

  The CPU 4a reads out and executes a boot program for starting the X-ray CT apparatus 1 from the ROM 4b based on an input signal from the input unit 4f, and reads out various operating systems stored in the storage unit 4i. The CPU 4a controls various devices based on input signals from other external devices not shown in FIG. 1 via the input unit 4f and the input / output interface 4d.

  Further, the CPU 4a reads out the program and data stored in the RAM 4c, the storage unit 4i and the like and loads them into the RAM 4c. At the same time, based on the program command read out from the RAM 4c, the drive control processing of each unit and the calculation and processing of data. Etc., and a processing device that realizes a series of processing.

The input unit 4f is configured by an input device such as a keyboard and a dial for an operator (for example, a doctor or a laboratory technician) of the X-ray CT apparatus 1 to input various operations, and an input signal based on the operation of the operator Is transmitted to the CPU 4a via the bus 4e.

  The display unit 4g is, for example, a liquid crystal display as shown in FIG. The display unit 4g receives an output signal from the CPU 4a via the bus 4e, and displays, for example, images necessary for setting various conditions for shooting and image processing, or processing results of the CPU 4a. To do.

  The communication control unit 4h is a means such as a LAN card or a modem, and is a means that enables the X-ray CT apparatus 1 to be connected to a communication network such as the Internet or a LAN. Data transmitted / received to / from the communication network via the communication control unit 4h is transmitted / received as an input signal or an output signal to / from the CPU 4a via the input / output interface 4d and the bus 4e.

  The storage unit 4i is composed of a semiconductor or a magnetic disk, and stores programs and data executed by the CPU 4a.

  The removable disk 4j is an optical disk or a flexible disk, and signals read / written by the disk drive are transmitted / received to / from the CPU 4a via the input / output interface 4d and the bus 4e.

  The image generation unit 4m generates a medical image based on the volume data obtained by imaging the subject H. The generated medical image (fluoroscopic image) is displayed on the display unit 4g when CT fluoroscopy is performed. In the following embodiment, the description will be made on the assumption that the image generation unit 4m and the display unit 4g are included in the control device 4. For example, the image generation unit 4m and the display unit 4g are provided on the gantry 3. It is also possible to adopt a configuration that is used.

  Next, the flow from the photographing to the puncture based on the medical image displayed will be described based on the flowchart shown in FIG. It should be noted that the scene to which the embodiment of the present invention is applied is that when a puncture is performed on the subject H, the needle is placed inside the subject H before the actual procedure is performed, that is, when the puncture is performed. It is until just before the puncture is actually started to determine how to reach a certain treatment target.

  First, the top 2 a on which the subject H lies is inserted into the opening 3 a of the gantry 3. The position at which the top 2a is inserted into the opening 3a is a position where the treatment target can be imaged on the assumption that the position of the treatment target is roughly known in advance. Is a position overlapping with the X-ray path 3b.

  When the bed apparatus 2 (top plate 2a) reaches a predetermined position, the subject H is scanned in the gantry 3 based on an instruction from the control apparatus 4 to obtain volume data (ST1). In this case, as a general rule, during imaging, the top 2a does not move in the direction of arrow A and the gantry 3 does not move in the direction of arrow C, and the subject H is irradiated with X-rays in a direction perpendicular to the body axis. .

  Volume data, which is internal information of the subject H acquired by imaging, is generated as a medical image in the image generation unit 4m. As described above, since the gantry 3 is imaged without moving in the direction of arrow C (tilt angle 0 °), the medical image generated based on the volume data obtained by imaging is basically the subject. A tomographic image is shown in a direction perpendicular to the body axis of H. The generated medical image is displayed as a tomographic image on the display unit 4g (ST2).

Here, the number of medical images displayed on the display unit 4g differs depending on scanning conditions (for example, the width in the slice direction, the slice thickness, and the detection element array). In addition, as described above, since the photographing is performed in advance in accordance with the position where the treatment target exists, the treatment target is displayed in any of the displayed medical images.

  Therefore, the operator of the control device 4 selects a medical image on which a treatment target (represented as “tumor” in the flowchart shown in FIG. 3) is displayed. That is, a treatment target is specified. Specifically, for example, a medical image that is considered appropriate for specifying the puncture route is selected from the medical images displayed on the display unit 4g. Using this, the control device 4 is instructed to select (ST3).

  For the selection, for example, an appropriate medical image may be clicked using an input device such as a mouse, or the display unit 4g adopts a touch panel method and constitutes a part of the input unit 4f. In this case, the selection is made by touching the medical image displayed on the display unit 4g.

  After the treatment target is specified by the operator, an instruction to select a medical image on which the treatment target is displayed is transmitted to the image generation unit 4m. When receiving the signal, the image generation unit 4m generates a medical image including a treatment target (tumor) that can be acquired when the image is captured at a preset tilt angle (ST4).

  That is, as described above, when collecting the internal information of the subject H, the gantry 3 does not move in the direction of the arrow C shown in FIG. Therefore, the volume data obtained is also internal information in a state where the tilt angle is 0 °.

  However, even if a tomographic image perpendicular to the body axis of the subject H is generated and displayed based on the volume data obtained in this state, is it an appropriate medical image that can be used as a reference when formulating a puncture path? It may not be the case. In this case, if a medical image is generated based on the volume data obtained when the gantry 3 is tilted several times in the direction of the arrow C, it is possible to obtain a tomographic image that is optimal for route planning.

  On the other hand, it is possible to generate a medical image indicating internal information collected with the gantry 3 tilted in the direction of arrow C based on the obtained volume data. Further, as described above, performing imaging in all cases with the tilt angle of the gantry 3 being gradually changed with respect to the subject H cannot be adopted from the viewpoint of exposure to the subject H. .

  Therefore, the image generation unit 4m generates a medical image including a treatment target that should be obtained when the gantry 3 is tilted so as to have a preset tilt angle based on the collected volume data.

  As described above, the gantry 3 can be tilted in the direction of the arrow C shown in FIG. The tiltable angle differs depending on the X-ray CT apparatus. For example, when the X-ray is irradiated perpendicularly to the body axis of the subject H without tilting the gantry 3, the bed apparatus is set to “0 °”. The case of tilting to the second side is represented as “+ (plus)”, and the case of tilting to the opposite side is represented as “− (minus)”, and tilting in both directions is possible.

  FIG. 4 is a screen example showing an example of display of a tomographic image generated in the embodiment of the present invention. The screen example shown in FIG. 4 shows a tomographic image in a state where the gantry 3 is 0 ° based on the volume data collected by the image generation unit 4m. A blackened area is a treatment target. Here, seven tomographic images are shown, and this indicates at which position of the volume data shown in the upper right of the screen the tomographic image.

In this way, the position in the volume data and each tomographic image correspond to each other, but the distance between the tomographic image and the tomographic image is displayed, that is, the pitch of each tomographic image is arbitrarily set. It is possible to set.

  In the first place, the screen example in FIG. 4 or FIG. 5 to be described later is merely an example, and the display content, layout, or the like can be freely set. Accordingly, the medical images to be displayed can be compared at a time by collecting the medical images for each tilt angle and displaying the sheets, tabs, and pages, or by displaying them in a list. It is also conceivable to display them with a tilt angle of 0 ° as a reference, and display these medical images and medical images representing other tilt angles side by side.

  Here, a tomographic image is shown when the tilt angle of the gantry 3 is 0 °, but the tilt angle is shown in increments of 5 ° up to ± 15 ° as shown in the screen example of FIG. By selecting one of the tilt angles, a medical image obtained when the gantry 3 is imaged with each tilt angle being tilted is displayed.

  Although the tilt angle is displayed in increments of 5 ° in FIG. 4, the pitch of the tilt angle displayed as a medical image can be arbitrarily set, for example, in increments of 0.5 ° or in increments of 1 °. Is possible. In addition, when display of a medical image at any tilt angle is selected, a tilt angle to be displayed (generated) in advance in increments of 5 ° up to ± 15 ° including 0 ° may be determined. Alternatively, it may be set such that a medical image at the tilt angle is generated by an operator setting an arbitrary angle. Furthermore, the number of medical images displayed at each tilt angle can be arbitrarily set.

  The operator selects a medical image that seems to be appropriate for specifying the puncture route. In this case, first, the medical image displayed for each tilt angle is confirmed, and then the tilt angle including the medical image to be displayed is selected (ST5). The control device 4 displays a medical image represented at the selected tilt angle on the display unit 4g (ST6), and waits until a medical image that is considered appropriate for puncturing is selected (ST7). If an appropriate medical image is not selected in this state (NO in ST7), the flow of returning to step ST5 and selecting a medical image is repeated.

  In the screen example shown in FIG. 4, a button “specific” is provided at the lower right of the screen. Therefore, for example, the operator selects a medical image that seems to be appropriate, and then clicks the “specific” button to select the medical image.

  If a medical image that is considered appropriate for specifying the puncture route is selected (YES in ST7), for example, a three-section image is displayed on the display unit 4g based on the selected medical image (ST8). ). Here, three medical images are displayed on the display unit 4g, centering on the selected medical image, but it is possible to arbitrarily set how many medical images are to be displayed.

  FIG. 5 is a screen example showing an example of display of a tomographic image generated in the embodiment of the present invention. The screen example shown in FIG. 5 is basically the same as the screen example shown in FIG. However, since the screen example shown in FIG. 5 is a screen example after an appropriate medical image used for specifying the puncture route has already been selected, for example, three medical images are displayed. . In addition, these medical images show the inside of the subject H including the treatment target when the tilt angle of the gantry 3 is taken as “−15 °”.

Further, in the screen example of FIG. 5, an icon indicating which cross section of the volume data is displayed as the medical image to be displayed is shown, and each tomographic image is indicated by a broken line (see the upper right of the screen example). ). As described above, the interval (pitch) between the tomographic images can be arbitrarily deflected. When the pitch is changed, the medical image displayed together is also changed to the corresponding tomographic image.

  With the above-described flow, the operator of the X-ray CT apparatus can specify the puncture route while avoiding the organs that exist from the body surface of the subject H until reaching the treatment target.

  Next, various information such as information about the subject H and information such as imaging conditions are added to the selected and displayed medical images. These pieces of information include information about the tilt angle of the gantry 3 and information about the position of the bed apparatus 2 at the time of shooting. Therefore, the control device 4 moves the gantry 3 and the couch device 2 to a position where the medical image can be captured based on the information added to the selected medical image (ST9). The bed apparatus 2 is moved so that the treatment target displayed on the display unit 4g is displayed in the center.

  Further, a laser beam is emitted from the light source 3c provided on the gantry 3 toward the body surface of the subject H to clearly indicate the puncture position (ST10). By clarifying this position on the body surface of the subject H, a doctor or the like who performs the procedure can easily grasp the position and reduce errors related to the puncture position. And by actually puncturing in this state, it is possible to proceed with treatment more smoothly and definitely.

  As described above, it is possible to provide an X-ray CT apparatus capable of providing an optimal tomographic image in order to easily and surely secure a route for reaching a treatment target while avoiding other organs in advance. . In other words, by generating and displaying a medical image to be displayed at an optimal angle based on the captured medical image, it is troublesome to search for a puncture route by hand-pumping while actually performing a procedure, and in some cases to other organs The danger of touching and penetrating can be eliminated.

  In addition, since each part of the X-ray CT apparatus such as the gantry 3 can be moved to an appropriate position simply by selecting an appropriate medical image, the setting of the X-ray CT apparatus for puncturing is simplified. In addition, the test time can be shortened and the burden on the subject and the operator can be reduced. Furthermore, since the embodiment of the present invention can be basically performed without adding a special configuration to the X-ray CT apparatus, this aspect is also excellent.

  Although an embodiment of the present invention has been described, this embodiment is presented as an example and is not intended to limit the scope of the invention. This embodiment can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. This embodiment and its modifications are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 1 X-ray CT apparatus 2 Bed apparatus 3 Stand 4 Control apparatus 4m Image generation part

Claims (5)

In an X-ray CT apparatus that irradiates a subject with X-rays and generates an image inside the subject based on the obtained X-ray projection data,
A bed apparatus for placing a subject;
A gantry comprising a rotating unit that supports the X-ray tube and the detector and rotates around the subject; and a tilt mechanism that tilts the rotating unit;
A control device for controlling the driving of the bed apparatus and the gantry;
An image generation unit that performs generation of medical images corresponding to a plurality of angles when the subject is imaged at a position where the gantry is tilted based on the acquired internal information;
A display unit that displays the medical images generated by the image generation unit side by side for each angle of the gantry;
An X-ray CT apparatus comprising:   The X-ray CT apparatus according to claim 1, wherein the image generation unit generates a cross-sectional image corresponding to the angle based on volume data captured by the gantry.   The X-ray CT apparatus according to claim 1, wherein the image generation unit generates the medical image so that a treatment target is included in the medical image.   The control device selects the selected medical image based on information included in the selected medical image when a medical image suitable for reference is selected from among the generated medical images. The X-ray CT apparatus according to any one of claims 1 to 3, wherein at least one of the gantry or the bed is moved to a position where a medical image can be acquired. 5. The gantry includes a light source for indicating a puncture position based on a selected medical image on the body surface of the subject at a position facing the bed apparatus. An X-ray CT apparatus according to any one of the above.

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