JP2013162951A - X-ray image diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray image diagnostic apparatus capable of shortening a radioscopic inspection time.SOLUTION: This X-ray image diagnostic apparatus 1 includes: an image-capturing unit 3 for image-capturing a plurality of cross-sectional images on a real-time basis by X-ray irradiation with thickness along a body axis direction of a subject P; an information obtaining unit 4a1 for acquiring three-dimensional relative position information of a target region for puncture and a tip for puncture contained in the plurality of cross-sectional images on a real-time basis; and a display unit 4e for displaying the cross-sectional images and the three-dimensional relative position information on a real-time basis. Accordingly, a radioscopic inspection time can be shortened.

Description

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

  An X-ray diagnostic imaging apparatus detects an X-ray dose transmitted through a subject by irradiating the subject such as a patient, and a cross section of the subject through reconstruction processing on X-ray transmission data based on the X-ray dose. This is an apparatus for obtaining an image (slice image). As this X-ray diagnostic imaging apparatus, for example, an X-ray CT apparatus (X-ray computed tomography) in which an X-ray irradiator and an X-ray detector are arranged to face each other and are rotated around the body axis of the subject. Imaging devices) have been developed.

  This X-ray CT apparatus is used for puncture by CT fluoroscopy in addition to normal examination. Usually, in the X-ray CT apparatus, it is possible to measure the distance and angle between the puncture target part and the puncture tip part (tip part of the puncture needle) on a still image obtained by CT fluoroscopy. For this reason, the surgeon performs puncture by grasping the separation distance and angle between the puncture target portion and the puncture tip portion on the still image. At this time, the puncture tip gradually advances toward the puncture target portion in the subject, but even during this puncture, the operator determines the separation distance and angle between the current puncture tip portion and the puncture target portion. Measurement may be performed to grasp.

JP 2000-102533 A JP 2009-106502 A

  However, as described above, in order to grasp the separation distance and angle between the puncture target portion and the puncture tip portion during the puncture, it is necessary to perform the measurement on the above-described still image after the CT fluoroscopy is interrupted. For this reason, it is necessary to repeat measurement on a still image every time CT fluoroscopy is stopped, which causes a long fluoroscopic examination time.

  The problem to be solved by the present invention is to provide an X-ray image diagnostic apparatus capable of reducing fluoroscopic examination time.

  An X-ray diagnostic imaging apparatus according to an embodiment includes an imaging unit that captures a plurality of cross-sectional images in real time by X-ray irradiation having a thickness in the body axis direction of a subject, and a puncture target unit included in the plurality of cross-sectional images. The information acquisition part which calculates | requires three-dimensional relative position information with a puncture front-end | tip part in real time, and the display part which displays a cross-sectional image and three-dimensional relative position information in real time are provided.

1 is a diagram illustrating a schematic configuration of an X-ray image diagnostic apparatus according to a first embodiment. It is explanatory drawing for demonstrating the production | generation of the three-dimensional relative position information of the puncture object part and puncture tip part which the X-ray image diagnostic apparatus shown in FIG. 1 performs. It is a flowchart which shows the flow of CT fluoroscopy processing which the X-ray image diagnostic apparatus shown in FIG. 1 performs. It is explanatory drawing for demonstrating the display of the fluoroscopic image by CT fluoroscopy process shown in FIG. It is a figure which shows schematic structure of the X-ray-image diagnostic apparatus which concerns on 2nd Embodiment. It is explanatory drawing for demonstrating the display of the warning message for an approach alert | report by the X-ray image diagnostic apparatus shown in FIG. It is a figure which shows schematic structure of the X-ray-image diagnostic apparatus which concerns on 3rd Embodiment. It is explanatory drawing for demonstrating the display of the puncture prediction path | route by the X-ray image diagnostic apparatus shown in FIG. It is explanatory drawing for demonstrating the display of the warning message for avoidance notification by the X-ray-image diagnostic apparatus shown in FIG.

(First embodiment)
A first embodiment will be described with reference to FIGS.

  As shown in FIG. 1, the X-ray diagnostic imaging apparatus 1 according to the first embodiment uses a bed 2 on which a subject P such as a patient is placed, and tomographic imaging of the subject P on the bed 2. An imaging device 3 that performs the above-described operation and a control device 4 that controls the imaging device 3.

  The bed 2 includes a top 2a on which the subject P is placed, and a top drive 2b that supports the top 2a and moves it horizontally and vertically. In the bed 2, the top plate 2 a is moved by the top plate driving unit 2 b, and the subject P on the top plate 2 a is moved in the horizontal direction and the vertical direction.

  The imaging apparatus 3 includes a rotating body 3a that is rotatably provided in a CT gantry serving as a housing, a rotation driving unit 3b that rotates the rotating body 3a, and an X-ray that is provided on the rotating body 3a and emits X-rays. An irradiator 3c, a high voltage generator 3d for supplying a high voltage to the X-ray irradiator 3c, an X-ray detector 3e for detecting X-rays provided on the rotating body 3a, and detection by the X-ray detector 3e And a data collection unit 3f that collects the X-rays as X-ray transmission data. This imaging device 3 functions as an imaging unit.

  The rotating body 3a is an annular rotating frame that supports and rotates the X-ray irradiator 3c, the X-ray detector 3e, and the like. For this reason, the X-ray irradiator 3c and the X-ray detector 3e rotate the periphery of the subject P on the bed 2 around the body axis of the subject P with the subject P on the bed 2 in between.

  The rotation drive unit 3 b is provided in the CT mount of the imaging device 3. The rotation driving unit 3 b performs rotation driving of the rotating body 3 a according to control by the control device 4. For example, the rotation drive unit 3b rotates the rotating body 3a in one direction at a predetermined rotation speed based on the control signal transmitted from the control device 4.

  The X-ray irradiator 3c includes an X-ray tube 3c1 that emits X-rays, and a slit mechanism 3c2 that blocks a part of the X-rays emitted from the X-ray tube 3c1. The X-ray irradiator 3c emits X-rays by an X-ray tube 3c1, shields a part of the X-rays by a slit mechanism 3c2, and has a fan beam shape having a cone angle with respect to the subject P on the bed 2. For example, a pyramid-shaped X-ray is irradiated. This X-ray becomes an X-ray having a thickness in the body axis direction of the subject P.

  The high voltage generator 3 d is provided in the CT mount of the imaging device 3. The high voltage generator 3d is a device that generates a high voltage to be supplied to the X-ray tube 3c1 of the X-ray irradiator 3c. The high voltage generator 3d boosts and rectifies the voltage supplied from the control device 4, and supplies the voltage to the X-ray tube. To 3c1. The control device 4 controls various conditions such as the waveform of the voltage applied to the high voltage generator 3d, that is, the amplitude and the pulse width, in order to generate a desired X-ray by the X-ray tube 3c1.

  The X-ray detector 3e is fixed to the rotating body 3a so as to face the X-ray irradiator 3c. The X-ray detector 3e converts X-rays transmitted through the subject P on the bed 2 into, for example, optical information, converts the optical information into an electrical signal, and transmits the electrical signal to the data collection unit 3f.

  Here, as the X-ray detector 3e, for example, a multi-row multi-channel X-ray detector can be used. This multi-row multi-channel X-ray detector is configured by arranging X-ray detection elements for detecting X-rays in a grid pattern. The channel row is a row in which a plurality of X-ray detection elements are arranged in the channel direction (direction around the body axis of the subject P), and the channel row is plural along the row direction (the body axis direction of the subject P). Arranged in columns. In this way, the X-ray detector 3e is configured to be capable of imaging in which the thickness of the subject P in the body axis direction is several tens to several hundreds mm (for example, 160 mm).

  The data collection unit 3 f is provided in the CT mount of the imaging device 3. The data collection unit 3 f collects the electrical signals transmitted from the X-ray detector 3 e as X-ray transmission data and transmits the X-ray transmission data to the control device 4.

  The control device 4 is operated by a user (user), a control unit 4a that controls each unit, an image processing unit 4b that performs various image processing, a storage unit 4c that stores various data such as X-ray images and various programs, and the like. 4d, and a display unit 4e for displaying an image. These parts 4a to 4e are electrically connected by a bus line 4f.

  The control unit 4a is a control unit that controls driving of each unit such as the top plate driving unit 2b, the rotation driving unit 3b, and the high voltage generating unit 3d based on various programs and various data stored in the storage unit 4c. In addition, the control unit 4a also controls the slit mechanism 3c2 of the X-ray irradiator 3c, and further performs display control for displaying an X-ray image on the display unit 4e. As the control unit 4a, for example, a CPU (Central Processing Unit) or the like can be used.

  The image processing unit 4b is a processing unit that performs image processing such as preprocessing using the X-ray transmission data transmitted from the data collection unit 3f as projection data and image reconstruction processing for performing image reconstruction on the projection data. is there. As this image processing unit 4b, for example, an array processor or the like can be used.

  The storage unit 4c is a storage device that stores various programs, various data, and the like, and stores, for example, cross-sectional images (slice images) that are X-ray images as various data. For example, a ROM (Read Only Memory), a RAM (Random Access Memory), a flash memory, a hard disk, or the like can be used as the storage unit 4c.

  The operation unit 4d is an input unit that receives an input operation by a user, and receives various input operations such as an imaging instruction, image display, image switching, and various settings. For example, an input device such as a keyboard, a mouse, or a lever can be used as the operation unit 4d.

  The display unit 4e is a display device that displays various images such as a cross-sectional image and an operation screen of the subject P. As the display unit 4e, for example, a liquid crystal display, a CRT (CRT) display, or the like can be used.

  In such an X-ray diagnostic imaging apparatus 1, as an imaging mode, a scan mode (for example, a multi-slice scan or a helical scan) that captures a cross-sectional image that is an X-ray image, and a cross-sectional image is captured in real time (real time). There is a fluoroscopy mode for performing CT fluoroscopy.

  In the normal scan mode, the X-ray irradiator 3c and the X-ray detector 3e are rotated around the body axis of the subject P on the top 2a, and the top 2a is moved in the direction of the body axis of the subject P. Then, the X-ray is irradiated by the X-ray irradiator 3c and the X-ray transmitted through the subject P on the top 2a is detected by the X-ray detector 3e, and X-ray transmission data is collected. Thereafter, the X-ray transmission data is processed by the image processing unit 4b to generate a plurality of cross-sectional images, and the generated cross-sectional images are stored in the storage unit 4c.

  On the other hand, in the fluoroscopic mode, the top 2a is moved in the horizontal direction and the vertical direction so that the subject P on the top 2a is positioned and fixed at a predetermined position. The X-ray detector 3e detects X-rays that rotate around the body axis of the subject P on the top plate 2a, irradiate X-rays by the X-ray irradiator 3c, and pass through the subject P on the top plate 2a. X-ray transmission data is collected. Thereafter, the X-ray transmission data is processed by the image processing unit 4b to generate a plurality of cross-sectional images, and the generated cross-sectional images are displayed on the display unit 4e in real time. In this fluoroscopic mode, it is possible to capture a plurality of cross-sectional images in real time (real time) by X-ray irradiation having a thickness in the body axis direction of the subject P.

  Next, the aforementioned control unit 4a will be described in detail.

  As shown in FIG. 1, the control unit 4 a includes an information acquisition unit 4 a 1 that calculates and acquires necessary information from a plurality of cross-sectional images captured by CT fluoroscopy in the fluoroscopic mode. As shown in FIG. 2, the information acquisition unit 4a1 is configured to obtain three-dimensional relative position information (for example, a three-dimensional separation distance) between the puncture target portion A1 and the puncture tip portion A2 included in a plurality of cross-sectional images captured by CT fluoroscopy. And 3D angles) in real time.

  In accordance with CT fluoroscopy, the information acquisition unit 4a1 extracts a linear structure from each cross-sectional image to obtain a puncture part (puncture needle) N1, and specifies the puncture tip part (tip part of the puncture needle) A2. Thereafter, three-dimensional relative position information between the puncture target part A1 and the puncture tip part A2, for example, a three-dimensional separation distance is obtained. This three-dimensional separation distance is calculated from the three-dimensional coordinate position of the puncture target portion A1 and the three-dimensional coordinate position of the puncture tip portion A2. The three-dimensional relative position information is displayed on the display unit 4e together with the cross-sectional image in real time. The puncture target part A1 is set according to the user's input operation to the operation part 4d.

  The information acquisition unit 4a1 may be configured by hardware such as an electric circuit, or may be configured by software such as a program that executes these functions. Moreover, you may comprise by the combination of both hardware and software.

  Next, CT fluoroscopic processing performed by the above-described X-ray image diagnostic apparatus 1 will be described.

  As shown in FIG. 3, a preliminary image in the normal scan mode is captured (step S1), and a puncture target part A1 is set in the preliminary image (step S2). In this step S2, when the user operates the operation unit 4d and marks, for example, a portion to be punctured on the pre-image, that portion is set as the puncture target portion A1. The prior image may be in any form as long as it is an image that can designate a portion to be punctured.

  When step S2 is completed, CT fluoroscopy is performed in the fluoroscopy mode (step S3), and a plurality of cross-sectional images captured by CT fluoroscopy are displayed on the display unit 4e (step S4). For example, as shown in FIG. 4, a cross-sectional image G1 including the puncture target portion A1 is displayed.

  When step S4 is completed, a linear structure is extracted from the plurality of cross-sectional images taken by CT fluoroscopy by the information acquisition unit 4a1, the puncture unit N1 is specified, and the puncture unit N1 is displayed as a line on the display unit 4e (step S5). Further, the information acquisition unit 4a1 acquires the three-dimensional relative position information of the puncture target portion A1 and the puncture tip portion A2, and the three-dimensional relative position information is displayed on the display unit 4e (step S6). For example, as shown in FIG. 4, a line L1 indicating the puncture portion N1, and a three-dimensional separation distance (a numerical value of 150.0 mm in FIG. 4) between the puncture target portion A1 and the puncture tip portion A2 are on the cross-sectional image G1. Is displayed.

  After completion of step S6, it is determined whether or not CT fluoroscopy is complete (step S7). In this step S7, when the user operates the operation unit 4d to instruct the end of CT fluoroscopy, for example, since a flag is set, it is determined whether or not CT fluoroscopy is ended based on the state of the flag.

  If it is determined in step S7 that the CT fluoroscopy has been completed in response to a user input operation on the operation unit 4d (YES in step S7), the process ends. On the other hand, if it is determined that CT fluoroscopy does not end in response to the operator's input operation on the operation unit 4d (NO in step S7), the process returns to step S3, and CT fluoroscopy is repeated (step S3).

  According to such CT fluoroscopic processing, the cross-sectional image G1 is displayed on the display unit 4e in real time. On the cross-sectional image G1, the line L1 indicating the puncture portion N1, and the puncture target portion A1 and the puncture tip portion A2 are displayed. 3D relative position information such as 3D separation distance is displayed in real time. During this display, the puncture tip portion A2 gradually approaches the puncture target portion A1, but the line L1 indicating the puncture portion N1 and the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2 are real time. Is updated and displayed on the cross-sectional image G1. For example, in FIG. 4, a numerical value of 150.0 mm is displayed on the cross-sectional image G1 as the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2, but this value is the puncture tip portion A2 to be punctured It becomes smaller as it gradually approaches part A1.

  Thereby, the operator who performs puncture can perform puncture while confirming the position of the puncture tip portion A2 updated in real time, the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2, and the like. . In this way, the surgeon can accurately and easily grasp the three-dimensional positional relationship between the puncture target portion A1 and the puncture tip portion A2 in real time even during puncture, thus reducing the risk of puncture mistakes. In addition, the inspection efficiency of CT fluoroscopy can be improved.

  As described above, according to the first embodiment, a plurality of cross-sectional images are captured in real time (in real time) by X-ray irradiation having a thickness in the body axis direction of the subject P, and these cross-sectional images are displayed. The three-dimensional relative position information (for example, three-dimensional separation distance) between the included puncture target part A1 and puncture tip part A2 is obtained in real time, and the three-dimensional relative position information is displayed in real time together with the cross-sectional image. As a result, it is possible to obtain and display the three-dimensional relative position information without interrupting CT fluoroscopy, and the CT fluoroscopy inspection efficiency can be improved, so that the fluoroscopy time can be shortened. Reduction can be realized. In addition, since the three-dimensional positional relationship between the puncture target portion A1 and the puncture tip portion A2 can be accurately grasped in real time, the risk of puncture mistakes can be reduced.

(Second Embodiment)
A second embodiment will be described with reference to FIGS.

  The second embodiment is basically the same as the first embodiment. Therefore, in the second embodiment, a different part from the first embodiment will be described, and the description of the same part as the part described in the first embodiment will be omitted.

  As shown in FIG. 5, the control device 4 according to the second embodiment includes a sound in addition to the control unit 4a, the image processing unit 4b, the storage unit 4c, the operation unit 4d, and the display unit 4e according to the first embodiment. Is provided with a sound output unit 4g. These parts 4a to 4e and 4g are electrically connected by a bus line 4f.

  The sound output unit 4g changes the interval and magnitude of the sound according to the three-dimensional relative position information (for example, the three-dimensional separation distance and the three-dimensional angle) between the puncture target unit A1 and the puncture tip portion A2. For example, as the puncture tip portion A2 approaches the puncture target portion A1, and the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2 is shortened, the interval between sounds is shortened or the volume of the sound is increased. To do. For example, a speaker or the like can be used as the sound output unit 4g.

  In addition, the display unit 4e displays the three-dimensional relative position information according to the three-dimensional relative position information (for example, the three-dimensional separation distance and the three-dimensional angle) between the puncture target part A1 and the puncture tip part A2. To change. For example, as the puncture tip portion A2 approaches the puncture target portion A1 and the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2 becomes shorter, the display color is changed from blue to yellow and from yellow to red.

  In addition, the control unit 4a determines whether or not the three-dimensional relative position information between the puncture target portion A1 and the puncture tip portion A2, that is, whether the three-dimensional separation distance is a predetermined value (for example, 5 mm, 10 mm, or the like). A determination unit 4a2 is provided. The predetermined value serving as the threshold value can be changed by a user input operation on the operation unit 4d. When the information determination unit 4a2 determines that the three-dimensional separation distance between the puncture target portion A1 and the puncture tip portion A2 is equal to or less than a predetermined value, a warning message indicating that fact is notified to the user.

  For example, as shown in FIG. 6, a warning message M1 such as “very close to the puncture target part”, that is, an approach notification warning message M1 indicating that the puncture tip part A2 is very close to the puncture target part A1 is displayed. Displayed by the display unit 4e. At this time, the content of the warning message M1 may be notified by voice by the sound output unit 4g. Therefore, either one or both of the display unit 4e and the sound output unit 4g function as a notification unit.

  As described above, according to the second embodiment, the same effect as that of the first embodiment can be obtained. In particular, when the surgeon keeps an eye on the display screen because the interval and the volume of the sound are changed according to the three-dimensional relative position information between the puncture target portion A1 and the puncture tip portion A2 (for example, the subject Even when the puncture location on P or the puncture portion N1 is visually recognized), the three-dimensional positional relationship between the puncture target portion A1 and the puncture tip portion A2 can be grasped, thereby reducing the risk of puncture mistakes. Can be reduced. In addition, the surgeon can easily perform puncture, and the CT fluoroscopic examination efficiency is improved. Therefore, the fluoroscopic examination time can be shortened, and further, the exposure dose can be reduced.

  Further, the display unit 4e changes the display color for displaying the three-dimensional relative position information in accordance with the three-dimensional relative position information of the puncture target part A1 and the puncture tip part A2, so that the operator can change from the display screen. Even when the eyes are away (for example, when the puncture site or the puncture portion N1 on the subject P is visually recognized), the puncture target portion A1 and the puncture tip portion A2 can be separated by returning the eyes to the display screen for a moment. Since the three-dimensional positional relationship can be grasped intuitively, the risk of puncture mistakes can be reduced. In addition, the surgeon can easily perform puncture, and the CT fluoroscopic examination efficiency is improved. Therefore, the fluoroscopic examination time can be shortened, and further, the exposure dose can be reduced.

  Further, when it is determined whether or not the three-dimensional separation distance between the puncture target part A1 and the puncture tip part A2 is a predetermined value or less, and it is determined that the three-dimensional separation distance is a predetermined value or less, A warning message M1 indicating that the part A2 is very close to the puncture target part A1 is notified to the user. Accordingly, the surgeon can grasp that the puncture tip portion A2 is close to the puncture target portion A1 and perform more careful puncture, thereby reducing the risk of puncture mistakes.

(Third embodiment)
A third embodiment will be described with reference to FIGS.

  The third embodiment is basically the same as the first embodiment. Therefore, in 3rd Embodiment, a different part from 1st Embodiment is demonstrated and description of the same part as the part demonstrated in 1st Embodiment is abbreviate | omitted.

  As shown in FIG. 7, the control device 4 according to the third embodiment includes a sound in addition to the control unit 4 a, the image processing unit 4 b, the storage unit 4 c, the operation unit 4 d, and the display unit 4 e according to the first embodiment. Is provided with a sound output unit 4g. For example, a speaker or the like can be used as the sound output unit 4g. These parts 4a to 4e and 4g are electrically connected by a bus line 4f.

  Moreover, as shown in FIG. 8, the display part 4e displays the puncture extension line L2 which is an extension line of the line L1 which shows the puncture part N1 in real time. At this time, for example, the puncture extension line L2 is displayed in color by a two-dot chain line. Thereby, the puncture prediction path is clearly shown on the cross-sectional image G1. The line type of the puncture extension line L2 is not limited to the two-dot chain line, and may be another line type such as a one-dot chain line or a broken line.

  Further, as shown in FIG. 9, the control unit 4a includes an avoidance determination unit 4a3 (see FIG. 7) that determines whether there is an avoidance target portion B1 on the puncture extension line L2. Examples of the avoidance target part B1 include bones and blood vessels. When the avoidance determination unit 4a3 determines that there is an avoidance target part B1 on the puncture extension line L2, a warning message indicating that fact is notified to the user.

  For example, as shown in FIG. 9, a warning message M2 “There is an avoidance target part on the predicted route”, that is, an avoidance notification warning message M2 indicating that the avoidance target part B1 is on the puncture extension line L2. Displayed by the display unit 4e. At this time, the content of the warning message M2 may be notified by voice by the sound output unit 4g. Therefore, either one or both of the display unit 4e and the sound output unit 4g function as a notification unit.

  As the warning message M2, the avoidance target part B1 may be indicated by a specific name such as “there is a bone on the predicted path” or “there is a blood vessel on the predicted path”. In this case, the type of the avoidance target portion B1 is specified from each cross-sectional image, and one warning message is selected and displayed from a plurality of warning messages according to this specification.

  As described above, according to the third embodiment, the same effect as that of the first embodiment can be obtained. In particular, since the puncture extension line L2 extending from the puncture tip A2 is displayed in real time, the puncture prediction path is clearly indicated on the cross-sectional image G1. This makes it easier for the operator to perform puncture and enables accurate puncture, thereby reducing the risk of puncture mistakes. Moreover, since the inspection efficiency of CT fluoroscopy is improved by facilitating puncture, the fluoroscopy time can be shortened, and furthermore, the exposure dose can be reduced.

  Further, when it is determined whether or not the avoidance target part B1 is on the puncture extension line L2, and it is determined that the avoidance target part B1 is on the puncture extension line L2, a warning message M2 indicating that fact is sent to the user. Inform. Accordingly, the surgeon can grasp that the avoidance target part B1 is on the puncture prediction path during the puncture and can change the puncture path, so that the risk of puncture mistake can be reduced.

  As mentioned above, although some embodiment of this invention was described, these embodiment is shown as an example and is not intending limiting the range of invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof 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 image diagnostic apparatus 3 Imaging apparatus 4a1 Information acquisition part 4a2 Information judgment part 4a3 Avoidance judgment part 4e Display part 4g Sound output part A1 Puncture object part A2 Puncture tip part B1 Avoidance part G1 Cross-sectional image L2 Puncture extension line P Subject

Claims (6)

An imaging unit that captures a plurality of cross-sectional images in real time by X-ray irradiation having a thickness in the body axis direction of the subject;
An information acquisition unit for obtaining, in real time, three-dimensional relative position information of a puncture target part and a puncture tip part included in the plurality of cross-sectional images;
A display unit for displaying the cross-sectional image and the three-dimensional relative position information in real time;
An X-ray diagnostic imaging apparatus comprising:   The X-ray diagnostic imaging apparatus according to claim 1, wherein the display unit changes a display color for displaying the three-dimensional relative position information according to the three-dimensional relative position information.   The X-ray diagnostic imaging apparatus according to claim 1, further comprising a sound output unit that changes a sound interval or a magnitude according to the three-dimensional relative position information. The three-dimensional relative position information is a three-dimensional separation distance between the puncture target portion and the puncture tip portion,
An information determination unit for determining whether the three-dimensional separation distance is a predetermined value or less;
When the information determining unit determines that the three-dimensional separation distance is equal to or less than a predetermined value, a notifying unit that notifies that the puncture tip is very close to the puncture target unit;
The X-ray image diagnostic apparatus according to claim 1, further comprising:   The X-ray diagnostic imaging apparatus according to any one of claims 1 to 4, wherein the display unit displays a puncture extension line extending from the puncture tip in real time. An avoidance determination unit that determines whether or not there is an avoidance target portion on a puncture extension line extending from the puncture tip portion;
When it is determined by the avoidance determination unit that there is an avoidance target part on the puncture extension line, a notification unit that notifies that there is an avoidance target part on the puncture extension line;
The X-ray image diagnostic apparatus according to claim 1, further comprising:

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