JP2014004491A - X-ray diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a technique that facilitates a grasp of an inserted object by an operator and allows an X-ray image to be generated associated with movement of a catheter or the like while reducing radiation exposure of a body to be inspected when a medical image for supporting insertion operation of the catheter or the like is generated by an X-ray imaging device.SOLUTION: An X-ray diagnostic apparatus generates a first image having a large visual field from X-rays detected by a first X-ray detector, subsequently narrows an irradiation range of X-rays in response to a detection range having a small visual field of a second X-ray detector, sequentially generates a second image including a leading end of an inserted object from X-rays detected by the second X-ray detector, obtains displacement of a leading end position of the inserted object on the basis of the second image, moves a relative position of the second X-ray detector with respect to a body to be inspected in response to the displacement obtained, and enlarges and displays the second image in parallel while indicating the relative position in the first image in response to movement of the relative position.

Description

  The present invention relates to an X-ray diagnostic apparatus, and more particularly to a medical image presentation function that supports an insertion operation of an insert into a subject.

  The X-ray diagnostic apparatus exposes X-rays to a subject placed between an X-ray source and an X-ray detector that are arranged to face each other. Furthermore, the X-ray diagnostic apparatus detects X-rays transmitted through the subject and generates a medical image indicating information in the subject based on the detected X-rays.

  Conventionally, an insert such as a catheter or a guide wire is inserted into a patient's blood vessel in order to perform diagnosis, treatment, drainage, supply, or the like. In addition, when an operator inserts a catheter or the like into the patient's vasculature, a medical image indicating information in the subject generated by a medical image diagnostic apparatus or the like is viewed, so that the subject (patient or the like) can be viewed in real time. IVR (Interventional Radiology), which performs insertion while observing a catheter or the like in the body, has become widespread. For example, when a catheter or the like is inserted into a blood vessel or the like of a subject, when the catheter or the like in the subject is observed using an X-ray diagnostic apparatus, a contrast agent is inserted into the blood vessel or the like of the subject into which the catheter or the like is inserted. Inject. Further, an X-ray image of the subject is taken by the X-ray diagnostic apparatus and fluoroscopically performed. The operator inserts and advances the catheter or the like while viewing the fluoroscopic image and grasping the position of the catheter or the like in the subject.

  The operation of the X-ray diagnostic apparatus for performing such fluoroscopy is performed as follows. First, X-rays are irradiated from the X-ray tube to the subject arranged between the X-ray tube and the X-ray detector. Further, the X-ray detector detects X-rays transmitted through the subject. Various processes such as image processing are performed on the detected transmitted X-rays to generate and display X-ray images periodically or continuously. Thus, fluoroscopy is performed.

  Here, it is necessary for the X-ray diagnostic apparatus to sequentially display the position (tip position, etc.) of the catheter or the like in the subject in accordance with the progress of the catheter or the like inserted into the subject. For example, conventionally, when an operator inserts a catheter or the like and inputs an instruction to move the imaging region from the operation input unit, and sequentially moves the imaging region according to the progress of the catheter or the like, the distal end portion of the catheter or the like is moved to a desired position. There is an X-ray fluoroscopic apparatus that guides to (see Patent Document 1: paragraphs 0010, 0053, etc.).

  However, in the X-ray fluoroscopic imaging apparatus in Patent Document 1, it is necessary to move the imaging part by the operation input unit each time the catheter or the like progresses, which complicates the operation of the apparatus and lowers the examination treatment efficiency. It also becomes. In particular, an insertion / advance operation of a catheter or the like requires skillful techniques and concentration, and it is difficult to move the imaging region in accordance with the advancement of the catheter or the like.

  On the other hand, the following X-ray diagnostic apparatuses have been proposed (see Patent Document 2: paragraphs 0002 to 0012, 0018, 0033 to 0038, etc.). That is, in this X-ray diagnostic apparatus, first, a reference image (road map) in a range wider than the range of the fluoroscopic image is formed and stored in advance before fluoroscopy. At the time of fluoroscopy, fluoroscopy range detection means (imaging range detection means) detects the fluoroscopy range of the fluoroscopic image. Further, a range corresponding to the fluoroscopic range is read out from the reference images stored in advance. Then, the cut-out partial reference image and the fluoroscopic image are superimposed and displayed on the display means. When the fluoroscopic range is changed, the read range of the reference image that is read following the change is changed.

JP 2001-78992 A JP 2000-342565 A

  In the X-ray diagnostic apparatuses in Patent Document 1 and Patent Document 2, the field of view of a fluoroscopic image increases as the fluoroscopic range (fluoroscopic region) of the subject increases. However, when the imaging region is wide, the X-ray irradiation field is widened. In order to perform fluoroscopy, X-rays must be irradiated periodically or continuously. Therefore, if the X-ray irradiation field is widened, the amount of exposure of the subject increases. In addition, the expansion of the X-ray irradiation field leads to an increase in the size of the X-ray detector that detects transmitted X-rays. This increase in the size of the X-ray detector may cause a reduction in resolution of the fluoroscopic image. For example, in the case of an FPD (Flat Panel Detector / flat panel detector) with a visual field of about 40 cm, the pixel size is about 150 to 200 μm.

  In particular, when inserting a catheter into a complex part of a blood vessel such as a cerebral blood vessel, the resolution of the fluoroscopic image is reduced, making it difficult for the operator to identify the insertion object such as the catheter, which hinders grasping of the catheter or the like. There is a fear. Therefore, in fluoroscopy, it is desired to reduce the amount of exposure and to make the fluoroscopic image high definition (high resolution). These can be realized by reducing the size of the X-ray detector while narrowing the X-ray irradiation field.

  However, in the X-ray diagnostic apparatus having such a configuration, the field of view of the displayed fluoroscopic image may be narrowed. For example, when the pixel size is 20 μm, the visual field is about 20 mm to 30 mm. Thus, the narrower the field of view of the fluoroscopic image, the more difficult it becomes to display the position (tip, etc.) of the catheter in accordance with the progress of the catheter inserted into the subject. For example, depending on the level of skill of the operator in catheter insertion, the catheter advancement speed may increase, and the catheter tip position display / display operation may not be able to keep up with the catheter advancement.

  Also, it is difficult to simply increase the size and definition of the X-ray detector. For example, a high-definition FPD includes a scintillator mounted on a CCD and stored in a container. Since the CCD in this FPD is made of a single crystal Si material, it is difficult to realize a large field of view of about 40 cm on a side. Even if the X-ray detector can be increased in size and definition, if the X-ray detector is increased in size and definition, the cost of the X-ray detector such as FPD increases. As a result, the cost of the X-ray diagnostic apparatus is increased. For example, when the pixel size of an FPD with a side of 40 cm is 50 μm, the number of pixels is 16 million, and excessive hardware is required for image processing. In addition, even if the fluoroscopic image has a wide field of view and high definition, if the display area of the catheter or the like is not large, it does not contribute to grasping the state of the catheter or the like, and efficiently supports the insertion operation of the catheter or the like. I don't get it. That is, even if the X-ray detector is increased in size and refined, it does not contribute to grasping the state of the catheter or the like unless the display area of the entire fluoroscopic image is increased.

  The present invention has been made in view of the above problems, and an object of the present invention is to generate an amount of exposure of a subject in generating a medical image that supports an insertion operation of an insert such as a catheter or a guide wire by an X-ray diagnostic apparatus. And a technique that makes it easy for an operator to grasp an insert and enables generation of an X-ray image in accordance with the progress of the insert.

  The embodiment includes an X-ray source, an X-ray diaphragm means, a first X-ray detector, a second X-ray detector having a detection range narrower than the first X-ray detector, and a first control means. And an X-ray image generation means, a position detection means, a second control means, and a display means. The X-ray source generates X-rays that are irradiated to the subject. The X-ray diaphragm means narrows the X-ray irradiation range for the subject. The first X-ray detector detects X-rays that have passed through the subject. The first control means controls the X-ray diaphragm means to change the irradiation range. X-ray image generation means generates a first image based on the X-rays detected by the first X-ray detector, and based on the X-rays detected over time by the second X-ray detector. Then, a second image including at least the tip of the insert inserted into the subject is sequentially generated. The position detection means obtains the displacement of the tip position of the insert based on the second image. The second control means displaces a relative position between the subject and the second X-ray detector. The display means displays the relative position in the first image and displays the second image in parallel with the movement of the relative position. Further, after the first image is generated, the first control means narrows the X-ray irradiation range by the X-ray diaphragm means according to the detection range of the second X-ray detector. Furthermore, the second control means displaces the relative position between the subject and the second X-ray detector in accordance with the displacement of the insert obtained by the position detection means.

  According to the above, the entire imaging range of the subject is imaged with the first detector, and thereafter, imaging is performed over time with the second detector whose imaging range is limited according to the progress of the insert. Further, the relative position of the subject and the second detector is configured to be shown in an image based on the first detector. Accordingly, the surgeon can grasp the position of the insert in the imaging range of the subject, for example, between the insertion position of the insert and the lesioned part. As a result, it is possible to avoid a situation in which the operator loses sight of the position of the insert in the subject. Furthermore, not only the position of the insert with respect to the entire imaging range is displayed, but also the second image is displayed in parallel with the second detector, that is, the image focused on the tip of the insert. It is possible to avoid a situation in which the resolution of the second image showing the tip portion is lowered. As a result, it is possible to prevent the surgeon from grasping the progress of the insert. Furthermore, since the X-ray irradiation range is narrowed when the second image is taken, it is possible to reduce the exposure amount of the subject.

1 is a schematic block diagram showing an overall configuration of an X-ray diagnostic apparatus according to an embodiment of the present invention. (A) It is a schematic side view which shows the structure of each X-ray detector and X-ray detector moving mechanism of the X-ray diagnostic apparatus concerning embodiment of this invention. (B) It is the schematic which looked at each X-ray detector and X-ray detector moving mechanism of the X-ray diagnostic apparatus concerning embodiment of this invention from the X-ray generation part side. It is a schematic side view which shows the positional relationship of the X-ray generation part of the X-ray diagnostic apparatus concerning this Embodiment, a top plate, each X-ray detector, and the subject mounted on the said top plate. It is a schematic block diagram showing a part of functional structure of the system control part of the X-ray diagnostic apparatus concerning embodiment of this invention. It is the schematic which shows an example of the reference image image | photographed with the X-ray diagnostic apparatus concerning embodiment of this invention. It is the schematic which shows the reference image image | photographed with the X-ray diagnostic apparatus concerning embodiment of this invention, the position display of the X-ray detector shown on the said reference image, and the progress locus | trajectory of a marker. It is the schematic which shows the fluoroscopic image image | photographed and enlarged by the X-ray diagnostic apparatus concerning embodiment of this invention. It is the schematic which shows the advancing locus | trajectory of the reference image by the X-ray diagnostic apparatus concerning embodiment of this invention, the marker displayed on the said reference image, and a position display. 4 is a flowchart showing an outline of an operation from setting of an imaging range of a reference image to display through fluoroscopic imaging in the X-ray diagnostic apparatus according to the embodiment of the present invention. It is a flowchart which shows the outline of operation | movement until it calculates | requires the displacement of the marker arrange | positioned at the front-end | tip of an insert after a fluoroscopic image is produced | generated by the X-ray diagnostic apparatus of embodiment of this invention. 6 is a flowchart showing an outline of an operation from when each moving mechanism of the mechanism unit is controlled based on a calculation result obtained by a displacement calculating unit of the X-ray diagnostic apparatus according to the embodiment of the present invention to storing a marker travel locus. is there. It is the schematic which shows the reference image and fluoroscopic image which were produced | generated by the X-ray diagnostic apparatus concerning the modification of embodiment of this invention.

[First embodiment]
An example of the configuration of the X-ray diagnostic apparatus according to the first embodiment of the present invention will be described with reference to FIGS.

(Overview of X-ray diagnostic equipment as a whole)
As shown in FIG. 1, the X-ray diagnostic apparatus according to the first embodiment includes an X-ray generation unit 1 that performs imaging of a state of a subject or the like, and an X-ray detection unit 2. The X-ray diagnostic apparatus includes a mechanism unit 3 that drives the movement of each unit in the X-ray generation unit 1 and the X-ray detection unit 2, and a high voltage generation unit 4 that supplies a high voltage to the X-ray generation unit 1. And a C-arm 5 that supports the X-ray detectors 21a and 21b of the X-ray detector 2 and the X-ray generator 1 to face each other, and a top plate 6 on which the subject is placed. When the subject placed on the top plate 6 of the X-ray diagnostic apparatus is irradiated with X-rays from the X-ray generation unit 1 and the X-rays transmitted through the subject are detected by the X-ray detection unit 2, The detected X-rays are converted into image data through each process by the X-ray detector 2. The X-ray diagnostic apparatus has an image processing unit 7 that processes this image data. Furthermore, the X-ray diagnostic apparatus includes a display unit 8 that displays an X-ray image that has been subjected to image processing by the image processing unit 7, an operation unit 9 that receives an operation by an operator and operates each unit of the X-ray diagnostic apparatus, And a system control unit 10 that performs overall control. Hereafter, the component which each comprises is demonstrated.

  The X-ray generation unit 1 is a device that generates X-rays that are irradiated onto a subject on the top 6, and includes an X-ray tube 11 and an X-ray diaphragm 12. A high voltage is supplied to the X-ray tube 11 from the high voltage generator 4, and the X-ray tube 11 generates X-rays by this high voltage. The X-ray diaphragm 12 shields a part of the X-ray irradiation field generated by the X-ray tube 11. Depending on the degree of shielding, the width of the X-ray irradiation field can be changed, and the X-ray irradiation direction can be changed.

  The X-ray detection unit 2 is an apparatus that detects X-rays that have passed through the subject and generates image data. The X-ray detector 21a is a flat detector that is normally used when imaging a subject, Although the detection range is narrower than that of the line detector 21a (small field of view), the X-ray detector 21b has high definition and is used for detailed observation of a lesioned part, etc., and a gate driver 22 that extracts charges from the X-ray detectors 21a and 21b A charge / voltage converter 23 for converting the charges detected by the X-ray detectors 21a and 21b into a voltage, and an A / D converter 24 for converting the voltage converted by the charge / voltage converter 23 into a digital value; Have The detection range of the X-ray detector 21b is a range in which at least the distal end of an insert such as a catheter or a guide wire and its surroundings can be imaged. The X-ray detector 21a in the present embodiment corresponds to an example of a “first X-ray detector” according to the present invention. Further, the X-ray detector 21b in the present embodiment corresponds to an example of a “second X-ray detector” according to the present invention.

  The mechanism unit 3 is a moving mechanism group that moves the X-ray detectors 21a and 21b, the C-arm 5, the top plate 6, and the like. That is, the mechanism unit 3 includes an X-ray detector moving mechanism 31 that moves the X-ray detectors 21 a and 21 b, a C-arm rotating / moving mechanism 32 that rotates and moves the C-arm 5, and a ceiling that moves the top plate 6. A plate moving mechanism 33. Further, the mechanism unit 3 includes a mechanism control unit 34 that controls the driving of the X-ray detector moving mechanism 31, the C-arm rotating / moving mechanism 32, and the top plate moving mechanism 33. The mechanism controller 34 controls the X-ray detector moving mechanism 31, the C-arm rotating / moving mechanism 32, and the top board moving mechanism 33 based on a control signal from the system controller 10.

  The X-ray detector moving mechanism 31, the C-arm rotating / moving mechanism 32, and the top plate moving mechanism 33 are provided with detecting means (not shown) such as a rotary encoder. That is, the X-ray detector moving mechanism 31 has detection means for detecting the positions of the X-ray detectors 21a and 21b, and the C-arm rotating / moving mechanism 32 is used to move and rotate the C-arm 5. It has a detection means to detect. Similarly, the top plate moving mechanism 33 is provided with detection means for detecting the position of the top plate 6. Each of these detection means transmits displacement information to the mechanism control unit 34 in accordance with the movement of the detection target (each X-ray detector 21a, 21b, C arm 5, top plate 6). The mechanism control unit 34 receives displacement information of each X-ray detector 21a, 21b, C-arm 5 and top plate 6 from each detection means, and each X-ray detector 21a, 21b, C-arm 5 and top plate 6 respectively. The relative position (distance) of is calculated.

  The high voltage generator 4 includes an X-ray controller 41 and a high voltage generator 42 and supplies a high voltage necessary for X-ray irradiation by the X-ray generator 1. The X-ray control unit 41 controls the high voltage generator 42 based on a control signal from the system control unit 10. The high voltage generator 42 is controlled by the X-ray control unit 41 to generate a high voltage and supply it to the X-ray tube 11. This controls the X-ray irradiation.

  The image processing unit 7 includes an image calculation circuit 71 and an image data storage circuit 72. The image calculation circuit 71 performs image processing such as reconstruction calculation and subtraction calculation on the image data generated by the X-ray detection unit 2. The image calculation circuit 71 also performs image analysis for detection of the tip position of the insert described later. The display unit 8 includes a display control unit 81 and a monitor 82 that displays an image stored in the image data storage circuit 72. The display control unit 81 controls display of images on the monitor 82. The monitor 82 of the display unit 8 may be single or plural. Furthermore, the display unit 8 performs control to display a progress locus 122 of the marker M described later.

(X-ray detector moving mechanism)
Next, the configuration of the X-ray detector moving mechanism 31 of the mechanism unit 3 in the X-ray diagnostic apparatus will be described with reference to FIGS. 2 (A), 2 (B) and FIG. FIG. 2A is a schematic side view showing the configuration of the X-ray detectors 21a and 21b and the X-ray detector moving mechanism 31 of the X-ray diagnostic apparatus according to the embodiment of the present invention. FIG. 2B is a schematic view of the X-ray detectors 21a and 21b and the X-ray detector moving mechanism 31 of the X-ray diagnostic apparatus according to the embodiment of the present invention as viewed from the X-ray generation unit 1 side. FIG. 3 shows the positional relationship between the X-ray generator 1, the top plate 6, the X-ray detectors 21 a and 21 b and the subject placed on the top plate 6 of the X-ray diagnostic apparatus according to the embodiment of the present invention. It is a schematic side view shown. As shown in FIG. 1, the large-field X-ray detector 21 a is supported by one end of the C arm 5. As shown in FIG. 2A, a small-field X-ray detector 21b is connected to the side surface of the X-ray detector 21a so as to protrude from the side surface.

  The X-ray detector 21b includes a connection base 210, a support guide 211, a Y-axis movement mechanism 212, and an X-axis movement mechanism 213. As shown in FIG. 2A, the connection base 210 is connected to the side surface of the X-ray detector 21a and supports the entire X-ray detector 21b. 2A and 2B, the support guide 211 is connected to the protruding end side of the connection base 210, and a guide groove 211a is formed on the surface on the X-ray tube 11 side (subject side). Is provided. The guide groove 211a is substantially parallel to the top plate 6 as shown in FIG. 2A, and is long in the longitudinal direction of the top plate 6 (the body axis direction of the subject) as shown in FIG. Has a direction. This direction is the Y direction shown in FIGS. 2 (A) and 2 (B). As shown in FIG. 2A, the protrusion of the Y-axis moving mechanism 212 is engaged with the guide groove 211a, so that the support guide 211 holds the Y-axis moving mechanism 212 movably.

  As shown in FIG. 2A, the Y-axis moving mechanism 212 is disposed adjacent to the top plate 6 side of the support guide 211, and extends in the same direction as the guide groove 211a on the surface facing the support guide 211. A substantially rail-shaped protrusion is provided. The protrusion has a width that engages with the guide groove 211a, and is slidably engaged with the guide groove 211a. Therefore, the Y-axis moving mechanism 212 can reciprocate in the Y direction shown in FIGS. 2A and 2B with respect to the support guide 211 and is supported by the support guide 211.

  The Y-axis moving mechanism 212 includes an X-axis movement that expands and contracts in a direction (X direction in FIGS. 2A and 2B) that is substantially parallel to the subject placement surface of the top plate 6 and substantially orthogonal to the guide groove 211a. A mechanism 213 is connected. The X-axis moving mechanism 213 is provided with an X-ray detector 21b at the end in the extending direction. The X-ray detector 21b is substantially parallel to both the top plate 6 and the X-ray detector 21a. According to the X-ray detector moving mechanism 31 having such a configuration, in parallel and two-dimensionally with respect to the subject placement surface of the top plate 6 and the detection surface of the large-field X-ray detector 21a, It is possible to move the small-field high-definition X-ray detector 21b. Here, the two-dimensional movement is parallel to the top plate 6 and the X-ray detector 21a in one Y direction and the X direction orthogonal to the Y direction as shown in FIGS. 2 (A) and 2 (B). Is to move. Thus, when the X-ray detector 21b moves in the X direction, for example, the X-ray detector 21b moves relative to the subject placed on the top 6 as shown in FIG. The fluoroscopic imaging region by the X-ray detector 21b is displaced with respect to the subject. Further, when the X-ray detector 21b is displaced in this way, the above-described detecting means (not shown) transmits information on the relative position with respect to the detected top plate 6 and the like to the mechanism control unit 34.

  In imaging other X-ray images that do not require the X-ray detector 21b, the X-ray detector moving mechanism 31 can be retracted from the imaging area between the subject and the X-ray detector 21a. It is.

(Reference image shooting)
Next, a control configuration when a reference image is acquired by the X-ray diagnostic apparatus according to the present embodiment will be described with reference to FIGS. FIG. 4 is a schematic block diagram showing a part of the functional configuration of the system control unit 10 of the X-ray diagnostic apparatus according to the embodiment of the present invention. FIG. 5 is a schematic view showing an example of the reference image 110 taken by the X-ray diagnostic apparatus according to the embodiment of the present invention. As shown in FIG. 4, the system control unit 10 includes a transmission / reception unit 10a, an imaging control unit 10b, a storage unit 10c, and a displacement calculation unit 10d. As shown in FIG. 4, the transmission / reception means 10 a transmits and receives signals between the operation unit 9, the display control unit 81, the mechanism control unit 34, the image calculation circuit 71, and the system control unit 10. Signals and image data received by the transmission / reception means 10a are processed by the imaging control means 10b and the displacement calculation means 10d, and are appropriately stored in the storage means 10c. The imaging control unit 10b and the displacement calculation unit 10d transmit control signals and the like to the display control unit 81, the mechanism control unit 34, and the like based on the processing results via the transmission / reception unit 10a.

  In the X-ray diagnostic apparatus according to the present embodiment, when assisting an insertion operation of an insert such as a catheter or a guide wire, first, an imaging range of a reference image (see roadmap / reference numeral 110 in FIGS. 5 and 6) is determined. A reference image of the subject is taken by the X-ray detector 21a with a large field of view. Here, the reference image is an image including a region from an insertion position of the catheter or the like to the subject to a lesioned portion or the like that is a return point of the inserted catheter or the like. This reference image is used to grasp the relative position of the X-ray detector 21b with respect to the subject when a fluoroscopic image (see reference numeral 120 in FIG. 7) is taken by the X-ray detector 21b with a small field of view. It is an image.

  After the subject is placed on the top plate 6 of the X-ray diagnostic apparatus, the operator performs an operation for instructing to start imaging related to the IVR by the operation unit 9 on the operation screen displayed on the monitor 82 of the display unit 8. If it does, the transmission / reception means 10a of the system control part 10 will receive the signal based on the said instruction | indication operation. When the system control unit 10 receives this signal, the imaging control unit 10b reads the image format of the imaging range setting screen (not shown) of the reference image from the storage unit 10c and sends it to the display control unit 81. The display control unit 81 displays a shooting range setting screen on the monitor 82.

  The operator can set the imaging range of the reference image based on the subject (or the top plate 6) on the imaging range setting screen displayed on the monitor 82 by the operation unit 9 such as a mouse. The setting of the imaging range is performed by the operator via the operation unit 9. For example, it is assumed that the subject and the top 6 are shown on the imaging range setting screen. Further, on the screen, a frame display indicating an imaging range is shown with respect to the display of the subject, and the frame display can be specified by enlarging or reducing the range by an operator's operation. The operator can confirm the imaging range by operating the operation unit so that the insertion position of the catheter or the like and the lesioned part are included in the frame display. The imaging range determined here is set by the imaging control means 10b as the imaging range of the reference image.

  That is, when the shooting range is set on the shooting range setting screen in this way, the display control unit 81 sets the relative position of the shooting range with respect to the top plate 6, for example, based on the coordinate position on the shooting range setting screen. Set as shooting range information. In other words, the relative position of the imaging range with respect to the top plate 6 indicates the relative position of the X-ray detector 21a (large field of view) with respect to the top plate 6. Information on the imaging range set here is transmitted from the display control unit 81 to the system control unit 10. When a touch panel monitor 82 is used, there is an input directly on the monitor 82, and the shooting range is set.

  The system control unit 10 receives information on the set shooting range via the transmission / reception means 10a, and processes it as follows by the shooting control means 10b. That is, the photographing control means 10b converts the photographing range information set on the screen into photographing range information in the size of the real space. For example, as described above, when the outer edge of the shooting range is set by frame display on the shooting range setting screen, the position of the outer edge of the shooting range on the top plate 6 on the screen is determined on the screen. It is set in association with the coordinates. The imaging control means 10b converts the imaging range information into information corresponding to the size of the real space by converting the imaging range information according to the display magnification of the imaging range setting screen. In other words, the relative position of the X-ray detector 21a (large visual field) with respect to the top plate 6 is converted into a distance from the top plate 6 corresponding to the real space. Further, this display magnification is predetermined, and for example, it is assumed that it is temporarily stored in the storage means 10c, or is stored so as to be readable at any time.

  Further, the imaging control means 10b causes at least the outer edge of the detection range of the X-ray detector 21a to be slightly outside the imaging range so that the imaging range is included in the X-ray detection range of the X-ray detector 21a. Thus, the mechanism unit 3 is controlled. That is, the imaging control means 10b uses information on the relative distance between the top plate 6 and the X-ray detector 21a based on the outer edge of the imaging range associated with the top board 6 based on the converted imaging range information. To the mechanism control unit 34 of the unit 3. The mechanism control unit 34 receives information on the relative distance between the top plate 6 and the X-ray detector 21a, and drives the X-ray detector moving mechanism 31 based on the information. As a result, the X-ray detector 21a moves relative to the top plate 6, and the set imaging range is at least within the detection range of the X-ray detector 21a. The mechanism control unit 34 does not necessarily need to drive the X-ray detector moving mechanism 31 when receiving information on the relative distance between the top 6 and the X-ray detector 21a. It is also possible to move the top plate 6 by driving and match the detection range of the X-ray detector 21a with the imaging range.

  Further, the imaging control means 10b controls the C-arm rotating / moving mechanism 32 to be driven via the mechanism control unit 34 in accordance with various imaging conditions for the reference image imaging set by the operator and the setting of the imaging range. I do. When the C-arm rotation / movement mechanism 32 is driven, the C-arm 5 is rotated so as to match the position of the X-ray detector 21a. Further, the imaging control means 10b controls the high voltage generator 42 via the X-ray control unit 41 based on various set imaging conditions. Further, the imaging control means 10b controls the X-ray diaphragm 12 of the X-ray generator 1 so that the X-rays generated from the X-ray tube 11 become an X-ray irradiation field corresponding to the set imaging range.

  In photographing the reference image, X-rays irradiated on the subject are transmitted through the subject and detected by the X-ray detector 21a having a large field of view. Further, the detected X-ray is converted into image data by the X-ray detection unit 2 as described above. The image data converted by the X-ray detection unit 2 is transmitted to the image processing unit 7. Here, when a contrast image taken in a state where a contrast agent is injected is used as a reference image, the image calculation circuit 71 performs a reconstruction process or the like on the image data received from the X-ray detection unit 2. On the other hand, when a DSA image of only a blood vessel is used as a reference image, a mask image that is photographed in a state in which no contrast medium is injected is generated by the above-described process, and then a contrast medium is injected before a contrast image is injected. Is generated. The image calculation circuit 71 of the image processing unit 7 performs subtraction processing between the contrast image and the mask image to generate a DSA image. The reference image 110 (see FIG. 5) processed in this way by the image calculation circuit 71 is transmitted to the display unit 8 and displayed on the monitor 82 via the display control unit 81.

(Transparent image shooting)
Next, in order to assist the operator in inserting an insert such as a catheter or guide wire, a control configuration when acquiring a fluoroscopic image by the X-ray diagnostic apparatus according to the present embodiment will be described with reference to FIGS. I will explain. FIG. 6 shows a reference image 110 photographed by the X-ray diagnostic apparatus according to the embodiment of the present invention, a position display 121 of the detection range of the X-ray detector 21b shown on the reference image 110, and a progress locus of the marker M. FIG. FIG. 7 is a schematic view showing a fluoroscopic image 120 taken and enlarged by the X-ray diagnostic apparatus according to the embodiment of the present invention.

  When a reference image 110 as shown in FIG. 5 is generated and displayed on the monitor 82, an operator inserts an insert such as a catheter into the subject. The insertion position of the catheter or the like is any position within the preset imaging range and within the range included in the reference image 110. The surgeon performs an operation of acquiring the fluoroscopic image 120 in order to grasp the progress of the catheter or the like. The fluoroscopic image 120 is a transmission that is detected continuously or intermittently at predetermined intervals by an X-ray detector 21b that is smaller in field of view and higher in definition than the X-ray detector 21a and that is used for detailed observation of a lesioned part or the like. It is an X-ray image generated based on X-rays, and is an image mainly including a tip position of a catheter or the like and including a region around the tip position. The fluoroscopic image 120 is a high-definition enlarged image for more reliably grasping the state of the shape and the like of the X-ray detector 21b when an insertion operation of a catheter or the like is performed. Hereinafter, the control configuration of the system control unit 10 when the mechanism unit 3 moves the X-ray detector 21b with the movement of the catheter or the like will be described for each step.

<Initialization>
When an insert such as a catheter is inserted into a subject and the catheter or the like is seen through the X-ray diagnostic apparatus, a fluoroscopic image is displayed via the operation unit 9 on the operation screen displayed on the monitor 82 of the display unit 8 by the operator. An instruction to start shooting is performed. The transmission / reception means 10a of the system control unit 10 receives a signal based on the instruction operation. When the system control unit 10 receives this signal, the imaging control unit 10 b first transmits the data of the reference image 110 from the image data storage circuit 72 of the image processing unit 7 to the display control unit 81. The display control unit 81 displays a reference image 110 as shown in FIG.

  Further, the imaging control means 10b acquires relative position information between the top board 6 and the small-field X-ray detector 21b from the mechanism control unit 34. Further, when the imaging control means 10b acquires the relative position information of the X-ray detector 21b and the top board 6, the imaging at the current position of the X-ray detector 21b is made on the reference image 110 based on the position information. The area is displayed (see reference numeral 121 in FIG. 6). That is, since the photographing range of the reference image 110 set in advance is also set based on the relative position with respect to the top plate 6, the position of the X-ray detector 21b and the photographing range of the reference image 110 are the same. It corresponds in the point which is the information of the relative position on the basis of the coordinate position in.

  Therefore, the imaging control means 10b converts the acquired relative position information between the X-ray detector 21b and the top board 6 by a predetermined display magnification, thereby replacing the coordinate position in the reference image 110 with X. The position of the line detector 21b can be obtained. The imaging control means 10b transmits to the display unit 8 information on the current position of the X-ray detector 21b and information on the imaging area that is currently available based on the detection range of the X-ray detector 21b. As shown in the position display 121 in FIG. 6, the display control unit 81 displays on the monitor 82 the position of the imaging region that can be imaged at the current position of the X-ray detector 21 b in the reference image 110 based on this information. This position display 121 indicates the relative position of the X-ray detector 21b with respect to the subject placed on the top board 6.

  The operator indicates the relative position of the X-ray detector 21b with respect to the subject (or the top plate 6) on the screen of the reference image 110 displayed on the monitor 82 by the operation unit 9 such as a mouse, and displays the position display 121. It is possible to move by dragging. For example, when the insertion position of the catheter or the like in the reference image 110 is not included in the imaging region of the X-ray detector 21b, the operator uses the operation unit 9 to specify the imaging region of the X-ray detector 21b in the reference image 110. Move according to the insertion position. When the imaging region (detection position A1 or the like) of the X-ray detector 21b is moved on the screen of the reference image 110, the imaging control unit 10b moves the X-ray detector 21b via the mechanism control unit 34.

  That is, first, the display control unit 81 transmits information on the image coordinate positions (detection positions A1 to An in FIG. 6, etc.) of the imaging region of the X-ray detector 21 b in the moved reference image 110 to the system control unit 10. This position information is converted into physical coordinate position information with respect to the top board 6 by the imaging control means 10b and transmitted to the mechanism control unit 34. The mechanism control unit 34 uses the position information as information on the relative position of the X-ray detector 21b with respect to the top plate 6. Further, the mechanism control unit 34 drives the X-ray detector moving mechanism 31 based on the position information to move the X-ray detector 21b in accordance with the position of the imaging region of the X-ray detector 21b in the reference image 110. .

<Starting fluoroscopy>
Further, the imaging control means 10b controls the X-ray diaphragm 12 to move the X-ray irradiation direction according to the movement of the X-ray detector 21b, and limits the irradiation field to the detection range of the X-ray detector 21b. To do. As described above, in the X-ray diagnostic apparatus according to the present embodiment, after obtaining the reference image 110 by the large-field X-ray detector 21a, the fluoroscopic image 120 showing the catheter or the like in the subject is displayed as the small-field X-ray detector 21b. In addition, the X-ray diaphragm 12 limits the X-ray irradiation field according to the detection range of the X-ray detector 21b and performs imaging. Therefore, compared with an X-ray diagnostic apparatus that detects the fluoroscopic image 120 with the X-ray detector 21a having a large field of view, it is possible to reduce the exposure amount of the subject by photographing the fluoroscopic image 120.

  When switching to fluoroscopic imaging, the imaging control means 10b detects X-rays emitted from the X-ray generator 1 and transmitted through the subject by the X-ray detector 21b. The detected X-rays are converted into image data by the X-ray detection unit 2 as described above and transmitted to the image processing unit 7. The image calculation circuit 71 of the image processing unit 7 performs reconstruction processing and the like, and generates a perspective image 120 as shown in FIG. The steps from the X-ray irradiation to the generation of the fluoroscopic image 120 are performed continuously or intermittently at predetermined intervals. Further, the fluoroscopic image 120 generated in this way is transmitted from the image processing unit 7 to the display unit 8 and sequentially displayed on the monitor 82 via the display control unit 81.

<Calculation of tip position displacement>
Next, calculation of the displacement of the distal end position of the catheter or the like by the displacement calculation means 10d of the system control unit 10 in the X-ray diagnostic apparatus of the present embodiment will be described. The displacement calculating unit 10d obtains the coordinate position of the tip in the fluoroscopic image 120 by causing the image processing unit 7 to recognize the tip of an insert such as a catheter in the fluoroscopic image 120. Further, when the coordinate position of the tip obtained by the displacement calculating unit 10d exceeds a predetermined range set in advance, the system control unit 10 sends an X-ray detector to the imaging control unit 10b based on the obtained image coordinate position information. The movement control of 21b is performed. As a result, the X-ray detector 21b is moved so as to cancel the displacement of the tip position. These controls are performed as follows.

  First, the displacement calculating means 10d detects the tip position of an insert such as a catheter in the fluoroscopic image 120 by causing the image calculation circuit 71 to perform image analysis every time the image processing unit 7 generates the fluoroscopic image 120. . For example, as shown in FIG. 7, by providing a marker M having a low X-ray transmittance at the distal end of the catheter, the image calculation circuit 71 detects a marker M having a specific pixel value in the fluoroscopic image by image analysis. . As a result, the displacement calculating means 10d can acquire the coordinate position of the tip of the catheter or the like. Even if the marker M is not provided at the distal end of the catheter, the image calculation circuit 71 can detect the distal end by analyzing the shape of the distal end.

In the X-ray diagnostic apparatus according to the present embodiment, a predetermined range in the fluoroscopic image 120 is set in advance corresponding to the coordinate position of the fluoroscopic image 120. For example, the range from the center position C of the fluoroscopic image 120 to a range separated by a predetermined threshold in the X direction and the Y direction (see FIG. 7) is set as the predetermined range (see the broken line in the center of FIG. 7). ). Information on this predetermined range is stored in the storage means 10c of the system control unit 10 or the like. Displacement calculating means 10d tip position of the catheter or the like in the fluoroscopic image 120 (marker position a _1, etc.), are detected for each frame of the fluoroscopic image 120 that is generated over time, the detected catheter tip image coordinates of position comparison with (marker position a ₁ ~a _n, etc.) previously set predetermined range information.

Result of the comparison by the displacement calculation unit 10d, when the front end position (marker position a ₁ ~a _n, etc. FIG. 7) exceeds a predetermined range, the displacement calculating unit 10d is a coordinate position of the center of the predetermined range in the image Is compared with the coordinate position (for example, marker position a ₂ ) of the distal end of the catheter in the current fluoroscopic image 120, and in the X direction / Y direction (see FIG. 7) with respect to the coordinate position of the center. Find how much each is displaced. The displacement calculating means 10d in the present embodiment corresponds to an example of the “position detecting means” according to the present invention.

<< Movement of X-ray detector >>
Based on the displacement information of the marker M obtained by the displacement calculating unit 10d, the imaging control unit 10b determines that the distal end position of the catheter or the like is the center position C in the predetermined range in the fluoroscopic image 120 (or the central position C of the fluoroscopic image 120). The X-ray detector 21b is moved so as to be displayed in FIG.

That is, the imaging control means 10b performs control for moving the X-ray detector 21b so as to cancel the displacement based on the displacement information. For example, as shown in FIG. 7, when the center position C and the marker position a ₂ at the tip are compared and displaced by (X ₀ , Y ₀ ), the imaging control means 10b The information on the displacement (X ₀ , Y ₀ ) in the image coordinates is converted into displacement information on the physical coordinates in the real space and transmitted to the mechanism control unit 34. The mechanism control unit 34 receives this displacement information, controls the X-ray detector moving mechanism 31 based on the displacement information, and moves the X-ray detector 21b by the X-ray detector moving mechanism 31. Specifically, the Y-axis moving mechanism 212 and the X-axis moving mechanism 213 of the X-ray detector moving mechanism 31 are driven to move the X-ray detector 21b in each of the X direction and the Y direction in the displacement information. This displacement information is also used for aperture control of the X-ray diaphragm 12 by the imaging control means 10b, and the X-ray irradiation direction is changed by the X-ray diaphragm 12 in conjunction with the movement of the X-ray detector 21b. Is called.

  Thereby, even if the coordinate position of the tip of the catheter or the like in the fluoroscopic image 120 exceeds a predetermined range due to the progress of the catheter or the like, the X-ray detector is arranged to cancel the displacement of the coordinate position of the tip or the like in the fluoroscopic image 120. Since 21b moves, the coordinate position of the tip moves in a direction to return to the center position C. Accordingly, it is possible to move the imaging region of the fluoroscopic image in accordance with the progress of the catheter or the like by the operator, and as a result, it is possible to prevent the operator from losing the tip of the catheter or the like in the fluoroscopic image.

<Display of shooting area position and progress track>
As described above, when an instruction to start fluoroscopic imaging is given from the operation unit 9 in the X-ray diagnostic apparatus according to the present embodiment, the imaging control unit 10b acquires the current position information of the X-ray detector 21b from the mechanism unit 3. Based on this, information on the imaging region of the current fluoroscopic image 120 is transmitted to the display unit 8. Based on this information, the display control unit 81 sets the position of the imaging region (see the detection positions A1 to An in FIG. 6) in the reference image 110 where the fluoroscopic image can be captured at the current position of the X-ray detector 21b. indicate.

As described above, when the operator performs an operation of aligning the position display 121 indicating the imaging region of the X-ray detector 21b with the insertion position of the catheter or the like in the reference image 110, the imaging control means 10b next displays the position shown in FIG. The display control of the traveling locus 122 and the position display 121 of the distal end of the catheter or the like as shown in FIG. For example, the insertion position of the catheter or the like is the marker position a ₁ at the detection position A1 in FIG. 6, and the displacement of the position of the marker M obtained by the progression of the catheter or the like is displaced from the marker position a ₁ to the marker position a ₂ . In this case, when the imaging control unit 10b moves the X-ray detector 21b based on the fluoroscopic image 120 as described above, the imaging control unit 10b further corresponds to the position in the reference image 110 corresponding to the movement of the X-ray detector 21b. The display 121 is moved from the detection position A1 to the detection position A2 based on the displacement information of the position of the marker M obtained by the displacement calculation means 10d.

  In other words, from the start of photographing of the fluoroscopic image 120, the photographing control means 10b uses the reference image 110 based on the displacement information of the coordinate position of the marker M in the fluoroscopic image 120 and the information of the display magnification difference obtained by the displacement calculating means 10d. The displacement of the coordinate position of the marker M at is obtained. Further, the imaging control unit 10b transmits the obtained displacement information of the marker M to the display unit 8. The display unit 8 causes the display control unit 81 to move the coordinate position of the marker M in the reference image 110 to the position after the displacement based on the received displacement information, and display it on the monitor 82. Further, the display control unit 81 causes the reference image 110 to display the traveling locus 122 of the marker M that connects the positions of the marker M before and after the displacement, as shown in FIG.

  Further, the traveling locus 122 displayed by the display control unit 81 is transmitted to the system control unit 10 and stored in the storage unit 10c. The stored information of the traveling locus 122 is used for fluoroscopic imaging at the time of inserting a stent, a balloon or the like, for example. That is, after inserting an insert such as a catheter, an operation to perform fluoroscopic imaging again via the operation unit 9 when another insert (stent, balloon, etc.) is inserted from the insertion position of the catheter. Then, the imaging control unit 10b reads the information on the travel locus 122 from the storage unit 10c. Based on the read information, the imaging control unit 10b can control the movement of the X-ray detector 21b via the mechanism control unit 34.

  In this manner, by moving the position display 121 in accordance with the progression of the catheter in the reference image 110, the operator can grasp the degree of progression of the catheter within the subject. The position display 121 in this embodiment corresponds to an example of “display of relative position” and “position of fluoroscopic image” according to the present invention.

《Search for insert tip》
As described above, the displacement calculation means 10d of the system control unit 10 in the X-ray diagnostic apparatus according to the present embodiment moves the X-ray detector 21b in accordance with the progress of the catheter or the like by the operator, and the tip of the catheter displayed in the fluoroscopic image. The imaging region of the fluoroscopic image 120 can be moved based on the position. However, the more skilled the operator is, the smoother the catheter insertion operation is and the faster the catheter travels within the subject. Therefore, depending on the operator, the catheter speed may be extremely fast. In this case, the X-ray detector 21b may not be able to follow the actual catheter progress even if the X-ray detector 21b is moved quickly. Thus, when the X-ray detector 21b cannot follow, the distal end of the catheter is not displayed in the fluoroscopic image, and the operator may lose sight of the distal end position of the catheter.

  In response to such a situation, the displacement calculating means 10d according to the present embodiment refers to a plurality of past images, estimates the amount and direction of advancement of the catheter, and causes the X-ray detector 21b to respond to the estimated displacement. Move. As a result, the tip position is again included in the imaging region by the X-ray detector 21b, and the tip is displayed on the fluoroscopic image 120. These controls will be described below with reference to FIG. FIG. 8 is a schematic diagram showing the reference image 110 by the X-ray diagnostic apparatus according to the embodiment of the present invention, the marker M displayed on the reference image 110, and the traveling locus 122 of the position display 121. Note that FIG. 8 shows an image different from the reference image 110 shown in FIG. 6 for convenience of explanation.

A specific example will be described with reference to FIG. In the case of the reference image 110 in FIG. 8, although the marker position a ₆ at the detection position A6 is within a predetermined range including the center position C (see FIG. 7), the progression of such a catheter, the marker M in the detection position A6 a marker When moved to the position a _7, the displacement calculating means 10d as shown in FIG. 7 calculates the displacement of the marker M in the fluoroscopic image 120. The imaging control unit 10b moves the X-ray detector 21b via the mechanism control unit 34 based on the calculated image coordinate position information. This is moved in the X-ray detector 21b is detected positions A7 as shown in FIG. 8, the marker position a ₇ falls within a predetermined range of the detected position A7. Similarly marker M is moved when it is moved X-ray detector 21b is to follow the detection position A8 to the marker position a _8.

Further, as shown in FIG. 8, a catheter or the like changes direction according vessels in the subject, and the displacement amount is moved from the marker position a ₉ (displacement L2 from the displacement L1) increasing the marker position a ₁₀ As long as the marker M is displayed in the fluoroscopic image 120, the displacement calculating means 10d calculates the displacement. Therefore, the imaging control means 10b follows the movement of the marker M and detects the X-ray detector 21b. It is possible to move from A9 to the detection position A10. However, when the marker M is not displayed in the fluoroscopic image 120, the displacement calculation method described above cannot calculate the displacement of the marker M, and the X-ray detector 21b is moved according to the progress of the catheter or the like. It is difficult to do.

That is, in the case shown in FIG. 8, the movement from the marker position a ₉ to the marker position a ₁₀ and the movement from the marker position a ₁₀ to the marker position a ₁₁ are within the detection range of the X-ray detector 21b. Therefore, the displacement can be calculated. In contrast, if the marker position a ₁₁ movement to the marker position a _12, since the detection position A11 does not contain any marker located a _12, a displacement calculation method described above, it is impossible to determine the displacement. In this case, the displacement calculating means 10d estimates the amount and direction of travel of the catheter and the like as follows.

  When the distal end position of the catheter or the like is not detected by the displacement calculating means 10d, that is, when the marker M as shown in FIG. 7 is not detected in the generated fluoroscopic image 120, the displacement calculating means 10d first performs image processing. A plurality of past images are read from the image data storage circuit 72 of the unit 7. This past image is an image generated at least one frame before the image in which the marker M is not detected in the sequentially generated perspective images 120. For example, the displacement calculating unit 10d reads from the image data storage circuit 72 the past image two frames before and the past image three frames before the image in which the marker M is not detected.

In the case shown in FIG. 8, the image marker position a ₁₂ is shown the marker position a ₁₁ past image of two frames before with respect to the fluoroscopic image 120, that is, the detection position A10 of the detection position A11 was not detected Is read. Further displacement calculation unit 10d is three frames prior to the previous image, that reads an image at the detection position A10 shown marker position a ₁₀ is. Further, when the displacement calculating unit 10d reads the past image, the displacement calculating unit 10d acquires the coordinate position of the marker M in the past image three frames before and the coordinate position of the marker M in the past image three frames before. In the example of FIG. 8, the displacement calculating unit 10d calculates the coordinate position of the marker position _{a 11} and marker position _{a 10} shown the detection position A10 in the fluoroscopic image 120.

Furthermore the displacement calculation unit 10d is of the time-series marker position a _11, comparing the coordinates of the marker position a _10. As a result, the displacement calculating means 10d obtains the displacement of the position of the marker M two frames before with respect to the marker M three frames before. As a result of obtaining the displacement, the displacement calculating unit 10d obtains the displacement direction and the displacement amount of the marker M between the read past images.

Further displacement calculation unit 10d is assumed that marker position a ₁₂ that could not be detected in the detection position A11 marker M is, toward the displacement direction obtained above, is advanced by an amount of n times the displacement amount determined . Marker position a ₁₂ assuming thereon moves the X-ray detector 21b so as to be included in the next detection position A12. In the example of FIG. 8, the displacement calculating unit 10d is towards the displacement direction of the marker position a ₁₂ is determined, it is assumed that advanced by twice the amount of displacement determined, moves the X-ray detector 21b By doing so, the marker M, that is, the tip of the catheter or the like is displayed in the fluoroscopic image 120 taken at the detection position A12. Here, the control for moving the X-ray detector 21b by the imaging control means 10b based on the displacement information obtained by the displacement calculating means 10d is the same as the control of the imaging control means 10b described above.

  According to such a configuration, there is a case where the X-ray detector 21b cannot follow the movement of the marker M because the operator's insertion operation of the catheter or the like is smooth and the traveling speed of the catheter or the like in the subject is extremely fast. However, the displacement calculating means 10d searches for the tip position of the catheter or the like, the X-ray detector 21b is moved by the imaging control means 10b, and the tip of the catheter is displayed again in the fluoroscopic image 120. It is possible to avoid the possibility of losing sight of the tip position.

(Operation)
Next, the operation of the X-ray diagnostic apparatus according to the first embodiment described above will be described with reference to FIGS. FIG. 9 is a flowchart showing an outline of the operation (from the setting of the imaging range of the reference image 110 through the display to the start of fluoroscopic imaging) in the X-ray diagnostic apparatus according to the embodiment of the present invention. FIG. 10 is a flowchart showing an outline of the operation from when the fluoroscopic image 120 is generated by the X-ray diagnostic apparatus according to the embodiment of the present invention until the displacement of the marker M arranged at the tip of the insert is obtained. FIG. 11 shows the process from when each moving mechanism of the mechanism unit 3 is controlled based on the calculation result obtained by the displacement calculating means 10d of the X-ray diagnostic apparatus according to the embodiment of the present invention until the progress locus of the marker M is stored. It is a flowchart which shows the outline | summary of operation | movement.

(Step 01)
When there is an instruction to start imaging related to IVR from the operation unit 9, the imaging control unit 10 b of the system control unit 10 in the X-ray diagnostic apparatus displays an imaging range setting screen (not shown) on the monitor 82 via the display unit 8. Display. When the imaging range is set on the setting screen, the imaging control means 10b uses the top plate 6 as a reference and sets the coordinate position on the screen relative to the top plate 6 in the real space and the X-ray detector 21a. Convert to position information (distance, etc.). The mechanism control unit 34 receives the information of the converted relative distance, and drives the X-ray detector moving mechanism 31 based on the information to move the X-ray detector 21a, and the set imaging range and The detection range of the X-ray detector 21a is matched.

(Step 02)
Further, the imaging control means 10b generates X-rays from the X-ray tube 11 via the X-ray control unit 41 based on various set imaging conditions, and an X-ray irradiation field corresponding to the set imaging range is obtained. The X-ray diaphragm 12 of the X-ray generator 1 is controlled to irradiate the subject with X-rays. X-rays transmitted through the subject are detected by the X-ray detector 21a having a large field of view.

(Step 03)
The detected X-ray is further converted by the X-ray detection unit 2 to become image data, which is transmitted to the image processing unit 7. The image data is subjected to reconstruction processing and the like by the image arithmetic circuit 71, and a reference image 110 (see FIG. 5) is generated. Further, the data of the reference image 110 is transmitted to the display unit 8 and displayed on the monitor 82 via the display control unit 81.

(Step 04)
When the reference image 110 is displayed, the imaging control unit 10b acquires relative position information (distance, etc.) between the top plate 6 and the X-ray detector 21b from the mechanism unit 3, and based on this position information, the current position information is displayed. The position of the X-ray detector 21b is displayed on the reference image 110.

(Step 05)
When the position display 121 of the X-ray detector 21b is adjusted to the insertion position of the insertion object such as a catheter on the reference image 110 by the operator's operation, the system control unit 10 causes the display control unit 81 to display the reference image 110 Information on the image coordinate positions (detection positions A1 to An in FIG. 6 and the like) of the imaging region of the X-ray detector 21b is acquired. This position information is converted into physical coordinate position information with respect to the top board 6 by the imaging control means 10b and transmitted to the mechanism control unit 34. Further, the mechanism control unit 34 drives the X-ray detector moving mechanism 31 based on this position information, and moves the X-ray detector 21 b corresponding to the position display 121 in the reference image 110.

(Step 06)
When the X-ray detector 21b is moved in accordance with the position display 121, the imaging control means 10b further controls the X-ray diaphragm 12, changes the X-ray irradiation direction, and sets the irradiation field to the X-ray. It is limited to the detection range of the detector 21b. Furthermore, the imaging control means 10b irradiates the X-ray generator 1 with X-rays, causes the X-ray detector 2 to detect transmitted X-rays, and converts them into image data.

(Step 07)
Further, the image processing unit 7 performs a reconstruction process or the like on the image data to generate a perspective image 120 as shown in FIG. The steps from the X-ray irradiation to the generation of the fluoroscopic image 120 are performed continuously or intermittently at predetermined intervals. Further, the fluoroscopic image 120 generated in this way is transmitted from the image processing unit 7 to the display unit 8 and displayed on the monitor 82 via the display control unit 81.

(Step 08)
The displacement calculation means 10d detects the marker M at the tip of the insert as shown in FIG. 7 by causing the image calculation circuit 71 to perform image analysis each time the image processing unit 7 generates the fluoroscopic image 120. Further, the displacement calculating means 10d acquires the coordinate position of the marker M in the fluoroscopic image 120.

(Step 09)
Displacement calculating unit 10d is compared with the detected catheter tip image coordinate position (marker position a ₁ ~a _n, etc.) information of preset predetermined range of 6, the marker M is fluoroscopic image 120 It is judged whether it is in the predetermined range. The displacement calculation unit 10d, if the marker position a _n is determined to be within the set predetermined range; as (step 09 Yes) photographing control means 10b is step 08, then according to the generated frame The coordinate position of the marker M in the fluoroscopic image 120 is acquired.

(Step 10)
The displacement calculation unit 10d, when it is determined that the marker position a _n has exceeded the set predetermined range (step 09; No), the displacement calculating unit 10d determines whether the marker M is detected in the fluoroscopic image 120 .

(Step 11)
Result of the determination by the displacement calculation unit 10d, if the marker M is judged to have been detected in the fluoroscopic image 120 (step 10; Yes), the displacement calculating unit 10d is a marker position a _n coordinate position and the central position C Contrast with coordinate position.

(Step 12)
As a result of the comparison in step 12 by the displacement calculating means 10d, the displacement calculating means 10d obtains how much the X position and the Y direction (see FIG. 7) are displaced with respect to the coordinate position of the center position C, respectively.

(Step 13)
As a result of the determination by the displacement calculating means 10d, when it is determined that the marker M is not detected in the fluoroscopic image 120 (Step 10; No), the displacement calculating means 10d is at least 1 more than the image in which the marker M is not detected. An image generated before the frame and a past image one frame before the image are read from the image data storage circuit 72.

(Step 14)
The displacement calculating unit 10d acquires the coordinate positions of the markers M in the read past images.

(Step 15)
The displacement calculating means 10d compares the coordinate position of the marker M in time series order. In the example of FIG. 8, determine the coordinate position of the marker position a ₁₀ according the marker position a ₁₁ shown the detection position A10 in the fluoroscopic image 120 in the previous frame. As a result, the displacement calculating means 10d obtains the displacement of the position of the marker M.

(Step 16)
As a result of obtaining the displacement, the displacement calculating means 10d obtains the displacement direction and the displacement amount of the marker M. Furthermore, the displacement calculating means 10d assumes that the amount of the displacement obtained is n times the calculated displacement direction, and predicts the current position of the X-ray detector 21b.

(Step 17)
The imaging control unit 10b is configured to detect the X-ray detector moving mechanism 31 by the mechanism control unit 34 of the mechanism unit 3 based on the displacement information obtained by the displacement calculation unit 10d or the predicted position of the current X-ray detector 21b. Control the drive.

(Step 18)
When the X-ray detector moving mechanism 31 is driven, the relative position between the top plate 6 and the X-ray detector 21b is displaced according to the movement of the marker M, that is, the progress of the insertion member such as the catheter. Further, the X-ray diaphragm 12 is controlled by the imaging control means 10b to change the X-ray irradiation direction on the subject.

(Step 19)
When the X-ray detector 21b is moved, the imaging control unit 10b further moves and displays the position display 121 in the reference image 110 based on the displacement information of the position of the marker M obtained by the displacement calculation unit 10d. In other words, from the start of photographing of the fluoroscopic image 120, the photographing control means 10b uses the reference image 110 based on the displacement information of the coordinate position of the marker M in the fluoroscopic image 120 and the information of the display magnification difference obtained by the displacement calculating means 10d. The displacement of the coordinate position of the marker M at is obtained. Further, the imaging control unit 10b transmits the obtained displacement information of the marker M to the display unit 8. The display unit 8 causes the display control unit 81 to move the coordinate position of the marker M to the position after displacement and display it on the monitor 82.

(Step 20)
Further, the display control unit 81 causes the reference image 110 to display the traveling locus 122 of the marker M that connects the positions of the marker M before and after the displacement, as shown in FIG. The traveling locus 122 is transmitted to the system control unit 10 and stored in the storage unit 10c.

(Action / Effect)
In the X-ray diagnostic apparatus of the present embodiment described above, the reference image 110 including the insertion position of the insertion object such as the catheter to the lesioned part is photographed by the X-ray detector 21a having a large visual field. Further, when an insert is inserted, fluoroscopic imaging is started, switching to imaging with a small-field X-ray detector 21b, and the X-ray irradiation field is also limited according to the detection range of the X-ray detector 21b.

  Further, the displacement calculating unit 10d causes the image processing unit 7 to analyze the distal end (marker M or the like) of an insert such as a catheter in the fluoroscopic image 120, and the displacement calculating unit 10d obtains the coordinate position of the distal end in the fluoroscopic image 120. . As a result, when the coordinate position of the tip exceeds the predetermined range, the imaging control means 10b is caused to perform movement control of the X-ray detector 21b based on the obtained image coordinate position information. As a result, the X-ray detector 21b is moved so as to cancel the displacement of the tip position.

  Further, the imaging control means 10b displays the position of the X-ray detector 21b (reference numeral 121) in the reference image 110, and further moves the detection position An of the X-ray detector 21b in accordance with the movement of the X-ray detector 21b. . According to the configuration as described above, the operator can grasp where the insert is in the subject between the insertion position of the insert and the lesion, and insert the catheter or the like. Can be displayed as a high-definition fluoroscopic image.

  Therefore, it is possible to avoid a situation in which the operator loses sight of the position of the insert in the subject, and at the same time, since a fluoroscopic image showing an insert such as a catheter is displayed in parallel, a situation in which the fluoroscopic image resolution is reduced. As a result, it is possible to prevent the operator from grasping the progress of the insertion of the catheter or the like. Further, in fluoroscopic imaging, the X-ray detector 21b having a small field of view is switched, and the X-ray irradiation field is limited accordingly, so that the amount of exposure of the subject can be reduced.

[Second Embodiment]
Next, the configuration of the X-ray diagnostic apparatus according to the second embodiment of the present invention will be described. In the second embodiment, the control configuration for moving the position display 121 in the reference image 110 to an insertion position such as a catheter is different from that in the X-ray diagnostic apparatus according to the first embodiment described above. Other parts are the same as in the first embodiment. Hereinafter, only the configuration different from the first embodiment will be described in the second embodiment.

  In the X-ray diagnostic apparatus according to the second embodiment, when an insert such as a catheter is inserted into a subject and the catheter or the like is seen through the X-ray diagnostic apparatus, the position display 121 is set to the insertion position by the operation of the operator. Rather than being moved, the position of the marker M is detected as a function of the X-ray diagnostic apparatus, the X-ray detector 21b is moved, and the fluoroscopic imaging is started after the position display 121 is set to the insertion position.

  In the X-ray diagnostic apparatus according to the second embodiment as well, upon receiving an operation to start fluoroscopic imaging from the operation unit 9, the imaging control unit 10 b displays the data of the reference image 110 from the image data storage circuit 72. The process until the reference image 110 as shown in FIG. 5 is displayed on the monitor 82 is the same as that of the X-ray diagnostic apparatus according to the first embodiment.

  Further, the imaging control means 10b acquires relative position information between the top board 6 and the small-field X-ray detector 21b from the mechanism control unit 34, and on the reference image 110 based on the position information, the current X-ray detector 21b. The control for displaying the imaging region at the position of the line detector 21b (see FIG. 6) is the same as in the first embodiment.

  In the X-ray diagnostic apparatus according to the second embodiment, when an operation for starting fluoroscopic imaging is received from the operation unit 9, the imaging control unit 10 b in the system control unit 10 further sends a reference image to the X-ray generation unit 1. X-ray irradiation is performed in the imaging range at 110. X-rays irradiated at this time and transmitted through the subject are detected by the X-ray detector 21a and converted into image data by the X-ray detector 2. Here, the image processing unit 7 does not generate and display the reference image 110 again, but the image calculation circuit 71 determines at which position in the image data of the reference image 110 photographed at this time the tip of the insert. Detect about. That is, the image calculation circuit 71 detects the position of the marker M having a specific luminance value in the reference image 110. Furthermore, the imaging control means 10 b acquires the coordinate position of the marker M in the reference image 110 by the image calculation circuit 71. As in the first embodiment, even when the marker M is not provided on the insert, the image calculation circuit 71 identifies the shape of the tip position by image analysis and acquires the coordinate position of the tip position. It may be.

  This position information is converted into physical coordinate position information with respect to the top board 6 by the imaging control means 10b and transmitted to the mechanism control unit 34. The mechanism control unit 34 uses the position information as information on the relative position of the X-ray detector 21b with respect to the top plate 6. Further, the mechanism control unit 34 drives the X-ray detector moving mechanism 31 based on the position information to move the X-ray detector 21b in accordance with the position of the imaging region of the X-ray detector 21b in the reference image 110. .

(Action / Effect)
The X-ray diagnostic apparatus according to the second embodiment described above also avoids a situation in which the operator loses sight of the position of the insert in the subject as in the first embodiment, and at the same time inserts such as catheters. Since the fluoroscopic images to be displayed are displayed in parallel, a situation in which the fluoroscopic image resolution is reduced can be avoided, and as a result, it is possible to prevent the surgeon from grasping the progress of the insert such as the catheter. Moreover, in fluoroscopic imaging, the X-ray irradiation field is limited according to switching to the X-ray detector 21b having a small field of view, so that it is possible to reduce the exposure amount of the subject. Further, by omitting the operation of moving the X-ray detector 21b to the fluoroscopic imaging start position, the operator can concentrate on the insertion operation of an insert such as a catheter, and the insertion operation can be supported more suitably. It becomes.

[First modification]
Next, a first modification of the X-ray diagnostic apparatus according to the first embodiment and the second embodiment will be described. In the X-ray diagnostic apparatus according to the first embodiment and the second embodiment, the top plate 6 is used as a reference for setting the imaging range of the reference image 110 and moving the X-ray detector 21b. However, the X-ray diagnostic apparatus according to the present invention is not limited to this configuration, and at least after setting the imaging range of the reference image 110, if the relative position between the top 6 and the X-ray detector 21a is fixed, It is also possible to use the X-ray detector 21a as a reference without using the top plate 6 as a reference.

[Second modification]
Next, with reference to FIG. 12, the 2nd modification of 1st Embodiment and 2nd Embodiment is demonstrated. FIG. 12 is a schematic diagram showing a reference image 110 and a fluoroscopic image 120 generated by an X-ray diagnostic apparatus according to a modification of the embodiment of the present invention. In the X-ray diagnostic apparatus according to the first embodiment and the second embodiment, as shown in FIGS. 6 and 7, the reference image 110 and the fluoroscopic image 120 are separately displayed, or at least divided and displayed on a single monitor 82. However, the X-ray diagnostic apparatus according to the present invention is not limited to this configuration. For example, as shown in FIG. 12, an empty area in the reference image 110 where a vessel or the like is not displayed is used as a display area of the fluoroscopic image 120. It is also possible to do.

[Third Modification]
Next, a third modification will be described. In the X-ray diagnostic apparatus according to the first embodiment and the second embodiment, when the marker M is not detected in the fluoroscopic image 120, the displacement calculation unit 10d refers to a plurality of past images and detects the current X-ray. The position of the detector 21b is predicted and the X-ray detector 21b is moved. However, the X-ray diagnostic apparatus according to the present invention is not limited to this configuration, and can adopt the following configuration.

  The X-ray diagnostic apparatus according to this modification has an insert tip position detection system. In this insert tip position detection system, a plurality of receivers are arranged around the imaging region, and signals from the receivers are transmitted to the position detection units, respectively. The installation positions of the plurality of receivers are set and stored in advance. Further, a transmitter is provided at the tip of the insert, and when detecting the position, the transmitter transmits a signal including unique identification information. The plurality of receivers measure the electric field strength of the signal from the transmitter together with the identification information. The position detection unit determines the height of the electric field strength of the signal received by each receiver from the measurement results of the plurality of receivers. The position detector assumes the coordinates of the tip position based on the position of each receiver and the distribution of electric field strength. Based on the assumed coordinate position information, the imaging control means 10b of the system control unit 10 performs control to move the X-ray detector 21b.

  Effects similar to those of the above-described embodiment can also be realized by the configurations of the X-ray diagnostic apparatuses according to the first to third modifications described above.

DESCRIPTION OF SYMBOLS 1 X-ray generation part 2 X-ray detection part 3 Mechanism part 4 High voltage generation part 5 C arm 6 Top plate 7 Image processing part 8 Display part 9 Operation part 10 System control part 10a Transmission / reception means 10b Imaging | photography control means 10c Storage means 10d Displacement Calculation means 11 X-ray tube 12 X-ray restrictor 21a / 21b X-ray detector 22 Gate driver 23 Charge / voltage converter 24 A / D converter 31 X-ray detector moving mechanism 32 C-arm rotating / moving mechanism 33 Sky Plate moving mechanism 34 Mechanism control unit 41 X-ray control unit 42 High voltage generator 71 Image calculation circuit 72 Image data storage circuit 81 Display control unit 82 Monitor 110 Reference image 120 Perspective image 121 Position display 122 Progress track 210 Connection base 211 Support guide 211a Guide groove 212 Y-axis moving mechanism 213 X-axis moving mechanism A1 to An Detection position C Center position a1-an marker position

Claims (7)

An X-ray source for generating X-rays irradiated on the subject;
X-ray diaphragm means for narrowing the irradiation range of the X-ray to the subject;
A first X-ray detector for detecting X-rays transmitted through the subject;
A second X-ray detector having a detection range narrower than that of the first X-ray detector;
First control means for controlling the X-ray diaphragm means to change the irradiation range;
A first image is generated based on the X-ray detected by the first X-ray detector, and is inserted into at least the subject based on the X-ray detected over time by the second X-ray detector. X-ray image generation means for sequentially generating a second image including the tip of the inserted insert,
Position detecting means for obtaining a displacement of the tip position of the insert based on the second image;
Second control means for displacing a relative position between the subject and the second X-ray detector;
Display means for indicating the relative position in the first image according to the movement of the relative position and displaying the second image in parallel;
After the first image is generated, the first control means narrows the X-ray irradiation range by the X-ray diaphragm means according to the detection range of the second X-ray detector,
The second control means displaces a relative position between the subject and the second X-ray detector according to the displacement of the insert obtained by the position detection means;
X-ray diagnostic apparatus characterized by the above. After the first image is generated, the second control means includes the second X-ray detector so that at least the insertion position of the insert is included in the detection range of the second X-ray detector. Move
The first control means limits the irradiation range of the X-rays by the X-ray diaphragm means according to the detection range of the second X-ray detector;
The X-ray diagnostic apparatus according to claim 1. The position detecting means sequentially detects the tip position of the insert in the second image to obtain a displacement amount and a displacement direction with respect to the tip position detected previously;
The X-ray diagnostic apparatus according to claim 1. The position detecting means further detects the tip of the insert by the first X-ray detector after the first image is generated,
The second detecting means moves the second X-ray detector in accordance with the tip position when the position detecting means detects the tip;
The X-ray diagnostic apparatus according to claim 2. A bed on which the subject lies;
The second control means moves at least one of the second detector and the bed to move a relative position between the subject and the second detector;
The X-ray diagnostic apparatus according to claim 1. The position detecting means, when the tip position of the insert is not detected from the second image, the first past image before the second image and the first past image before the first past image. 2 by estimating a tip position of the insert by referring to a plurality of past images including two past images;
The second control means determines a relative position between the subject and the second X-ray detector so that the estimated tip position is included in a detection range of the second X-ray detector. Displacing,
The X-ray diagnostic apparatus according to claim 3, wherein: The position detecting means includes
If the tip position of the insert is not detected from the second image, the first tip position detected from the first past image before the second image, and the first past image Contrast with the second tip position detected from the previous second past image,
Further, from the comparison result, a displacement direction and a displacement amount of the first tip position and the second tip position are obtained,
Further, a position displaced from the first tip position by n times the obtained amount of displacement toward the obtained displacement direction is obtained as the estimated tip position.
The X-ray diagnostic apparatus according to claim 6.