JP2015009097A - X-ray diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray diagnostic apparatus capable of reducing burden on an operator in setting of a photography condition to an esophagus region of an analyte.SOLUTION: An X-ray diagnostic apparatus 1 includes: an X-ray detection part 7 which detects an X-ray generated by an X-ray generation part 3 and transmitted through an analyte; an irradiation range limiting device 5 which limits the irradiation range of the X-ray; a rotation support mechanism 11 which supports the X-ray generation part 3, the irradiation range limiting device 5, the X-ray detection part 7 and a top board 14 rotatably around a rotation axis parallel to the short axis of the top board 14; an imaging method switching part 19 which executes switching from the imaging method of a stomach region to the imaging method of an esophagus region on the basis of at least one of the magnitude of the irradiation range, the imaging mode and the inspection name, and a rotation angle of the top board 14 around the rotation axis; a condition determination part 21 which determines the imaging condition corresponding to the switched imaging method; and a control part 23 which controls the X-ray generation part 3 and the irradiation range limiting device 5 for imaging the analyte in accordance with the imaging condition.

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus capable of fluoroscopic imaging of a subject.

  Conventionally, in an upper gastrointestinal contrast examination for a subject, first, fluoroscopic imaging of the esophagus is performed, and then fluoroscopic imaging of the stomach is performed. The esophageal contrast examination for the subject is performed in a good double contrast state (a state in which a barium contrast agent is thinly attached to the inner wall of the esophagus that has been appropriately inflated with air), as in the case of the gastric contrast examination. However, both air and barium contrast agent in the esophagus immediately flow into the stomach. Therefore, in the esophagus, air and barium contrast agents do not collect in the esophagus, unlike air and barium contrast agents in gastrographs. From this, a good double contrast state appears only for a short period of time. Continuous imaging is effective for capturing images with good timing during a period in which a good double contrast state is maintained.

  In addition to the above, the esophageal imaging examination using the X-ray diagnostic apparatus is different from the gastric imaging examination in many respects. Therefore, in order to obtain a photographed image with high diagnostic ability, the following various settings are made by the operator. It is necessary to change from stomach to esophagus according to the input instruction.

1. Fluoroscopy table tilt angle: Stand in a standing position so that the subject can easily take the contrast medium with his / her own cup.

2. Split format: Since the esophagus is long and narrow, it does not irradiate X-rays on parts that are not necessary for the examination. In addition, in order to efficiently interpret the captured image of the esophagus region, the short axis direction ( Left / Right splitting or Left / Right splitting is automatically selected.

3. Shooting mode / Sequence shooting sequence: Continuous shooting with a frame rate of 2 to 3 fps (frame per second) and a number of shots of 2 to 6 in order to capture a good period of time during which a good double contrast state is maintained. Set.

4). Imaging dose: The imaging dose of the esophagus is controlled by AEC (Auto Exposure Control) as in the case of stomach imaging. The esophagus is in front of the thoracic vertebra and in the middle of the longitudinal. Therefore, in the esophageal contrast examination, the left and right sides of the esophagus are imaged in the lung field with little X-ray absorption. Since AEC controls the average dose of the irradiation field, when the lung field enters the irradiation field, the dose of the longitudinal and esophagus decreases. For this reason, when the esophagus is imaged with the AEC setting for gastric imaging, noise increases and the diagnostic ability decreases. In order to avoid this, the dose of AEC is increased by about 30% in the esophageal radiography compared to the gastric radiography which is the standard of the apparatus.

5. Imaging X-ray conditions: The contrast medium flows fast in the upper esophagus. The lower esophagus vibrates due to the heartbeat. For these reasons, the photographed image is blurred and the diagnostic ability is likely to deteriorate. In order to avoid this, in the esophagus radiography, radiography X-ray conditions (about 100 kV / 250 mA), which is an imaging time of about 10 msec shorter than the gastric radiography, are set.

6). Photographed image processing conditions: The esophagus is the background of the esophagus in the low-dose region in the image, and further, the longitudinal and thoracic vertebrae have a small dose difference from the double-contrast esophagus. Therefore, when gradation processing similar to that performed for a stomach image is applied, the esophagus is drawn with a slight density difference against a low density background, and the diagnostic ability tends to deteriorate. To avoid this, esophageal radiography is processed with a higher density and higher contrast than gastric radiography.

7). DICOM TAG: Body Part Examined or the like is set for the esophagus so that an esophageal photographed image can be easily searched in DICOM Storage.

Specifically, in the X-ray diagnostic apparatus, the operator selects “examination name: upper gastrointestinal image examination” and starts examination before esophageal radiography. In the examination name, three items of imaging X-ray conditions (several types are registered and a registration number of a function for determining the imaging X-ray conditions from the fluoroscopic X-ray conditions), DICOM TAG (Body Parts), and imaging image processing conditions are registered. ing. These three items are all set for gastric imaging. The imaging mode is preset for one-shot imaging for gastric imaging, and the imaging dose is preset for the apparatus standard (for gastric imaging). The operator executes an operation of manually switching all the seven items to esophageal photography before esophageal photography. That is,
1. Perspective shooting table tilt angle: Standing position 2. 2. Split format: Select left or right split or left and right split 3. Shooting mode / Shooting sequence: Switch to continuous shooting / Select from (for example, frame rate 2 fps 4 shots) set or preset. Imaging dose: AEC dose increased by about 30% from the standard equipment (for gastroscopy). Imaging X-ray condition: Selection of a registration number in which imaging X-ray conditions for esophageal imaging (such as a function for determining imaging X-ray conditions from fluoroscopic X-ray conditions) are registered, or imaging X-ray conditions are determined from fluoroscopic X-ray conditions 5. Set the X-ray conditions for the esophagus. 6. Captured image processing conditions: Change to high density and high contrast processing for esophageal captured images DICOM TAG: Body Part Examined is changed to Esophagus (esophagus) When the esophagus has been imaged, the operator returns the imaging mode to the one-shot imaging mode for subsequent stomach imaging. Next, the operator returns the dose and imaging conditions to the stomach dose and imaging conditions, respectively. After this, the operator continues the gastrograph.

  Conventionally, in the esophageal angiography examination, it is necessary to manually set, change, etc. 1 to 7 described above. In addition, when changing from a food imaging examination to a gastric imaging examination, it is necessary to manually set, change, etc. 1 to 7. For this reason, operations such as setting / changing are troublesome for the operator, and there is a problem that burdens the operator. In addition, the manual change of the setting has a problem of hindering the flow of inspection, increasing the inspection time, and lowering the diagnostic efficiency. In addition, when esophageal imaging is performed without inputting the above settings, there is a problem in that continuous imaging cannot be performed on the esophagus, so that the imaging timing is missed and unnecessary exposure to an originally shielded area occurs. Furthermore, since the radiographic X-ray conditions (dose, radiation quality) and image processing do not match the settings for esophageal radiography, there is a problem that the image quality is degraded and the diagnostic ability is degraded.

  Furthermore, in a gastroscopy performed after an esophageal imaging test, if you forget to change the setting items such as the imaging conditions related to the esophageal imaging test to the setting items such as the imaging conditions related to the gastroscopy test, There is a problem in that there is a decrease in the temperature and the occurrence of unnecessary exposure.

JP 2013-111366 A

  An object of the present invention is to provide an X-ray diagnostic apparatus that can reduce the burden on the operator in setting the imaging conditions for the esophageal region of the subject.

  The X-ray diagnostic apparatus according to this embodiment includes an X-ray generation unit that generates X-rays, an X-ray detection unit that detects X-rays generated by the X-ray generation unit and transmitted through a subject, and the X-rays The X-ray detector, X-ray generator, X-ray generator, top plate, and top plate can be rotated about a rotation axis parallel to the short axis of the top plate. Based on the rotation support mechanism to be supported, at least one of the size of the irradiation range, the imaging mode, and the examination name, and the rotation angle of the top plate around the rotation axis, from the imaging method of the stomach region to the esophageal region An imaging method switching unit that performs switching to the imaging method, a condition determining unit that determines imaging conditions corresponding to the switched imaging method, and the X-ray for imaging the subject according to the imaging conditions A generator and the irradiation range limiter; A control unit for controlling, characterized by including the.

FIG. 1 is a diagram illustrating an example of the configuration of the X-ray diagnostic apparatus according to the present embodiment. FIG. 2 is a diagram showing an example of the outline of the form of the X-ray diagnostic apparatus according to the present embodiment. FIG. 3 is a diagram illustrating a plurality of first direction diaphragm blades, a plurality of second direction diaphragm blades, and a maximum irradiation range in the irradiation range limiter according to the present embodiment. FIG. 4 is a diagram illustrating an example of an irradiation range according to the present embodiment, in which the division format is right and left division and is limited by the irradiation range limiter. FIG. 5 is a diagram illustrating an example of a plurality of division formats according to the present embodiment. FIG. 6 is a diagram illustrating an example of the frame rate and the X-ray exposure time in continuous imaging according to the esophageal imaging conditions in the present embodiment. FIG. 7 is a diagram illustrating an example of timings for switching between shooting methods and determining shooting conditions according to the present embodiment. FIG. 8 relates to the present embodiment, and the division format is divided into right and left, and the first and second medical images (esophageal region images) corresponding to two imaging operations (first imaging and second imaging), respectively. It is a figure which shows an example of a display. FIG. 9 relates to the present embodiment, and the division format is divided into left and right three divisions, and first to third medical images (esophagus) corresponding to three imaging (first imaging, second imaging, and third imaging), respectively. It is a figure which shows an example of a display of (region image). FIG. 10 is a flowchart illustrating an example of the procedure of the imaging method switching process according to the present embodiment. FIG. 11 is a schematic diagram illustrating an esophageal region to be imaged with an anatomical name according to the first modification of the present embodiment. FIG. 12 relates to a first modification of the present embodiment, and shows a detection surface for imaging the upper esophagus region and a detection surface for imaging the lower esophagus region, together with an anatomical name and a schematic position in the subject. It is a schematic diagram. FIG. 13 is a flowchart illustrating an example of a procedure for esophageal region imaging processing according to the first modification of the present embodiment. FIG. 14 is a schematic diagram illustrating a detection surface in the imaging of the upper esophagus region and the imaging of the lower esophagus region together with the anatomical name and the schematic position in the subject according to the second modification of the present embodiment. is there. FIG. 15 relates to a second modification of the present embodiment, and selects a field of view size suitable for the upper esophagus region and the lower esophagus region, and the division format is divided into left and right, and in the first photographing and the second photographing. It is a figure which shows an example of the area | region limited asymmetrically along the 1st direction (X-axis direction). FIG. 16 is a diagram illustrating an example of an irradiation range limiter in which the first X-ray transmission region is formed according to the first movement amount in the first imaging according to the second modification of the present embodiment. FIG. 17 is a diagram illustrating an example of an irradiation range limiter in which the second X-ray transmission region is formed according to the first movement amount in the second imaging according to the second modification of the present embodiment. FIG. 18 is a flowchart illustrating an example of the procedure of the irradiation range asymmetry limiting process according to the second modification of the present embodiment.

  The X-ray diagnostic apparatus according to this embodiment will be described below with reference to the drawings. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

  FIG. 1 shows a configuration of an X-ray diagnostic apparatus 1 according to the present embodiment. The X-ray diagnostic apparatus 1 includes an X-ray generation unit 3, an irradiation range limiter 5, an X-ray detection unit (Flat Panel Detector: hereinafter referred to as FPD) 7, an X-ray generation unit 3, and an irradiation range limiter. 5 and a movable support mechanism 9 that supports the FPD 7 so as to be movable along the long axis direction of the top plate 14, and the top plate 14 and the movable support mechanism 9 can be rotated about the short axis direction of the top plate 14 as a rotation axis. A rotation support mechanism 11 to support, a support mechanism drive unit 13 for driving the movement support mechanism 9 and the rotation support mechanism 11, an interface unit 15, an input unit 17, an imaging method switching unit 19, and a condition determination unit 21. A control unit 23, an image generation / processing unit 25, a storage unit 27, and a display unit 29.

  FIG. 2 is a diagram illustrating an example of an outline of the configuration of the X-ray diagnostic apparatus 1. As shown in FIG. 2, the proximity console and the remote console correspond to the input unit 17. The proximity console and the remote console control the X-ray diagnostic apparatus in the examination room and the operation room, respectively, and are used for fluoroscopic imaging. In FIG. 2, the fluoroscopic monitor and the system monitor correspond to the display unit 29. The fluoroscopic monitor displays a fluoroscopic image. The system monitor displays the collected captured image and fluoroscopic image. In FIG. 2, the X-ray tube that emits X-rays is included in the X-ray generation unit 3. The irradiation range limiter 5 in FIG. 2 limits the X-ray irradiation area.

  The fluoroscopic imaging table in FIG. 2 includes a top plate 14 on which a subject is placed, a movement support mechanism 9, an X-ray detection unit 7, and a rotation support mechanism 11, and the tilting and imaging system (X-ray generation unit 3, The X-ray detection unit 7) performs operations such as vertical movement, oblique insertion, and compression. The X-ray detection unit 7 in FIG. 2 detects X-rays that have passed through the subject and transfers them to the image processing apparatus 2. The image processing apparatus 2 in FIG. 2 includes, for example, an imaging method switching unit 19, a condition determining unit 21, a control unit 23, an image generation / processing unit 25, a storage unit 27, and the like. The image processing apparatus 2 collects fluoroscopic image data and captured image data based on an output from an X-ray detection unit 7 described later, and executes various image processes for display. Further, the image processing apparatus 2 displays an image on each of the monitors.

  The X-ray generator 3 includes an X-ray tube and a high voltage generator. The high voltage generator generates a tube current supplied to an X-ray tube, which will be described later, and a tube voltage applied to the X-ray tube. The high voltage generator supplies a tube current suitable for X-ray imaging and X-ray fluoroscopy to the X-ray tube, and applies a tube voltage suitable for X-ray imaging and X-ray fluoroscopy to the X-ray tube, respectively. Specifically, the high voltage generator generates a tube voltage and a tube current according to the X-ray imaging conditions under the control of the control unit 23 described later.

  The X-ray tube generates X-rays from the X-ray focal point (hereinafter referred to as the tube focal point) based on the tube current supplied from the high voltage generator and the tube voltage applied by the high voltage generator. To do. The generated X-rays are emitted from an X-ray emission window in the X-ray tube. Hereinafter, an axis that passes through the tube focus and is perpendicular to the X-ray detection surface in the X-ray detection unit 7 to be described later is referred to as a Z-axis. A direction (hereinafter referred to as a first direction) that is perpendicular to the Z-axis and parallel to the long-axis direction of the top plate 14 described later is referred to as an X-axis. An axis perpendicular to the Z axis and the X axis (a direction parallel to the short axis direction of the top plate 14; hereinafter referred to as a second direction) is defined as a Y axis.

  The irradiation range limiter 5 is a front surface of the X-ray generator 3 and is provided between the X-ray generator 3 and an X-ray detector 7 described later. Specifically, the irradiation range limiter 5 is provided in front of the X-ray emission window in the X-ray generator 3. The irradiation range limiter 5 is also referred to as an X-ray movable diaphragm. The irradiation range limiter 5 prevents the X-rays generated by the X-ray generation unit 3 from being exposed unnecessarily to a region other than the imaging region desired by the operator, and is hereinafter referred to as a maximum irradiation range. ) Is limited to a predetermined irradiation range. The irradiation range limiter 5 moves the diaphragm blade according to the irradiation range limitation instruction input by the input unit 17 described later or the irradiation range limitation condition determined by the condition determination unit 21 described later, thereby Limit.

  Specifically, the irradiation range limiter 5 has a plurality of first direction diaphragm blades movable in the first direction and a plurality of second direction diaphragm blades movable in the second direction. Each of the first and second direction diaphragm blades is made of lead that shields the X-rays generated by the X-ray generator 3. The irradiation range limiter 5 has a plurality of filters (hereinafter referred to as additional filters) inserted into the X-ray irradiation field for the purpose of reducing the exposure dose to the subject P and improving the image quality. May be. The additional filter is also called an X-ray filter, a filter plate, a beam filter, a quality filter, or a beam spectrogram filter.

  FIG. 3 is a diagram illustrating a plurality of first direction diaphragm blades, a plurality of second direction diaphragm blades, and a maximum irradiation range in the irradiation range limiter 5. As shown in FIG. 3, each of the plurality of first direction diaphragm blades is movable along the first direction (X-axis direction). As shown in FIG. 3, each of the plurality of second direction diaphragm blades is movable along the second direction (Y-axis direction).

  The X-ray detection unit 7 detects X-rays generated from the X-ray generation unit 3 and transmitted through the subject P. For example, the X-ray detection unit 7 is a flat panel detector (FPD), for example. The FPD 7 has a plurality of semiconductor detection elements. The semiconductor detection element includes a direct conversion type and an indirect conversion type. The direct conversion type is a type in which incident X-rays are directly converted into electrical signals. The indirect conversion form is a form in which incident X-rays are converted into light by a phosphor and the light is converted into an electrical signal.

  Electrical signals generated by a plurality of semiconductor detection elements with the incidence of X-rays are output to an analog-to-digital converter (hereinafter referred to as an A / D converter) (not shown). The A / D converter converts an electrical signal into digital data. The A / D converter outputs the digital data to a preprocessing unit (not shown). Note that an image intensifier or the like may be used as the X-ray detection unit 7.

  The moving support mechanism 9 moves the video system (X-ray generation unit 3, irradiation range limiter 5, and X-ray detection unit 7) in the first direction (X-axis direction) under the control of the control unit 23 described later. It is supported so that it can move along. For example, when a photographing method for photographing a subject by moving a video system is input via the input unit 17 in long photographing, esophageal photographing, or the like for the subject, the moving support mechanism 9 receives the inputted photographing method. The video system is moved along the first direction according to the shooting timing at. In addition, when it is not necessary to move the video system, the movement support mechanism 9 can also fix the video system to the top plate 14.

  The rotation support mechanism 11 includes a movable support mechanism 9 including an X-ray generation unit 3, an irradiation range limiter 5, and an X-ray detection unit 7, and a top plate 14, and a short axis (Y axis) of the top plate 14 to be described later. Is supported so as to be rotatable around a rotation axis parallel to the axis. Specifically, the rotation support mechanism 11 rotates the top plate 14 around the rotation axis in accordance with an operator instruction via the input unit 17 described later. The rotation support mechanism 11 outputs the angle of the top plate 14 around the rotation axis to the imaging method switching unit 19 described later. Here, the rotation angle is, for example, a horizontal position of the top plate 14 is 0 °, and a rotation angle obtained by rotating the top plate 14 to a position parallel to the vertical direction is 90 °. Hereinafter, the position of the top plate 14 at which the rotation angle is 90 ° is referred to as a standing position. That is, the subject placed on the top 14 is in a standing position at the position of the top 14 where the rotation angle is 90 °.

  In addition, the movement support mechanism 9 and the rotation support mechanism 11 include an X-ray generation unit 3, an irradiation range limiter 5, an X-ray detection unit 7, and a top plate 14, as shown in FIG. (Axis, Y axis, Z axis) may be supported so as to be movable. For example, the moving support mechanism 9 can change the distance between the focal point of X-ray generation in the X-ray tube and the FPD 7 (the distance between the source image receiving surfaces (hereinafter referred to as SID)) and the X-ray. The generator 3, the irradiation range limiter 5, and the FPD 7 are supported.

  The support mechanism drive unit 13 drives the movement support mechanism 9 and the rotation support mechanism 11 under the control of the control unit 23 described later. Specifically, the support mechanism drive unit 13 drives the rotation support mechanism 11 in order to rotate the rotation support mechanism 11 around the rotation axis in accordance with a control signal from the control unit 23. Thereby, each component, such as the top plate 14, is rotated around the rotation axis. For example, when an instruction to place the top plate 14 in the upright position is input via the input unit 17, the support mechanism driving unit 13 rotates to rotate the top plate 14 to the upright angle (90 °). The support mechanism 11 is driven. The support mechanism drive unit 13 drives the movement support mechanism 9 in order to move the video system along the first direction (X-axis direction) in accordance with an instruction from the operator via the input unit 17.

  A top plate drive unit (not shown) moves the top plate 14 by driving the top plate 14 under the control of the control unit 23 described later. Specifically, the top board drive unit slides the top board 14 in the first and second directions based on a control signal from the control unit 23.

  A preprocessing unit (not shown) performs preprocessing on the digital data output from the X-ray detection unit 7. The preprocessing includes correction of non-uniform sensitivity between channels in the X-ray detection unit 7 and correction related to data loss. The preprocessed digital data is output to an image generation / processing unit 25 described later.

  The interface unit 15 is, for example, an interface related to a network and an external storage device (not shown). Data such as X-ray images and analysis results obtained by the X-ray diagnostic apparatus 1 can be transferred to other apparatuses via the interface unit 15 and the network.

  The input unit 17 inputs ROI, SID, X-ray imaging conditions, X-ray fluoroscopy conditions, and the like. Specifically, the input unit 17 captures various instructions / commands / information / selections / settings from the operator into the X-ray diagnostic apparatus 1. Although not shown, the input unit 17 includes a trackball for setting a region of interest, a switch button that triggers the start of X-ray imaging or X-ray fluoroscopy, a mouse, a keyboard, and the like. The input unit 17 detects the coordinates of the cursor displayed on the display screen, and outputs the detected coordinates to the control unit 23 described later. Note that the input unit 17 may be a touch panel provided so as to cover the display screen. In this case, the input unit 17 detects the coordinates instructed by touch based on the coordinate reading principle such as the electromagnetic induction type, the electromagnetic distortion type, and the pressure sensitive type, and outputs the detected coordinates to the control unit 23.

  At the start of the examination, the operator inputs the examination name for the subject via the input unit 17. During the examination, the operator divides the field of view size of the FPD 7 via the input unit 17 (hereinafter referred to as a divided format), an imaging mode for the subject (hereinafter referred to as an imaging mode), and other Enter settings, operations, etc. when necessary. The examination name is, for example, an esophageal contrast examination or the like, and is an examination name related to a contrast examination of the subject's esophageal region (hereinafter referred to as an esophageal region examination name).

  The input unit 17 inputs an examination name (hereinafter referred to as an esophageal / stomach region examination name) related to a contrast examination of an esophagus and a stomach region of a subject such as an upper gastrointestinal contrast examination, or an examination name for another region. It is also possible to input. The shooting mode is to select whether the shooting while the shooting switch is pressed is continuous multiple times at regular intervals (hereinafter referred to as continuous shooting) or once (hereinafter referred to as one-shot shooting). is there.

  As the division format, the input unit 17 normally prepares two divisions on the left and right, three divisions on the left and right, two divisions on the top and bottom, and four divisions. For example, in the left and right division, a vertically long region whose length along the second direction is one half of the visual field size and whose length along the first direction is the same as the visual field size is vertically and horizontally from the center of the visual field. In both cases, the captured images set at symmetrical positions are arranged on the left and right, and two images are displayed with the size of the field of view. Here, the visual field size is a range in which data is collected from the FPD 7 in fluoroscopy / photographing, and usually 3 to 4 sizes are prepared in the input unit 17. The maximum visual field size is usually set as the entire surface of the FPD 7. Usually, the collection range of other visual field sizes is set at a position that is symmetrical both vertically and horizontally from the center of the maximum visual field size. Since any field size is displayed in the same area of the display unit 29, the smaller the field size, the larger the narrow collection range is displayed. The visual field size is appropriately selected according to the size of the examination site.

  In the case of division format cancellation, the full open setting of the irradiation range limiter 5 in the input unit 17 becomes the selected visual field size so as not to expose a portion that is not collected and displayed as an image. Therefore, the irradiation range limiter 5 does not open larger than the visual field size. Further, when the left and right split is selected, the fully open setting of the irradiation range limiter 5 in the input unit 17 becomes the above-described vertically cut out region. Similarly, the left and right three-part division is a vertical region whose length along the second direction is one third of the visual field size and whose length along the first direction is the same as the visual field size. The captured images set at symmetrical positions on the left and right are arranged side by side, and three images are displayed with the size of the field of view. Similarly, in the upper and lower divisions, a horizontally long region whose length along the second direction is the same as the visual field size and whose length along the first direction is one half of the visual field size is vertically divided from the center of the visual field. The captured images set at symmetrical positions on both the left and right sides are arranged vertically, and two images are displayed with the size of the field of view. Similarly, in the four divisions, an area whose length along the second direction is one half of the visual field size and whose length along the first direction is one half of the visual field size is vertically changed from the center of the visual field, The captured images set at symmetrical positions on both the left and right sides are arranged in 2 rows and 2 columns, and 4 images are displayed with the size of the field of view. Similarly, the fully open setting of the irradiation range limiter 5 in the input unit 17 is also a cut-out area of each divided format so as not to expose a portion that is not collected and displayed as an image. FIG. 4 is a diagram illustrating an example of an irradiation range in which the division format is divided into left and right divisions and is limited by the irradiation range limiter 5.

  The input unit 17 has a plurality of buttons respectively corresponding to the above-described division formats. For example, a division schematic diagram schematically showing a division format may be provided on the upper surface of each of the plurality of buttons. When any one of the plurality of buttons is pressed, a division format corresponding to the pressed button is input.

  FIG. 5 is a diagram illustrating an example of a plurality of division formats. The left side in FIG. 5 shows an example in which the division format is left and right division. The right side in FIG. 5 shows an example in which the division format is left and right division. In an area limited by the irradiation range limiter 5, X-rays are shielded by a plurality of second direction diaphragm blades.

  The input unit 17 outputs the input examination name, imaging mode, and division format to the imaging method switching unit 19 described later. Note that the input unit 17 can also output to the display unit 29 described later in order to display the input examination name, imaging mode, and division format. Note that the input unit 17 can input the visual field size as the size of the irradiation range by inputting the division format cancellation.

  Based on at least one of the examination name, the imaging mode, and the division format and the rotation angle (90 °, that is, standing position), the imaging method switching unit 19 captures the stomach region of the subject (hereinafter referred to as a gastric imaging method). Switching to an imaging method for the esophageal region of the subject (hereinafter referred to as an esophageal imaging method). A plurality of items (examination name, imaging mode, division format, and rotation angle) related to switching from the stomach imaging method to the esophageal imaging method can be appropriately selected, changed, and registered by the operator via the input unit 17. Note that the imaging method switching unit 19 may execute switching between the esophageal imaging method and the gastric imaging method depending on the number of standing positions after the start of the examination instead of the rotation angle of 90 ° (standing position). . The photographing method switching unit 19 outputs the switched photographing method to the condition determining unit 21 described later.

  Specifically, when the rotation angle is 90 ° (standing position) and right and left split or left and right split are input, the imaging method switching unit 19 changes the imaging method for the subject to the stomach. Switch from shooting method to esophageal shooting method. Further, the imaging method switching unit 19 maintains the esophageal imaging method when the standing position and the divided format are maintained. When at least one of the standing position and the division format is changed, the imaging method switching unit 19 switches from the esophageal imaging method to the gastric imaging method. When at least one of the standing position and the divided format does not satisfy the condition of the esophageal imaging method, the imaging method switching unit 19 maintains the gastric imaging method.

  In the standing position and the input imaging mode is continuous imaging, the imaging method switching unit 19 switches the imaging method for the subject from the stomach imaging method to the esophageal imaging method. The imaging method switching unit 19 maintains the esophageal imaging method when standing and continuous imaging are maintained. When at least one of the standing position and the continuous photographing is changed, the photographing method switching unit 19 switches from the esophageal photographing method to the gastric photographing method. When at least one of the standing position and the continuous photographing does not satisfy the condition of the esophageal photographing method, the photographing method switching unit 19 maintains the gastric photographing method.

  In addition, when the imaging method switching unit 19 is in a standing position and the input examination name is an esophageal region examination name, the imaging method switching unit 19 changes the imaging method for the subject from the stomach imaging method to the esophageal imaging method. Switch to the method. The imaging method switching unit 19 maintains the esophageal imaging method when the standing position and the esophageal region examination name are maintained. When at least one of the standing position and the esophageal region examination name is changed, the imaging method switching unit 19 switches from the esophageal imaging method to the gastric imaging method. When at least one of the standing position and the esophageal region examination name does not satisfy the condition of the esophageal imaging method, the imaging method switching unit 19 maintains the gastric imaging method. Note that the imaging method may be switched by a combination of the name of the esophageal / stomach region test as the test name and the nth standing position after the start of the test. The number n is registered in advance according to the inspection method.

  The condition determining unit 21 determines the shooting condition for the shooting method switched by the shooting method switching unit 19. Specifically, when the gastrographing method is switched to the esophageal photographing method by left and right or right and left division of the divided format, the condition determination unit 21 captures photographing conditions relating to the esophageal photographing method (hereinafter referred to as esophageal photographing conditions). Called). The esophageal imaging conditions include, for example, the imaging mode is continuous imaging, the imaging sequence is a frame rate of 2 fps, the number of images to be captured is 4, and the imaging dose is a dose in gastric imaging (dose in standard automatic exposure control). This is a condition that increases by 30% and the X-ray exposure time is about 10 ms. The condition that the X-ray exposure time is about 10 ms is, for example, a condition for short-time imaging (imaging tube voltage 100 kV) in a method of determining imaging conditions using the tube voltage of the fluoroscopic conditions used at the time of fluoroscopy before imaging. Before and after, the tube current is about 250 mA).

  FIG. 6 is a diagram illustrating an example of the frame rate and the X-ray exposure time in continuous imaging, according to esophageal imaging conditions. The exposure interval in FIG. 6 corresponds to the reciprocal of the frame rate. For example, when the frame rate is 2 fps, the exposure interval is 1/2 second. Further, the exposure time in FIG. 6 is 10 ms.

  In addition, when at least one of the standing position and the divided format is changed and the esophageal imaging method is switched to the gastric imaging method, the condition determining unit 21 captures imaging conditions related to the gastric imaging method (referred to as gastric imaging conditions). ). The gastric imaging conditions include, for example, the one-shot imaging mode, an imaging dose of 30% reduction (or standard dose) in esophageal imaging, and an X-ray exposure time of 30 to 60 ms ( Standard exposure time). The condition that the X-ray exposure time is 30 to 60 ms is, for example, a standard condition (around the imaging tube voltage of about 90 kV) among the methods for determining the imaging condition using the tube voltage of the fluoroscopic condition used at the time of fluoroscopy before imaging. , The tube current is about 200 mA). Here, when the standing position is changed first between the standing position and the split format, the split format may be switched to the split format cancellation which is the gastrographing condition, and the full opening size of the irradiation range may be switched to the visual field size. .

  When the gastric imaging method is switched to the esophageal imaging method by standing and continuous imaging, the condition determining unit 21 determines esophageal imaging conditions having the following contents. The esophageal imaging conditions are, for example, that the division format is 2 left and right or 3 left and right, the imaging sequence is a frame rate of 2 fps, the number of images to be taken is 4, and the imaging dose is 30% increase in the gastric imaging dose. Thus, the X-ray exposure time is about 10 ms. When continuous shooting is selected in the shooting mode, a certain shooting sequence is set, but when the esophageal shooting method is switched, the condition determining unit 21 switches to a frame rate of 2 fps, which is an esophageal shooting condition, and four shots.

  In addition, when the esophageal imaging method is switched to the gastric imaging method because at least one of the standing position and the continuous imaging is changed, the condition determination unit 21 determines the gastrographing conditions. The gastric imaging conditions are, for example, cancellation of the division format, the imaging dose is 30% reduction (or standard dose) of the esophageal imaging, and the X-ray exposure time is 30 to 60 ms (standard exposure). Is a condition that is a shooting time). Here, when the standing position is changed first between the standing position and the continuous photographing, the photographing mode may be switched to the one-shot photographing which is the stomach photographing condition.

  If the gastrographing method is switched to the esophageal radiographing method based on the standing and esophageal region examination name or the nth standing and esophageal / stomach region examination name after the start of the examination, the condition determination unit 21 has the following contents: Determine esophageal imaging conditions. The esophageal imaging conditions are, for example, the division format is left and right or left and right division, the imaging mode is continuous imaging, the imaging sequence is a frame rate of 2 fps, the number of imaging is 4, and the imaging dose is the stomach. This is a condition that the dose in imaging is increased by 30% and the X-ray exposure time is about 10 ms.

  In addition, when at least one of the standing position and the examination name is changed and the esophageal imaging method is switched to the gastric imaging method, the condition determining unit 21 determines the gastric imaging conditions. The gastric imaging conditions are, for example, cancellation of the division format, the imaging mode is one-shot imaging, the imaging dose is 30% reduction (or standard dose) of the esophageal imaging, and X-ray exposure This is a condition where the firing time is 30 to 60 ms (standard exposure time).

  FIG. 7 is a diagram illustrating an example of timings for switching between shooting methods and determining shooting conditions. As shown in FIG. 7, in synchronization with the switching of the shooting method, shooting conditions corresponding to the switched shooting method are determined.

  When the gastrographing method is switched to the esophageal imaging method, the condition determining unit 21 displays image processing conditions (hereinafter referred to as an esophageal image) for displaying a medical image generated by the esophageal imaging method (hereinafter referred to as an esophageal region image). (Referred to as processing conditions). The esophageal image processing condition is, for example, a condition for processing an esophageal region image so that it is displayed with a higher density and a higher contrast than a medical image generated by a stomach imaging method (hereinafter referred to as a stomach region image).

  When the condition determining unit 21 is switched from the esophageal imaging method to the gastric imaging method, the condition determining unit 21 determines an image processing condition (hereinafter referred to as a stomach image processing condition) for displaying a stomach region image. May be. The stomach image processing conditions are, for example, conditions for performing image processing so that a stomach region image is displayed at a lower density and lower contrast (or standard density and standard contrast) than an esophageal region image.

  Further, when the gastric imaging method is switched to the esophageal imaging method, the condition determination unit 21 may determine a tag (for example, DICOM TAG) related to the esophageal region image. At this time, the tag is, for example, Body Part Examined = ESOPHAGUS. In addition, when the condition determining unit 21 is switched from the esophageal imaging method to the gastric imaging method, the condition determining unit 21 may determine a tag related to the stomach region image. At this time, the tag is, for example, Body Part Examined = STOMACH. These determined tags are output to the control unit 23 described later.

  The control unit 23 includes a CPU (Central Processing Unit) and a memory (not shown). The control unit 23 controls each unit in the X-ray diagnostic apparatus 1 in order to perform X-ray imaging and fluoroscopy in accordance with an operator instruction, imaging conditions, fluoroscopy conditions, and the like sent from the input unit 17.

  The control unit 23 controls the X-ray generation unit 3 and the irradiation range limiter 5 in accordance with the imaging conditions (esophageal imaging conditions, gastric imaging conditions) determined by the condition determining unit 21. The control unit 23 controls the image generation / processing unit 25 in accordance with the image processing conditions (esophageal image processing conditions, stomach image processing conditions) determined by the condition determining unit 21. The control unit 23 controls the storage unit 27 in order to store the medical image in the storage unit 27 together with the tag determined by the condition determination unit 21.

  Specifically, the control unit 23 controls the X-ray generation unit 3 according to the frame rate, the number of images, the X-ray exposure conditions, and the imaging dose in order to perform continuous imaging according to the esophageal imaging conditions. The control unit 23 controls the irradiation range limiter 5 in order to limit the irradiation range corresponding to the input division format according to the esophageal imaging conditions. The control unit 23 controls the image generation / processing unit 25 in order to perform image processing on the esophageal region image according to the esophageal image processing conditions. The control unit 23 controls the storage unit 27 in order to cause the storage unit 27 to store the DICOM TAG with Body Part Examined = ESOPHAGUS together with the esophageal region image.

  The control unit 23 controls the X-ray generation unit 3 in accordance with the X-ray exposure condition and the imaging dose in order to execute one-shot imaging according to the stomach imaging conditions. The control unit 23 controls the irradiation range limiter 5 in order to change the size of the irradiation range to the visual field size in accordance with the gastrographing conditions. The control unit 23 controls the image generation / processing unit 25 to perform image processing on the stomach region image according to the stomach image processing conditions. The control unit 23 controls the storage unit 27 in order to cause the storage unit 27 to store the DICOM TAG with Body Part Exposed = STOMACH together with the stomach region image.

  The image generation / processing unit 25 generates a captured image under the control of the control unit 23 based on the digital data pre-processed after being imaged according to the imaging conditions determined by the condition determining unit 21, Image processing is performed according to the processing conditions. The image generation / processing unit 25 generates a fluoroscopic image under the control of the control unit 23 based on the digital data pre-processed after X-ray fluoroscopy at the fluoroscopic position, and performs image processing according to the image processing conditions. To do. Hereinafter, the captured image and the fluoroscopic image are collectively referred to as an X-ray image. The image generation / processing unit 25 outputs the generated and processed X-ray image to the storage unit 27 and the display unit 29 described later.

  Specifically, the image generation / processing unit 25 generates an esophageal region image related to the esophageal region of the subject imaged according to the esophageal imaging conditions, and respectively corresponds to a plurality of imaging according to the division format and the esophageal image processing conditions. Image processing is performed on a plurality of esophageal region images. At this time, the esophageal region image is cut out and arranged in a predetermined layout corresponding to the division format, and image processing is performed so that the density is higher than the standard density and the contrast is higher than the standard contrast. The image generation / processing unit 25 generates a stomach region image related to the esophageal region of the subject imaged according to the stomach imaging conditions, and performs image processing on the stomach region image according to the stomach image processing conditions. At this time, the stomach region image is image-processed with standard density and standard contrast. The image generation / processing unit 25 outputs the esophageal region image and the stomach region image to the display unit 29.

  FIG. 8 is a diagram illustrating an example of display of first and second medical images (esophageal region images) corresponding to two imaging operations (first imaging and second imaging), each of which is divided into right and left images. It is. As shown in FIG. 8, when the division format is left and right division, the image generation / processing unit 25 cuts out and arranges the first medical image and the second medical image in parallel.

  FIG. 9 shows the display of the first to third medical images (esophageal region images) corresponding to the three imaging operations (first imaging, second imaging, and third imaging). It is a figure which shows an example. As shown in FIG. 9, when the division format is left and right division, the image generation / processing unit 25 cuts out and arranges the first to third medical images in parallel.

  The storage unit 27 generates various X-ray images generated by the image generation / processing unit 25, the control program of the X-ray diagnostic apparatus 1, a diagnostic protocol, and an operator sent from the input unit 17 described later. , Various data groups such as imaging conditions and fluoroscopic conditions, volume data of the subject P transmitted via the interface unit 15 and the network, and the like are stored. The storage unit 27 may store a program that realizes the function related to the condition determination unit 21 and the function related to the imaging method switching unit 19.

  Under the control of the control unit 23, the storage unit 27 stores an esophageal region image together with DICOM TAG where Body Part Examined = ESOPHAGUS. Under the control of the control unit 23, the storage unit 27 stores a stomach region image together with DICOM TAG where Body Part Examined = STOMACH.

  The display unit 29 displays the X-ray image generated by the image generation / processing unit 25 and subjected to image processing. The display unit 29 may display an input screen for inputting imaging conditions in X-ray imaging, fluoroscopy conditions in X-ray fluoroscopy, SID, X-ray imaging imaging conditions, X-ray fluoroscopy conditions, and the like.

(Shooting method switching function)
The imaging method switching function executes switching from the gastric imaging method to the esophageal imaging method based on at least one of the examination name, the imaging mode, and the division format and the rotation angle (90 °, that is, standing position). This is a function of imaging an esophageal region of a subject according to an esophageal imaging condition determined according to a method and displaying an esophageal region image under an esophageal display condition determined according to the esophageal imaging method.

  Hereinafter, processing related to the shooting method switching function (hereinafter referred to as shooting method switching processing) will be described. The imaging method switching process is a process for automatically switching the imaging method between the gastric imaging method and the esophageal imaging method. The imaging method set in advance is a gastric imaging method. When imaging the esophageal region in a non-standing position (hereinafter referred to as non-standing esophageal imaging), the rotation angle used for switching the imaging method corresponds to the angle of the top plate in non-standing esophageal imaging.

FIG. 10 is a flowchart illustrating an example of the procedure of the imaging method switching process.
When the X-ray diagnostic apparatus 1 is activated, the rotation support mechanism 11 detects the position of the top board, that is, the rotation angle, and starts output to the imaging method switching unit 19. The detection and output of the rotation angle continues until the apparatus stops. (Step Sa1). The examination name for the subject is input via the input unit 17, and the examination is started (step Sa2). At least one of the shooting mode and the division format is input via the input unit 17 (step Sa3). The rotation angle is 90 ° (standing position), the imaging mode is continuous imaging, the division format is divided into left and right (or right and left three divisions), the examination name is the esophageal region examination name, or the rotation angle is n after the examination starts. It is determined whether the examination name is 90 ° (standing position) and the examination name is an esophageal area examination name (step Sa4). In the process of step Sa4, in the case of Yes, the imaging method is switched from the stomach imaging method to the esophageal imaging method (step Sa5). Imaging conditions (esophageal imaging conditions) corresponding to the esophageal imaging method are determined (step Sa6). Image processing conditions (esophageal image processing conditions) corresponding to the esophageal imaging method are determined (step Sa7). A subject is imaged according to esophageal imaging conditions, and a medical image (esophageal region image) is generated (step Sa8). The esophageal region image is image-processed and displayed according to the determined esophageal image processing conditions (step Sa9).

  In the process of step Sa4, if the result is No and the imaging method is the esophageal shadow method in the preceding process, the imaging method is switched from the esophageal imaging method to the gastric imaging method (standard imaging method). At this time, imaging conditions (standard imaging conditions: stomach imaging conditions) corresponding to the stomach imaging method are determined. In addition, image processing conditions (standard image processing conditions: gastric image processing conditions) corresponding to the stomach imaging method are determined. Further, in the preceding process, when the imaging method is the stomach imaging method, the stomach imaging method is maintained. A subject is imaged in accordance with standard imaging conditions (gastric imaging conditions), and a medical image (stomach region image) is generated (step Sa10). The stomach region image is subjected to image processing according to stomach image processing conditions (standard image processing conditions) and displayed (step Sa11). When there is the next shooting (step Sa12), the processing from step Sa3 to step Sa11 is repeated.

(First modification)
The difference from this embodiment is that the esophageal region to be imaged by the esophageal imaging method is two regions, an upper esophagus region and a lower esophagus region, and different images for the upper esophagus region and the lower esophagus region, respectively. It is to be photographed with the position of the system and the photographing sequence.

  FIG. 11 is a diagram showing esophageal regions to be imaged together with anatomical names. The esophageal region has a cervical esophagus, an upper thoracic esophagus, a middle thoracic esophagus, a lower thoracic esophagus, and an abdominal esophagus. The upper esophageal region includes the cervical esophagus, the upper chest esophagus, and the middle thoracic esophagus. When the contrast agent flows into the esophagus region, a double contrast state (a state in which barium contrast agent is thinly attached to the inner wall of the esophagus that is appropriately inflated with air) occurs in the upper esophagus region. That is, in the upper esophagus region, imaging is performed with the inflow of contrast medium. In addition, since the flow of the contrast medium is fast, the period during which the double contrast state is set is short.

  On the other hand, in the lower esophagus region, the contrast agent temporarily accumulates in the lower esophagus region by closing the cardia (the connecting portion between the stomach and the esophagus) due to the inflow of the contrast agent. Next, as the cardia portion opens, the contrast medium accumulated in the lower esophagus region flows into the stomach. Due to the inflow of the contrast agent into the stomach, a double contrast state occurs in the lower esophagus region. That is, in the lower esophagus region, imaging is performed in response to the inflow of the contrast agent accumulated in the lower esophagus region into the stomach. Moreover, compared with the upper esophagus region, the period during which the double contrast state is maintained is long.

  From the above, the imaging timing of the esophagus region according to the esophageal imaging method is different between the upper esophagus region and the lower esophagus region. For this reason, imaging of the esophagus region is performed in two steps for the upper esophagus region and the lower esophagus region, respectively.

  FIG. 12 is a schematic diagram showing a detection surface for imaging the upper esophagus region and a detection surface for imaging the lower esophagus region, together with an anatomical name and a schematic position in the subject. As shown in FIG. 12, in order to image the lower esophagus region after imaging the upper esophagus region, the video system (X-ray generation unit 3, irradiation range limiter 5, and X-ray detection unit 7) includes a movement support mechanism. 9 automatically moves along the first direction (X-axis).

  The display unit 29 displays a fluoroscopic image seen through from the upper end to the lower end of the esophagus to confirm the position and state of the esophagus region before photographing the esophagus region.

  The input unit 17 inputs an upper end and a lower end of the esophageal region on the fluoroscopic image. Here, the upper end of the esophageal region is, for example, between the cricoid cartilage and the pharynx and in the vicinity of the starting portion (first stenosis portion). The lower end of the esophageal region is between the cardia and the stomach corner. The input unit 17 outputs the input upper end and lower end to the control unit 23. Note that the input order of the upper end and the lower end may be the lower end next to the upper end, or the upper end next to the lower end.

  The condition determination unit 21 determines an imaging condition (hereinafter referred to as an upper esophageal imaging condition) suitable for imaging the upper esophageal region as an esophageal imaging condition. The condition determining unit 21 determines an imaging condition suitable for imaging the lower esophagus region (hereinafter referred to as a lower esophageal imaging condition) as an esophageal imaging condition. The upper esophageal imaging condition has a condition in which, in the esophageal imaging condition in the above embodiment, the imaging sequence is changed to 3 frames with a high frame rate and 6 images with a large number of images. The lower esophageal imaging conditions include the esophageal imaging conditions in the embodiment described above, wherein the imaging sequence is a frame rate 2 fs different from the upper esophageal imaging conditions and the number of images to be captured is 4. The condition determining unit 21 outputs the upper esophageal imaging condition and the lower esophageal imaging condition to the control unit 23.

  The control unit 23 supports the moving support mechanism 9 that supports the video system (the X-ray generation unit 3, the irradiation range limiter 5, and the X-ray detection unit 7) movably along the first direction (X-axis direction). The support mechanism drive unit 13 is controlled to automatically move and align one end of the detection surface of the X-ray detection unit 7 with the input upper end. After the above control, the control unit 23 controls the X-ray generation unit 3 to execute the first imaging for imaging the upper esophageal region according to the upper esophageal imaging conditions.

  After the first photographing, the control unit 23 automatically moves the moving support mechanism 9 that supports the video system so as to be movable along the first direction (X-axis direction), and faces the one end of the detection surface. The support mechanism drive unit 13 is controlled to match the end with the input lower end. After the above control, the control unit 23 controls the X-ray generation unit 3 to execute the second imaging for imaging the lower esophageal region according to the lower esophageal imaging conditions.

  The support mechanism drive unit 13 controls the video system (X-ray generation unit 3, irradiation range limiter 5) in order to align one end of the detection surface with the upper end under the control of the control unit 23 before execution of the first imaging. , And the X-ray detection unit 7) are driven so as to be movable along the first direction (X-axis direction). By driving the movement support mechanism 9, one end of the X-ray detection unit 7 is automatically aligned with the upper end. In addition, the tube focus in the X-ray generator 3 is arranged on a straight line passing through the center of the detection surface and parallel to the Z axis.

  Prior to execution of the second imaging, the support mechanism drive unit 13 controls the video system (the X-ray generation unit 3,. The movement support mechanism 9 that supports the irradiation range limiter 5 and the X-ray detection unit 7) to be movable along the first direction (X-axis direction) is driven. By driving the movement support mechanism 9, the other end facing the one end of the X-ray detection unit 7 is automatically adjusted to the lower end. In addition, the tube focus in the X-ray generator 3 is arranged on a straight line passing through the center of the detection surface and parallel to the Z axis.

  In the first and second imaging, the irradiation range limiter 5 limits the maximum irradiation range (field size) according to the division format, for example, as shown in FIG. Furthermore, for example, the imaging of the upper esophagus region may be changed into three parts on the left and right, and the imaging of the lower esophagus region may be changed into two parts on the left and right.

(Esophageal area photography function)
The esophageal region imaging function automatically moves the video system (X-ray generation unit 3, irradiation range limiter 5, and X-ray detection unit 7) based on the upper and lower ends input to the esophageal region. The upper esophagus region and the lower esophagus region are respectively photographed according to the upper esophageal photographing condition and the lower esophageal photographing condition.

  Hereinafter, processing related to the esophageal region imaging function (hereinafter referred to as esophageal region imaging processing) will be described.

  FIG. 13 is a flowchart illustrating an example of a procedure of esophageal region imaging processing. The flowchart in FIG. 13 may be incorporated in the processing of steps Sa8 and Sa9 in the flowchart of FIG.

  Regarding the esophageal region, the upper end and the lower end are input (step Sb1). Upper esophageal imaging conditions and lower esophageal imaging conditions are determined (step Sb2). In order to align one end of the detection surface with the upper end, the video system (X-ray generation unit 3, irradiation range limiter 5, and X-ray detection unit 7) is automatically moved (step Sb3). In accordance with the upper esophageal imaging condition, the first imaging is performed on the upper esophageal region (step Sb4). Based on the first imaging, a first medical image is generated (step Sb5). The first medical image is subjected to image processing according to esophageal image processing conditions and displayed (step Sb6).

  In order to match the other end of the detection surface to the lower end, the video system (X-ray generation unit 3, irradiation range limiter 5, and X-ray detection unit 7) is automatically moved (step Sb7). In accordance with the lower esophageal imaging conditions, the second imaging is performed on the lower esophageal region (step Sb8). Based on the second imaging, a second medical image is generated (step Sb9). The second medical image is subjected to image processing according to esophageal image processing conditions and displayed (step Sb10).

  Here, an example in which the video system moves only along the first direction (X axis) has been described. However, the position input of the upper esophagus region and the lower esophagus region in the second direction (Y axis) is added, and A slide along the second direction (Y axis) may be combined, and the detection surface may move obliquely with respect to the subject.

(Second modification)
The difference from the first modification is that, when the size of the X-ray detection unit 7 extends over the entire esophagus region, the video system is not moved, but according to the imaging target in the esophagus region (upper esophagus region and lower esophagus region). In other words, the irradiation range is limited to be asymmetric along the first direction.

  FIG. 14 shows the detection planes in the upper esophageal region imaging (hereinafter referred to as the first imaging) and the lower esophageal region imaging (hereinafter referred to as the second imaging). It is a schematic diagram shown with a position. As shown in FIG. 14, in the first imaging and the second imaging, the irradiation range by the irradiation range limiter 5 is limited asymmetrically along the first direction (X-axis direction).

FIG. 15 shows a visual field size suitable for the upper esophagus region and the lower esophagus region, and the division format is divided into right and left, and the first and second photographings are performed along the first direction (X-axis direction). It is a figure which shows an example of the area | region limited to asymmetry. As shown in FIGS. 14 and 15, in the first imaging for the upper esophagus region and the second imaging for the lower esophagus region, the region limited along the first direction (X-axis direction) is
Asymmetric.

  The detection surface of the X-ray detection unit 7 has a size that covers the entire esophageal region, for example. The size of the detection surface is, for example, 42 cm × 42 cm. At this time, the detection surface can cover the entire esophageal region. The video system is moved by the movement support mechanism 9 so that the X-ray detection unit 7 includes the esophageal region and the upper and lower ends.

  The condition determination unit 21 performs switching from a standard imaging method (gastroscopic imaging method) to an esophageal imaging method, and has a visual field size and division format suitable for the upper and lower esophageal areas, In order to confirm the state, a fluoroscopy from the upper end to the lower end of the esophagus is performed, and when the upper end and the lower end are input via the input unit 17, the X-ray detection unit 7 can include an esophagus region and an upper and lower end. Determine the position. In addition, the condition determination unit 21 determines a region (hereinafter referred to as a first limited region) that limits the irradiation range from the maximum irradiation range in the first imaging, and the irradiation range from the maximum irradiation range in the second imaging. A region to be limited (hereinafter referred to as a second limited region) is determined. The first and second limited regions are associated with movement amounts for moving the first and second direction diaphragm blades, respectively, in order to block X-rays generated at the tube focus. Hereinafter, the movement amount of the first and second direction diaphragm blades related to the first limited region is referred to as a first movement amount. Further, the movement amount of the first and second direction diaphragm blades with respect to the second limited area is referred to as a second movement amount. The condition determining unit 21 outputs the first and second movement amounts to the control unit 23.

  The first movement amount is, for example, a length corresponding to each of A, B, and C in FIG. Specifically, in the realization of the first limited region from the maximum irradiation range, A in FIG. 15 indicates the amount of movement of the first direction diaphragm blade b in FIG. Further, B in FIG. 15 indicates the amount of movement of the second direction diaphragm blade a in FIG. C in FIG. 15 indicates the amount of movement of the second direction diaphragm blade b in FIG.

  The second movement amount is, for example, a length corresponding to each of D, E, and F in FIG. Specifically, in the realization of the second limited region from the maximum irradiation range, D in FIG. 15 indicates the amount of movement of the first direction diaphragm blade a in FIG. Further, E in FIG. 15 indicates the amount of movement of the second direction diaphragm blade a in FIG. F in FIG. 15 indicates the amount of movement of the second direction diaphragm blade b in FIG.

  In FIG. 15, B and C relating to the first movement amount and E and F relating to the second movement amount are determined by selection / setting of the visual field size and the division format. In FIG. 15, A for the first movement amount and D for the second movement amount are determined by the visual field size. As a result, A in FIG. 15 is set near the boundary between the middle chest esophagus and the lower chest esophagus, for example. A in FIG. 15 is set near the boundary between the upper chest esophagus and the middle chest esophagus, for example.

  When the center line of the esophagus is inclined with respect to the second direction (Y-axis direction) in each of the upper esophagus region and the lower esophagus region, the condition determination unit 21 sets the irradiation range asymmetrically along the second direction. You may determine the 1st, 2nd movement amount for making it limit. At this time, for example, in FIGS. 15 to 17, the irradiation range is limited asymmetrically along the second direction. Furthermore, the position input in the second direction (Y axis) of the upper esophagus region and the lower esophagus region is added, and the movement along the second direction (Y axis) is combined in the first and second imaging to obtain an X-ray transmission region. May move obliquely with respect to the subject. Furthermore, for example, the first shooting may be changed into left and right divisions, and the second shooting may be changed into right and left divisions.

  Further, when the length of the detection surface of the X-ray detection unit 7 in the first direction (X axis) is longer than the length from the upper end to the lower end of the subject's esophagus, the upper end of the first limited region or the second limited region The lower end or both may move inward from the upper end and the lower end of the detection surface, respectively.

  The control unit 23 controls the irradiation range limiter 5 in order to move the first direction diaphragm blade and the second direction diaphragm blade according to the first and second movement amounts determined by the condition determination unit 21. Specifically, the control unit 23 sets the irradiation range limiter 5 in order to move the first and second direction diaphragm blades to the first limited area before X-ray irradiation (before the first imaging) to the upper esophagus area. To control. Next, the control unit 23 controls the irradiation range limiter 5 to move the first and second direction diaphragm blades to the second limited region before X-ray irradiation (before the second imaging) to the lower esophagus region. .

  The irradiation range limiter 5 moves the first direction diaphragm blades and the second direction diaphragm blades according to the first movement amount under the control of the control unit 23 to form the first limited region. Due to the movement of these diaphragm blades, as shown in FIG. 15, an X-ray transmission region in the first imaging (hereinafter referred to as a first X-ray transmission region) is formed. The first X-ray transmission region corresponds to the upper esophagus region in FIG.

  The irradiation range limiter 5 moves the first direction diaphragm blades and the second direction diaphragm blades according to the second movement amount under the control of the control unit 23 in order to form the second limited region. By movement of these diaphragm blades, as shown in FIG. 15, an X-ray transmission region (hereinafter referred to as a second X-ray transmission region) in the second imaging is formed. The second X-ray transmission region corresponds to the lower esophagus region in FIG.

  FIG. 16 is a diagram illustrating an example of the irradiation range limiter 5 in which the first X-ray transmission region is formed according to the first movement amount in the first imaging. FIG. 17 is a diagram illustrating an example of the irradiation range limiter 5 in which the second X-ray transmission region is formed according to the first movement amount in the second imaging. As shown in FIGS. 15 to 17, the limitation of the irradiation range is asymmetric along the first direction.

(Irradiation range asymmetry limiting function)
The irradiation range asymmetry limiting function is a function that limits the irradiation range to be asymmetric along the first direction in the first and second imaging. Hereinafter, processing related to the irradiation range asymmetry limiting function (hereinafter referred to as irradiation range asymmetry limiting processing) will be described.

  FIG. 18 is a flowchart illustrating an example of the procedure of the irradiation range asymmetry limiting process. The flowchart in FIG. 18 may be incorporated in the processing of steps Sa8 and Sa9 in the flowchart of FIG.

  For the esophagus region, the upper and lower ends are input. The video system is automatically moved so that the X-ray detection unit 7 includes the esophageal region and the upper and lower ends. With respect to imaging of the upper esophagus area (first imaging), a first limited area that limits the irradiation range is determined (step Sc1). Based on the first limited area, the first movement amount is determined (step Sc2). With respect to imaging of the lower esophagus area (second imaging), a second limited area that limits the irradiation range is determined (step Sc3). Based on the second limited area, the second movement amount is determined (step Sc4).

  The first and second direction diaphragm blades are moved according to the first movement amount (step Sc5). First imaging is performed on the upper esophagus region, and a first medical image is generated (step Sc6). The first medical image is subjected to image processing according to esophageal image processing conditions and displayed on the display unit 29 (step Sc7).

  The first and second direction diaphragm blades are moved according to the second movement amount (step Sc8), the second imaging is performed on the lower esophagus region, and a second medical image is generated (step Sc9). The second medical image is processed according to the esophageal image processing conditions and displayed on the display unit 29 (step Sc10).

According to the configuration described above, the following effects can be obtained.
According to the X-ray diagnostic apparatus 1 of the present embodiment, based on at least one of the division format, imaging mode, and examination name, and the rotation angle of the top plate around the rotation axis, the imaging method of the stomach region and the esophageal region The shooting method can be switched between the shooting methods. In addition, according to the X-ray diagnostic apparatus 1 according to the present embodiment, imaging conditions can be determined according to the switched imaging method. From these things, according to the X-ray diagnostic apparatus 1 according to the present embodiment, if any one of the division format, the imaging mode, and the examination name is input and the top 14 is in the standing state, The standard imaging method (gastroscopic method) can be switched to an imaging method suitable for esophageal imaging. In addition, even when a gastroscopic examination is performed after the esophageal imaging examination, the imaging method can be automatically switched from the esophageal imaging technique to the gastric imaging technique.

  Further, according to the X-ray diagnostic apparatus 1 according to the first modification of the present embodiment, by inputting the upper and lower ends of the esophagus region, the imaging position and the imaging sequence suitable for the upper esophagus region and the lower esophagus region The upper esophagus region and the lower esophagus region can each be photographed.

  Furthermore, according to the second modification of the present embodiment, the upper and lower ends of the esophagus region in the X-ray diagnostic apparatus 1 having the large-field X-ray detection unit 7 (large-field plane detector) covering the entire esophagus region. To limit the irradiation range asymmetrically with respect to the major axis direction of the top plate in accordance with the imaging of the upper esophagus region (first imaging) and the imaging of the lower esophagus region (second imaging). it can. Thereby, unnecessary exposure to the subject can be reduced in each of the first and second imaging.

  As described above, according to the X-ray diagnostic apparatus 1, various settings, changes, and the like suitable for imaging of the esophageal region can be automatically executed in the esophageal contrast examination. This reduces the burden on the operator and improves the inspection efficiency. Furthermore, since imaging of the esophagus and stomach can always be performed under appropriate conditions, images can always be displayed with appropriate image quality (high diagnostic ability). The upper esophagus region and the lower esophagus region can each be imaged with appropriate imaging conditions and irradiation range limitations, thereby reducing exposure to the subject. In addition, unnecessary exposure due to switching errors can be avoided in switching the imaging method from esophageal imaging examination to gastroscopic imaging examination.

  In addition, each function according to the embodiment can also be realized by installing a program for executing the processing in a computer such as a workstation and developing the program on a memory. At this time, a program capable of causing the computer to execute the method is stored in a storage medium such as a magnetic disk (floppy (registered trademark) disk, hard disk, etc.), an optical disk (CD-ROM, DVD, etc.), or a semiconductor memory. It can also be distributed.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

  DESCRIPTION OF SYMBOLS 1 ... X-ray diagnostic apparatus, 3 ... X-ray generation part, 5 ... Irradiation range limiter, 7 ... X-ray detection part (FPD), 9 ... Movement support mechanism, 11 ... Rotation support mechanism, 13 ... Support mechanism drive part, DESCRIPTION OF SYMBOLS 14 ... Top plate, 15 ... Interface part, 17 ... Input part, 19 ... Imaging | photography method switching part, 21 ... Condition determination part, 23 ... Control part, 25 ... Image generation and processing part, 27 ... Memory | storage part, 29 ... Display part

Claims (9)

An X-ray generator for generating X-rays;
An X-ray detector that detects X-rays generated by the X-ray generator and transmitted through the subject;
An irradiation range limiter for limiting the X-ray irradiation range;
A rotation support mechanism for supporting the X-ray detection unit, the X-ray generation unit, the irradiation range limiter, and the top plate so as to be rotatable around a rotation axis parallel to a short axis of the top plate;
Switching from the gastric region imaging method to the esophageal region imaging method is performed based on at least one of the irradiation range size, imaging mode, and examination name and the rotation angle of the top plate around the rotation axis. A shooting method switching unit to
A condition determining unit for determining a shooting condition corresponding to the switched shooting method;
A control unit for controlling the X-ray generation unit and the irradiation range limiter to image the subject according to the imaging conditions;
An X-ray diagnostic apparatus comprising: The size of the irradiation range is
It is a predetermined ratio of the length along the minor axis in the irradiation range, and includes a midpoint of the length,
The shooting mode is
A mode in which the subject is imaged multiple times at a predetermined frame rate;
The rotation angle is
An angle of the top plate upright along the vertical direction;
The inspection name is
Being a name relating to imaging of the esophageal region,
The X-ray diagnostic apparatus according to claim 1. An image generation / processing unit for generating and processing a medical image based on an output from the X-ray detection unit;
A display unit for displaying the medical image;
The condition determining unit
Determining image processing conditions corresponding to the esophageal region imaging method;
The controller is
Controlling the display unit to image-process and display the medical image captured according to the imaging condition according to the image processing condition;
The X-ray diagnostic apparatus according to claim 1. The image processing conditions are:
High contrast and high density compared to the medical image related to the stomach region,
The X-ray diagnostic apparatus according to claim 3. A storage unit for storing the medical image;
The controller is
Controlling the storage unit to store a predetermined tag corresponding to the imaging method of the esophageal region in the storage unit together with the medical image related to the esophageal region;
The X-ray diagnostic apparatus according to claim 3. The imaging conditions corresponding to the imaging method of the esophageal region are as follows:
A dose greater than the dose of X-rays in the imaging method of the stomach region, the exposure time being shorter than the X-ray exposure time;
The X-ray diagnostic apparatus according to claim 1. The photographing method switching unit
When the size of the irradiation range is the maximum size, executing switching from the esophageal region imaging method to the stomach region imaging method,
The X-ray diagnostic apparatus according to claim 1. A movement support mechanism for supporting the X-ray detection unit movably along the long axis direction of the top plate;
An input unit for inputting an upper end and a lower end of the esophageal region;
The control unit is based on the shooting conditions.
A first of the upper esophageal region having the upper end, the cervical esophagus, the upper thoracic esophagus, and the middle thoracic esophagus in the esophageal region at a position where one end of the X-ray detection surface of the X-ray detection unit is aligned with the upper end. Shoot,
The lower part having the lower end, the middle thoracic esophagus, the lower thoracic esophagus, and the abdominal esophagus in the esophageal region at a position where the other end of the detection surface facing the one end is aligned with the lower end after the first imaging. In order to perform a second shot on the esophagus area,
Controlling the X-ray generation unit, the irradiation range limiter, the X-ray detection unit, and the movement support mechanism;
The X-ray diagnostic apparatus according to claim 1. The condition determining unit
In the first imaging, to irradiate the upper esophagus region with the X-ray, determine a first limited region that limits the irradiation range asymmetrically along the major axis direction of the top plate,
Determining a second limited region that limits the irradiation range asymmetrically along the major axis direction in order to irradiate the lower esophagus region with the X-rays in the second imaging,
The irradiation range limiter is
In the first imaging, the irradiation range is limited to the first limited area,
Limiting the irradiation range to the second limited region in the second imaging,
The X-ray diagnostic apparatus according to claim 8.

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