JP2015073584A - Ultrasonic diagnostic device, controller of ultrasonic diagnostic device and control method of ultrasonic diagnostic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic diagnostic device capable of highly accurately detecting a lumen tunica intima boundary and a tunica media-tunica externa boundary, a controller of the ultrasonic diagnostic device and a control method of the ultrasonic diagnostic device.SOLUTION: An ultrasonic diagnostic device includes: an ROI setting part 6 which sets an area of interest on a front wall of a carotid artery; a first boundary candidate detection part 7 which generates signal intensity distribution in a depth direction of a reception signal in the area of interest, and detects a first tunica media-tunica externa boundary candidate position and a first lumen tunica intima boundary candidate position in the signal intensity distribution as a first blood vessel boundary candidate position; a second boundary candidate detection part 8 which detects a second tunica media-tunica externa boundary candidate position and a second lumen tunica intima boundary candidate position as a second blood vessel boundary candidate position; a boundary candidate selection part 9 which selects one of the first blood vessel boundary candidate position and the second blood vessel boundary candidate position; and an IMT measurement part 10 which performs IMT measurement on the basis of the tunica media-tunica externa boundary candidate position and the lumen tunica intima boundary candidate position of the selected blood vessel boundary candidate position.

Description

  The present application relates to an ultrasonic diagnostic apparatus, a controller for the ultrasonic diagnostic apparatus, and a control method for the ultrasonic diagnostic apparatus.

In the diagnosis of arteriosclerosis, carotid artery echo examination using an ultrasonic diagnostic apparatus is performed. The blood vessel wall has a structure having three layers of an intima, a media, and an adventitia in order from the blood vessel lumen side. The carotid echocardiography is performed by measuring the thickness of the intima-media complex ( Intima-Media
Thickness; hereinafter abbreviated as “IMT”. ) Is measured (hereinafter referred to as “IMT measurement”), and the measured value (hereinafter referred to as “IMT value”) is used as an index of the degree of progression of arteriosclerosis.

  Conventionally, IMT measurement is based on a tomographic image of a cross-section (hereinafter referred to as “long-axis cross section”) cut in the carotid artery blood vessel extension direction (hereinafter referred to as “long-axis direction”). The distance between the boundary with the membrane (hereinafter referred to as the “luminal intima boundary”) and the boundary between the media and the outer membrane (hereinafter referred to as the “intima-membrane boundary”) In the recent years, an ultrasonic diagnostic apparatus that automatically performs this IMT measurement has been developed. Yes.

  Such an apparatus detects a lumen intima boundary and a medial epicardial boundary based on the luminance distribution of tomographic image data including the carotid artery, and an IMT based on the detected lumen intima boundary and medial epicardial boundary. It is the structure which performs a measurement (for example, patent document 1).

JP 2008-161220 A

  In the above-described conventional technology, it has been required to accurately detect the intima boundary and the intima boundary in order to correctly measure or improve the measurement accuracy. Non-limiting exemplary embodiments of the present application provide an ultrasonic diagnostic apparatus, a controller for an ultrasonic diagnostic apparatus, and an ultrasonic diagnostic apparatus capable of accurately detecting a lumen-intima boundary and an intima-media boundary. A control method is provided.

An ultrasonic diagnostic apparatus according to one aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits and receives ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. An ultrasonic diagnostic apparatus that acquires a plurality of reception signals corresponding to one image frame including a long-axis cross section of the carotid artery by performing a predetermined process from the reception signal or the reception signal For the signal, a ROI setting unit that sets a region of interest in the anterior wall of the carotid artery based on the position of the blood vessel lumen of the carotid artery, and a predetermined process from the received signal or the received signal in the region of interest A signal intensity distribution in the depth direction, which is the transmission direction of the ultrasonic wave, of the performed signal is generated, and a position indicating the most likely intima-media boundary in the signal intensity distribution as a first blood vessel boundary candidate position The first epicardial boundary alignment And a first boundary candidate detection unit for detecting a first lumen-intima boundary candidate position at a position deeper than the first medial-endocardial boundary candidate position, the position indicating the most likely lumen-intima boundary position; As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary candidate. A second boundary candidate detection unit for detecting a second lumen-intima boundary candidate position at a position deeper than the position and the second medial-endocardial boundary candidate position; When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal Processed signal and second lumen intima boundary candidate position A first determination based on the received signal corresponding to the vascular lumen and the intima in the blood vessel or a signal obtained by performing a predetermined process from the received signal, the second medial epicardial boundary candidate position, and the first Whether or not the second candidate boundary position is a true blood vessel boundary position based on the first and second determination results. And determining that the second boundary candidate position in the acoustic line direction, which is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI, is a true blood vessel boundary position. Based on the determined range, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position, and based on the third determination result, the first blood vessel boundary candidate position and the Boundary candidate selection for selecting one of the second blood vessel boundary candidate positions And an IMT measurement unit that performs IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position selected.

  According to an ultrasonic diagnostic apparatus, an ultrasonic diagnostic apparatus controller, and an ultrasonic diagnostic apparatus control method according to an embodiment of the present application, it is possible to accurately detect a lumen intima boundary and an intima-media boundary. it can.

It is an example of the functional block diagram of the ultrasound diagnosing device by Embodiment 1 of this application. It is an example of the hardware block diagram of the ultrasound diagnosing device by Embodiment 1 of this application. It is a figure which shows an example of the 1st template of the ultrasound diagnosing device by Embodiment 1 of this application. It is a figure which shows an example of the 2nd template of the ultrasonic diagnosing device by Embodiment 1 of this application. It is a figure which shows an example of the 3rd template of the ultrasound diagnosing device by Embodiment 1 of this application. It is an example of the operation | movement flowchart of the ultrasound diagnosing device by Embodiment 1 of this application. It is a figure which shows an example of the result of having detected the 1st blood-vessel boundary candidate of the ultrasound diagnosing device by Embodiment 1 of this application. It is a figure which shows an example of the result of having detected the 2nd blood vessel boundary candidate of the ultrasound diagnosing device by Embodiment 1 of this application. It is an auxiliary figure explaining an example of a method in which a boundary candidate selection part of an ultrasonic diagnostic apparatus according to Embodiment 1 of the present application selects a blood vessel boundary position based on detection results of first and second blood vessel boundary candidates.

  The inventors of the present application examined the characteristics of the method disclosed in Patent Document 1 in detail. As a result, in the acquired reception signal including the long-axis cross section of the carotid artery, a tissue (cervical region) having a pattern similar to the signal intensity of the reception signal corresponding to the luminal intima boundary and medial epicardial boundary of the carotid artery. When a tissue related to a position close to the vascular wall of the carotid artery is located, the tissue is erroneously detected as the luminal intima boundary and medial epicardial boundary of the carotid artery It turns out that there is a case.

The inventors of the present application have conducted intensive studies on a technique capable of automatically and accurately detecting the lumen-intima boundary and the medial-medial boundary of the carotid artery even in the above case, and a novel ultrasonic diagnostic apparatus. The inventors have come up with a control method for an ultrasonic diagnostic apparatus and a controller for the ultrasonic diagnostic apparatus. The outline of one aspect of the present application is as follows.

  An ultrasonic diagnostic apparatus according to one aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits and receives ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. An ultrasonic diagnostic apparatus that acquires a plurality of reception signals corresponding to one image frame including a long-axis cross section of the carotid artery by performing a predetermined process from the reception signal or the reception signal For the signal, a ROI setting unit that sets a region of interest in the anterior wall of the carotid artery based on the position of the blood vessel lumen of the carotid artery, and a predetermined process from the received signal or the received signal in the region of interest A signal intensity distribution in the depth direction, which is the transmission direction of the ultrasonic wave, of the performed signal is generated, and a position indicating the most likely intima-media boundary in the signal intensity distribution as a first blood vessel boundary candidate position The first epicardial boundary alignment And a first boundary candidate detection unit for detecting a first lumen-intima boundary candidate position at a position deeper than the first medial-endocardial boundary candidate position, the position indicating the most likely lumen-intima boundary position; As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary candidate. A second boundary candidate detection unit for detecting a second lumen-intima boundary candidate position at a position deeper than the position and the second medial-endocardial boundary candidate position; When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal Processed signal and second lumen intima boundary candidate position A first determination based on the received signal corresponding to the vascular lumen and the intima in the blood vessel or a signal obtained by performing a predetermined process from the received signal, the second medial epicardial boundary candidate position, and the first Whether or not the second candidate boundary position is a true blood vessel boundary position based on the first and second determination results. And determining that the second boundary candidate position in the acoustic line direction, which is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI, is a true blood vessel boundary position. Based on the determined range, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position, and based on the third determination result, the first blood vessel boundary candidate position and the Boundary candidate selection for selecting one of the second blood vessel boundary candidate positions And an IMT measurement unit that performs IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position selected.

An ultrasonic diagnostic apparatus according to one aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits and receives ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. An ultrasonic diagnostic apparatus that acquires a plurality of reception signals corresponding to one image frame including a long-axis cross section of the carotid artery by performing a predetermined process from the reception signal or the reception signal For the signal, a ROI setting unit that sets a region of interest in the posterior wall of the carotid artery based on the position of the vascular lumen of the carotid artery, and a predetermined process from the received signal or the received signal in the region of interest A signal intensity distribution in the depth direction, which is the transmission direction of the ultrasonic wave, of the performed signal is generated, and a position indicating the most likely intima-media boundary in the signal intensity distribution as a first blood vessel boundary candidate position The first epicardial boundary alignment And a first boundary candidate detection unit for detecting a first lumen-intima boundary candidate position at a position shallower than the first medial-endocardial boundary candidate position, the position indicating the most likely lumen-intima boundary position, For the signal intensity distribution, a second blood vessel boundary candidate position is a second position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position. A second endoluminal intima boundary candidate position is detected from a position that is most likely to be a lumen intima boundary at a position shallower than the medial epicardial boundary candidate position and the second medial epicardial boundary candidate position. And when the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position Or a signal that has undergone predetermined processing from the received signal and the signal A first determination based on the received signal corresponding to the blood vessel lumen and the intima at two lumen-intima boundary candidate positions or a signal obtained by performing a predetermined process from the received signal; A second determination is performed based on the epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the second boundary candidate position is true based on the first and second determination results. The second boundary candidate position in the acoustic line direction, which is a direction orthogonal to the depth direction, determined as the true blood vessel boundary candidate position in the ROI. Based on the range determined to be a true blood vessel boundary position, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position, and based on the third determination result, One of the first blood vessel boundary candidate position and the second blood vessel boundary candidate position And a IMT measurement unit that performs IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position selected.

  The controller of the ultrasonic diagnostic apparatus according to one aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. And a controller of an ultrasonic diagnostic apparatus for acquiring a plurality of reception signals corresponding to one image frame including the long-axis cross section of the carotid artery by performing reception, wherein the controller receives a predetermined value from the reception signal or the reception signal. A ROI setting unit that sets a region of interest in the anterior wall of the carotid artery based on the position of the vascular lumen of the carotid artery with respect to the signal subjected to the above processing, and the received signal or the reception in the region of interest A signal intensity distribution in a depth direction that is a transmission direction of the ultrasonic wave of a signal that has been subjected to predetermined processing is generated from the signal, and is used as a first blood vessel boundary candidate position as the most extramural signal in the signal intensity distribution. The position that indicates the membrane boundary is in the first position. A first boundary for detecting a first lumen-intima boundary candidate position at a position deeper than an epicardial boundary boundary position and a position deeper than the first medial-endocardial boundary candidate position A candidate detection unit, and a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second A second luminal intima boundary candidate position is detected at a position deeper than the medial epicardial boundary candidate position and the second medial epicardial boundary candidate position. When the boundary candidate detection unit and the second boundary candidate position are assumed to be true blood vessel boundary positions, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or A signal that has undergone predetermined processing from the received signal and the second signal A first determination based on the received signal corresponding to a blood vessel lumen and an intima at an intima boundary candidate position or a signal obtained by performing a predetermined process from the received signal; and the second intima-endocardial boundary A second determination is made based on the candidate position and the distance between the second lumen-intima boundary candidate position, and the second boundary candidate position is a true blood vessel boundary position based on the first and second determination results. The second boundary candidate position in the acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI is the true blood vessel boundary. Based on the range determined to be a position, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position, and the first blood vessel is determined based on the third determination result. Select either the boundary candidate position or the second blood vessel boundary candidate position And a IMT measurement unit that performs IMT measurement based on the medial-epicardial boundary candidate position and the lumen-intima boundary candidate position selected.

The controller of the ultrasonic diagnostic apparatus according to one aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. And a controller of an ultrasonic diagnostic apparatus for acquiring a plurality of reception signals corresponding to one image frame including the long-axis cross section of the carotid artery by performing reception, wherein the controller receives a predetermined value from the reception signal or the reception signal. A ROI setting unit that sets a region of interest in the posterior wall of the carotid artery based on the position of the vascular lumen of the carotid artery, and the received signal or the received signal in the region of interest A signal intensity distribution in a depth direction that is a transmission direction of the ultrasonic wave of a signal that has been subjected to predetermined processing is generated from the signal, and is used as a first blood vessel boundary candidate position as the most extramural signal in the signal intensity distribution The position that indicates the membrane boundary is in the first position. A first boundary for detecting a first lumen-intima boundary candidate position at a position that is most probable of a lumen-intima boundary at a position that is shallower than an epicardial boundary boundary position and the first medial epicardial boundary candidate position A candidate detection unit, and a second blood vessel boundary candidate position that is a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position. A second luminal intima boundary candidate position is detected from a position that is most likely to be a luminal intima boundary at a position that is shallower than the medial epicardial boundary candidate position and the second medial epicardial boundary candidate position. When the boundary candidate detection unit and the second boundary candidate position are assumed to be true blood vessel boundary positions, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or A signal that has undergone predetermined processing from the received signal and the second signal A first determination based on the received signal corresponding to a blood vessel lumen and an intima at an intima boundary candidate position or a signal obtained by performing a predetermined process from the received signal; and the second intima-endocardial boundary A second determination is made based on the candidate position and the distance between the second lumen-intima boundary candidate position, and the second boundary candidate position is a true blood vessel boundary position based on the first and second determination results. The second boundary candidate position in the acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI is the true blood vessel boundary. Based on the range determined to be a position, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position, and the first blood vessel is determined based on the third determination result. Select either the boundary candidate position or the second blood vessel boundary candidate position And a IMT measurement unit that performs IMT measurement based on the medial-epicardial boundary candidate position and the lumen-intima boundary candidate position selected.

  An ultrasonic diagnostic apparatus control method according to an aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. And a method for controlling an ultrasonic diagnostic apparatus for acquiring a plurality of reception signals corresponding to one image frame including a long-axis cross section of the carotid artery by performing reception, wherein the reception signal or the reception signal is a predetermined method. A region of interest in the anterior wall of the carotid artery based on the position of the vascular lumen of the carotid artery with respect to the processed signal, and the received signal or the received signal in the region of interest To generate a signal intensity distribution in a depth direction that is a transmission direction of the ultrasonic wave of a signal that has been subjected to a predetermined process, and as the first blood vessel boundary candidate position, The position indicating the boundary is the first media A step B of detecting a first lumen-intima boundary candidate position at a position deepest than the membranous boundary boundary position and a position deeper than the first medial epicardial boundary candidate position; As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary candidate. Detecting a second lumen-intima boundary candidate position at a position deeper than the position and the second medial-endocardial boundary candidate position, and detecting the second lumen-intima boundary candidate position; and the second boundary When the candidate position is assumed to be a true blood vessel boundary position, predetermined processing has been performed from the received signal or the received signal corresponding to the outer membrane and the media at the second medial epicardial boundary candidate position Signal and blood vessel at the second lumen-intima boundary candidate position A first determination based on the received signal corresponding to the cavity and the intima or a signal that has been subjected to a predetermined process from the received signal, the second medial-endocardial boundary candidate position, and the second internal A second determination is made based on the distance between the endoluminal boundary candidate positions, and it is determined whether or not the second boundary candidate position is a true blood vessel boundary position based on the first and second determination results. The range in which the second boundary candidate position in the acoustic line direction, which is the direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI, is determined as the true blood vessel boundary position Based on the above, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position. Based on the third determination result, the first blood vessel boundary candidate position and the second Step D for selecting one of the blood vessel boundary candidate positions, and the selected blood vessel boundary And a step E of performing IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position.

An ultrasonic diagnostic apparatus control method according to an aspect of the present application is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and transmits ultrasonic waves from the ultrasonic probe to a subject including a carotid artery. And a method for controlling an ultrasonic diagnostic apparatus for acquiring a plurality of reception signals corresponding to one image frame including a long-axis cross section of the carotid artery by performing reception, wherein the reception signal or the reception signal is a predetermined method. A region of interest in the posterior wall of the carotid artery based on the position of the vascular lumen of the carotid artery, and the received signal or the received signal in the region of interest. To generate a signal intensity distribution in a depth direction that is a transmission direction of the ultrasonic wave of a signal that has been subjected to a predetermined process, and as the first blood vessel boundary candidate position, The position indicating the boundary is the first media A step B of detecting a first lumen-intima boundary candidate position at a position that is most likely to be a lumen-intima boundary at a position that is shallower than the candidate position of the membranous boundary and the first candidate position of the intima-epicardium; and As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position is a second medial epicardial boundary candidate. A step C of detecting a second lumen-intima boundary candidate position at a position and a position that is most likely to be a lumen-intima boundary at a position shallower than the second medial-endocardial boundary candidate position; and the second boundary When the candidate position is assumed to be a true blood vessel boundary position, predetermined processing has been performed from the received signal or the received signal corresponding to the outer membrane and the media at the second medial epicardial boundary candidate position Signal and blood vessel at the second lumen-intima boundary candidate position A first determination based on the received signal corresponding to the cavity and the intima or a signal that has been subjected to a predetermined process from the received signal, the second medial-endocardial boundary candidate position, and the second internal A second determination is made based on the distance between the endoluminal boundary candidate positions, and it is determined whether or not the second boundary candidate position is a true blood vessel boundary position based on the first and second determination results. The range in which the second boundary candidate position in the acoustic line direction, which is the direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI, is determined as the true blood vessel boundary position Based on the above, a third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position. Based on the third determination result, the first blood vessel boundary candidate position and the second Step D for selecting one of the blood vessel boundary candidate positions, and the selected blood vessel boundary And a step E of performing IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position.

  Hereinafter, an ultrasonic diagnostic apparatus, a controller for the ultrasonic diagnostic apparatus, and a control method for the ultrasonic diagnostic apparatus according to one aspect of the embodiment of the present application will be described with reference to the drawings.

(Embodiment 1)
Hereinafter, an ultrasonic diagnostic apparatus, an ultrasonic diagnostic apparatus controller, and an ultrasonic diagnostic apparatus control method according to the first embodiment will be described with reference to the drawings.

  FIG. 1 is a schematic block diagram showing the configuration of the ultrasonic diagnostic apparatus according to Embodiment 1 of the present invention. FIG. 1 shows a state where an ultrasonic probe 101 and a display 102 are connected to the ultrasonic diagnostic apparatus 100.

  The ultrasonic diagnostic apparatus 100 according to the first embodiment includes a controller 1 and an operation unit 2. The controller 1 includes a transmission unit 3, a reception unit 4, a tomographic image processing unit 5, a ROI setting unit 6, a first boundary candidate detection unit 7, a second boundary candidate detection unit 8, a boundary candidate selection unit 9, and an IMT measurement. Unit 10, display processing unit 11, and control unit 12.

  FIG. 2 shows an example of the hardware configuration of the ultrasonic diagnostic apparatus 100. From the viewpoint of hardware, the ultrasonic diagnostic apparatus 100 includes, for example, a pulsar 52, an AD converter 53, an amplifier 54, a transmission beam former 55, a reception beam former 56, an image processor 57, a tomographic image processor 58, and a memory 59. And an arithmetic processor 60. The ultrasonic probe 101 includes a plurality of piezoelectric conversion elements 51 that transmit and receive ultrasonic waves, and a plurality of pulsars 52, AD converters 53, and amplifiers 54 are prepared corresponding to the number of piezoelectric conversion elements 51. In the memory 59, a program that defines a procedure for realizing the function of each component shown in FIG. 1, and each component is operated according to a predetermined procedure, whereby the ultrasound diagnostic apparatus 100, the ultrasound probe, and the like. A program defining the procedure for controlling I101 and the display 102 and performing IMT measurement is stored. These programs are sequentially read from the memory 59 and executed by the arithmetic processor 60.

  Each component shown in FIG. 1 is configured using the hardware shown in FIG.

  The transmission unit 3 includes a pulsar 52 and a transmission beam former 55. The receiving unit 4 includes an amplifier 53 and an AD converter 54. The tomographic image processing unit 5 and the display processing unit 11 are constituted by a tomographic image processor 58 and an image processor 57, respectively. The control unit 12 includes an arithmetic processor 60 and a memory 59.

  The functions of the ROI setting unit 6, the first boundary candidate detection unit 7, the second boundary candidate detection unit 8, the boundary candidate selection unit 9, and the IMT measurement unit 10 are realized by software. Specifically, when the arithmetic processor 60 executes the program stored in the memory 59, the first boundary candidate detection unit 7, the second boundary candidate detection unit 8, the boundary candidate selection unit 9, and the IMT measurement unit Ten functions are realized. That is, it can be said that the first boundary candidate detection unit 7, the second boundary candidate detection unit 8, the boundary candidate selection unit 9, and the IMT measurement unit 10 are configured by the arithmetic processor 60 and the program.

  The hardware configuration described above is merely an example, and various modifications can be made. For example, the function of the tomographic image processing unit 5 may be realized by software. Further, the functions of the transmission beam former 55 and the reception beam former 56 may be realized by software. A personal computer including the arithmetic processor 60, the memory 59, and the image processor 57 may be used in place of these hardware.

  Further, with respect to each functional block of the controller 1, a part or all of the functions of each functional block can be realized as an LSI which is typically an integrated circuit. These may be individually made into one chip, or may be made into one chip so as to include a part or all of them. Here, although LSI is used, it may be called IC, system LSI, super LSI, or ultra LSI depending on the degree of integration.

Further, the method of circuit integration is not limited to LSI's, and implementation using dedicated circuitry or general purpose processors is also possible. FPGA (Field that can be programmed after LSI manufacturing)
A programmable gate array or a reconfigurable processor capable of reconfiguring the connection and setting of circuit cells inside the LSI may be used.

  Furthermore, if integrated circuit technology comes out to replace LSI's as a result of the advancement of semiconductor technology or a derivative other technology, it is naturally also possible to carry out function block integration using this technology.

  As described above, the ultrasonic probe 101 has a plurality of piezoelectric transducer elements arranged in a one-dimensional direction, and each of the piezoelectric transducer elements converts a transmission electric signal from a transmitter 3 described later into an ultrasonic wave. Convert and generate an ultrasonic beam. Therefore, the operator can irradiate the inside of the subject with the ultrasonic beam by arranging the ultrasonic probe 101 on the surface of the subject which is the object to be measured. In the IMT measurement, the operator can acquire a tomographic image of the longitudinal cross section of the carotid artery of the ultrasonic probe 101 (that is, the arrangement direction of the piezoelectric transducers and the extension direction of the blood vessels of the carotid artery are aligned. And the ultrasound beam is irradiated to the inside of the subject including the carotid artery. The ultrasonic probe 101 receives reflected ultrasonic waves from the inside of the subject, converts the reflected ultrasonic waves into received electrical signals with a plurality of piezoelectric transducers, and supplies the received electrical signals to the receiving unit 4 described later.

In the first embodiment, the ultrasonic probe 101 is described as an example of the ultrasonic probe 101 in which a plurality of piezoelectric transducer elements are arranged in a one-dimensional direction, but the present invention is not limited to this. . For example, it is also possible to use an ultrasonic probe 101 in which a plurality of piezoelectric transducers are arranged two-dimensionally or an ultrasonic probe 101 in which a plurality of piezoelectric transducers arranged in a one-dimensional direction are swung. is there. The ultrasonic probe 101 is based on the control of the control unit 13, and the transmission unit 3 selects the piezoelectric transducer to be used in the ultrasonic probe 101, the timing at which the voltage is applied to the piezoelectric transducer, and the voltage By changing the values individually, it is possible to control the irradiation position and irradiation direction of the ultrasonic beam to be transmitted.

  Further, the ultrasound probe 101 may include some functions of the transmission unit 3 and the reception unit 4 described later. For example, the ultrasound probe 101 transmits within the ultrasound probe 101 based on a control signal (hereinafter referred to as “transmission signal”) for generating a transmission electrical signal output from the transmission unit 3. An electrical signal is generated, the transmission signal is converted into an ultrasonic wave by a piezoelectric transducer, and the received reflected ultrasonic wave is converted into a received electrical signal. The ultrasonic probe 101 receives a later-described reception based on the received electrical signal. A configuration for generating a signal is given.

  The display 102 is a so-called monitor that displays an image output from the ultrasonic diagnostic apparatus 100 (a display processing unit 12 described later).

  The operation unit 2 receives an input from the operator and outputs a command based on the operator's input to the ultrasonic diagnostic apparatus 100, specifically, the control unit 10 of the controller 1.

  The transmission unit 3 performs a transmission process in which at least the transmission unit 3 generates a transmission signal and causes the ultrasonic probe 101 to transmit an ultrasonic beam. As an example, the transmission unit 3 performs a transmission process for generating a transmission signal for transmitting an ultrasonic beam from the ultrasonic probe 101 having the piezoelectric transducer 51, and the ultrasonic probe 101 is based on the transmission signal. The piezoelectric transducer 51 of the ultrasonic probe 101 is driven by supplying a high-voltage transmission electrical signal generated at a predetermined timing. Thereby, the ultrasonic probe 101 can irradiate the subject which is a measurement object with the ultrasonic beam by converting the transmission electric signal into the ultrasonic wave.

  The receiving unit 4 performs a reception process for generating a reception signal based on at least the reflected ultrasound. For example, the receiving unit 4 receives reflected ultrasound by the ultrasound probe 101 and amplifies the received electrical signal to perform A / D conversion on the received electrical signal converted based on the reflected ultrasound. Generate a received signal. Then, by performing transmission processing by the transmission unit 3 and reception processing by the reception unit 4, a plurality of reception signals corresponding to one image frame are obtained, and this is performed repeatedly and continuously, so that the reception unit 4 A plurality of received signals corresponding to the image frames are acquired. Then, the reception signal corresponding to the acquired frame is supplied to the tomographic image processing unit 5 and the ROI setting unit 6. The reception unit 4 sequentially generates image frames including a plurality of reception signals by transmitting and receiving ultrasonic waves. However, for ease of explanation, one of the sequentially generated image frames (hereinafter, referred to as “image frame”). This will be described in “first frame”.

  The received signal is, for example, a one-dimensional direction in which the transducers of the ultrasonic probe 101 are arranged (hereinafter referred to as an arrangement direction) and an ultrasonic transmission direction (hereinafter referred to as a depth direction). Each signal means a digital signal obtained by A / D converting an electric signal converted from the amplitude of the echo signal.

  The tomographic image processing unit 5 has the same structure as a general ultrasonic diagnostic apparatus. Although not shown, the tomographic image processing unit 5 includes, for example, various filters, detectors, logarithmic amplifiers, scan converters and other signal / image processors, and mainly analyzes the amplitude of the received signal, Data in which the internal structure of the subject is imaged (hereinafter referred to as “tomographic image data”) is generated. This tomographic image data is data to be displayed on the display 102, and is converted into a luminance signal corresponding to the signal strength of the received signal, and the luminance signal is coordinate-converted to correspond to the orthogonal coordinate system. It is the image signal which gave. The tomographic image data of the first frame generated by the tomographic image processing unit 5 is supplied to the display processing unit 11.

The ROI setting unit 6 sets a region of interest (hereinafter abbreviated as “ROI”) in the vascular wall of the carotid artery based on the received signal of the first frame supplied from the receiving unit 4. The received signal of the first frame is a plurality of received signals including received signals of the longitudinal cross section of the carotid artery, and this data includes a relatively shallow direction and a relatively deep direction in the depth direction. Includes two vessel walls of the carotid artery. Hereinafter, the blood vessel wall of the carotid artery that appears in the relatively shallow direction is referred to as an “anterior wall”, and the blood vessel wall of the carotid artery that appears in a relatively shallow direction is referred to as a “rear wall”.

  The ROI is a rectangular region having a predetermined range, and has a predetermined length in each of the depth direction and the direction orthogonal to the depth direction (hereinafter referred to as “acoustic ray direction”). It has a range that can straddle the rear wall.

  The ROI setting unit 6 detects the position of the blood vessel lumen (specifically, the position of the blood vessel center) in the long-axis cross section of the carotid artery based on the signal strength of the received signal of the first frame, and uses that position as a reference The ROI is automatically set on the anterior or posterior wall of the carotid artery. A method for automatically setting the ROI as described above is disclosed in, for example, Japanese Patent Application Laid-Open No. 2007-283035. In the first embodiment, in order to explain IMT measurement of the anterior wall of the carotid artery as an example, the ROI setting unit 6 applies the received signal in the range including the anterior wall of the carotid artery in the received signal of the first frame. Set the ROI.

  The first boundary candidate detection unit 7 generates a signal intensity distribution in the depth direction with respect to the received signal in the ROI, and sets the position indicating the most likely intima boundary in the first in the signal intensity distribution. It is detected as a medial epicardial boundary candidate position. In addition, the first boundary candidate detection unit 7 sets a position that is most likely to be a lumen-intima boundary at a position deeper than the first media-to-media boundary position in the first lumen in the signal intensity distribution. It detects as a film | membrane boundary candidate position. The first boundary candidate detection unit 7 performs these processes at each position in the acoustic line direction within the ROI.

  Specifically, the first boundary candidate detection unit 7 includes in advance a first template for detecting the intima-media boundary of the anterior wall of the carotid artery and a second template for detecting the lumen-intima boundary, The similarity is calculated for each of the signal intensity distributions using the first template and the second template. Next, the first boundary candidate detection unit 7 detects the position most similar to the first template as the first medial epicardial boundary candidate position, and is a position deeper than the first medial epicardial boundary candidate position. The position most similar to the second template is detected as the first lumen-intima boundary candidate position.

  Then, the first boundary candidate detection unit 7 calculates the continuity of the boundary in the acoustic line direction based on the respective positions of the first medial epicardial boundary candidate position and the first lumen-intima boundary candidate position. Then, each boundary candidate position in the ROI is determined by evaluating the combination of the similarity and the continuity calculated at each position in the acoustic line direction in the ROI.

  The detailed boundary detection method processed by the first boundary candidate detection unit 7 is based on WO011 / 099102. Further, hereinafter, when the two candidates, the first medial epicardial boundary candidate and the first lumen-intima boundary candidate, are referred to as the first blood vessel boundary candidate position.

  Next, details of the first template and the second template described above will be described.

  The first template is, for example, as shown in FIG. The adventitia and media of the anterior wall of the carotid artery are located in the depth direction from the shallower to the adventitia and the media. The signal strength of the received signal of the adventitia is relatively strong. The signal strength appears relatively weak. Therefore, the first template shown in FIG. 3 is set based on the signal intensity pattern of the epicardium and the media in the depth direction of the general anterior wall of the carotid artery.

Of the first template shown in FIG. 3, L1 in FIG. 3 is a portion set based on the signal strength of the epicardium of the anterior wall of the carotid artery and the length in the depth direction, and the length of L1 Can be set as appropriate based on the general length of the outer membrane. Further, the coefficient L1 in FIG. 3 is set to a coefficient corresponding to the ultrasonic wave because the ultrasonic wave is strongly reflected at the outer membrane portion and the signal intensity of the received signal is relatively strong. Can be set.

  Further, L2 in FIG. 3 is a portion set based on the signal strength of the media of the anterior wall of the carotid artery and the length in the depth direction, and the length of L2 is a general length of the media. It can set suitably based on thickness (thickness). Further, the coefficient of L2 in FIG. 3 corresponds to the fact that the reflection of the ultrasonic wave in the middle film part is reflected weaker than the reflection in the outer film part, and the signal intensity of the received signal becomes relatively weak. A coefficient is set, and this coefficient can also be set as appropriate.

  The second template is, for example, as shown in FIG. The intima and vascular lumen of the anterior wall of the carotid artery are located in order from the shallowest in the depth direction to the intima and vascular lumen, and the signal strength of the received signal of the intima is relatively strong. The signal strength of the received signal appears relatively weak. Therefore, the second template shown in FIG. 4 is set based on the signal intensity pattern of the intima and the blood vessel lumen in the depth direction of the general anterior wall of the carotid artery.

  Of the second template shown in FIG. 4, L3 in FIG. 4 is a portion set based on the signal strength of the intima of the anterior wall of the carotid artery and the length in the depth direction, and the length of L3 Can be appropriately set based on the general length of the inner membrane. In addition, the coefficient L3 in FIG. 4 is set as a coefficient corresponding to the ultrasonic wave because the ultrasonic wave is strongly reflected at the intima portion and the signal intensity of the received signal becomes relatively strong. Can be set.

  Further, L4 in FIG. 4 is a portion set based on the signal intensity of the vascular lumen of the anterior wall of the carotid artery and the length in the depth direction. The length of L4 is a general value of the vascular lumen. The length can be set as appropriate. In addition, the coefficient of L4 in FIG. 4 corresponds to the fact that the reflection of the ultrasonic wave in the blood vessel lumen part is weaker than the reflection of the intima part, and the signal intensity of the received signal is relatively weak. A coefficient to be set is set, and this coefficient can also be set as appropriate.

  The second boundary candidate detection unit 8 determines a position that is most likely to be an epicardial boundary at a position deeper than the first medial epicardial boundary candidate position in the signal intensity distribution. It is detected as a boundary candidate position. Further, the second boundary candidate detection unit 8 sets a position indicating the most likely lumen-intima boundary at a position deeper than the second medial epicardial boundary candidate position in the signal intensity distribution as the second lumen. It is detected as an intima boundary candidate position. The second boundary candidate detection unit 8 performs these processes at each position in the acoustic line direction within the ROI.

  Specifically, the second boundary candidate detection unit 8 includes the same first template and second template as the first boundary candidate detection unit 7 in advance, and the first boundary candidate detection unit 7 receives the first template from the first boundary candidate detection unit 7. Information on the position of the medial epicardial boundary candidate is acquired. And the 2nd boundary candidate detection part 8 is a position deeper than a 1st medial epicardial boundary candidate position among the similarity calculated with respect to the said signal intensity distribution using the 1st and 2nd template. The position most similar to the first template is the second epicardial boundary candidate position, the position deeper than the second epicardial boundary candidate position is the second most similar position to the second template. It is detected as a lumen intima boundary candidate position.

  Then, the second boundary candidate detection unit 8 calculates the continuity of the boundary in the acoustic line direction based on the respective positions of the second medial epicardial boundary candidate position and the second lumen-intima boundary candidate position. Then, each boundary candidate position in the ROI is determined by evaluating the combination of the similarity and the continuity calculated at each position in the acoustic line direction in the ROI.

  Hereinafter, when two of the second intima-media boundary candidate and the second lumen-intima boundary candidate are shown, they are referred to as second blood vessel boundary candidates.

  The boundary candidate selection unit 9 selects a blood vessel boundary candidate for performing IMT measurement from the first blood vessel boundary candidate and the second blood vessel boundary candidate. A specific selection method of the boundary candidate selection unit 9 will be described next.

  The boundary candidate selection unit 9 determines and selects a true blood vessel boundary candidate by assuming the second blood vessel boundary candidate as a true blood vessel boundary candidate and performing the following first determination to third determination. .

  The reason why the boundary candidate selection unit 9 performs the process described below assuming that the second blood vessel boundary candidate is a true blood vessel boundary candidate is that the second blood vessel boundary candidate is more vascular lumen than the first blood vessel boundary candidate. If there is no tissue that is erroneously detected as a blood vessel boundary from the medial epicardial boundary and the lumen-intima boundary to the blood vessel lumen, the second blood vessel boundary candidate indicates the likelihood of a blood vessel boundary. This is because the second blood vessel boundary candidate can inevitably be selected as the true blood vessel boundary candidate.

  The first determination is a predetermined position in the acoustic line direction within the ROI, and (1) the clarity of the signal strength of the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position; (2) The signal strength of the received signal corresponding to the blood vessel lumen and intima at the second lumen-intima boundary candidate position and the received signal corresponding to the media and adventitia at the second medial-membrane boundary candidate position And whether or not it is a true blood vessel boundary candidate.

  The first determination will be specifically described below.

The signal intensity of the received signal corresponding to the blood vessel lumen and intima at the second lumen intima boundary candidate position is equivalent to the blood vessel lumen and intima at the second lumen intima boundary candidate position. It is determined whether the difference in the signal strength of the received signal satisfies the difference in the signal strength of the received signal between the generally obtained blood vessel lumen and the intima.
More specifically, the boundary candidate selection unit 9 determines whether or not the similarity at the second lumen-intima boundary candidate position calculated by the second boundary candidate detection unit 8 satisfies a predetermined first criterion. Judge by. This predetermined first standard can be determined as appropriate.

  The signal intensity of the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position and the clarity of the received signal corresponding to the media and adventitia at the second medial-membrane boundary candidate position With respect to the difference between the signal strengths of the received signals corresponding to the blood vessel lumen and the intima, the media and the adventitia at the second medial and adventitia boundary candidate position, the generally obtained vessel lumen and intima It is determined whether or not the difference in signal strength of the received signal between the media and the outer membrane is satisfied.

  More specifically, the boundary candidate selection unit 9 determines the signal strength of the adventitia, media, intima, and blood vessel lumen located from the shallower side to the deeper side in the anterior wall of the carotid artery and the depth direction of each of these tissues. The third template is set based on the length of. Then, the degree of similarity is calculated using the third template for the signal intensity distribution described above, and it is determined whether or not the degree of similarity at the second blood vessel candidate position satisfies a predetermined second criterion.

  The third template will be described in detail below.

  The third template will be described in more detail. The third template is a combination of the first template and the second template, and FIG. 5 shows an example of the third template.

  Of the third template shown in FIG. 5, L1 in FIG. 5 is the same as L1 of the first template in FIG. 3, and L4 in FIG. 5 is the same as L4 of the second template in FIG. The lengths of L1 and L4 are fixed lengths regardless of the acquired frame. On the other hand, L2 'and L3' in FIG. 6 correspond to L2 of the first template in FIG. 3 and L3 of the second template in FIG. 4, respectively, but have different lengths. That is, the lengths of L2 ′ and L3 ′ are variable according to the acquired frame, and from the second medial epicardial boundary candidate to the second lumen-intima boundary candidate in the depth direction The distance is measured and set in accordance with the measured distance.

The second determination is based on the distance between the second medial epicardial boundary candidate position and the second lumen-intima boundary candidate position to determine whether or not it is a true blood vessel boundary candidate.
Regarding the distance between the second medial epicardial boundary candidate position and the 2nd lumen intima border candidate position, the second medial epicardial boundary candidate position and the 2nd lumen intima border candidate position are It is determined whether or not it exists at a distance between a general medial adventitia boundary candidate position and a second lumen-intima boundary candidate position from the position. For example, it is determined whether the distance from the blood vessel center to the second blood vessel boundary is within a general carotid artery distance (approximately 2 to 4 mm).

  In the second determination, the distance from the blood vessel center to the second blood vessel boundary is used in the first embodiment. However, in the case of IMT measurement of the front wall, the distance from the outer membrane of the rear wall (rear wall In the case of IMT measurement, it is also possible to use the distance from the outer wall of the front wall.

  The boundary candidate selection unit 9 performs the first determination and the second determination described above at each position in the acoustic line direction within the ROI.

  Next, the third determination will be specifically described below.

  The boundary candidate selection unit 9 determines that the position satisfying the determination item is the true blood vessel boundary position among the first determination and the second determination performed at each position in the acoustic line direction within the ROI, and The ratio (that is, the range determined as the true blood vessel boundary position in the ROI in the acoustic line direction) is calculated. Then, the boundary candidate selection unit 9 selects the second blood vessel boundary candidate position as the target of IMT measurement if the calculated ratio is equal to or greater than a predetermined ratio (that is, equal to or greater than a predetermined third reference). On the other hand, if the ratio is less than the predetermined ratio (that is, if the predetermined third criterion is not satisfied), the first blood vessel boundary candidate position is selected as an IMT measurement target.

  The IMT measurement unit 11 performs the lumen-intima boundary candidate and the extra-medial in the depth direction with respect to the blood vessel boundary position (lumen-intima boundary candidate and media-epicardial boundary candidate) determined by the boundary candidate selection unit 10. The distance from the film boundary candidate is measured at each position in the acoustic line direction. Then, the IMT measurement unit 11 determines, for example, a maximum value (maxIMT) or an average value (meanIMT) as an IMT value among the calculated distances between the lumen intima boundary and the medial epicardial boundary in the ROI. To do. Then, the IMT measurement unit 11 outputs the determined IMT value to the display processing unit 12. As a specific IMT calculation procedure, for example, a general method described in Japanese Patent No. 4829960 can be used.

  The display processing unit 12 performs processing for displaying the tomographic image data from the tomographic image processing unit 5 as a tomographic image. Further, the display processing unit 12 performs processing for displaying the IMT measurement result from the IMT measurement unit 11 on the display 102. The display processing unit 12 may perform a process of highlighting the lumen intima boundary and the medial epicardial boundary in the measurement region of the tomographic image displayed on the display device 102, and displays the ROI on the tomographic image. You may perform the process which superimposes and displays an image. Based on these processes, the display unit 102 displays a tomographic image, an IMT measurement result, and the like.

  The control unit 13 controls the entire ultrasound diagnostic apparatus 100 (each block in the controller 1) in accordance with a command from the operation unit 2.

  A specific operation of the ultrasonic diagnostic apparatus 100 having the above configuration will be described with reference to the operation flowchart of FIG. The processing in the tomographic image processing unit 5 is the same as that of a general ultrasonic diagnostic apparatus, and thus the description thereof is omitted. Here, the operation of determining the blood vessel boundary of the anterior wall of the carotid artery and performing IMT measurement will be described. .

  In step 1 (S01), the ultrasound probe 101 is placed on the surface of the neck of the subject, and the reception signal including the long-axis cross section of the carotid artery is sequentially acquired by the processing of the transmission unit 3 and the reception unit 4. Then, a plurality of reception signals corresponding to one image frame are acquired by the transmission process of the transmission unit 3 and the reception process of the reception unit 4. By repeating this, received signals corresponding to a plurality of image frames are obtained.

  In step 2 (S02), the ROI setting unit 6 includes a reception signal corresponding to the anterior wall of the carotid artery from a plurality of reception signals corresponding to the first frame acquired in step 1 (S01). Set the ROI.

  Specifically, the ROI setting unit 6 detects the position of the blood vessel center in the longitudinal cross section of the carotid artery based on the signal strength of the received signal of the first frame, and the depth direction based on the position of the blood vessel center An ROI is set on the anterior wall of the carotid artery by arranging a rectangular region prepared in advance in a relatively shallow direction.

  In Step 3 (S03), the first boundary candidate detection unit 7 generates an intensity distribution of the received signal strength in the depth direction at each position in the acoustic line direction in the ROI. Then, the first boundary candidate detection unit 7 calculates the similarity with the template for the generated signal intensity distribution using the first and second templates described above, and based on the calculated similarity to the first blood vessel boundary candidate A position (first medial epicardial boundary candidate position and first lumen-intima boundary candidate position) is detected.

  FIG. 7 is a diagram illustrating an example of a detection result of the first blood vessel boundary candidate position by the first boundary candidate detection unit 7. The first boundary candidate detection unit 7 according to the first embodiment is configured to detect the first blood vessel boundary candidate from the received signal of the first frame, but here, in order to facilitate understanding, Description will be made using a tomographic image constructed based on the luminance signal converted according to the signal intensity of the received signal.

  The rectangular area shown in FIG. 7 (particularly FIG. 7B) is the ROI set by the ROI setting unit 6, and the two lines in the ROI are the first detected by the first boundary candidate detection unit 7. Blood vessel boundary candidate positions, which are a first medial epicardial boundary candidate position and a first lumen-intima boundary candidate position in order from the paper surface.

  In step 4 (S04), the second boundary candidate detection unit 8 uses the second blood vessel boundary candidate position (first) based on the similarity calculated based on the first and second templates for the signal intensity distribution described above. 2 medial epicardial boundary candidate positions and second lumen-intima boundary candidate positions).

  FIG. 8 is a diagram illustrating an example of a detection result of the second blood vessel boundary candidate position by the second boundary candidate detection unit 8. The rectangular area shown in FIG. 8 (particularly FIG. 7 (8)) is the ROI set by the ROI setting unit 6, and the two lines in the ROI are the first detected by the second boundary candidate detection unit 8. Blood vessel boundary candidate positions, which are a second medial epicardial boundary candidate position and a second lumen-intima boundary candidate position in order from the page.

  In step 5 (S05), the boundary candidate selection unit 9 performs the first determination to the third determination described above at the second blood vessel boundary candidate position, and the second blood vessel boundary candidate position is the true blood vessel boundary. It is determined whether or not it is a candidate position. When the boundary candidate selection unit 9 determines that the second blood vessel boundary candidate position is a true blood vessel boundary candidate position, the boundary candidate selection unit 9 selects the second blood vessel boundary candidate position as an IMT measurement target. On the other hand, when the boundary candidate selection unit 9 determines that the second blood vessel boundary candidate position is not a true blood vessel boundary candidate position, the first blood vessel boundary candidate position is selected as an IMT measurement target.

  FIG. 9 is a diagram in which the first and second blood vessel boundary candidate positions in step 3 (S03) and step 4 (S04) are simultaneously displayed on the tomographic image of the first frame. The four lines represent the first medial epicardial boundary candidate position (a in FIG. 9), the first lumen-intima boundary candidate position (b in FIG. 9), and the second medial epicardial boundary, respectively. They are a boundary candidate position (c in FIG. 9) and a second lumen-intima boundary candidate position (d in FIG. 9).

  When the present inventors confirmed the tomographic image of the first frame shown in the first embodiment, the second blood vessel boundary candidate position was the true blood vessel boundary candidate position. Even when the second determination was made, the second blood vessel boundary candidate position could be selected as the true blood vessel boundary candidate position.

  In step 6 (S06), based on the blood vessel boundary position selected in step 5 (S05), the IMT measurement unit 11 calculates the distance between the lumen intima boundary candidate and the medial epicardial boundary candidate in the ROI in the acoustic line direction. Measure at each position. Then, the IMT measurement unit 11 determines, for example, a maximum value (maxIMT) or an average value (meanIMT) as an IMT value among the calculated distances between the lumen intima boundary and the medial epicardial boundary in the ROI. The result is output to the display processing unit 12.

  In step 7 (S07), the display processing unit 12 performs a process of displaying the IMT measurement result supplied from the IMT measurement unit 11 on the display 102. Thereby, the IMT measurement result is displayed on the display 102, and the operator can know the measurement result based on the IMT measurement result.

  According to one embodiment of the present application shown in the above configuration, the received signal corresponding to the lumen intima boundary and the media intima boundary of the carotid artery in the acquired reception signal including the long-axis cross section of the carotid artery. Even if the tissue (such as the jugular vein or muscle layer) having a pattern similar to the signal intensity of is included, and the tissue related to the vascular wall of the carotid artery is located, the lumen of the carotid artery It is possible to automatically and accurately detect the intima boundary and the intima-outer film boundary.

  In the embodiment of the present application, the processing of the ROI setting unit 6, the first boundary candidate detection unit 7, the second boundary candidate detection unit 8, the boundary candidate selection unit 9, and the IMT measurement unit 10 uses received signals. As described in the configuration, it goes without saying that a signal obtained by performing a predetermined process from the received signal may be used. The signal that has undergone predetermined processing from the received signal is a signal corresponding to the signal strength of the received signal, for example, a process of generating a luminance signal from the tomographic image data or the received signal. Signal.

  In addition, when these functional blocks process using a luminance signal, for example, it is not the structure which outputs a received signal to the ROI setting part 6 from the receiving part 4 of FIG. Is output to the ROI setting unit 6.

  In the embodiment of the present application, an example of IMT measurement of the anterior wall in the longitudinal cross section of the carotid artery has been described. However, as an embodiment of the present application, it is naturally used also in the case of IMT measurement of the rear wall. Needless to say, it can be done.

  In this case, the ROI setting unit 6 sets the ROI on the deep side with respect to the position of the vascular lumen of the carotid artery, that is, the posterior wall of the carotid artery.

  In these cases, the first boundary candidate detection unit sets the position indicating the most likely epicardial boundary as the first blood vessel boundary candidate position for the generated signal intensity distribution. The position is detected as a boundary candidate position, and the position that is most likely to be a lumen-intima boundary at a position shallower than the first medial epicardial boundary candidate position is detected as the first lumen-intima boundary candidate position.

  Further, in these cases, the second boundary candidate detection unit detects, as the second blood vessel boundary candidate position, the most extra-medium in the position shallower than the first epicardial boundary candidate position with respect to the generated signal intensity distribution. The position indicating the membrane boundary likelihood is detected as the second medial epicardial boundary candidate position, and the position indicating the most lumen-intima boundary potential at the position shallower than the second medial epicardial boundary candidate position is the second position. This is detected as a lumen intima boundary candidate position.

  Furthermore, in these cases, the posterior wall in the longitudinal cross section of the carotid artery in the depth direction is located in order of the blood vessel lumen, the intima, the media, and the adventitia from the shallow side to the deep side. The second template also needs to be changed accordingly.

  According to an ultrasonic diagnostic apparatus, an ultrasonic diagnostic apparatus control method, and an ultrasonic diagnostic apparatus controller according to an embodiment of the present application, it is possible to accurately detect a lumen intima boundary and an intima-media boundary. it can.

DESCRIPTION OF SYMBOLS 1 Controller 2 Operation part 3 Transmission part 4 Reception part 5 Tomographic image processing part 6 ROI setting part 7 1st boundary candidate detection part 8 2nd boundary candidate detection part 9 Boundary candidate selection part 10 IMT measurement part 11 Display processing part DESCRIPTION OF SYMBOLS 12 Control part 51 Piezoelectric conversion element 52 Pulsar 53 AD converter 54 Amplifier 55 Transmission beam former 56 Reception beam former 57 Image processor 58 Tomographic image processor 59 Memory 60 Arithmetic processor 100 Ultrasonic diagnostic apparatus 101 Ultrasonic probe 101 102 Display

Claims (12)

It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. An ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
An ROI setting unit that sets a region of interest in the anterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal subjected to predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the deepest lumen intima at a position deeper than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A first boundary candidate detection unit for detecting a first lumen intima boundary candidate position as a position indicating the likelihood of boundary;
As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary. A second boundary candidate detection unit for detecting a second lumen intima boundary candidate position at a position deeper than the candidate position and the second tunica intima boundary candidate position; ,
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A boundary candidate selection unit that selects one of the two blood vessel boundary candidate positions;
An ultrasound diagnostic apparatus comprising: an IMT measurement unit configured to perform IMT measurement based on a medial epicardial boundary candidate position and a lumen-intima boundary candidate position selected at a selected blood vessel boundary candidate position. It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. An ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
An ROI setting unit that sets a region of interest in the posterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal that has undergone predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the innermost lumen at a position shallower than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A first boundary candidate detection unit for detecting a first lumen intima boundary candidate position as a position indicating the likelihood of boundary;
For the signal intensity distribution, a second blood vessel boundary candidate position is a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position. The second luminal intima boundary candidate position is detected at a position that is the shallowest than the second medial epicardial boundary candidate position and the second medial epicardial boundary candidate position. Two boundary candidate detection units;
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A boundary candidate selection unit that selects one of the two blood vessel boundary candidate positions;
An ultrasound diagnostic apparatus comprising: an IMT measurement unit configured to perform IMT measurement based on a medial epicardial boundary candidate position and a lumen-intima boundary candidate position selected at a selected blood vessel boundary candidate position.   The boundary candidate selection unit includes a blood vessel lumen at a second lumen-intima boundary candidate position and a clear signal intensity of a received signal corresponding to the intima and a blood vessel lumen at a second lumen-intima boundary candidate position. The first determination is performed based on the signal strength of the received signal corresponding to the intima and the clarity of the signal strength of the received signal corresponding to the media and the outer membrane at the second medial-membrane boundary candidate position. The ultrasonic diagnostic apparatus according to claim 1, which is performed.   The boundary candidate selection unit, as the third determination, is determined as a true blood vessel boundary position by the first determination among the second blood vessel boundary candidate positions detected at each position in the ROI. The ultrasonic diagnostic apparatus according to claim 3, wherein a ratio is calculated, and if the ratio is equal to or greater than a predetermined value, the second blood vessel boundary candidate is selected, and if the ratio is less than a predetermined value, the first blood vessel boundary candidate is selected. .   The first boundary candidate detection unit detects the first medial epicardial boundary candidate position at each position in the acoustic line direction within the ROI, and at each position in the acoustic line direction within the ROI. The ultrasonic diagnostic apparatus according to claim 1, wherein the first lumen-intima boundary candidate position is detected.   The second boundary candidate detection unit detects the second medial epicardial boundary candidate position at each position in the acoustic line direction within the ROI, and at each position in the acoustic line direction within the ROI. The ultrasonic diagnostic apparatus according to claim 5, wherein the first lumen-intima boundary candidate position is detected. The first boundary candidate detection unit includes a first pattern set based on the signal intensity pattern of the outer membrane and the media in the depth direction of the blood vessel wall and the length of each, and the depth of the blood vessel wall. A second pattern set based on the signal intensity pattern of the blood vessel lumen and the intima in the direction and the respective lengths,
Similarity is calculated for each of the signal intensity distributions using the first pattern and the second pattern, and the first medial epicardial boundary candidate position and the first lumen are calculated based on the similarity. The ultrasonic diagnostic apparatus according to claim 1, wherein a film boundary candidate position is detected.   The ultrasound according to claim 6, wherein the second boundary candidate detection unit detects the second medial epicardial boundary candidate position and the second lumen-intima boundary candidate position based on the similarity. Diagnostic device. It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. A controller of an ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
An ROI setting unit that sets a region of interest in the anterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal subjected to predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the deepest lumen intima at a position deeper than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A first boundary candidate detection unit for detecting a first lumen intima boundary candidate position as a position indicating the likelihood of boundary;
As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary. A second boundary candidate detection unit for detecting a second lumen intima boundary candidate position at a position deeper than the candidate position and the second tunica intima boundary candidate position; ,
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A boundary candidate selection unit that selects one of the two blood vessel boundary candidate positions;
A controller for an ultrasound diagnostic apparatus, comprising: an IMT measurement unit that performs IMT measurement based on a medial epicardial boundary candidate position and a lumen-intima boundary candidate position selected at a selected blood vessel boundary candidate position. It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. A controller of an ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
An ROI setting unit that sets a region of interest in the posterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal that has undergone predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the innermost lumen at a position shallower than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A first boundary candidate detection unit for detecting a first lumen intima boundary candidate position as a position indicating the likelihood of boundary;
As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position is a second medial epicardial boundary. A second boundary candidate detection unit for detecting a second endoluminal intima boundary candidate position at a position shallower than the candidate position and the second medial epicardial boundary candidate position; ,
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A boundary candidate selection unit that selects one of the two blood vessel boundary candidate positions;
A controller for an ultrasound diagnostic apparatus, comprising: an IMT measurement unit that performs IMT measurement based on a medial epicardial boundary candidate position and a lumen-intima boundary candidate position selected at a selected blood vessel boundary candidate position. It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. A method for controlling an ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
A step of setting a region of interest in the anterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal subjected to predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the deepest lumen intima at a position deeper than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A step B of detecting a first lumen-intima boundary candidate position for a position indicating the boundary,
As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position deeper than the first medial epicardial boundary candidate position is a second medial epicardial boundary. Detecting a second endoluminal intima boundary candidate position at a position deeper than the candidate position and the second medial epicardial boundary candidate position, the position indicating the most likely lumen intima boundary;
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A step D of selecting any one of the two blood vessel boundary candidate positions;
And a step E of performing IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position selected at the selected blood vessel boundary candidate position. It is configured to be connectable to an ultrasonic probe having a piezoelectric transducer, and includes a longitudinal section of the carotid artery by transmitting and receiving ultrasonic waves from the ultrasonic probe to a subject including the carotid artery. A method for controlling an ultrasonic diagnostic apparatus for acquiring a plurality of received signals corresponding to one image frame,
A step of setting a region of interest in the posterior wall of the carotid artery with respect to the position of the vascular lumen of the carotid artery with respect to the received signal or a signal subjected to predetermined processing from the received signal;
Generate a signal intensity distribution in the depth direction that is the transmission direction of the ultrasonic wave of the reception signal in the region of interest or a signal that has been subjected to predetermined processing from the reception signal, as a first blood vessel boundary candidate position, In the signal intensity distribution, the position indicating the most likely epicardial boundary is the innermost lumen at a position shallower than the first medial epicardial boundary candidate position and the first medial epicardial boundary candidate position. A step B of detecting a first lumen-intima boundary candidate position for a position indicating the boundary,
As a second blood vessel boundary candidate position, a position that is most likely to be a medial epicardial boundary in the signal intensity distribution at a position shallower than the first medial epicardial boundary candidate position is a second medial epicardial boundary. Detecting a second endoluminal intima boundary candidate position from a candidate position and a position that is most likely to be a lumen intima boundary at a position shallower than the second medial epicardial boundary candidate position; and
When the second boundary candidate position is assumed to be a true blood vessel boundary position, the received signal corresponding to the epicardium and the media at the second medial epicardial boundary candidate position or a predetermined value from the received signal A first signal based on the processed signal and the received signal corresponding to the blood vessel lumen and the intima at the second lumen-intima boundary candidate position or a signal that has undergone a predetermined process from the received signal; And a second determination based on the second medial epicardial boundary candidate position and the distance between the second lumen-intima boundary candidate position, and the first and second determination results It is determined whether or not the second boundary candidate position is a true blood vessel boundary position, and an acoustic line direction that is a direction orthogonal to the depth direction determined as the true blood vessel boundary candidate position in the ROI It is determined that the second boundary candidate position is a true blood vessel boundary position. A third determination is made as to whether or not the second boundary candidate position is a true blood vessel boundary position based on the determined range, and the first blood vessel boundary candidate position and the first A step D of selecting any one of the two blood vessel boundary candidate positions;
And a step E of performing IMT measurement based on the medial epicardial boundary candidate position and the lumen-intima boundary candidate position selected at the selected blood vessel boundary candidate position.