JP2015100619A - Medical diagnosis support device, method and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To obtain a medical diagnosis support device, method, and program capable of performing display in which the position of a part having the possibility of a lesion can intuitively be specified at a glance and which is suitable to diagnose a lumen-like tissue.SOLUTION: A medical diagnosis support device 1 is a device for using medical image data of the colon in a supine position and a prone position to perform display for supporting colon diagnosis. The device includes: virtual display means 20 for displaying a virtual endoscope image of the colon in each body position on the basis of the medical image data; and position information display means 21 for displaying a length from a display reference position to the display position of position information in a prescribed display direction in association with a distance from a prescribed position of the colon to an interest part in a longitudinal direction, when the position information on the interest part is displayed in parallel along the prescribed display direction in each body position, the interest part being different from a normal colon state, specified on the basis of the virtual endoscopic image, and formed by inputting position information in the longitudinal direction of the colon.

Description

  The present invention relates to a diagnosis support for a tubular tissue, and more specifically, a display suitable for the diagnosis of a tubular tissue by appropriately displaying position information indicating a portion having a possibility of a lesion. The present invention relates to a medical diagnosis support apparatus, method, and program.

  In recent years, mortality due to colorectal cancer has risen among the causes of death in cancer, and in response to this, a screening program using endoscopy or the like has been developed for early detection and treatment of colorectal cancer. Among them, a technique for examining the intestinal tract using a virtual endoscope function based on medical image data obtained by photographing the large intestine using CT (computed tomography) is called CT-Colonography (CTC). It is used in various facilities (see, for example, Patent Document 1). However, if a residue is present in the intestinal tract, this residue may be erroneously detected as a lesion when a lesion (including a polyp or tumor in addition to cancer) is detected. In addition, there is a possibility of erroneous detection as a shape that does not actually exist, depending on noise components at the time of imaging by CT and errors when generating a virtual endoscopic image.

  Therefore, in CTC, in order to screen the residue and distinguish it from the lesioned part, it is common to expand the intestinal tract with air and perform CT imaging in the supine position and prone position, respectively. After CT imaging in both positions, first, interpretation of one position is performed, and the position information of the part that may be a lesion is input to the PC as the distance from the anus, for example, and managed in a list in the software Is done. Subsequently, interpretation of other body positions is performed, and position information of a portion that may have a lesion is input to a PC or the like as a distance from the anus, and the list is managed.

  Here, lesions such as cancer have changed intestinal tissue, so even if the posture is changed, it does not move in the intestinal tract, but on the other hand, the residue adheres to the intestinal tract surface. It can move in the intestine accordingly. For this reason, for example, as shown in FIG. 10, if the input position information is displayed in a list for each body position, and there is position information that matches or nearly matches between both body positions, there is a possibility that a lesion is present at that position. Can be judged to be high. In the example of FIG. 10, it can be determined that there is a high possibility that a lesion is present in the vicinity of positions 101 cm and 23 cm from the anus. In addition, when there is no corresponding position information between different body positions, this position information may be due to erroneous detection based on a noise component or the like, and such erroneous detection can be eliminated.

JP 2011-088891 A

  However, when displaying the input position information as a list, conventionally, as shown in FIG. 10, numbers (positions from the anus) indicating the position information are arranged in descending order from top to bottom. For this reason, for example, when the number of position information displayed in a list is different between positions (in the example of FIG. 10, there are six pieces of position information corresponding to position 1, whereas position information corresponding to position 2 is 3 However, there is a problem that it is difficult to intuitively identify position information that is coincident or almost coincident between both body positions, that is, the position of a portion that may be a lesion.

  The present invention has been made in view of the problems as described above, and is a display capable of intuitively specifying the position of a portion having a possibility of a lesion at a glance, and is suitable for diagnosis of a luminal tissue. An object of the present invention is to provide a medical diagnosis support apparatus, method and program that can be performed.

  In order to achieve the above object, a medical diagnosis support apparatus, method and program according to the present invention are configured as follows.

That is, the medical diagnosis support apparatus according to the present invention is:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display means for displaying an image of the tubular tissue for each body position;
The positional information in the longitudinal direction of the tubular tissue, which is specified based on the image and is different from the state of the normal tubular tissue, is input, and the positional information for each body position. When displaying in parallel along a predetermined display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is set to the predetermined length of the tubular tissue in the longitudinal direction. And position information display means for displaying in correspondence with the distance from the position to the portion of interest.

  In the above-described medical diagnosis support apparatus, a direction from the core line position of the tubular tissue to a predetermined site in a plane orthogonal to the longitudinal direction is set as a reference angle, and a direction from the core line position to the region of interest is predetermined. The position information display means receives an input of an angle interval from the reference angle to the predetermined angle, which is specified based on the image, and determines the other angle interval determined in advance. It is preferable that the position information is provided with a color corresponding to the above.

Another medical diagnosis support apparatus according to the present invention is:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
A part of interest specifying means for specifying a part of interest different from the normal state of the tubular tissue based on the medical image data;
Position information calculating means for calculating position information of the identified portion of interest in the longitudinal direction of the tubular tissue;
When the position information in the longitudinal direction of each calculated part of interest is displayed in parallel along a predetermined display direction for each body position, the position information is calculated from a display reference position in the predetermined display direction. Position information display means for displaying the length to the display position in correspondence with the distance from the predetermined position of the tubular tissue to the region of interest in the longitudinal direction is provided.

  In the above-described medical diagnosis support apparatus, the position information calculation unit uses a direction from a core line position of the tubular tissue toward a predetermined site in a plane orthogonal to the longitudinal direction as a reference angle, and When the direction toward the portion of interest is a predetermined angle, the angle interval from the reference angle to the predetermined angle is calculated, and the position information display unit is preliminarily set according to the calculated angle interval. It is preferable that a predetermined color is added to the position information.

  Note that the medical image data is preferably acquired by different image acquisition methods for each body position.

A medical diagnosis support method according to the present invention includes:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. In the medical diagnosis support method for performing display processing for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
In response to the input of positional information in the longitudinal direction of the tubular tissue of the region of interest different from the normal state of the tubular tissue identified based on the image, the positional information is stored for each body position. When displaying in parallel along a predetermined display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is set to the predetermined length of the tubular tissue in the longitudinal direction. A position information display step of displaying in correspondence with a distance from a position to the portion of interest is performed in this order.

Furthermore, the medical diagnosis support program according to the present invention includes:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support program for executing display processing for supporting diagnosis of the tubular tissue using a medical image data of the tubular tissue in a computer,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
The position information is predetermined for each body position according to input of position information in the longitudinal direction of the tubular tissue of the region of interest different from the state of the tubular tissue identified based on the image. When displaying in parallel along the display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is determined from the predetermined position of the tubular tissue in the longitudinal direction. And a position information display step for displaying in correspondence with the distance to the portion of interest in the computer.

  The medical diagnosis support apparatus according to the present invention calculates the length from the display reference position in the predetermined display direction to the display position of the position information when displaying the position information of the portion of interest along the predetermined display direction for each body position. The display is configured so as to correspond to the distance from the predetermined position of the tubular tissue to the portion of interest. With this configuration, position information about the same lesion is displayed with the display positions aligned between different positions. For this reason, there is a lesion in the tubular tissue simply by looking at the list displayed by the medical diagnosis support apparatus according to the present invention and confirming the presence or absence of positional information with different display positions between different positions. Whether or not to do so can be diagnosed intuitively at a glance. Furthermore, this makes it possible to reduce the burden on the interpreter and to diagnose the luminal tissue accurately and efficiently.

  In addition, when the portion of interest is a residue, it can move within the luminal tissue as the body position changes. Therefore, when the list display is performed, the display position of the position information is shifted between different body positions. For this reason, the lesioned part and the residue can be easily and clearly distinguished based on the display position of the position information, and a display suitable for the diagnosis of the luminal tissue can be performed. In addition, when photographing with CT while changing the body position, it is rare that an error occurs at the same position in the longitudinal direction. For this reason, when the position information is displayed in a list, it can be said that the position information based on the error is hardly displayed between different positions. Therefore, by looking at the list display, it is possible to provide simple and highly accurate diagnosis support that eliminates erroneous detection (noise component) based on errors.

1 is a block diagram showing a schematic configuration of a medical diagnosis support apparatus according to a first embodiment of the present invention. It is a flowchart which shows the flow of the process performed in the medical diagnosis assistance apparatus shown in FIG. (A) and (b) are images showing the vicinity of the same lesion in the changed position, and (c) and (d) are the same residue in the changed position. It is the image shown. It is an example of the list display obtained by the medical diagnosis support apparatus shown in FIG. It is explanatory drawing which represented the change of the color attached | subjected to a positional information cyclically | annularly. It is a block diagram which shows schematic structure of the medical diagnosis assistance apparatus which concerns on 2nd Example of this invention. It is a flowchart which shows the flow of the process performed in the medical diagnosis assistance apparatus shown in FIG. FIG. 5 is a modification of the list display shown in FIG. 4, which is a list display with marks indicating the possibility of lesions. It is sectional drawing which shows an example of the form of a lesioned part, Comprising: (a) is sectional drawing in the longitudinal direction of an intestinal tract, (b) is sectional drawing in the surface orthogonal to this longitudinal direction. It is an example of the list display obtained by the conventional medical diagnosis assistance apparatus.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the above-mentioned drawings. First, the apparatus configuration of the medical diagnosis support apparatus 1 according to the first embodiment of the present invention will be described with reference to FIG.

  The medical diagnosis support apparatus 1 shown in FIG. 1 is for diagnosing a region selected by the operation device 3 such as a mouse or a keyboard based on medical image data of a living body obtained by an image capturing device 4 (for example, CT). Is displayed on the display device 2. The medical diagnosis support apparatus 1 is characterized in that a display suitable for diagnosing a tubular tissue such as a large intestine can be performed.

  The medical diagnosis support apparatus 1 includes a computer or the like, and includes a control unit 11, a data storage unit 12, a display data output interface 14, an operation input interface 15, and an image data input interface 16, as shown in FIG. Composed.

  The control unit 11 includes a CPU that performs various arithmetic processes, and includes a virtual display unit 20 and a position information display unit 21 (details will be described later). The data storage unit 12 is configured by a storage device such as a hard disk, RAM, or ROM, and is configured to be able to transmit and receive various data to and from the control unit 11.

  The display data output interface 14 is an interface that transmits display data output from the control unit 11 to the display device 2. The operation input interface 15 is an interface that transmits various operation signals input from the operation device 3 to the control unit 11. The image data input interface 16 is an interface that transmits medical image data from the image capturing apparatus 4 to the control unit 11.

  Next, an operation of the medical diagnosis support apparatus 1, that is, a procedure for generating display data output to the display device 2 will be described along the flowchart shown in FIG. 2 with reference to FIGS. 3 and 4.

  In the following, based on medical image data (for example, CT value) consisting of tomographic images obtained by tomographic imaging of the living body in the supine position and prone position with the image capturing device 4. A case where the display device 2 performs display for diagnosing the target large intestine will be described. The medical diagnosis support apparatus 1 according to the present invention is characterized in that a list display can be performed so that the existence position of a portion having a possibility of a lesion can be grasped intuitively at a glance. Note that the following display data generation and output procedure to the display device 2 is executed according to the medical diagnosis support program according to the embodiment of the present invention.

  <1> First, medical image data obtained by tomographic imaging of a living body as a subject is input from the image pickup apparatus 4 to the medical diagnosis support apparatus 1 (medical image data input step; see step S10 in FIG. 2). ). The medical image data input to the medical diagnosis support apparatus 1 is stored in the data storage unit 12. In the present embodiment, a configuration is assumed in which medical image data of a living body is acquired from the image capturing device 4, but instead of this configuration, medical image data stored in an information storage medium such as a CD or a DVD is used. You may make it read and acquire as needed.

  <2> The virtual display unit 20 of the control unit 11 is stored in the data storage unit 12 based on an operation signal (in this case, an operation signal for selecting the large intestine) for selecting a diagnosis target input from the operation device 3. Medical image data is read and a virtual endoscopic image inside the large intestine is generated. Then, this virtual endoscopic image (image data) is output to the display device 2, and the virtual endoscopic image is displayed on the display device 2 (virtual endoscope display step; see step S20 in FIG. 2). At this time, a virtual endoscopic image based on medical image data obtained by photographing in the supine position and a virtual endoscopic image based on medical image data obtained by photographing in the prone position are obtained. Each is displayed on the display device 2. Here, in order to unify the display of the virtual endoscopic image between the body positions, the virtual endoscopic image is displayed on the display device 2 with the back side of the living body being the lower side of the image and the abdominal side being the upper side of the image.

  FIG. 3 shows an example of a virtual endoscopic image inside the large intestine displayed on the display device 2. Among these, FIGS. 3A and 3B are virtual endoscopic images showing the vicinity of the lesioned part B, which is a part having a distance D1 from the anus, respectively. 3A is a virtual endoscopic image based on medical image data in the prone position, and FIG. 3B is a virtual endoscopic image based on medical image data in the supine position. Since the lesion B is a change in the intestinal tract tissue and does not move in the intestine even if the body position is changed, the lesion B is located at substantially the same position in the virtual endoscopic images of FIGS. 3 (a) and 3 (b). Is displayed.

  On the other hand, FIGS. 3C and 3D are virtual endoscopic images showing the vicinity of the residue Z, each being a portion having a distance D2 from the anus. 3C is a virtual endoscopic image based on medical image data in the supine position, and FIG. 3D is a virtual endoscopic image based on medical image data in the prone position. The upper side of the drawing is displayed as the ventral side. Since the residue Z adheres to the intestinal tract surface and can move in the intestinal tract according to changes in body position, it is displayed at different positions in the virtual endoscopic images of FIGS. 3 (c) and 3 (d). . In addition, the residue Z can move along the longitudinal direction in the intestinal tract, or can rotate and move within a plane orthogonal to the longitudinal direction by changing the body position.

  <3> The radiogram interpreter first interprets a virtual endoscopic image of the large intestine corresponding to one body position (for example, supine position) displayed on the display device 2 from the anal side toward the mouth side. Then, a part (interested part K) that is determined to have a lesion based on the shape inside the large intestine is specified, and the distance from the anus of the interested part K to the anus is operated by operating the operating device 3. Input to the diagnosis support apparatus 1 (position input step; see step S30 in FIG. 2). In this way, after inputting the position of the portion of interest K based on the virtual endoscopic image corresponding to one body position, subsequently, based on the virtual endoscopic image corresponding to the other body position, the portion of interest K The position of is input. The distance (position information) from the anus of the part of interest K input to the medical diagnosis support apparatus 1 is stored in the data storage unit 12 for each body position.

  <4> The position information display means 21 of the control unit 11 reads the position information stored in the data storage unit 12 and generates display data for list display (position information arrangement step; see step S40 in FIG. 2). ). FIG. 4 shows an example of a list display displayed on the display device 2. Generation of display data for list display will be specifically described with reference to this figure.

  In the example shown in FIG. 4, the input position information is displayed in order from the smallest numerical value to the top for each body position 1 (for example, supine position) and body position 2 (for example, prone position). is there. Here, the lower end position of the list is an anus position (display reference position), and the display position of the position information with respect to this display reference position is made to correspond to a numerical value indicating the position information. For example, when the position information of “10 cm” is displayed on the list of the body posture 1, the position information of “10 cm” is arranged at a position that is separated from the lower end position of the list by a distance d corresponding to 10 cm. Further, the position information of “23 cm” of the body position 1 corresponds to a distance 2.3 times as large as 10 cm, and is therefore positioned at a distance of 2.3 d from the lower end position of the list. Similarly, the remaining position information (85 cm, 90 cm, 101 cm, and 121 cm) in the body position 1 is arranged at the vertical position corresponding to the numerical value indicating the position information.

  On the other hand, since the position information “15 cm” for the body position 2 corresponds to a distance 1.5 times as large as 10 cm, the position information “15 cm” is arranged at a distance of 1.5 d from the lower end position of the list. In the same manner, the remaining position information (22 cm and 100 cm) in the body posture 2 is arranged at the vertical position corresponding to the numerical value indicating the position information. In this way, display data for displaying a list of position information input by the radiogram interpreter is generated.

  <5> The position information display means 21 of the control unit 11 outputs the display data generated in step S40 to the display device 2 to display the list on the display device 2 (list display step; see step S50 in FIG. 2). . At this time, since the position of the lesioned part B with respect to the intestinal tract does not change even if the body position is changed, in the displayed list, when the display positions match or substantially match between different body positions, the part indicated by the position information Is likely to be a lesion B. On the other hand, the residue Z can move in the intestinal tract when the body position is changed. For this reason, in the displayed list, when there is position information in which the display position is shifted in the vertical direction between different positions, the portion indicated by the position information is likely to be a residue Z.

  Note that position information corresponding to the left-right direction may not exist between different positions. Here, it is considered that there is not necessarily a large possibility that the residue in the intestinal tract T moves to the small intestine connected to the intestinal tract T by changing the body position. Therefore, such position information is erroneously detected based on a false component corresponding to a noise component when imaging a subject by CT or a conversion error when generating a virtual endoscopic image from medical image data. It is also considered that there is a high possibility that

  For this reason, the radiogram interpreter looks at the list displayed on the display device 2 and confirms the presence or absence of position information whose display positions match or substantially match in the left-right direction between different positions, so A simple diagnosis can be performed. For example, when the list shown in FIG. 4 is displayed on the display device 2, 101 cm (100 cm) and 23 cm (22 cm) are used as position information in which the display positions of the body position 1 and the body position 2 match or substantially match in the left-right direction. Position information can be identified intuitively at a glance. Then, it can be determined that the portions 101 cm (100 cm) and 23 cm (22 cm) from the anus indicated by these position information may be affected. Note that a deviation of about 1 cm, for example, between body positions is allowed as a measurement error.

  In FIG. 4, the display positions of “10 cm” in the body position 1 and “15 cm” in the body position 2 are more consistent in the horizontal direction as the display positions of “23 cm” in the body position 1 and “22 cm” in the body position 2. It is not up and down. For this reason, it can be determined that this position information is likely to indicate a residue Z that has moved in the intestinal tract T due to a change in body position, or a false detection based on noise or error. Further, position information corresponding to the left and right directions does not exist in the body position 2 for body positions 1 of “121 cm”, “90 cm”, and “85 cm”. Therefore, it can be determined that there is a high possibility that these pieces of position information are erroneously detected based on the shape based on noise or conversion error. From the above, in the diagnosis performed while looking at the displayed list, it is only necessary to pay attention to only the position information whose display positions match or substantially match in the left-right direction, thereby reducing the burden on the reader.

  In the above-described medical diagnosis support apparatus 1, in addition to the distance from the anus of the portion of interest K, a list display that reflects the position of the portion of interest K in a cross section orthogonal to the longitudinal direction of the intestinal tract (hereinafter referred to as an orthogonal cross section). If this is done, a simple diagnosis of the large intestine can be performed with higher accuracy. The medical diagnosis support apparatus 1 ′ having this configuration will be described with reference to FIG. 5 additionally with a focus on differences from the medical diagnosis support apparatus 1.

  FIG. 5 shows a cross section of the intestinal tract T in an orthogonal cross section with the back side on the lower side of the paper and the abdomen side on the upper side of the paper, and a hue ring C set corresponding to the orthogonal cross section. In the hue ring C, an angle from the core A of the intestinal tract T toward the ventral side (upward in the drawing) is set as a reference angle (0 degree). Corresponding colors are set for each predetermined angle from the reference angle. In FIG. 5, the corresponding colors are roughly shown every 45 degrees, but for example, between 0 degrees and 45 degrees, the color that gradually switches from light blue to green as the angle approaches 0 degrees to 45 degrees is an angle. It is set to be displayed accordingly. The same applies to other angle ranges (45 to 360 degrees). Of course, each angle range may be set to have a corresponding corresponding color.

  The operation of the medical diagnosis support apparatus 1 ′ will be described along the flowchart shown in FIG. In the medical diagnosis support apparatus 1 ′, in addition to steps S10 to S50 executed in the medical diagnosis support apparatus 1, steps S31 and S41 indicated by a two-dot chain line are executed. That is, step S40 is executed after step S30 and step S31 are executed, and step S50 is executed after step S40 and step S41 are executed. For this reason, it demonstrates centering on step S31 and step S41 which are shown with a dashed-two dotted line here.

  When the interpreter interprets the virtual endoscopic image displayed in step S20, for example, by positioning the pointer on the position of the portion of interest K displayed in the virtual endoscopic image and clicking the mouse, An angle from the reference angle to the portion of interest K is input (angle input step; see step S31 in FIG. 2). Specifically, for example, in FIG. 5, when the pointer is placed on the position of the portion of interest K and the mouse is clicked, the angle from the reference angle to the portion of interest K, that is, an angle of 180 degrees is stored in the data storage unit 12. The The angle input in step S31 is stored in the data storage unit 12 in association with the distance from the anus input in step S30. Instead of inputting the angle from the reference angle to the portion of interest K by clicking the mouse, the interpreter reads the angle from the reference angle to the portion of interest K directly based on the virtual endoscopic image. You may do it.

  Then, in step S40, the position information is arranged at the upper and lower positions corresponding to the distance from the anus, and then each position information is displayed in a color corresponding to the angle from the reference angle based on the hue ring C shown in FIG. (Color imparting step; see step S41 in FIG. 2). For example, after the list display shown in FIG. 4 is obtained in step S40, the position information “101 cm” is red, “23 cm” is green, and the position 2 Assume that “100 cm” is displayed in red and “22 cm” is displayed in orange.

  When diagnosing while looking at the list display with the colors attached in this way, first, the display positions between the body position 1 and the body position 2 substantially coincide with each other in the left-right direction on the paper, and are 101 cm (100 cm) and 23 cm (22 cm) from the anus. ) Can be judged to be affected. Since “101 cm” in the body position 1 and “100 cm” in the body position 2 displayed side by side are both displayed in red, it is intuitive that the position of the portion of interest K in the orthogonal section is the same. Can be judged at a glance. As described above, the portion of interest K 101 cm (100 cm) from the anus has the same position in the orthogonal cross section between the body position 1 and the body position 2, and therefore the region of interest K may be a lesion. Can be judged to be very high.

  On the other hand, “23 cm” in the body posture 1 and “22 cm” in the body posture 2 displayed side by side are different from each other in green and orange. For this reason, based on the color which displays position information, the interested part K at a position of 23 cm (22 cm) from the anus can intuitively grasp that the positions in the orthogonal cross section are different between both body positions. In this case, when the body position is changed, it can be determined that the residue Z that has moved in the orthogonal cross section without moving in the longitudinal direction of the intestinal tract has been detected. As described above, according to the medical diagnosis support apparatus 1 ′, the accuracy of simple diagnosis of the large intestine can be improved by displaying the list in which the position information is displayed in color based on the hue ring C.

  Next, a medical diagnosis support apparatus 100 according to a second embodiment of the present invention will be described with reference to FIGS. 6 and 7. In addition, the same number is attached | subjected to the same part as the medical diagnosis assistance apparatus 1 mentioned above, and the description is abbreviate | omitted.

  As illustrated in FIG. 6, the medical diagnosis support apparatus 100 includes a control unit 111. The control unit 111 includes a part of interest specifying unit 120, a position information calculating unit 121, and a position information display unit 21.

  The operation of the medical diagnosis support apparatus 100 will be described along the flowchart shown in FIG. Of the steps shown in FIG. 7, those corresponding to any of the steps shown in FIG. 2 are indicated in parentheses in FIG. 2, and description thereof is omitted.

  <1> First, medical image data is input to the medical diagnosis support apparatus 1 (medical image data input step; see step S110 in FIG. 7). In step S110, as in step S10 described above, medical image data obtained by imaging the supine position and medical image data obtained by imaging the prone position are respectively input.

  <2> The interested part specifying unit 120 of the control unit 111 automatically specifies the interested part K in the diagnosis target (large intestine) for each body position based on the input medical image data (interesting part specifying step; (See step S120 in FIG. 7). Here, since the CT values are different between the intestinal tract and the lesioned part B, for example, by setting a threshold value for the CT value, the lesioned part B (the part of interest K) can be specified based on the medical image data. . However, if there is a residue Z in the intestinal tract, there is a possibility that the residue Z is also identified as the portion of interest K together with the lesioned portion B in this step S120. For this reason, step S130 and step S140 described later are required.

  <3> The position information calculating means 121 of the control unit 111 automatically calculates the position of the portion of interest K identified in step S120 in the longitudinal direction of the intestinal tract (position calculating step; see step S130 in FIG. 7). In this step S130, the distance (positional information) from the anus of each interested part K is calculated and stored in the data storage unit 12 for each body position.

  <4> The position information display means 21 of the control unit 111 reads the position information stored in the data storage unit 12 and generates display data for list display (position information arrangement step; see step S140 in FIG. 7). ). The execution content of step S140 is the same as the execution content of step S40 described above.

  <5> The position information display unit 21 of the control unit 111 outputs the display data generated in step S140 to the display device 2 to display the list on the display device 2 (list display step; see step S150 in FIG. 7). . The radiogram interpreter looks at the list displayed on the display device 2 and confirms whether or not there is position information in which the display positions match or substantially match in the left-right direction between different positions, thereby making simple diagnosis of the large intestine simple and easy. It can be performed with high accuracy.

  In the medical diagnosis support apparatus 100 described above, a list display (color display based on the color wheel C shown in FIG. 5) that reflects the position of the part of interest K in the orthogonal cross section in addition to the distance of the part of interest K from the anus. If done, it becomes possible to diagnose the large intestine with higher accuracy. The medical diagnosis support apparatus 100 ′ having this configuration will be described with a focus on differences from the medical diagnosis support apparatuses 1, 1 ′, and 100.

  The operation of the medical diagnosis support apparatus 100 ′ will be described along the flowchart shown in FIG. In the medical diagnosis support apparatus 100 ′, in addition to steps S110 to S150 executed by the medical diagnosis support apparatus 100, steps S131 and S141 indicated by a two-dot chain line are executed. That is, Step S140 is executed after Step S130 and Step S131 are executed, and Step S150 is executed after Step S140 and Step S141 are executed. For this reason, it demonstrates centering on step S131 and step S141 which are shown with a dashed-two dotted line here.

  The position information calculation means 121 of the control unit 111 calculates an angle from the reference angle to the portion of interest K in the orthogonal cross section based on the medical image data (angle calculation step; see step S131 in FIG. 7). The angle calculated in step S131 is stored in the data storage unit 12 in association with the distance from the anus calculated in step S130.

  Subsequently, in step S140, the position information is arranged at the upper and lower positions corresponding to the distance from the anus, and then each position information is displayed in a color corresponding to the angle from the reference angle based on the hue ring C shown in FIG. (Color imparting step; see step S141 in FIG. 7). As described above, the medical diagnosis support apparatus 100 ′ can improve the accuracy of simple diagnosis of the large intestine by displaying the list in which the position information is displayed in color based on the hue ring C.

  As mentioned above, although one Embodiment of this invention was described, this invention is not limited to the said embodiment, A mode can be changed variously.

  In the above-described embodiment, the list display shown in FIG. 4 has been described as an example. Instead, the list shown in FIG. 8 may be displayed. The list shown in FIG. 8 is obtained by adding a mark M indicating the possibility that the portion indicated by the position information is lesioned to each of the position information with respect to the list shown in FIG. For example, when there is corresponding position information within 1 cm between body positions, a mark M of “◯” is added because there is a high possibility that the portion indicated by the position information is lesioned. In addition, when there is corresponding position information that is greater than 1 cm and within 5 cm between the body positions, a mark “Δ” is added because it is unlikely that the portion indicated by the position information is lesioned. Further, when there is no corresponding position information within 5 cm between the body positions, the portion indicated by the position information is marked with a “x” mark M because the possibility of a residue is high. In this way, if the list display with the mark M added is performed, it is possible to grasp a portion that is more likely to be lesioned more intuitively based on the mark M.

  In the above-described embodiment, the list display in which position information is arranged up and down as illustrated in FIG. 4 is described as an example. However, instead of this, a list display in which position information is arranged on the left and right is also possible. is there.

  In the above-described embodiment, as shown in FIG. 9A, one of the following three methods can be selected as a method for displaying position information when the portion of interest K is present along the longitudinal direction of the intestinal tract T. It is. As a first method, the center position (101 cm) of the portion of interest K in the longitudinal direction can be displayed as position information. As a second method, the start point position (99 cm) and end point position (103 cm) of the portion of interest K in the longitudinal direction can be displayed as position information. As a third method, a method combining the first and the second, that is, a method of displaying the center position together with the display of the start point position and the end point position is also possible.

  Further, as shown in FIG. 9B, one of the following two methods can be selected as the color display based on the hue ring C when the portion of interest K is present along the inner side of the intestinal tract in the orthogonal cross section. It is. As a first method, position information can be displayed by a color (yellow) based on the center position (135 degrees) of the portion of interest K. As a second method, the position information is displayed by a color from the start point position (90 degrees) to the end position (180 degrees) of the portion of interest K, that is, a color gradually changing from yellow green to yellow to red. Is possible.

  In the above-described embodiment, the example (medical diagnosis support apparatuses 1 ′ and 100 ′) in which the position information is displayed based on the color based on the position of the portion of interest K in the orthogonal cross section (color based on the hue ring C) has been described. Instead, a frame surrounding each position information may be displayed together with the position information, and the frame may be displayed in a color based on the position of the portion of interest K in the orthogonal cross section. In addition, a configuration in which the display background of the position information is displayed in a color based on the position of the portion of interest K in the orthogonal cross section is also possible. Furthermore, a mark for color display may be provided adjacent to each position information, and the mark may be displayed in a color based on the position of the portion of interest K in the orthogonal cross section.

  In the above-described embodiment, the case where the body position is changed between the supine position and the prone position in order to move the residue Z within the intestinal tract and distinguish the lesioned part B from the residue Z has been described. These positions (the supine position and the prone position) are merely examples, and may be changed between other positions as long as the residue Z can be moved in the intestinal tract.

  In the above-described embodiment, the case where medical image data captured by CT is used as an example, but medical image data obtained by MRI or an endoscope can also be used. Further, for example, medical image data in the supine position is acquired by CT, while medical image data in the prone position is acquired by an endoscope, and position information obtained based on these medical image data is obtained for each body position. It is also possible to display the list side by side.

  In the above-described embodiment, the configuration has been described in which medical image data is acquired by changing the body position between the supine position and the prone position, and the position information for each of these two body positions is displayed in a list. Instead of this configuration, for example, it is also possible to acquire medical image data at three or more different body positions and display a list of position information for each of these three or more body positions.

  In the above-described embodiment, the configuration example in which the distance from the anus of the portion of interest K is displayed as position information has been described. However, instead of this configuration, from other parts of the large intestine (for example, the mouth side end) The distance may be displayed in a list as position information.

  In the above-described embodiment, an example in which the large intestine is a diagnosis target has been described. However, the present invention is applied to diagnose a tubular tissue other than the large intestine, such as a bronchus, a lymphatic vessel, a small intestine, and a spine. Is possible.

DESCRIPTION OF SYMBOLS 1 Medical diagnostic assistance apparatus 2 Display apparatus 3 Operation apparatus 4 Image pick-up apparatus 11 Control part 12 Data storage part 14 Display data output interface 15 Operation input interface 16 Image data input interface 20 Virtual display means 21 Position information display means 120 Interesting part specification means 121 position information calculation means A core B B lesion part C hue ring K part of interest M mark T intestinal tract Z residue

That is, the medical diagnosis support apparatus according to the present invention is:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display means for displaying an image of the tubular tissue for each body position;
The positional information in the longitudinal direction of the tubular tissue, which is specified based on the image and is different from the state of the normal tubular tissue, is input, and the positional information for each body position. When sequentially displaying along a predetermined display direction on a predetermined display surface, the length from the display reference position in the predetermined display direction to the display position of the position information is the lumen in the longitudinal direction. And position information display means for displaying in correspondence with the distance from a predetermined position of the tissue to the region of interest.

In the above-described medical diagnosis support apparatus, a direction from the core line position of the tubular tissue to a predetermined site in a plane orthogonal to the longitudinal direction is set as a reference angle, and a direction from the core line position to the region of interest is predetermined. when the angle, the position information display means, were identified based on the image receives an input angular interval between the predetermined angle from the reference angle, predetermined, pre-Symbol angular intervals It is preferable that a color corresponding to the position information is added to the position information.

Another medical diagnosis support apparatus according to the present invention is:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
A part of interest specifying means for specifying a part of interest different from the normal state of the tubular tissue based on the medical image data;
Position information calculating means for calculating position information of the identified portion of interest in the longitudinal direction of the tubular tissue;
When the position information in the longitudinal direction of each calculated portion of interest is sequentially displayed along a predetermined display direction on a predetermined display surface for each body position, the display reference position in the predetermined display direction is used. Position information display means for displaying the length of the position information to the display position in correspondence with the distance from the predetermined position of the tubular tissue to the region of interest in the longitudinal direction. And

A medical diagnosis support method according to the present invention includes:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. In the medical diagnosis support method for performing display processing for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
In response to the input of positional information in the longitudinal direction of the tubular tissue of the region of interest different from the normal state of the tubular tissue identified based on the image, the positional information is stored for each body position. When sequentially displaying along a predetermined display direction on a predetermined display surface, the length from the display reference position in the predetermined display direction to the display position of the position information is the lumen in the longitudinal direction. And a position information display step of displaying in correspondence with a distance from a predetermined position of the tissue to the portion of interest.

Furthermore, the medical diagnosis support program according to the present invention includes:
One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support program for executing display processing for supporting diagnosis of the tubular tissue using a medical image data of the tubular tissue in a computer,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
In response to the input of positional information in the longitudinal direction of the tubular tissue of the region of interest different from the normal state of the tubular tissue identified based on the image, the positional information is stored for each body position. When sequentially displaying along a predetermined display direction on a predetermined display surface, the length from the display reference position in the predetermined display direction to the display position of the position information is the lumen in the longitudinal direction. And a position information display step for displaying in correspondence with the distance from the predetermined position of the tissue to the portion of interest.

The medical diagnosis support apparatus , method, and program according to the present invention, when displaying position information of a portion of interest along a predetermined display direction for each body position, from a display reference position in a predetermined display direction to a display position of the position information Is displayed in correspondence with the distance from the predetermined position of the tubular tissue to the region of interest. With this configuration, position information about the same lesion is displayed with the display positions aligned between different positions. For this reason, there is a lesion in the tubular tissue simply by looking at the list displayed by the medical diagnosis support apparatus according to the present invention and confirming the presence or absence of positional information with different display positions between different positions. Whether or not to do so can be diagnosed intuitively at a glance. Furthermore, this makes it possible to reduce the burden on the interpreter and to diagnose the luminal tissue accurately and efficiently.

On the other hand, the position information “15 cm” for the body position 2 corresponds to a distance that is 1.5 times as large as 10 cm, and is thus positioned at a distance of 1.5 d from the lower end position of the list. In the same manner, the remaining position information (22 cm and 100 cm) in the body posture 2 is arranged at the vertical position corresponding to the numerical value indicating the position information. In this way, display data for list display is generated based on the position information input by the radiogram interpreter.

Claims (7)

One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display means for displaying an image of the tubular tissue for each body position;
The positional information in the longitudinal direction of the tubular tissue, which is specified based on the image and is different from the state of the normal tubular tissue, is input, and the positional information for each body position. When displaying in parallel along a predetermined display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is set to the predetermined length of the tubular tissue in the longitudinal direction. A medical diagnosis support apparatus comprising: position information display means for displaying in correspondence with a distance from a position to the portion of interest. In a plane perpendicular to the longitudinal direction, a direction from the core line position of the tubular tissue toward a predetermined site is a reference angle, and a direction from the core line position to the portion of interest is a predetermined angle,
The position information display means receives an input of an angular interval from the reference angle to the predetermined angle specified based on the image, and determines a color corresponding to the predetermined other angular interval in advance. The medical diagnosis support apparatus according to claim 1, wherein the medical diagnosis support apparatus is attached to position information. One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support apparatus for performing display for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
A part of interest specifying means for specifying a part of interest different from the normal state of the tubular tissue based on the medical image data;
Position information calculating means for calculating position information of the identified portion of interest in the longitudinal direction of the tubular tissue;
When the position information in the longitudinal direction of each calculated part of interest is displayed in parallel along a predetermined display direction for each body position, the position information is calculated from a display reference position in the predetermined display direction. And a position information display means for displaying the length to the display position in correspondence with the distance from the predetermined position of the tubular tissue to the region of interest in the longitudinal direction. Support device. The position information calculation means uses a direction from the core line position of the tubular tissue toward a predetermined site as a reference angle in a plane orthogonal to the longitudinal direction, and sets a direction from the core line position to the region of interest as a predetermined angle. When it is an angle, it is configured to calculate an angle interval from the reference angle to the predetermined angle,
4. The medical diagnosis support apparatus according to claim 3, wherein the position information display means attaches a predetermined color to the position information according to the calculated angular interval.   The medical diagnosis support apparatus according to any one of claims 1 to 4, wherein the medical image data is acquired by different image acquisition methods for each body position. One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. In the medical diagnosis support method for performing display processing for supporting diagnosis of the tubular tissue, using the medical image data of the tubular tissue,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
In response to the input of positional information in the longitudinal direction of the tubular tissue of the region of interest different from the normal state of the tubular tissue identified based on the image, the positional information is stored for each body position. When displaying in parallel along a predetermined display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is set to the predetermined length of the tubular tissue in the longitudinal direction. And a position information display step for displaying the position information in correspondence with the distance from the position to the portion of interest. One body position in which the tubular tissue as the subject is arranged in a predetermined position state, and another body position from which the attached body is moved so that the attached substance can move in the tubular tissue. A medical diagnosis support program for executing display processing for supporting diagnosis of the tubular tissue using a medical image data of the tubular tissue in a computer,
Based on the medical image data, an intraluminal image display step of displaying an image of the tubular tissue for each body position;
The position information is predetermined for each body position according to input of position information in the longitudinal direction of the tubular tissue of the region of interest different from the state of the tubular tissue identified based on the image. When displaying in parallel along the display direction, the length from the display reference position in the predetermined display direction to the display position of the position information is determined from the predetermined position of the tubular tissue in the longitudinal direction. A medical diagnosis support program for causing a computer to execute a position information display step of displaying in correspondence with a distance to the portion of interest.