JP2015107253A - Ultrasonic image diagnostic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic image diagnostic device capable of preventing a push pulse from being transmitted to a region which may not be imaged correctly.SOLUTION: An ultrasonic image diagnostic device includes a target setting part which sets a target position for performing push pulse irradiation from an ultrasonic probe on an ultrasonic image, an image determination part which determines a non-propagation region where a shear wave is difficult to propagate with the ultrasonic image to acquire it, and an image generation part which generates an image for presenting the non-propagation region together with the ultrasonic image.

Description

  Embodiments described herein relate generally to an ultrasonic diagnostic imaging apparatus that images shear elastic waves.

  Since the ultrasonic diagnostic imaging apparatus is a non-invasive diagnostic apparatus without exposure, it is used in a wide range of clinical fields from diagnosis to follow-up. In recent years, elastography has been developed as a new diagnostic imaging method for detecting the elasticity (hardness) of tissue and evaluating it non-invasively and objectively as well as improving its performance. As a result, cancer evaluation of fibroadenoma such as breast and liver is expected.

  There are various methods for elastography. Among them, there is a parametric imaging method using shear elastic waves. The velocity of the shear elastic wave propagating in the substance correlates with the elastic coefficient of the substance, and it can be said that the faster the propagation speed, the harder the substance. Specifically, the tissue hardness is evaluated by measuring the propagation velocity of shear elastic waves (transverse elastic waves) generated by irradiating convergent ultrasonic waves (hereinafter referred to as push pulses) (see, for example, Patent Document 1). ).

  However, a shear elastic wave (hereinafter referred to as a shear wave) propagates in a solid having a twist, but has a property that it is difficult to propagate in a liquid or gas that does not have elasticity against torsion. For this reason, it has been pointed out that when a shear wave passes through a blood vessel or passes through a liquefied lesion, an image of the region after passing may not be correctly imaged. The push pulse transmitted to generate the shear wave has a higher acoustic power than usual. Sending a push pulse to an area that may not be imaged correctly is concerned about the effect on the human body, so it is necessary to prevent this. In addition, it is also possible to preliminarily irradiate a push pulse with low power before the diagnosis to check whether shear waves propagate, but this is a heavy burden on the patient.

Special table 2012-531937 gazette

  The problem to be solved by the present invention is to solve the above problems and to provide an ultrasonic diagnostic imaging apparatus that prevents a push pulse from being transmitted to a region that may not be imaged correctly.

  In order to achieve the above-described problem, the ultrasonic diagnostic imaging apparatus according to the present embodiment has a target setting unit that sets a target position for performing push pulse irradiation from an ultrasonic probe on an ultrasonic image, and a shear wave propagates. An image determination unit that determines and acquires a difficult non-propagation region from the ultrasonic image, and an image generation unit that generates an image that presents the non-propagation region together with the ultrasonic image.

1 is a block configuration diagram of an ultrasonic diagnostic imaging apparatus according to a first embodiment. The flowchart figure of the shear wave diagnostic mode which concerns on this embodiment. Explanatory drawing which sets the target area | region of a shear wave diagnostic mode. The schematic diagram explaining a B mode ultrasonic image. Explanatory drawing which determines the non-propagation area | region on a B mode ultrasonic image. The figure explaining the setting of the target which irradiates a push pulse, and the mode of shear wave propagation. The 1st explanatory view which judges a propagation improper field on an ultrasonic image. The 2nd explanatory view which judges a propagation unsuitable field on an ultrasonographic image. The flowchart figure which calculates a propagation area from the past reference image data in 2nd Embodiment.

  Hereinafter, embodiments will be described in detail with reference to FIGS. 1 to 9. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

(First embodiment)
The ultrasonic diagnostic imaging apparatus of the present embodiment shown in FIG. 1 has an ultrasonic probe 11 that transmits and receives ultrasonic waves with a transducer attached to the tip, transmits a drive signal for generating ultrasonic waves, and reflects from the subject. Transmission / reception unit 12 that detects an echo signal as an electrical signal, processor unit 13 that performs signal processing for various diagnostic modes of ultrasonic image diagnosis, and a scan converter that converts processing signals of various diagnostic modes performed by the processor unit 13 into video signals 14. Along with the diagnostic image output from the scan converter, push pulse irradiation target position for generating shear waves, display of areas where parametric imaging using shear waves may not be performed correctly, and alert Warning messages or side-by-side display of multiple medical images An image generating unit 16 for displaying operation information and image information on the display monitor 15, an operation console 17 for inputting various control commands for the ultrasonic diagnostic imaging apparatus, and various signals for controlling the ultrasonic diagnostic imaging apparatus. The interface unit 18 and a control unit 19 that integrally controls the ultrasonic diagnostic imaging apparatus are provided. On the console 17, user interface devices such as a mouse, a trackball, a joystick, a keyboard, and various switches are arranged for inputting various control commands. Moreover, the touch panel etc. which were formed in the display monitor 15 are also included.

  The ultrasonic diagnostic imaging apparatus of this embodiment includes a parametric imaging mode (hereinafter referred to as a shear wave diagnostic mode) using a shear wave. The ultrasonic probe 11 can transmit a push pulse which is a convergent ultrasonic wave in addition to a normal ultrasonic scan mode, and can capture a shear wave generated by the irradiation of the push pulse. The processor unit 13 includes a shear wave processor 131 that performs shear wave signal processing, and displays the propagation speed of the shear wave in association with the tissue hardness by a display method such as colorization. The processor unit 13 includes a compression-type elastic wave processor 132 that captures and images an elastic wave generated by compressing the subject, a Doppler spectrum processor 133 that observes movements such as blood flow from the Doppler amount, and a Doppler amount. And a color Doppler processor 134 for colorizing and displaying the image and a B-mode image processor 135 for processing the B-mode image.

  Furthermore, the ultrasonic diagnostic imaging apparatus of this embodiment has a push pulse transmission control function. When sending a push pulse to a part that is concerned about acoustic effects, display a region where parametric imaging using shear waves may not be performed correctly, alert the operator to alert, and push pulse transmission Processing such as prohibition can be performed. The control unit 19 controls the ultrasonic diagnostic imaging apparatus in an integrated manner. The configuration of the part that is a feature of the present embodiment will be mainly described.

  The control unit 19 of the present embodiment determines a region where parametric imaging using shear waves may not be performed correctly and performs mask processing on the ultrasonic image, and push pulse transmission control. And a message control unit 192 that generates an alert message related to the transmission of the push pulse.

  A propagation region determination unit 191 sets a target position for performing push pulse irradiation from the ultrasonic probe 11 on the ultrasonic image, and a non-propagation region in which shear waves are difficult to propagate from the ultrasonic image. Assuming the propagation of shear waves generated from the target position by the push pulse irradiation, the image determination unit 195 to be determined and acquired, and performing mask processing with the region located in the shadow of the non-propagation region as a propagation inappropriate region, A mask processing unit 196 that calculates a propagation region of the shear wave.

  The ultrasonic image storage unit 20 stores various ultrasonic images processed by the processor unit 13 and stores the spatial coordinates of the target position, non-propagation region, and non-propagation region that have been diagnosed. To do.

  The operation of the ultrasonic diagnostic imaging apparatus configured as described above will be specifically described with reference to the flowchart of the shear wave diagnostic mode in FIG.

  FIG. 3 is an explanatory diagram for setting a target region in the “shear wave diagnostic mode” within the ultrasonic transmission range. The ultrasonic probe 11 includes a plurality of types such as a convex type and a linear type. In this embodiment, the convex type will be described as an example. The ultrasonic probe 11 is applied perpendicularly to the body surface 30, and the transmission range of ultrasonic waves from the ultrasonic probe 11 is denoted by reference numeral 31. Target areas 32 a and 32 b for the “shear wave diagnostic mode” are set for the transmission range 31. Push pulses 33a and 33b, which are convergent ultrasonic waves, are transmitted to the target regions 32a and 32b, the shear waves generated thereby are captured, and signal processing is performed by the shear wave processor 131, whereby the target regions 32a and 32b Tissue hardness can be evaluated. In the following description, an example of evaluating liver tissue hardening will be described.

  In step ST <b> 201, the operator selects the shear wave diagnosis mode from the console 17. In step ST202, the B-mode image being observed is displayed. As shown in FIG. 4, on the B-mode image, an abdominal wall 42, a cyst 43, a blood vessel 44, and an outer portion 45 of the liver that are located in the liver peripheral portion 41 are displayed.

  FIG. 5 is an explanatory diagram for determining the non-propagating region 51 on the ultrasonic image. The non-propagating region 51 is a region in which shear waves are difficult to propagate, and represents a non-observing region that is not originally irradiated with a push pulse. The non-propagating region 51 can be determined by image analysis such as luminance information (pixel value) of the B-mode image. In the example of FIG. 4, the abdominal wall 42, the cyst 43, and the outer side 45 of the liver are non-propagating regions 51a obtained by image analysis such as luminance information and pattern matching. Although not shown here, the other non-propagating region 51 includes a bone portion having a high ultrasonic reflectance, a region using a contrast agent, and the like. In addition, when the area | region which a shear wave does not propagate is known beforehand using preliminary | backup push pulse irradiation or a compression-type elastic wave diagnosis, you may handle this as the non-propagation area | region 51. FIG.

  The blood vessel 44 is also the non-propagating region 51, but the blood vessel 44 is preferably determined using blood flow color information obtained from the color Doppler processor 134. Here, the non-propagating region 51 obtained from the color signal of the color Doppler processor 134 is denoted by reference numeral 51b. Then, the mask processing unit 196 fills the non-propagation region 51 (51a, 51b) and notifies the operator that shear waves do not propagate. If filling affects the diagnosis, remove the filling or make it translucent. If there is no problem with the non-propagating region 51, the coordinates of the non-propagating region 51 at this time are set and stored.

  In step ST204, the target 61 for push pulse irradiation is set. FIG. 6 is a diagram for explaining the setting of the target 61 for irradiating the push pulse and the state of shear wave propagation. This figure shows an example in which the target 61 is set at the upper part of the blood vessel 44. Shear waves generated from the target 61 propagate radially as indicated by dotted arrows. At this time, if there is a non-propagating region 51 (51a, 51b) in the ultrasonic propagation direction, there is a possibility that parametric imaging of the shadowed region may not be correctly observed. An area where parametric imaging may not be observed correctly is defined as a propagation inappropriate area. Here, the shear waves Sa, Sb, Sc, Sd, and Se indicated by dotted arrows indicate that the traveling direction of the shear wave is in contact with the non-propagating region 51 (51a, 51b).

  In step ST205, the mask processing unit 196 obtains this propagation inappropriate area.

  FIG. 7 is an explanatory diagram for calculating and determining a propagation inappropriate region on an ultrasound image. The propagation invincible areas in this figure are denoted by reference numerals 71a and 71b. Propagation inappropriate area 71a is a shaded portion of cyst 43, and is obtained from the straight lines indicating shear wave Sa and shear wave Sb in FIG. 6 and the coordinates of cyst 43 area. In addition, the propagation inappropriate area 71b is a shadowed portion in the blood vessel 44, and is obtained from the straight lines indicating the shear wave Sc, the shear wave Sd, and the shear wave Se in FIG.

  FIG. 8 shows an example in which the target 61 is set below the blood vessel 44. The propagation inadequate area 71c obtained from this figure is the same as in FIG. 7, and the straight line of the shear wave in which the traveling direction of the shear wave is in contact with the non-propagation area 51 (in this case, the blood vessel 44) is obtained. It is obtained from the coordinates.

  Then, a region where shear waves can propagate (hereinafter referred to as a propagation region) excluding the non-propagation region 71 and the non-propagation region 51 is obtained, and is displayed superimposed on the ultrasonic image.

  Various display methods are conceivable. For example, the following display mode may be selected.

(1) A propagation area in which both the non-propagation area 51 and the propagation inappropriate area 71 are filled is displayed.

(2) A propagation area in which only the non-propagation area 51 is filled is displayed. In this case, however, a warning message indicating that there is a possibility that parametric imaging using shear waves may not be performed correctly is also displayed.

(3) When the painting affects the diagnosis, the non-propagation region 51 and the propagation inappropriate region 71 are selected and the painting is canceled or made translucent so that the ultrasonic image can be seen.

  Since the push pulse applied to the target 61 has high power, if there is a part where the reflection is large, such as a bone, or a region where the shear wave does not propagate effectively near the target, the propagation speed of the shear wave may be erroneously measured, The power is not effectively attenuated and the target point may be damaged.

  Therefore, in step ST206, it is determined whether or not the propagation area 71 is larger than a predetermined area size. For example, it is determined whether the sufficient propagation area 71 has been calculated on the condition that the calculated propagation area 71 includes a circle having a predetermined radius or more from the center of the target 61. In consideration of safety, the size of this propagation area is set differently depending on the transmission power.

  If the propagation area 71 is smaller than the predetermined area size (step ST206: No), the target position is changed and resetting is performed, or a warning message “whether to reduce the power of the push pulse” (step ST207). Is displayed on the display monitor 15. The propagation area 71 can be displayed in real time in conjunction with the position of the target 61, and the target 61 can be designated at a desired position.

  In step ST208, after the target 61 is set, push pulses are transmitted, and hardness evaluation in the shear wave diagnostic mode is observed. Thereafter, the ultrasonic image storage unit 20 simultaneously stores the ultrasonic images of the various diagnostic modes performed, the target position of the shear wave diagnostic mode, the non-propagation region, the propagation inappropriate region, the coordinates of the propagation region, the transmission pulse condition, and the like. Is done.

  As described above, according to the first embodiment, the mask process indicating that the shear wave does not propagate is performed before the pulse is applied, and the region where the shear wave can propagate can be visually easily understood by the operator. Can show. The operator can execute an effective shear wave diagnostic mode by setting the target to which the push pulse is irradiated in this propagating region.

  Further, since it is not necessary to perform invalid push pulse irradiation or preliminary irradiation on the patient, it is possible to reduce damage and mental burden on the patient.

(Second Embodiment)
This embodiment demonstrates embodiment which presents a propagation area by referring to the image of the shear wave diagnostic mode performed in the past, and the past non-propagation area.

  FIG. 9 is a flowchart for calculating a propagation area from a past reference image. In periodic diagnosis such as follow-up after treatment for a patient, it is desirable to perform follow-up at the same target position with reference to an ultrasound image performed before treatment. In addition, when the area where shear waves do not propagate is known in advance using push-pulse irradiation or compression type elastic waves, the area where shear waves can propagate is calculated by referring to this. Can be displayed.

  First, in step ST901, the operator selects a shear wave diagnosis mode. In step ST902, an ultrasonic image taken in the past to be referred to is read from the ultrasonic image storage unit 20. At this time, the target position, the non-propagation region, the propagation inappropriate region, the coordinates of the propagation region, and the transmission condition when the reference image is captured are read from the ultrasonic image storage unit 20 at the same time. At this time, in the non-propagating region, the region where the shear wave did not propagate when the preliminary push pulse was irradiated in the diagnosis before treatment, the region where the elastic wave was not effectively observed by the compression type elastography, etc. Is included.

  In step ST903, the ultrasound image before treatment and the ultrasound image currently being diagnosed (after treatment) are displayed side by side on the display monitor 15 (side-by-side display), and the operator can view both B-mode images. The ultrasonic probe 11 is moved so as to substantially match. And it confirms that a target position corresponds.

  In step ST904, the propagation area is displayed when the target positions substantially match. At this time, the non-propagating region includes a region where the shear wave found by preliminary push pulse irradiation in the diagnosis before treatment has not propagated, a region where the compression-type elastic wave is not effectively observed, and the like. In step ST905, the operator confirms whether a target position and a propagation area of a predetermined size are secured. In this case, the propagation region of the reference image may be displayed, or the propagation region may be recalculated and displayed from the coordinates of the non-propagation region and the propagation inappropriate region acquired from the ultrasonic image storage unit 20.

  In step ST906, if there is no problem in the target position and the size of the propagation region, push pulses are transmitted under the previous push pulse transmission conditions.

  Therefore, according to the second embodiment, the setting of the same target position and the setting of the propagation region are automatically set in the diagnosis before and after treatment such as follow-up observation. For this reason, it is only necessary to visually confirm the target position and the propagation region, and it is possible to observe the progress of the liver tissue with respect to the same target position and the same push pulse condition without using unnecessary push pulse irradiation.

  According to the embodiment described above, there is an effect that it is possible to prevent a push pulse from being transmitted to an area that may not be correctly imaged.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. For example, the non-propagation region and the non-propagation region may be calculated widely in consideration of safety.

  In the embodiment, the hardness diagnosis of liver tissue has been described as a main example. However, the applied diagnosis is not limited to this. Further, the diagnosis procedure is not limited to the flowchart described above.

  These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

11 ... ultrasonic probe,
12: Transmitter / receiver,
13: Processor part,
14 ... Scan converter,
15 ... Display monitor,
16 ... image generation unit,
17 ... console,
18 ... interface part,
19 ... control unit,
194 ... Target setting section,
195 ... Image determination unit,
196: Mask processing unit.

Claims (6)

A target setting unit for setting a target position for performing push pulse irradiation from an ultrasonic probe on an ultrasonic image;
An image determination unit that determines and acquires a non-propagation region where shear waves are difficult to propagate from the ultrasonic image;
An image generating unit that generates an image that presents the non-propagating region together with the ultrasound image;
Ultrasound image diagnostic apparatus having Assuming propagation of shear waves generated from the target position by the push pulse irradiation, calculating a region located in the shadow of the non-propagating region as a non-propagating region, one of the non-propagating region and the non-propagating region or Using both, it further has a mask processing unit for calculating the propagation area of the shear wave,
The ultrasonic image diagnostic apparatus according to claim 1, wherein the image generation unit generates an image that presents the propagation region together with the ultrasonic image.   The ultrasound diagnostic imaging apparatus according to claim 1, wherein the non-propagating region is determined based on luminance information of a B-mode ultrasound image.   The ultrasonic image diagnostic apparatus according to claim 1, wherein the non-propagating region is determined based on color information of an ultrasonic image in a color Doppler mode.   Simultaneously with the ultrasound image, it further includes an ultrasound image storage unit for storing the coordinates of the non-propagation region and the propagation inadequate region. 3. The ultrasonic diagnostic imaging apparatus according to claim 1, wherein a shear wave propagation region is calculated using coordinates of a past non-propagation region and a propagation inadequate region stored in the unit.   The ultrasonic diagnostic imaging apparatus according to claim 1, further comprising a message unit that issues a warning when the propagation area does not have a predetermined area size.

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