JP2016007435A - X-ray diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reproduce a blood pressure measurement position before placement of a stent, after placement of the stent.SOLUTION: An X-ray diagnostic apparatus (10) includes a position detecting part (46a), a cycle detecting part (46b), a phase checking part (46c) and a display part (46d). The position detecting part detects positions of a measurement device from time-oriented X-ray images after placement of a blood vessel treatment instrument after detecting the positions of the measurement device in a blood vessel respectively from the time-oriented X-ray images before placement of the blood vessel treatment instrument. The cycle detecting part detects cycles of change in positions of the measurement device with respect to the X-ray images before placement and the X-ray images after placement. The phase checking part coordinates the X-ray images before placement having the most approximate phase of change in positions of the measurement device to each of the X-ray images after placement. The display part superimposes information on the positions of the measurement device in the X-ray images before placement having the most approximate phase when displaying a plurality of X-ray images after displacement.

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus.

  A stent is used to treat a disease caused by stenosis or occlusion of a blood vessel or other in-vivo lumen, and expand the stenosis or occlusion site and place it there to maintain the lumen size. It is a medical device. Stents are used in angioplasty of the heart, carotid artery, and lower limb artery, and are an important medical device in the field of cardiovascular treatment in, for example, ischemic heart disease.

  In the case of a stent formed of a metal material, there are problems such as that foreign matters remain in the body forever and that magnetic resonance imaging diagnosis is difficult due to the magnetic attractive force that the metal receives. For this reason, bioabsorbable stents that are made of a material that does not cause problems in magnetic resonance imaging and that is decomposed and absorbed by the living body in several years and disappears, for example, are becoming widespread.

  In a treatment in which a stent is placed at a stenosis site in a coronary artery, for example, FFR (Fractional Flow Reserve) is measured around the stenosis site in order to evaluate a therapeutic effect. FFR is an index indicating the degree of myocardial ischemia caused by stenosis of the coronary artery, and is indicated by a ratio between the maximum coronary blood flow in the presence of stenosis and the maximum coronary blood flow in the absence of stenosis. The FFR is calculated, for example, by measuring the blood pressure of the coronary artery before and after placement of the stent (in the absence of stenosis) and after placement of the stent (in the absence of stenosis) using a pressure wire (guide wire with pressure sensor) ( For example, see Patent Document 1).

JP 2014-61268 A

  The bioabsorbable stent is generally made of a material having a very low X-ray absorption rate such as a polymer, and is X-ray transparent. Therefore, even if a patient having a bioabsorbable stent in the body is imaged by an X-ray diagnostic apparatus, the polymer stent is projected brightly in an X-ray image in the same manner as the surrounding X-ray transparent human tissue, and thus cannot be identified. . That is, in the fluoroscopic treatment using the X-ray diagnostic apparatus, the bioabsorbable stent cannot be directly observed on the X-ray image.

  Here, in the measurement of FFR, blood pressure is measured from two points before and after the portion where the blood vessel diameter is narrowed due to, for example, stenosis before the bioabsorbable stent is placed. However, after the placement of the bioabsorbable stent, the blood vessel is ideally expanded to have the same diameter as the previous and next blood vessels, and the bioabsorbable stent is not projected on the X-ray image. It is difficult to identify blood pressure measurement points. On the other hand, in order to accurately evaluate the degree of improvement in blood flow, it is desirable that the blood pressure measurement locations in the FFR measurement are substantially matched before and after placement of the bioabsorbable stent.

  Therefore, from the viewpoint of accurate evaluation of blood flow improvement, in order to enable FFR measurement after stent placement at the same position as before stent placement, a new blood pressure measurement position before stent placement is reproduced after stent placement. Technology was demanded.

  Hereinafter, the aspect which embodiment of this invention can take is demonstrated for every aspect.

(1) In one embodiment, the X-ray diagnostic apparatus performs an imaging operation for generating projection data of a plurality of time-series X-ray images by detecting X-rays transmitted through the subject. It has a position detection unit, a cycle detection unit, a phase matching unit, and a display unit having the following configuration.
The position detection unit acquires, in real time, projection data of a plurality of time-series X-ray images before placement generated in an imaging operation before placement of the blood vessel treatment tool in the subject, After detecting the position of the measurement device inserted into the X-ray image from a plurality of pre-dwelling X-ray images, the projection data of a plurality of time-series post-in-dwelling X-ray images generated by the imaging operation after the placement of the vascular treatment device is acquired. By doing so, the position of the measuring device is detected in real time from a plurality of post-indwelling X-ray images.
The cycle detection unit calculates a cycle of position change of the measurement device with respect to a plurality of pre-in-dwelling X-ray images and a plurality of post-in-dwelling X-ray images based on each position of the measurement device detected by the position detection unit. Detect each.
The phase matching unit performs a phase matching process for associating a plurality of post-in-placement X-ray images with a pre-in-placement X-ray image having the closest phase of the position change of the measurement device, based on a cycle of position change of the measurement device. Run.
Based on the result of the phase matching process, the display unit superimposes the position information of the measuring device on the pre-in-dwelling X-ray image having the closest phase on the plurality of after-in-dwelling X-ray images. Display line images.

(2) In another embodiment, the X-ray diagnostic apparatus performs the same imaging operation as described above, and includes a position detection unit, a cycle detection unit, a phase matching unit, and a display unit having the following configuration.
The position detection unit acquires projection data of a plurality of time-series past X-ray images generated and stored in the past imaging operation, and a plurality of time-series projections generated in the imaging operation being performed in real time. By acquiring the projection data of the real-time X-ray image, the position of the measuring device inserted into the blood vessel of the subject is detected from the plurality of past X-ray images and the plurality of real-time X-ray images.
The cycle detection unit detects a cycle of position change of the measurement device for each of a plurality of past X-ray images and a plurality of real-time X-ray images based on each position of the measurement device detected by the position detection unit. To do.
The phase matching unit executes a phase matching process for associating a plurality of real-time X-ray images with past X-ray images having the closest phase of the position change of the measurement device, based on a cycle of position change of the measurement device. .
The display unit displays the plurality of real-time X-ray images while superimposing the position information of the measuring device in the past X-ray image having the closest phase on the plurality of real-time X-ray images based on the result of the phase matching process. indicate.

(3) In another embodiment, the X-ray diagnostic apparatus performs the same imaging operation as described above, and includes a position detection unit, a period detection unit, a phase matching unit, and a display unit having the following configuration.
The display unit acquires projection data of a plurality of time-series pre-in-dwelling X-ray images generated and stored in the imaging operation before the placement of the vascular treatment device in the subject, and the plurality of pre-in-dwelling X-ray images Is displayed.
The position detection unit obtains projection data of a plurality of time-sequential post-in-dwelling X-ray images generated by an imaging operation after the placement of the vascular treatment device, so that the measurement device inserted into the blood vessel of the subject The position is detected in real time from a plurality of post-indwelling X-ray images.
The cycle detection unit obtains input information related to the cycle of position change of the measuring device in the plurality of pre-detention X-ray images after the start of displaying the plurality of pre-detention X-ray images, and a plurality of pre-detention X-rays based on the input information After determining the cycle of the position change of the measuring device with respect to the line image, the cycle of the position change of the measuring device is detected with respect to a plurality of post-in-placement X-ray images based on the position of the measuring device detected by the position detector To do.
The phase matching unit performs a phase matching process for associating a plurality of post-in-placement X-ray images with a pre-in-placement X-ray image having the closest phase of the position change of the measurement device, based on a cycle of position change of the measurement device. Run.
Based on the result of the phase matching process, the display unit superimposes the position information of the measuring device on the pre-in-dwelling X-ray image having the closest phase on the plurality of after-in-dwelling X-ray images. Display line images.

(4) In another embodiment, the image processing apparatus includes a position detection unit, a period detection unit, a phase matching unit, and a display unit having the following configuration.
The position detection unit obtains projection data of a plurality of time-series pre-in-dwelling X-ray images generated by an imaging operation before the placement of the vascular treatment device in the subject, and inserts it into the subject's blood vessel. Obtaining the projection data of a plurality of post-in-dwelling X-ray images generated by the imaging operation after the placement of the vascular treatment device after detecting the position of the measured measuring device from the plurality of pre-indwelling X-ray images, respectively. Thus, the position of the measuring device is detected in real time from the plurality of post-indwelling X-ray images.
The cycle detection unit calculates a cycle of position change of the measurement device with respect to a plurality of pre-in-dwelling X-ray images and a plurality of post-in-dwelling X-ray images based on each position of the measurement device detected by the position detection unit. Detect each.
The phase matching unit is configured to associate a pre-placement X-ray image in which the phase of the position change of the measurement device matches each other with the plurality of post-placement X-ray images based on the cycle of the position change of the measurement device. Execute.
The display unit superimposes the position information of the measuring device on the X-ray image before placement in phase with each of the plurality of post-in-placement X-ray images based on the result of the phase matching process, and Display line images.

The block diagram which shows an example of a structure of the X-ray diagnostic apparatus in 1st Embodiment. The schematic diagram which shows an example of a structure of a FFR measuring apparatus. The schematic diagram of the time-sequential X-ray image before indwelling of the bioabsorbable stent which shows an example of the detection method of the period of a position change of the pressure sensor by a period detection part. The schematic diagram of each X-ray image before and behind indwelling of the bioabsorbable stent which shows an example of the phase collation process by a phase collation part. The schematic diagram which shows an example of the guide display by the display apparatus after the indwelling of a bioabsorbable stent. The flowchart which shows an example of operation | movement of the X-ray diagnostic apparatus of 1st Embodiment. The schematic diagram which shows an example of the blood pressure measurement of two points before and behind the stenosis site | part before and behind indwelling of a bioabsorbable stent. The schematic diagram of the X-ray image before indwelling of the bioabsorbable stent which shows the concept of the interpolation by a phase collation part. In 2nd Embodiment, the schematic diagram of each X-ray image before and behind indwelling which shows an example in which the information of the some measurement position before indwelling of a bioabsorbable stent is displayed after indwelling. In 3rd Embodiment, the schematic diagram of the time-sequential X-ray image which shows an example of the user's designation | designated input regarding the period detection of the pressure sensor PS before indwelling of a bioabsorbable stent. The flowchart which shows an example of operation | movement of the X-ray diagnostic apparatus of 3rd Embodiment.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, in each figure, the same code | symbol is attached | subjected to the same element and the overlapping description is abbreviate | omitted.

<First Embodiment>
FIG. 1 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 10 according to the first embodiment of the present invention. Also in the second and third embodiments described later, the hardware configuration of the X-ray diagnostic apparatus 10 is the same as that of the first embodiment. Here, as an example, the components of the X-ray diagnostic apparatus 10 will be described by dividing them into three parts: a bed apparatus 20, an X-ray generating / detecting system 30, and a computing system 40. .

  First, the bed apparatus 20 includes a support table 21, a top plate 22, and a top plate moving mechanism 23 disposed in the support table 21. A subject P is placed on the top 22.

  The support base 21 supports the top plate 22 so as to be movable in the horizontal direction (Z-axis direction of the apparatus coordinate system). The top plate moving mechanism 23 moves the top plate 22 in the Z-axis direction of the apparatus coordinate system under the control of a system control unit 42 of a computer system 40, which will be described later, whereby an X-ray detector 36 and a diaphragm device 35, which will be described later. An imaging region of the subject P is arranged between

  Here, as an example, the X axis, Y axis, and Z axis of the apparatus coordinate system are defined as follows. First, the vertical direction is the Y-axis direction, and the top plate 22 is arranged so that the normal direction of the upper surface thereof is the Y-axis direction. The horizontal movement direction of the top plate 22 is set as the Z-axis direction, and the top plate 22 is arranged so that the length direction thereof is the Z-axis direction. The X-axis direction is a direction orthogonal to these Y-axis direction and Z-axis direction.

  Second, the X-ray generation / detection system 20 includes a high voltage generator 31, a C-arm operation mechanism 32, a C-arm 33, an X-ray tube 34, an aperture device 35, and an X-ray detector 36. Have.

The C arm 33 is an arm that holds the X-ray tube 34, the diaphragm device 35, and the X-ray detector 36. By the C arm 33, the X-ray tube 34, the diaphragm device 35, and the X-ray detector 36 are arranged so as to face each other with the subject P interposed therebetween.
The C arm operating mechanism 32 rotates and moves the C arm 33 according to the imaging area under the control of the system control unit 42.

The high voltage generator 31 generates a high voltage and supplies the generated high voltage to the X-ray tube 34.
The X-ray tube 34 generates X-rays using the high voltage supplied from the high voltage generator 31.
The diaphragm device 35 squeezes so that, for example, X-rays are selectively irradiated to the imaging region of the subject P by sliding a plurality of diaphragm blades, and adjusts the opening degree of the diaphragm blades to irradiate X-rays. Control the range.

  The X-ray detector 36 converts and accumulates X-rays that have passed through the subject P by using a number of X-ray detection elements (not shown) arranged in a matrix, for example, and stores the accumulated electrical signals. It inputs into the projection data generation part 44 mentioned later.

  Third, the computer system 40 includes a system control unit 42, a projection data generation unit 44, a projection data storage unit 45, an image processing device 46, and an operation unit 48. Since the main feature of the X-ray diagnostic apparatus 10 is the function of the image analysis apparatus 46, the functions of the image analysis apparatus 46 will be described in detail after briefly describing the functions of the other components.

The projection data generation unit 44 generates projection data of an X-ray image using the electrical signal converted from the X-rays transmitted through the subject P by the X-ray detector 36, and the generated projection data is used as the projection data storage unit 45. To enter.
The projection data storage unit 45 stores the projection data of the X-ray image generated by the projection data generation unit 44.

  The system control unit 42 controls the entire X-ray diagnostic apparatus 10 in setting of imaging conditions, imaging operation, and display processing.

  The operation unit 48 includes a monitor, a keyboard, operation buttons, and the like for the user to input various commands such as imaging conditions, and transfers the input contents to the system control unit 42 and the image processing device 46.

  In the first embodiment, as an example, a bioabsorbable stent is placed in the blood vessel of the subject P by the operator while imaging and displaying the same region of the subject P continuously and in real time with a low X-ray dose, A case where FFR is measured before and after indwelling will be described. For this reason, the FFR measuring apparatus 200 is set on the subject P as shown in FIG. The FFR measuring apparatus 200 will be described later with reference to FIG. Here, as an example, it is assumed that the FFR measuring apparatus 200 has a configuration different from that of the X-ray diagnostic apparatus 10, but the FFR measuring apparatus 200 may be a part of the X-ray diagnostic apparatus 10.

Next, the image processing device 46 includes a position detection unit 46a, a cycle detection unit 46b, a phase matching unit 46c, a display device 46d, and a system bus SB.
The system bus SB is a communication wiring that electrically connects the components of the image processing apparatus 46 to each other.

The position detector 46a is configured to detect the pressure sensor PS at the tip of the pressure wire PW inserted into the blood vessel from the projection data of a plurality of time-series X-ray images generated in the imaging operation before the stent placement (a later-described figure). 2) is detected.
Further, the position detection unit 46a detects the position of the pressure sensor PS in the blood vessel in real time from the projection data of a plurality of time-series X-ray images generated by the imaging operation after stent placement.

  The cycle detection unit 46b detects the cycle of position change of the pressure sensor PS in a plurality of time-series X-ray images before stent placement. Further, the cycle detection unit 46b detects a cycle of position change of the pressure sensor PS in a plurality of time-series X-ray images after stent placement.

  The phase matching unit 46c executes phase matching processing based on the position change period of the pressure sensor PS and stores the result. Here, the phase matching process is a process of assigning an X-ray image before placement of the stent with the closest phase change of the position of the pressure sensor PS to each X-ray image after placement of the stent.

  The display device 46d superimposes the position information of the sensor in the X-ray image before the stent placement that matches the phase on each X-ray image after the stent placement based on the result of the phase matching process, while placing the stent in place. Each subsequent X-ray image is displayed in real time in time series.

  FIG. 2 is a schematic diagram illustrating an example of the configuration of the FFR measurement apparatus 200. The FFR measuring apparatus 200 includes an FFR calculator 200a and a pressure wire PW. The pressure wire PW includes, for example, a metal and bendable guide wire GY and a pressure sensor PS joined to the tip thereof. The FFR calculator 200a has a monitor (not shown), calculates the FFR value based on the blood pressure measured by the pressure sensor PS, and displays the FFR value on the monitor.

  Since the pressure sensor PS and the guide wire GY absorb X-rays, they are projected on the X-ray image. Here, the position detection unit 46a in FIG. 1 stores the shape (shadow pattern) of the pressure sensor PS before imaging. The position detection unit 46a detects the position of the pressure sensor PS from each X-ray image, for example, by pattern matching. Specifically, the guide wire GY can be detected as an elongated pixel region having the same luminance (X-ray transmittance) on the X-ray image. Then, the position detection unit 46a can detect the position of the pressure sensor PS as a region having a predetermined brightness and shape at the tip of the detected guide wire GY.

  Although FIG. 2 shows a pressure wire PW having a simple structure, this is merely an example. For example, the position of the pressure sensor PS may be easily detected by bonding a marker having an X-ray absorption characteristic characteristic to the tip of the pressure sensor PS.

  FIG. 3 is a schematic diagram of a time-series X-ray image before placement of the bioabsorbable stent, showing an example of a method for detecting the period of position change of the pressure sensor PS by the period detector 46b.

  In FIG. 3, as an example, 12 frames of X-ray images from frame 1 a to frame 12 a are arranged in order from the earliest imaging time. Assuming that the subject P on the top plate 22 does not move while the positions of the C-arm 33 and the top plate 22 are fixed, the frames 1a to 12a image the same region in time series in the apparatus coordinate system. It is a thing. In each of the frames 1a to 12a, the oval black area is the pressure sensor PS.

  The period detection unit 46b detects the position change period of the pressure sensor PS by, for example, the following algorithm. First, reference pixels such as the center of each image and the lower right corner are set as coordinate origins (x = 0, y = 0). x is a pixel position in the horizontal direction of the image, and y is a pixel position in the vertical direction of the image. Further, the coordinate position of the reference point (for example, the center point) of the pressure sensor PS in the frame n is defined by a vector Pn = (x, y). In the example of FIG. 3, n is 12 pieces from 1a to 12a.

  First, the period detector 46b calculates the coordinates of the reference point of the pressure sensor PS for each of the frames 1a to 12a.

Next, the period detection unit 46b calculates the position change amount ΔPn = | (Pn + 1) − (Pn) | of the reference point of the pressure sensor PS with the next frame of the imaging time. The position change amount ΔPn here may be, for example, the sum of the square of the x coordinate change amount with the next frame and the square of the y coordinate change amount with the next frame, or the square root of the sum value. Good.
That is, the position change amount ΔP1a of the reference point of the pressure sensor PS is calculated between the frame 2a and the frame 1a, and the position change amount ΔP2a of the reference point of the pressure sensor PS is calculated between the frame 3a and the frame 2a. The same applies hereinafter.

  Next, the period detection unit 46b identifies the frame having the smallest position change amount ΔPn from the next frame as the frame O, and defines the smallest ΔPn as ΔPn_min. In the example of FIG. 3, the frame 3a is the frame O, and the position change amount ΔP3a of the reference point of the pressure sensor PS between the frame 4a and the frame 3a is ΔPn_min.

  Next, the period detection unit 46b specifies a frame that satisfies the following three conditions as a frame Q.

The first condition is that ΔPn becomes a minimum value in comparison with ΔPn before and after from the viewpoint of imaging time.
As a second condition, the position vector Pn of the reference point of the pressure sensor PS is close to the frame O as compared with the previous and subsequent frames from the viewpoint of the imaging time.
As a third condition, among the frames that satisfy the first condition and the second condition, the frame has an imaging time later than the frame O and is closest to the frame O.

  Note that, in a situation where the surgeon does not move the pressure wire PW at all, the position change of the pressure sensor PS is caused by blood flow due to the heartbeat of the subject P. Therefore, the length of one cycle of the position change of the pressure sensor PS substantially matches the length of one cycle of the heartbeat of the subject P.

  For example, consider the case of a periodic motion in which the pressure sensor PS moves substantially up and down the image. In this case, the frame in which ΔPn is the minimum value is the frame in which the pressure sensor PS is positioned on the upper side in comparison with the two frames before and after the imaging time, and the pressure sensor PS in comparison with the two frames at the imaging time. Often the frame is located on the lower side. Therefore, when the second condition is removed, the position period of the position change of the pressure sensor PS may be detected with a length that is half of one period of the heartbeat of the subject P.

  In the example of FIG. 3, the frame O is the frame 3a in which the pressure sensor PS is below the frames with the imaging time before and after. In the example of FIG. 3, the frame 8 is a frame in which the pressure sensor PS is below the frames before and after the imaging time, and the position change amount ΔPn of the pressure sensor PS is minimal.

  The cycle detection unit 46b stores the X-ray image of each frame before stent placement after detecting one cycle as described above. At the time of storage, the period detection unit 46b electronically marks the frame O and the frame Q.

  The period detection unit 46b also detects one period as described above for each X-ray image after placement of the bioabsorbable stent that is sequentially generated in real time in time series, and the positional change amount with the next frame. The frame O ′ that minimizes ΔPn and the frame Q ′ that satisfies the first to third conditions are marked electronically. After the placement of the bioabsorbable stent, the cycle detection unit 46b updates the detection of one cycle at regular time intervals. Before the placement of the bioabsorbable stent, it is sufficient to detect one cycle once, and it is not necessary to update the value of one cycle in real time as needed after placement.

FIG. 4 is a schematic diagram of each X-ray image before and after the stent placement showing an example of the phase matching process by the phase matching unit 46c.
The upper part of FIG. 4 is frames 3a to 8a of X-ray images in time-series order before stent placement similar to FIG. 3, and one period is detected as 5 frames.

  The lower part of FIG. 4 shows X-ray image frames 1c to 10c in chronological order after placement of the bioabsorbable stent, and one period is detected as six frames by the period detection unit 46b. In addition, after placement of the bioabsorbable stent, the frame 1c is the frame O ′ that minimizes the positional change amount ΔPn from the next frame, and the frame Q ′ that satisfies the first to third conditions is the frame 7c. And

  The phase matching unit 46c sets the frame number of the frame O that minimizes the positional change amount ΔPn with respect to the next frame as Fmin and Cn as the number of frames in one cycle before the bioabsorbable stent is placed. In the upper example of FIG. 4, since the frame 3a which is the frame O is the third frame (see FIG. 3 described above), Fmin = 3 and the number of frames in one cycle Cn = 5.

  Further, the phase matching unit 46c sets the number of frames in one cycle as Cn ′ after the bioabsorbable stent is placed. Further, the phase matching unit 46c selects, as the first frame of each cycle (hereinafter referred to as Ftop), a frame that has a minimum positional change amount ΔPn with respect to the next frame, such as the frame O ′. Further, the phase matching unit 46c sets L how many frames are ahead of the first frame Ftop so that L <Cn ′.

  In the example in the lower part of FIG. 4, the latest frame 10c after placement of the stent is given by L = 3 within one cycle with the frame 7c as the top frame Ftop. At this time, the phase matching unit 46c executes phase matching processing based on, for example, the following equation (1).

  Fsamephase = Fmin + ROUND {(Cn / Cn ′) × L} (1)

  In the formula (1), Fsamephase is a frame number whose phase is closest to the latest frame after placement of the bioabsorbable stent before placement of the bioabsorbable stent. ROUND is a function that gives an integer rounded to {}.

In the example of FIG. 4, the right side of the equation (1) is 3 + ROUND {(5/6) × 3} = 3 + 2 = 5. Since Fsamephase = 5, the phase matching unit 46c determines that the frame 5a, which is the fifth frame before placement of the stent, is closest in phase to the latest frame 10c.
In this way, the phase matching unit 46c continuously executes a process for specifying a frame before placement of the bioabsorbable stent having the closest phase with respect to the latest frame after placement of the bioabsorbable stent sequentially generated in real time. Then, the result of the phase matching process is sequentially input to the display device 46d. Note that the above algorithm is merely an example of phase matching processing, and other methods may be used.

  FIG. 5 is a schematic diagram illustrating an example of guide display by the display device 46d after the bioabsorbable stent is placed. As shown in FIG. 5, in the time-series display of the X-ray image after the placement of the bioabsorbable stent by fluoroscopy, the display device 46d is arranged in the frame having the closest phase among the frames before the placement of the bioabsorbable stent. The position of the pressure sensor PS is displayed in a superimposed manner. The result of the phase matching process is used to select the frame with the closest phase.

  In FIG. 5, as an example, the position of the pressure sensor PS in the frame before stent placement is superimposed by an elliptical broken line. Instead of the broken line, the position information of the pressure sensor PS before placement of the stent may be identified and displayed by a chromatic color, for example.

  FIG. 6 is a flowchart illustrating an example of the operation of the X-ray diagnostic apparatus 10 according to the first embodiment. Hereinafter, the operation of the X-ray diagnostic apparatus 10 will be described according to the step numbers in the flowchart shown in FIG.

  [Step S1] The system control unit 42 (see FIG. 1), based on conditions such as the imaging region, tube current, tube voltage, and X-ray pulse width input via the operation unit 48, a bioabsorbable stent (not shown). 2) set the imaging conditions before and after placement. Thereafter, the process proceeds to step S2.

  [Step S2] Fluoroscopy and blood pressure measurement are performed before the bioabsorbable stent is placed. The operation of fluoroscopy is as follows. Specifically, the high voltage generator 31 (see FIG. 1) supplies a high voltage to the X-ray tube 34 according to the control of the system control unit 42, and the X-ray tube 34 generates X-rays. The X-ray irradiation range for the subject P is controlled.

  The X-ray detector 36 detects X-rays that have passed through the subject P, converts them into electrical signals, and inputs them to the projection data generation unit 44. The projection data generation unit 44 generates projection data of an X-ray image from the input electrical signal and stores it in the projection data storage unit 45.

  In this way, before placement of the bioabsorbable stent, the brightness of each pixel is set to a brightness corresponding to the dose received for each X-ray detection element (not shown) of the X-ray detector 36. Multi-phase projection data is generated for the same region, and is updated and displayed in real time on the display device 46d.

  The operator confirms the position with an X-ray image that is updated and displayed in real time by fluoroscopy, while holding the pressure wire PW (see FIG. 2) to the deepest vicinity of the target site of the subject P where the bioabsorbable stent is to be placed. insert. Thereafter, the operator operates the FFR measurement apparatus 200 while manually pulling out the pressure wire PW while confirming the position of the pressure sensor PS with an X-ray image, and blood pressure is measured at each measurement position in the blood vessel of the subject P. measure.

  Here, before placement of the bioabsorbable stent, the blood vessel is narrower in the stenotic region than in the front and rear, and this is a landmark, and the blood pressure is measured so that at least two points before and after the stenotic site are included.

At the same time as the operation of sequentially generating and updating display of X-ray image projection data in real time, the position detector 46a sequentially detects the position of the pressure sensor PS from these X-ray image projection data in real time to detect the period. The part 46b detects one cycle of the position change of the pressure sensor PS (see FIG. 3). It should be noted that it is sufficient to detect one cycle once before the placement of the bioabsorbable stent, and it is not necessary to update the value of one cycle in real time as needed after the placement of the bioabsorbable stent.
Thereafter, the process proceeds to step S3.

  [Step S3] The cycle detection unit 46b stores the projection data of the X-ray image of each frame before placement of the bioabsorbable stent together with the data of one cycle calculated in Step S2. At the time of storage, the frame O and the frame Q are marked electronically. Thereafter, the process proceeds to step S4.

  [Step S4] The operator moves a bioabsorbable stent (not shown) to the stenosis site in the subject P while confirming the X-ray image updated and displayed in real time by the same fluoroscopy as described above. In place. Thereafter, the process proceeds to step S5.

  [Step S5] The fluoroscopy after placement of the bioabsorbable stent is performed. That is, by repeating the following <1> to <3>, the position of the pressure sensor PS in the in-phase image before the placement of the bioabsorbable stent is updated while periodically updating the position change period of the pressure sensor PS. It is displayed superimposed on the latest frame (X-ray image).

  <1> The position detection unit 46a sequentially detects the position of the pressure sensor PS from the projection data of the X-ray images sequentially generated by the same operation as described above, and inputs the result to the period detection unit 46b.

  <2> The cycle detector 46b detects one cycle of the position change of the pressure sensor PS from the time-series X-ray image after placement of the bioabsorbable stent as described above (see FIGS. 3 and 4). .

  <3> As described in the above-described formula (1) and the like, the period detection unit 46b places the bioabsorbable stent whose phase is closest to the latest frame after placement of the bioabsorbable stent sequentially generated in real time. A phase matching process for specifying the previous frame is executed. Then, the period detection unit 46b sequentially inputs the result of the phase matching process to the display device 46d. In the update display of the X-ray image after placement of the bioabsorbable stent by fluoroscopy, the display device 46d superimposes and displays the position of the pressure sensor PS in the frame having the closest phase in the frame before placement of the bioabsorbable stent ( (See the lower part of FIG. 5).

The surgeon inserts the pressure wire PW to the deepest vicinity of the target region of the subject P while confirming the position with an X-ray image updated and displayed in real time by fluoroscopy. Thereafter, the operator pulls out the pressure wire PW while confirming the X-ray image updated and displayed in real time together with the position information of the pressure sensor PS before placement of the bioabsorbable stent as described above.
As a result, the surgeon measures and stores blood pressure in the FFR measuring apparatus 200 at at least two points (in the insertion direction of the pressure wire PW) behind the stenosis site and a point before the stenosis site. Thereafter, the process proceeds to step S6.

  [Step S6] The FFR measuring apparatus 200 uses the pressure wire PW to measure the blood pressure at two points before and after the stenosis site measured before placement of the bioabsorbable stent and two points before and after the stenosis site measured after placement of the bioabsorbable stent. FFR is calculated based on the blood pressure and displayed on the monitor.

  In the above example, for simplification of explanation, the FFR is calculated by measuring the blood pressure with the minimum number of times, but this is only an example. For example, in step S5, the blood pressure may be measured at each position while the pressure wire PW is pulled out, and the calculation of the FFR value may be repeated several times. The above is the description of the operation of the X-ray diagnostic apparatus 10 of the first embodiment.

Hereinafter, the difference from the prior art will be described with reference to FIG.
FIG. 7 is a schematic diagram showing an example of blood pressure measurement at two points before and after a stenosis site before and after placement of a bioabsorbable stent. The upper part of FIG. 7 corresponds to before placement of the bioabsorbable stent, the lower part of FIG. 7 corresponds to after placement of the bioabsorbable stent, and the thick line is the outer wall of the blood vessel. In the upper part of FIG. 7, the central part with a narrow blood vessel width corresponds to a stenosis site, and the bioabsorbable stent is placed in this stenosis site.

  Before placement of the bioabsorbable stent, for example, in the insertion direction of the pressure wire PW, the blood pressure before placement of the bioabsorbable stent is at two points, a position Psa deeper than the stenosis site and a position Psb before the stenosis site. Measured. In this case, since the blood vessel is narrower than the front and rear in the X-ray image, the pressure sensor PS of the FFR measuring apparatus 200 is placed at a position behind the stenosis site and a position before the stenosis site. Positioning each is relatively easy for the operator.

  On the other hand, after the placement of the bioabsorbable stent, the blood vessel width of the stenotic site is expanded by the placed bioabsorbable stent and ideally becomes substantially the same as the front and rear blood vessel widths as shown in the lower part of FIG. . In this case, it is difficult for the surgeon to search the X-ray image for a portion that was a stenosis site with the conventional technique. On the other hand, in order to accurately evaluate the degree of improvement in blood flow, it is desirable that blood pressure measurement locations are substantially matched before and after placement of the bioabsorbable stent.

  Further, the conventional X-ray diagnostic apparatus has no function of automatically storing a fluoroscopic image (X-ray image) before placement of the bioabsorbable stent. For this reason, in the prior art, if the blood pressure measurement position is to be adjusted before and after placement of the bioabsorbable stent, the user manually creates an X-ray image on which the pressure sensor is projected at the blood pressure measurement position before placement of the bioabsorbable stent. I have to save it.

  Therefore, in the first embodiment, the position detection unit 46a detects the position of the pressure sensor PS from time-series X-ray images before and after placement of the bioabsorbable stent, and the period detection unit 46b detects the position change of the pressure sensor PS. The period is detected separately before and after the placement (step S2). At this time, the cycle detection unit 46b automatically saves the projection data of each X-ray image before placement of the bioabsorbable stent together with the calculated data of one cycle (step S3).

  Next, the phase matching unit 46c identifies an X-ray image before placement that is closest in phase to the X-ray image after placement of the bioabsorbable stent. The display device 46d superimposes the position information of the pressure sensor PS in the X-ray image before placement of the bioabsorbable stent with the closest phase, and updates and displays the X-ray images after placement of the bioabsorbable stent sequentially captured in real time. (See step S5 and the lower part of FIG. 5).

  Accordingly, in the pulling-out operation of the pressure wire PW in step S5, the surgeon checks the positional information of the pressure sensor PS before placement of the bioabsorbable stent with an X-ray image, and presses the pressure at substantially the same position as before placement of the bioabsorbable stent. The position of the sensor PS can be adjusted. This facilitates FFR measurement at the same position as before the placement after placement of the bioabsorbable stent. As a result, the degree of blood flow improvement can be accurately evaluated.

  In general, before the bioabsorbable stent is placed, a contrast agent is used to detect a stenosis site. In the first embodiment, in the FFR measurement after the placement of the bioabsorbable stent, the blood pressure measurement position (position of the pressure sensor PS) before placement is displayed as an image, so that there is an increased possibility that the contrast agent is not used. That is, the drug load on the subject P can be reduced as a further effect of the first embodiment.

  In the following, three points will be supplemented for the first embodiment, but these three points also hold for the second and third embodiments described later.

  First, consider a case where the number of frames in one cycle is smaller before placement of the bioabsorbable stent than after placement of the bioabsorbable stent. In this case, the phase matching unit 46c may generate an X-ray image of one cycle before placement that is the same number as one cycle after placement of the bioabsorbable stent by executing interpolation processing instead of phase matching processing. .

  FIG. 8 is a schematic diagram of an X-ray image before placement of the bioabsorbable stent showing the concept of interpolation by the phase matching unit 46c. The upper part of FIG. 8 corresponds to each X-ray image before interpolation (X-ray image stored in the period detection unit 46b). The lower part of FIG. 8 corresponds to each X-ray image after interpolation. In the example of FIG. 8, one cycle is 5 frames before the bioabsorbable stent is placed, and one cycle is 6 frames after the bioabsorbable stent is placed.

  For example, for the first frame O (frame 3a), the phase matching unit 46c can directly use the X-ray image before interpolation as the X-ray image after interpolation as the first phase. By interpolating the remaining four frames, post-interpolation X-ray images of the second time phase to the sixth time phase can be generated. In this case, the post-interpolation X-ray image has a one-to-one correspondence with the one-cycle X-ray image after placement of the bioabsorbable stent from the viewpoint of phase. Therefore, the phase matching unit 46c and the display device 46d may superimpose and display the position information of the pressure sensor PS in the post-interpolation X-ray image in the same phase in the X-ray image after placement of the bioabsorbable stent that is sequentially updated and displayed. .

  Secondly, in the above flowchart, the subject P remains placed at the same position on the top plate 22 from before the placement of the bioabsorbable stent until the end of the FFR measurement after placement, and the C arm 33 In addition, an example has been described in which the position of the top plate 22 is fixed and the same region of the apparatus coordinate system is seen through. Even after the placement of the bioabsorbable stent, imaging of another place is sandwiched between them, and the position of the C-arm 33 or the top plate 22 moves, the technique of the above embodiment can be applied.

  In that case, the system control unit 42 stores the position of the C-arm 33 and the position of the top plate 22 at the time of FFR measurement before the placement of the bioabsorbable stent. If the position of the subject P on the top board 22 is the same, the system control unit 42 determines the positions of the C arm 33 and the top board 22 when the FFR measurement is performed after the bioabsorbable stent is placed. What is necessary is just to control to the same position as the time of FFR measurement before indwelling of an absorption stent. Thereby, the same region of the subject can be seen through before and after the placement of the bioabsorbable stent.

  Thirdly, the example in which the bioabsorbable stent is placed has been described, but the embodiment of the present invention is not limited to such an aspect. The above technical idea can also be applied to the case where another treatment tool that is not projected on the X-ray image is placed in the subject P and the measurement is performed while operating the position of the measuring device in the subject before and after the placement. .

<Second Embodiment>
In the first embodiment, the example in which the information of one measurement position (position of the pressure sensor PS) before placement of the bioabsorbable stent is superimposed and displayed on the X-ray image after placement has been described. In the second embodiment, as an example, information on two measurement positions (positions of the pressure sensor PS) before placement of the bioabsorbable stent is superimposed and displayed on the X-ray image after placement. Note that information on three or more measurement positions before placement may be superimposed on the X-ray image after placement.

  FIG. 9 is a schematic diagram of each X-ray image before and after placement showing an example in which information on a plurality of measurement positions before placement of the bioabsorbable stent is displayed after placement in the second embodiment. That is, in the second embodiment, for example, as shown in the upper part of FIG. 7 described above, in the insertion direction of the pressure wire PW, the measurement positions on the back side and the near side from the stenosis site before the bioabsorbable stent is placed ( The position of the pressure sensor PS) is displayed in a superimposed manner.

  The upper part of FIG. 9 shows one-cycle X-ray image frames 3a to 7a at the measurement position PSa (see the upper part of FIG. 7) behind the stenosis site before the bioabsorbable stent is placed, and the next frame. 8a. Here, as an example, the position change due to the phase of the pressure sensor PS at the measurement position PSa is the same as that shown in FIG. 3 of the first embodiment, and is set to 5 frames per cycle.

  The middle part of FIG. 9 shows X-ray image frames 3b to 7b of one cycle at the measurement position PSb (see the upper part of FIG. 7) before the stenosis site before the bioabsorbable stent is placed, and the next frame. 8b. Here, as an example, it is assumed that the position change due to the phase of the pressure sensor PS at the measurement position PSb is 5 frames in one cycle, the frame 3b corresponds to the frame O, and the frame 3c corresponds to the frame Q.

  The lower part of FIG. 9 is a real-time display of the frames 1c to 7c of the X-ray images after placement of the bioabsorbable stent. Here, as an example, the position change due to the phase of the pressure sensor PS is the same as the lower part of FIG. .

  In the second embodiment, the position information of the pressure sensor PS at the measurement position PSa on the back side of the stenosis site is transferred to the frames 1c to 7c after the placement of the bioabsorbable stent by the same processing as in the first embodiment. It is displayed superimposed. At the same time, the position information of the pressure sensor PS at the measurement position PSb on the near side of the stenosis site is also superimposed and displayed on the frames 1c to 7c after the placement of the bioabsorbable stent by the same processing as in the first embodiment.

  In the lower part of FIG. 9, as an example, the position information of the pressure sensor PS at the measurement position PSa before detention is displayed with an elliptical broken line, and the position information of the pressure sensor PS at the measurement position PSb before detention is represented by an elliptical solid line. Is displayed. This is only one aspect of the identification display. The position information of the pressure sensor PS at the measurement position PSa is indicated by a chromatic color such as red, and the position information of the pressure sensor PS at the measurement position PSb is identified by another chromatic color. It may be displayed.

The difference in operation on the flowchart from the first embodiment is as follows.
In step S2 of FIG. 6, the cycle detection unit 46b detects one cycle of the position change of the pressure sensor PS from the time-series X-ray image at the measurement position PSa, and further, the time-series at the measurement position PSb. One cycle of position change of the pressure sensor PS is detected from the X-ray image.

  In step S3, the period detection unit 46b stores the time-series X-ray image projection data and one-period data at the measurement position PSa, and further projects the time-series X-ray image at the measurement position PSb. Data and one cycle of data are saved.

  In step S5, the period detection unit 46b performs (1) X-rays at the measurement position PSa before placement of the bioabsorbable stent that is closest in phase to the latest frame after placement of the bioabsorbable stent that is updated and displayed in real time. An image and (2) an X-ray image at the measurement position PSb before placement of the bioabsorbable stent having the closest phase are specified. Then, as shown in the lower part of FIG. 9, the position information of the pressure sensor PS before placement at the measurement positions PSa and Psb having the closest phases is superimposed and displayed on the latest frame.

  Thus, also in 2nd Embodiment, the effect similar to 1st Embodiment is acquired. Furthermore, in the second embodiment, information on two measurement positions on the back side and the near side of the stenosis site before placement of the bioabsorbable stent is superimposed and displayed on a real-time X-ray image after placement. Therefore, after the placement of the bioabsorbable stent, the measurement position before the placement of the bioabsorbable stent can be more easily reproduced.

<Third Embodiment>
In the first embodiment and the second embodiment, the example in which the position detection and period detection of the pressure sensor PS in the X-ray image before the placement of the bioabsorbable stent is performed in parallel with the imaging operation has been described. In the third embodiment, a time-series X-ray image before the placement of the bioabsorbable stent is stored in the projection data storage unit 45, and after the fluoroscopy before placement, the pressure sensor PS in the X-ray image before placement is completed. Position detection and period detection are performed.

  FIG. 10 is a schematic diagram of a time-series X-ray image showing an example of a user's designation input regarding the period detection of the pressure sensor PS before the bioabsorbable stent is placed in the third embodiment. In FIG. 10, frames 1 a to 12 a are continuous X-ray images before placement of the bioabsorbable stent similar to FIG. 3.

  When detecting the position and period of the pressure sensor PS before the detention, the user, for example, from a number of time-series X-ray frames 1a to 12a before detention as shown in FIG. Is specified. The position detection unit 46a and the cycle detection unit 46b detect one cycle from the designated X-ray image. In the example of FIG. 10, an example in which the frames 2a to 11a are designated by the user is shown.

  Alternatively, a time-series X-ray image before placement is displayed on the display device 46d, and the user visually determines one cycle, and the operation unit 48 determines the X-ray image at the beginning and the end of the one cycle. The configuration may be designated by the user via

  FIG. 11 is a flowchart illustrating an example of the operation of the X-ray diagnostic apparatus 10 according to the third embodiment. Hereinafter, the operation of the X-ray diagnostic apparatus 10 of the third embodiment will be described according to the step numbers in the flowchart shown in FIG.

  [Step S11] The same as step S1 in FIG. 6 of the first embodiment. Thereafter, the process proceeds to step S12.

  [Step S12] As in step S2 of the first embodiment, fluoroscopy and blood pressure measurement are performed before the bioabsorbable stent is placed. Here, as an example, the projection data storage unit 45 stores projection data of all (time-series) X-ray images generated by fluoroscopy. Thereafter, the process proceeds to step S13.

  [Step S13] The display device 46d acquires the projection data of the X-ray image before the placement of the bioabsorbable stent from the projection data storage unit 45 and displays it. The user designates a certain range of continuous X-ray images from a large number of time-series X-ray images before indwelling via the operation unit 48 (see FIG. 10). The position detection unit 46a detects the position of the pressure sensor PS from each X-ray image in the specified range and inputs it to the cycle detection unit 46b. The cycle detection unit 46b detects one cycle from the X-ray image in the specified range, One cycle of data and one cycle of X-ray image projection data are stored.

  Here, at the time of fluoroscopy after placement of the stent, only one location may be displayed as in the first embodiment regarding the display of the measurement position information before placement, but 2 as in the second embodiment. It may be displayed in places.

In the case of displaying two places, the user, for example, from the continuous X-ray image displayed on the display device 46d, the peripheral X-ray image at the time of blood pressure measurement on the back side of the stenosis site in the insertion direction of the pressure wire PW. An X-ray image in a range including one cycle is displayed.
Further, the user displays a peripheral X-ray image at the time of blood pressure measurement in front of the stenosis site in the insertion direction from the X-ray image displayed on the display device 46d, and displays an X in a range including one cycle. Specifies a line image.

  The position detection unit 46a detects the position of the pressure sensor PS from the two specified ranges of X-ray image groups, and inputs the detected position to the cycle detection unit 46b. The period detector 46b detects one period from each of the two designated X-ray image groups. The cycle detection unit 46b stores one cycle of data on the back side of the stenosis site and projection data of one cycle of X-ray images, and stores one cycle of data and one cycle on the near side of the stenosis site. X-ray image projection data is stored. At the time of this storage, the X-ray images corresponding to the aforementioned frame O and frame Q are marked electronically.

  Note that a time-series X-ray image before placement of the bioabsorbable stent is displayed on the display device 46d, and the user visually determines one cycle, and the X-ray image at the beginning of the cycle, the X-ray image at the end of the cycle, May be specified by the user via the operation unit 48. In that case, the cycle detection unit 46b stores the projection data of the X-ray image of one cycle designated by the user and stores the X-ray image at the beginning of the cycle as the frame O described above. Thereafter, the process proceeds to step S14.

  [Step S14] Same as step S4 in the first embodiment. Thereafter, the process proceeds to step S15.

  [Step S15] As with step S5 in the first embodiment, fluoroscopy after placement of the bioabsorbable stent is performed, and the position of the pressure sensor PS in the X-ray image before placement of the bioabsorbable stent having the closest phase is the latest. It is displayed superimposed on the frame (X-ray image). At this time, if the period at two places is detected in step S13, the positions of the pressure sensors PS of the images of the same phase at these two places are displayed in a superimposed manner (see FIG. 9). Thereafter, the process proceeds to step S16.

[Step S16] Same as step S6 in the first embodiment.
The above is the description of the operation of the X-ray diagnostic apparatus 10 of the third embodiment.

Thus, also in 3rd Embodiment, the effect similar to 1st and 2nd Embodiment is acquired.
According to each embodiment described above, the blood pressure measurement position before the stent placement can be reproduced after the stent placement by a technique different from the conventional one.

<Supplementary items of the embodiment>
[1] In each of the above embodiments, the example in which the FFR measuring apparatus 200 is used as a device for measuring information related to blood has been described. Embodiments of the present invention are not limited to such embodiments. The technical ideas of the above embodiments can also be applied to devices that measure other parameters.

  For example, a measuring apparatus that has a guide wire (Doppler wire) with an ultrasonic probe attached to the tip and calculates CFR (Coronary Flow Reserve) by measuring the blood flow velocity of the coronary artery with this ultrasonic probe. This can also be applied. CFR is an index indicating the ability to increase coronary blood flow in response to an increase in oxygen demand in the myocardium, and is indicated by the ratio of coronary blood flow between resting and maximum reactive hyperemia.

[2] In the first embodiment and the second embodiment, the position of the pressure sensor PS and the period of its position change in real time (imaging) with respect to the time-series X-ray image before placement of the bioabsorbable stent. An example of being detected (in parallel with the action) was described. The embodiment of the present invention is not limited to such an aspect.
As in the third embodiment, after the projection data of the time-series X-ray image before placement of the bioabsorbable stent is stored, before the imaging operation after placement of the bioabsorbable stent, the X-ray before placement Detection of the position of the pressure sensor PS and the period of its position change with respect to the image group may be automatically executed by the image processing device 46.

  [3] An image processing program may be created by converting the processing of steps S2, S3, and S5 of FIG. 5 of the first embodiment into a program code. The image processing apparatus 46 in FIG. 1 may be interpreted as having such an image processing program installed. Similarly, an image processing program may be created for the second embodiment and the third embodiment.

  [4] In the X-ray diagnostic apparatus 10 of each of the above embodiments, the X-ray tube 34 and the X-ray detector 36 are opposed to each other so as to sandwich the subject P, and the positions of the X-ray tube 34 and the X-ray detector 36 are set. An example in which the C arm 33 and the C arm operating mechanism 32 are used as a mechanism for controlling the above has been described (see FIG. 1). The embodiment of the present invention is not limited to such an aspect.

For example, an FPD (Flat Panel Detector) as an X-ray detector and an X-ray tube 34 may be held by separate position control arms to control these positions.
In an example of this mechanism, the FPD is fixed to one end side of the first position control arm, and the other end side is fixed to the ceiling or the wall. The second position control arm has an X-ray tube 34 (and an aperture device 35 etc.) fixed to one end side thereof, and the other end side fixed to the floor.
Alternatively, the other end side of the first position control arm that controls the position of the FPD is fixed to the floor, and the other end side of the second position control arm that controls the position of the X-ray tube 34 is fixed to the ceiling or the wall. But you can.

[5] A correspondence relationship between the terms of the claims and the embodiments will be described. In addition, the correspondence shown below is one interpretation shown for reference, and does not limit the present invention.
In the first embodiment and the second embodiment, the X-ray image generated by the fluoroscopy before the placement of the bioabsorbable stent is an example of the pre-placement X-ray image described in the claims.
In the first embodiment and the second embodiment, the X-ray image generated by the fluoroscopy after the placement of the bioabsorbable stent is an example of the post-placement X-ray image described in the claims.

In 3rd Embodiment, the X-ray image produced | generated by fluoroscopy before indwelling of a bioabsorbable stent is an example of the past X-ray image of a claim.
In 3rd Embodiment, the X-ray image produced | generated by fluoroscopy after the indwelling of a bioabsorbable stent is an example of the real-time X-ray image of a claim.

In the first and second embodiments, the X-ray image corresponding to the frame O is an example of a first reference X-ray image described in claims.
The X-ray image corresponding to the frame Q in the first embodiment and the second embodiment is an example of a second reference X-ray image described in claims.
The bioabsorbable stent is an example of a vascular treatment device described in the claims.
In the third embodiment, an X-ray image in a range designated as a one-cycle detection target input by the user via the operation unit 48 is an example of input information described in claims.

  [6] Although several embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

10: X-ray diagnostic device,
20: bed device, 21: support table, 22: top plate,
30: X-ray generation / detection system, 33: C-arm, 34: X-ray tube, 35: Aperture device,
40: Computer system, 46: Image processing device, SB: System bus, P: Subject

Claims (6)

An X-ray diagnostic apparatus that executes an imaging operation for generating projection data of a plurality of time-series X-ray images by detecting X-rays transmitted through a subject,
By acquiring in real time projection data of a plurality of time-series X-ray images before indwelling generated by the imaging operation before indwelling the vascular treatment device in the subject, it is inserted into the blood vessel of the subject. Projection data of a plurality of post-in-dwelling X-ray images generated in the imaging operation after the placement of the vascular treatment device after detecting the position of the measured measuring device from the plurality of pre-indwelling X-ray images, respectively. By acquiring in real time, a position detection unit that detects the position of the measurement device from the plurality of post-indwelling X-ray images,
Based on each position of the measurement device detected by the position detection unit, a cycle of a position change of the measurement device is set for the plurality of pre-in-placement X-ray images and the plurality of post-in-placement X-ray images. A period detection unit for detecting each;
Based on the position change period of the measurement apparatus, a phase matching process is performed for associating the pre-in-placement X-ray images with the close phase changes of the measurement apparatus with respect to the plurality of post-in-placement X-ray images. A phase matching unit;
Based on the result of the phase matching process, the position information of the measuring device in the pre-in-placement X-ray image with the close phase is superimposed on the plurality of post-in-placement X-ray images, respectively, An X-ray diagnostic apparatus comprising: a display unit that displays an X-ray image. An X-ray diagnostic apparatus that executes an imaging operation for generating projection data of a plurality of time-series X-ray images by detecting X-rays transmitted through a subject,
Projection data of a plurality of time-series past X-ray images generated and stored in the past imaging operation are acquired, and a plurality of time-series real-time X-rays generated in the imaging operation being executed in real time A position detection unit that detects the position of the measurement device inserted into the blood vessel of the subject from the plurality of past X-ray images and the plurality of real-time X-ray images by acquiring projection data of the image;
Based on each position of the measurement device detected by the position detection unit, a period of position change of the measurement device is detected for each of the plurality of past X-ray images and the plurality of real-time X-ray images. A period detector that performs
A phase for executing a phase matching process for associating the past X-ray image with the closest phase of the position change of the measurement device with each of the plurality of real-time X-ray images based on the position change cycle of the measurement device. A collation unit;
Based on the result of the phase matching process, the plurality of real-time X-rays are superimposed on the plurality of real-time X-ray images while the position information of the measuring device in the past X-ray image having the closest phase is superimposed on the plurality of real-time X-ray images. An X-ray diagnostic apparatus comprising: a display unit that displays an image. The X-ray diagnostic apparatus according to claim 1 or 2,
The period detector is
Detecting a position change amount of the measuring device between two successive X-ray images;
An arbitrary X-ray image in which the position change amount between the imaging time and the next X-ray image is a minimum value is specified as a first reference X-ray image,
The position change amount becomes a minimum value next to the first reference X-ray image, and the position of the measurement device is higher than the X-ray images before and after the imaging time of the measurement device in the first reference X-ray image. Identify a second reference X-ray image close to the position,
Detecting from the first reference X-ray image to an X-ray image one imaging time before the second reference X-ray image as an X-ray image group of one cycle of position change of the measuring device. A characteristic X-ray diagnostic apparatus. An X-ray diagnostic apparatus that executes an imaging operation for generating projection data of a plurality of time-series X-ray images by detecting X-rays transmitted through a subject,
Projection data of a plurality of time-series X-ray images before placement generated and stored in the imaging operation before placement of the vascular treatment device in the subject is acquired, and the plurality of pre-placement X-ray images are displayed. A display unit to
By acquiring projection data of a plurality of post-in-dwelling X-ray images generated by the imaging operation after the placement of the vascular treatment device, the position of the measurement device inserted into the blood vessel of the subject is determined. A position detector that detects each of the plurality of post-indwelling X-ray images in real time;
Input information on a period of change in position of the measuring device in the plurality of pre-indwelling X-ray images is acquired after the display of the plurality of pre-indwelling X-ray images, and the plurality of pre-indwelling Xs are obtained based on the input information. After determining the period of position change of the measurement device with respect to the line image, the position of the measurement device with respect to the plurality of post-in-placement X-ray images based on the position of the measurement device detected by the position detection unit A period detector for detecting the period of change;
Based on the period of change in position of the measurement device, a phase matching process is performed for associating the pre-placement X-ray image with the closest phase change of the measurement device with respect to the plurality of post-placement X-ray images. And a phase matching unit that
The display unit superimposes the position information of the measurement device on the pre-in-placement X-ray image having the closest phase on the plurality of post-in-placement X-ray images based on the result of the phase matching process. The X-ray diagnostic apparatus characterized by displaying the plurality of post-indwelling X-ray images. The X-ray diagnostic apparatus according to any one of claims 1 to 4,
When the blood pressure is measured by the measurement device at the first point and the second point across the placement position of the vascular treatment device during the execution of the imaging operation before the placement of the vascular treatment device,
The period detection unit detects a first period of a position change of the measuring device with respect to a first X-ray image group which is a plurality of time-series X-ray images before indwelling at the time of blood pressure measurement at the first point. And detecting a second period of position change of the measuring device with respect to a second X-ray image group which is a plurality of time-series X-ray images before indwelling at the time of blood pressure measurement at the second point,
The phase matching unit, as the phase matching process based on the first period and the second period, has a phase closest to each other in the first X-ray image group with respect to the plurality of post-in-placement X-ray images. Associating the pre-indwelling X-ray image and associating the pre-indwelling X-ray image having the closest phase in the second X-ray image group;
The display unit, when displaying the plurality of post-in-dwelling X-ray images, position information of the measuring device in the pre-indwelling X-ray image having the closest phase in the first X-ray image group, and the second X-ray image An X-ray diagnostic apparatus characterized by superimposing position information of the measuring apparatus on the pre-indwelling X-ray image having the closest phase in the group. The X-ray diagnostic apparatus according to any one of claims 1 to 4,
The said position detection part detects the position of the device which measures blood pressure as said measuring device. X-ray diagnostic apparatus characterized by the above-mentioned.

Images