JP2016010600A - Indicator, x-ray ct device and medical information processing device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an indicator, an X-ray CT device and a medical information processing device which make it possible to efficiently conduct puncture treatment.SOLUTION: An indicator comprises an indication part and a control mechanism. The indication part indicates the insertion angle of an insertion into a subject. The control mechanism controls the angle of the indication part on the basis of information on the three-dimensional insertion angle of the insertion into the subject.

Description

  Embodiments described herein relate generally to an indicator, an X-ray CT apparatus, and a medical information processing apparatus.

  Conventionally, in radiography using an X-ray CT apparatus (CT; computed tomography), CT fluoroscopy for generating and displaying an X-ray CT image almost in real time has been performed. Specifically, in CT fluoroscopy, an X-ray CT image is generated and displayed in real time by reducing the time required for image reconstruction processing by reducing the projection data collection rate. Thereby, the X-ray CT apparatus can display in real time an X-ray CT image in which a site to be treated is depicted for a doctor who performs a puncture treatment or the like.

  For example, in puncture treatment, first, a puncture plan for determining a puncture target position (target), a puncture insertion position (entry point), and the like using an X-ray CT image collected in advance is established and established. A puncture treatment is executed based on the puncture plan. Here, in the conventional X-ray CT apparatus, the direction of puncture established in the puncture plan is displayed by a projector that the apparatus itself has. However, in the above-described conventional technology, it may be difficult to efficiently perform the puncture treatment.

Japanese Patent Laid-Open No. 2001-299741

  The problem to be solved by the present invention is to provide an indicator, an X-ray CT apparatus, and a medical information processing apparatus that enable efficient puncture treatment.

  The indicator of the embodiment includes an instruction unit and a control mechanism. The instruction unit indicates an insertion angle of the insertion object of the subject. The control mechanism controls the angle of the instruction unit based on information on a three-dimensional insertion angle of the insert with respect to the subject.

FIG. 1 is a diagram illustrating a configuration example of an X-ray CT apparatus according to the first embodiment. FIG. 2 is a diagram illustrating an example of the configuration of the indicator according to the first embodiment. FIG. 3 is a diagram illustrating an example of the configuration of the control unit according to the first embodiment. FIG. 4 is a diagram illustrating an example of a three-dimensional puncture plan screen according to the first embodiment. FIG. 5 is a diagram for explaining an example of display of the puncture route by the indicator 200 according to the first embodiment. FIG. 6A is a diagram for explaining an example of entry point display by the projector 17 according to the first embodiment. FIG. 6B is a diagram for explaining an example of entry point display by the projector 17 according to the first embodiment. FIG. 7 is a flowchart for explaining an example of control processing of the indicator by the X-ray CT apparatus according to the first embodiment. FIG. 8 is a diagram illustrating an example of the configuration of the indicator according to the second embodiment.

  Hereinafter, embodiments of an indicator, an X-ray CT apparatus, and a medical information processing apparatus according to the present application will be described with reference to the accompanying drawings. In the following embodiments, an X-ray CT apparatus including the indicator according to the present application will be described as an example.

(First embodiment)
First, the configuration of the X-ray CT apparatus 1 according to the first embodiment will be described. FIG. 1 is a diagram illustrating a configuration example of an X-ray CT apparatus 1 according to the first embodiment. As shown in FIG. 1, the X-ray CT apparatus 1 according to the first embodiment includes a gantry device 10, a couch device 20, and a console device 30.

  The gantry device 10 is a device that irradiates the subject P with X-rays, detects the X-rays transmitted through the subject P, and outputs the detected X-rays to the console device 30. The gantry device 10 and the X-ray generator 12, a detector 13, a collecting unit 14, a rotating frame 15, a gantry driving unit 16, and a projector 17.

  The rotating frame 15 supports the X-ray generator 12 and the detector 13 so as to face each other with the subject P interposed therebetween, and is rotated at a high speed in a circular orbit around the subject P by a gantry driving unit 16 described later. It is an annular frame. The rotating frame 15 supports the projector 17.

  The projector 17 is supported by the rotating frame 15 and irradiates visible light to an imaging position where the subject P is irradiated with X-rays under the control of the gantry driving unit 16. Further, the projector 17 irradiates the insertion position of the puncture needle on the body surface of the subject P established by the puncture plan with visible light. For example, the projector 17 includes a slice surface projector that irradiates a slice plane (XY plane) with visible light, and a midline projector that irradiates a midline along the body axis (plane along the Z axis) with a visible ray. Have Here, the light projector 17 is controlled to emit visible light by continuous drive control or pulse drive control by the gantry drive unit 16. That is, the projector 17 continuously irradiates visible light by continuous drive control, and irradiates the visible light by pulses at predetermined time intervals by pulse drive control.

  The X-ray irradiation control unit 11 is a device that supplies a high voltage to the X-ray tube 12 a as a high voltage generation unit. The X-ray tube 12 a uses the high voltage supplied from the X-ray irradiation control unit 11 to perform X Generate a line. The X-ray irradiation control unit 11 adjusts the X-ray dose irradiated to the subject P by adjusting the tube voltage and tube current supplied to the X-ray tube 12a.

  Further, the X-ray irradiation control unit 11 switches the wedge 12b. The X-ray irradiation control unit 11 adjusts the X-ray irradiation range (fan angle and cone angle) by adjusting the aperture of the collimator 12c. In addition, this embodiment may be a case where an operator manually switches a plurality of types of wedges.

  The X-ray generator 12 is an apparatus that generates X-rays and irradiates the subject P with the generated X-rays, and includes an X-ray tube 12a, a wedge 12b, and a collimator 12c.

  The X-ray tube 12 a is a vacuum tube that irradiates the subject P with an X-ray beam with a high voltage supplied by a high voltage generator (not shown). The X-ray beam is applied to the subject P as the rotating frame 15 rotates. Irradiate. The X-ray tube 12a generates an X-ray beam that spreads with a fan angle and a cone angle. For example, under the control of the X-ray irradiation control unit 11, the X-ray tube 12a can continuously irradiate X-rays around the subject P for full reconstruction, or can be half reconfigured for half reconstruction. X-rays can be continuously exposed in the exposure range (180 degrees + fan angle). Further, the X-ray tube 12a can be intermittently irradiated with X-rays (pulse X-rays) at a preset position (tube position) by the control of the X-ray irradiation control unit 11. The X-ray irradiation control unit 11 can also modulate the intensity of X-rays emitted from the X-ray tube 12a. For example, the X-ray irradiation control unit 11 increases the intensity of X-rays emitted from the X-ray tube 12a at a specific tube position, and the X-ray tube 12a at a range other than the specific tube position. Reduces the intensity of X-rays exposed from.

  The wedge 12b is an X-ray filter for adjusting the X-ray dose of X-rays emitted from the X-ray tube 12a. Specifically, the wedge 12b transmits the X-rays exposed from the X-ray tube 12a so that the X-rays irradiated from the X-ray tube 12a to the subject P have a predetermined distribution. Attenuating filter. For example, the wedge 12b is a filter obtained by processing aluminum so as to have a predetermined target angle or a predetermined thickness. The wedge is also called a wedge filter or a bow-tie filter.

  The collimator 12c is a slit for narrowing the X-ray irradiation range in which the X-ray dose is adjusted by the wedge 12b under the control of the X-ray irradiation control unit 11 described later.

  The gantry driving unit 16 rotates the rotary frame 15 to rotate the X-ray generator 12 and the detector 13 on a circular orbit around the subject P. The gantry driving unit 16 controls the projector 17 by continuous drive control or pulse drive control.

  The detector 13 is a two-dimensional array type detector (surface detector) that detects X-rays transmitted through the subject P, and a detection element array formed by arranging X-ray detection elements for a plurality of channels is the subject P. A plurality of rows are arranged along the body axis direction (Z-axis direction shown in FIG. 1). Specifically, the detector 13 in the first embodiment includes X-ray detection elements arranged in multiple rows such as 320 rows along the body axis direction of the subject P. For example, the lungs of the subject P It is possible to detect X-rays transmitted through the subject P over a wide range, such as a range including the heart and the heart.

  The collection unit 14 is a DAS (Data Acquisition System), and collects projection data from X-ray detection data detected by the X-ray detector 13. For example, the collection unit 14 generates projection data by performing amplification processing, A / D conversion processing, inter-channel sensitivity correction processing, and the like on the X-ray intensity distribution data detected by the detector 13. The projection data is transmitted to the console device 30 described later. For example, when X-rays are continuously emitted from the X-ray tube 12a during the rotation of the rotating frame, the collection unit 14 collects projection data groups for the entire periphery (for 360 degrees). In addition, the collection unit 14 associates the tube position with each collected projection data and transmits the projection data to the console device 30 described later. The tube position is information indicating the projection direction of the projection data. Note that the sensitivity correction processing between channels may be performed by the preprocessing unit 34 described later.

  The couch device 20 is a device on which the subject P is placed, and includes a couch driving device 21 and a top plate 22 as shown in FIG. The couch driving device 21 moves the subject P into the rotary frame 15 by moving the couchtop 22 in the Z-axis direction. The top plate 22 is a plate on which the subject P is placed.

  For example, the gantry device 10 performs a helical scan that rotates the rotating frame 15 while moving the top plate 22 to scan the subject P in a spiral shape. Alternatively, the gantry device 10 performs a conventional scan in which the subject P is scanned in a circular orbit by rotating the rotating frame 15 while the position of the subject P is fixed after the top plate 22 is moved. Alternatively, the gantry device 10 executes a step-and-shoot method in which the position of the top plate 22 is moved at regular intervals and a conventional scan is performed in a plurality of scan areas.

  The console device 30 is a device that accepts an operation of the X-ray CT apparatus 1 by an operator and reconstructs X-ray CT image data using projection data collected by the gantry device 10. As shown in FIG. 1, the console device 30 includes an input device 31, a display device 32, a scan control unit 33, a preprocessing unit 34, a projection data storage unit 35, an image reconstruction unit 36, and an image storage. A unit 37 and a control unit 38.

  The input device 31 includes a mouse, a keyboard, and the like used by the operator of the X-ray CT apparatus 1 to input various instructions and various settings, and transfers instructions and setting information received from the operator to the control unit 38. For example, the input device 31 receives imaging conditions for X-ray CT image data, reconstruction conditions for reconstructing X-ray CT image data, image processing conditions for X-ray CT image data, and the like from the operator. The input device 31 also accepts a designation operation for designating the path of the puncture needle (for example, the insertion position and the target position) on the CT image generated from the X-ray CT image data. The designation operation for designating the insertion position and target position of the puncture needle will be described later.

  The display device 32 is a monitor that is referred to by the operator, displays X-ray CT image data to the operator under the control of the control unit 38, and provides various instructions and various information from the operator via the input device 31. A GUI (Graphical User Interface) for accepting settings and the like is displayed. The display device 32 displays a plan screen for a puncture plan.

  The scan control unit 33 controls the operations of the X-ray irradiation control unit 11, the gantry driving unit 16, the collection unit 14, and the bed driving device 21 under the control of the control unit 38 to be described later, thereby projecting on the gantry device 10. Control data collection processing.

  The preprocessing unit 34 performs correction processing such as logarithmic conversion processing, offset correction, sensitivity correction, and beam hardening correction on the projection data generated by the collection unit 14 to generate corrected projection data. To do.

  The projection data storage unit 35 stores the projection data generated by the preprocessing unit 34. The image reconstruction unit 36 reconstructs X-ray CT image data using the projection data stored in the projection data storage unit 35. As the reconstruction method, there are various methods, for example, back projection processing. Further, as the back projection process, for example, a back projection process by an FBP (Filtered Back Projection) method can be cited. Alternatively, the image reconstruction unit 36 may reconstruct X-ray CT image data using a successive approximation method.

  Further, the image reconstruction unit 36 generates image data by performing various kinds of image processing on the X-ray CT image data. The image reconstruction unit 36 stores the reconstructed X-ray CT image data and the image data generated by various image processes in the image storage unit 37. The image storage unit 37 stores the image data generated by the image reconstruction unit 36.

  The control unit 38 performs overall control of the X-ray CT apparatus 1 by controlling operations of the gantry device 10, the couch device 20, and the console device 30. Specifically, the control unit 38 controls the CT scanning performed by the gantry device 10 by controlling the scan control unit 33. The control unit 38 controls the image reconstruction unit 36 to control image reconstruction processing and image generation processing in the console device 30. The control unit 38 controls the display device 32 to display various image data stored in the image storage unit 37. Moreover, the control part 38 controls the angle instruct | indicated by an indicator by notifying the indicator which concerns on this application of the information of the path | route of the puncture needle based on a puncture plan. This point will be described in detail later.

  The overall configuration of the X-ray CT apparatus 1 according to the first embodiment has been described above. Under such a configuration, the X-ray CT apparatus 1 according to the first embodiment can perform puncture treatment efficiently. Here, a case where it is difficult to efficiently perform puncture treatment in the prior art will be described. In the puncture treatment by CT fluoroscopy of the X-ray CT apparatus according to the prior art, a two-dimensional puncture plan and puncture are common, and it is difficult to efficiently perform the puncture treatment when a three-dimensional puncture plan is necessary. It becomes.

  For example, in the puncture treatment by CT fluoroscopy of the X-ray CT apparatus according to the prior art, X-ray CT images (for example, MPR images) of a plurality of axial sections are generated from volume data collected by helical scan or volume scan. Then, an X-ray CT image of an axial section is displayed on the puncture plan screen.

  Here, an operator such as a doctor extracts an X-ray CT image from which a target position (target) as a treatment target site for puncture treatment can be observed well while referring to the displayed X-ray CT image of the axial section. By setting the target and the insertion position (entry point) of the puncture needle on the extracted X-ray CT image, a puncture route connecting the two positions is set.

  As described above, when the puncture route is set, the X-ray CT apparatus according to the related art controls the projector to irradiate the entry point on the body surface of the subject P with visible light in the puncture direction. . The operator performs puncture based on the information of the irradiated visible light.

  As described above, in the CT fluoroscopy according to the conventional technique, puncture along a two-dimensional cross section (for example, an axial cross section) is supported. However, in reality, there are important blood vessels, organs, bones, and the like between the target and the entry point, and it is difficult to deal with the above-described two-dimensional puncture plan and puncture alone. That is, if there are important blood vessels, organs, bones, etc. between the target and the entry point, it is difficult to efficiently perform the puncture treatment because the puncture needle cannot be inserted along the axial section. Become. Therefore, the X-ray CT apparatus 1 according to the first embodiment enables efficient puncture treatment by the control of the indicator 200 and the control unit 38, which will be described in detail below.

  FIG. 2 is a diagram illustrating an example of the configuration of the indicator 200 according to the first embodiment. As shown in FIG. 2, the indicator 200 includes a base 210, an instruction unit 220a, an instruction unit 220b, a rotation unit 230a, and a rotation unit 230b. The base 210 supports the instruction unit 220a and the instruction unit 220b through the rotation unit 230a. In addition, the base unit 210 includes a reception unit and a rotation control unit (not shown), and controls the angle of the instruction unit 220b by controlling the rotation unit 230a and the rotation unit 230b.

  Specifically, the receiving unit of the base unit 210 receives information on the path of the subject insert from the control unit 38. Then, the rotation control unit of the base unit 210 controls the rotating unit 230a and the rotating unit 230b based on the path information of the subject insert received by the receiving unit, so that the instruction unit 220b can insert the subject insert. The three-dimensional insertion angle is displayed. Here, the insert of the subject is, for example, any one of a puncture needle, a suction catheter, and a cautery needle. Details of the display of the three-dimensional insertion angle of the insertion object of the subject by the instruction unit 220b will be described later. Hereinafter, a case where a puncture needle is used as an insert will be described as an example.

  As shown in FIG. 2, the instruction unit 220a has one end coupled to the base 210 via the rotating unit 230a and the other end coupled to the indicating unit 220b via the rotating unit 230b. And the instruction | indication part 220a rotates in the direction of the arrow 41 of FIG. 2 by control of the rotation part 230a by the rotation control part of the base 210. FIG. That is, the instruction unit 220a rotates with the longitudinal direction as the rotation axis. Here, the instruction unit 220a rotates at least 360 ° with the longitudinal direction as the rotation axis. For example, the instruction unit 220a may be rotated by 360 ° in one direction, or may be rotated by 180 ° in one direction and rotated by 180 ° in the other direction.

  As shown in FIG. 2, the instruction unit 220b is coupled to the instruction unit 220a via the rotating unit 230b. And the instruction | indication part 220b rotates to the direction of the arrow 42 of FIG. 2 by control of the rotation part 230b by the rotation control part of the base 210. FIG. That is, the instruction unit 220b rotates with the rotating unit 230b as a rotation axis. Here, the instruction unit 220b rotates at least 180 degrees about the rotation unit 230b as a rotation axis. And the instruction | indication part 220b shows the insertion angle of a puncture needle by the rotation which used the rotation part 230b as a rotating shaft, and the change of direction accompanying the rotation to the direction of the arrow 41 of the instruction | indication part 220a. The display of the insertion angle of the puncture needle will be described in detail later.

  The rotating unit 230 a combines the base unit 210 and the instruction unit 220 a, and rotates the instruction unit 220 a in the direction of the arrow 41 under the control of the rotation control unit of the base unit 210. The rotation unit 230b couples the instruction unit 220a and the instruction unit 220b, and rotates the instruction unit 220b in the direction of the arrow 42 under the control of the rotation control unit of the base unit 210. Here, for example, a stepping motor or a servo motor is used for the rotation unit 230a and the rotation unit 230b in order to accurately control the angles of the indicator 220a and the indicator 220b.

  As described above, the indicator 200 is controlled by the rotation controller of the base 210 so that the indicator 220b indicates the insertion angle of the puncture needle. Here, in the indicator 200, information on the path of the puncture needle is received from the outside by the receiving unit of the base 210, and the rotation control unit controls the angle of the indicator 220b based on the information on the received path. For example, the reception unit receives information on the path of the puncture needle notified by the control unit 38 of the X-ray CT apparatus 1. The rotation control unit controls the angles of the instruction units 220a and 220b by controlling the rotation units 230a and 230b based on the received information.

  Therefore, the configuration of the control unit 38 of the X-ray CT apparatus 1 that notifies the indicator 200 of information on the path of the puncture needle will be described next. FIG. 3 is a diagram illustrating an example of the configuration of the control unit 38 according to the first embodiment. For example, as illustrated in FIG. 3, the control unit 38 includes an angle calculation unit 381 and an indicator control unit 382 and controls the indicator 200. Here, in the X-ray CT apparatus 1 according to the first embodiment, first, a puncture plan scan or a pre-scan (not limited to the puncture plan, a scan previously performed before) is first executed. Thus, three-dimensional X-ray CT image data (volume data) is collected. For example, in the X-ray CT apparatus 1, volume data of the subject is collected by performing a helical scan or a volume scan.

  In the X-ray CT apparatus 1, cross-sectional images from a plurality of angles are displayed on the display device 32 when a three-dimensional puncture plan is implemented. FIG. 4 is a diagram illustrating an example of a three-dimensional puncture plan screen according to the first embodiment. For example, when the operator activates a puncture plan screen (puncture mode), the display device 32 displays a puncture plan screen as shown in FIG. When the operator selects the volume data of the subject to be punctured via the input device 31, a cross-sectional image for a three-dimensional puncture plan is displayed.

  For example, the display device 32 displays MPR images of three orthogonal cross sections, “coronal cross section, axial cross section, sagittal cross section”, as shown in the upper left and lower left of FIG. For example, the control unit 38 controls the image reconstruction unit 36 to generate an MPR image having three orthogonal cross sections from the volume data. Then, the control unit 38 causes the display device 32 to display the generated MPR image. Although FIG. 4 shows an MPR image, the embodiment is not limited to this. For example, a volume rendering (VR) image may be displayed. In such a case, the control unit 38 controls the image reconstruction unit 36 to generate a volume rendering image.

  For example, the operator observes an MPR image of three orthogonal cross sections displayed by the display device 32 and sets a target and an entry point. However, when a two-dimensional puncture plan cannot be made as described above, for example, the input device 31 receives an input operation for generating an MPR image of an arbitrary cross section for making a puncture plan from an operator. Then, the display device 32 displays the generated MPR image of an arbitrary cross section.

  For example, the display device 32 displays an MPR image of an oblique cross section as shown on the lower right side of FIG. Even in such a case, the control unit 38 controls the image reconstruction unit 36 to generate an MPR image of an arbitrary cross section designated by the operator. Then, the control unit 38 causes the display device 32 to display the generated MPR image.

  When the MPR image of the oblique section is displayed on the display device 32 in this way, the operator sets the path of the puncture needle on the MPR image of the oblique section via the input device 31. For example, the operator sets the puncture route 53 by designating the target 52 and the entry point 51 as shown in the lower right diagram in FIG. In the above-described example, the case where the puncture route is set on the MPR image of the oblique section has been described. However, the embodiment is not limited to this, and for example, puncture is performed using the MPR image of three orthogonal sections. It may be a case where a route is set.

  In such a case, for example, the operator refers to the three orthogonal cross sections shown in FIG. 4 and extracts a cross-sectional image that the target can easily observe while changing the position of each of the coronal cross section, the axial cross section, and the sagittal cross section. . Then, the operator designates a target on the extracted cross-sectional image via the input device 31. Thereafter, the operator refers to the three orthogonal cross sections, and extracts a cross-sectional image in which a position suitable as an entry point of the puncture needle is depicted while changing the positions of the cross sections of the coronal cross section, the axial cross section, and the sagittal cross section Specify the entry point. For example, the operator designates an entry point on a body surface that has a short distance to the target point and does not have blood vessels, organs, bones, or the like in between. Thereby, a puncture path connecting the target and the entry point is set.

  The control unit 38 according to the first embodiment sets the angle of the indicator 200 based on the puncture route set as described above. Specifically, the angle calculation unit 381 calculates the angle of the puncture path set by the operator. More specifically, the angle calculation unit 381 calculates the three-dimensional angle of the set puncture path in the three-dimensional space in the imaging range of the gantry device 10. For example, as illustrated in FIG. 4, when the puncture route 53 is set, the angle calculation unit 381 determines the 3D of the puncture route 53 from the coordinates of the entry point 51 and the target 52 in the 3D space of the imaging range of the gantry device 10. The correct angle is calculated.

  The indicator control unit 382 notifies the indicator 200 of information on the path of the puncture needle calculated by the angle calculation unit 381. For example, the indicator controller 382 notifies the indicator 200 of the three-dimensional angle of the puncture path 53 calculated by the angle calculator 381. Here, the notification of the information on the path of the puncture needle to the indicator 200 by the indicator controller 382 varies depending on the installation method of the indicator 200. For example, the indicator 200 may be used in a state where it can be freely carried as a single unit, or may be installed at an arbitrary position of the X-ray CT apparatus 1.

  For example, when the indicator 200 is used in a state where it can be freely carried as a single unit, the indicator controller 382 and the indicator 200 transmit and receive information by wireless communication. In such a case, the base unit 210 of the indicator 200 includes a communication unit that transmits and receives information to and from the X-ray CT apparatus 1, and the indicator control unit 382 provides information on the path of the puncture needle to the communication unit of the base unit 210 (for example, , A three-dimensional angle of the puncture path 53). When the communication unit receives information on the path of the puncture needle, the communication unit notifies the rotation control unit of the base unit 210 of the information. The rotation control unit controls the rotation units 230a and 230b based on the notified information.

  On the other hand, when the indicator 200 is installed in the X-ray CT apparatus 1, the indicator controller 382 informs the rotation controller of the indicator 200 about puncture needle path information (for example, the three-dimensional puncture path 53. The correct angle). Then, the rotation control unit controls the rotation units 230a and 230b based on the notified information.

  As described above, the X-ray CT apparatus 1 according to the first embodiment calculates and calculates the three-dimensional angle of the puncture path based on the information of the puncture needle path set on the CT image. The indicator 200 displays the three-dimensional angle of the puncture path. Hereinafter, an example of the display of the angle of the puncture route by the indicator 200 will be described. FIG. 5 is a diagram for explaining an example of display of the puncture route by the indicator 200 according to the first embodiment. FIG. 5 shows the state of the indicator 200 before and after displaying the puncture path angle. 5A and 5B show the relationship between the indicator 200 and the three-dimensional space of the imaging range of the X-ray CT apparatus 1, respectively. FIG. 5 shows a case where the indicator 200 is used in a state where it can be freely carried as a single unit.

  First, when the indicator 200 displays the angle of the puncture route, the indicator 200 is calibrated. That is, the indicator 200 is aligned with the coordinates in the three-dimensional space of the imaging range of the X-ray CT apparatus 1. For example, the operator places the indicator 200 at a position where the indicator 200 is used and performs a calibration operation, so that the short side of the base 210 is set as the Y axis and the long side is set as the Z axis as shown in FIG. The instruction unit 220b is set perpendicular to the base 210. Thereby, the instruction unit 220b is in an angle “0 °” state with respect to the Y-axis direction and the Z-axis direction. Note that the calibration operation is executed by, for example, providing a calibration button on either the indicator 200 or the X-ray CT apparatus and pressing the button.

  When the puncture route is set on the CT image, the rotation control unit of the base unit 210 controls the rotation units 230a and 230b based on the angle of the puncture route in the three-dimensional space calculated by the angle calculation unit 381. For example, as shown in FIG. 5B, when the entry point 51 and the target 52 are specified and the puncture route 53 is set, the angle calculation unit 381 calculates the angle of the puncture route 53 in the three-dimensional space. The indicator control unit 382 transmits the calculated puncture path angles (for example, the angle in the Y-axis direction and the angle in the Z-axis direction) to the indicator 200.

  When the indicator 200 receives the angle of the puncture path, the rotation control unit controls the rotation units 230a and 230b to rotate the instruction units 220a and 220b so as to indicate the angle of the puncture path received by the instruction unit 220b. . For example, as shown in FIG. 5B, the rotation control unit rotates the rotation unit 230a in the direction of arrow 43 so that the angle of the instruction unit 220b is the same as that of the puncture path 53, and 230b is moved to the arrow. It controls to rotate in the direction of 44. Thereby, the indicator 200 physically displays the insertion angle of the puncture needle.

  In this way, the indicator 200 physically displays the insertion angle of the puncture needle, so that even if a three-dimensional puncture plan is required, the operator can puncture the needle so that it is parallel to this angle. Accurate puncture can be performed simply by inserting the, so that puncture treatment can be performed efficiently. Here, the entry point in the body surface of the subject is indicated by the projector 17.

  6A and 6B are diagrams for explaining an example of entry point display by the projector 17 according to the first embodiment. For example, as shown in FIG. 6A, when the puncture path 53 is set for the subject P, the rotation of the rotating frame 15 is stopped at an angle indicating the entry point, and the projector 17 installed on the rotating frame 15 is used. Shows the entry point by continuously irradiating visible light 54.

  Further, for example, as shown in FIG. 6B, when the puncture path 53 is set for the subject P, when the projector 17 is at an angle indicating the entry point during the rotation of the rotating frame 15, the projector 17 irradiates the visible light 54 with a pulse to indicate an entry point.

  That is, the operator inserts the puncture needle in parallel with the angle indicated by the instruction unit 220b from the entry point on the body surface of the subject P indicated by the projector 17, so that the angle is 3 in the body axis direction. Dimensional puncture can be performed accurately. Note that the entry point on the body surface of the subject P may be the case where the position of the visible light indicated by the projector 17 is used, or the case where the position where the position of the visible light is marked is used. Also good.

  Next, the control process of the indicator 200 by the X-ray CT apparatus 1 according to the first embodiment will be described with reference to FIG. FIG. 7 is a flowchart for explaining an example of control processing of the indicator 200 by the X-ray CT apparatus 1 according to the first embodiment.

  For example, as shown in FIG. 7, in the X-ray CT apparatus 1 according to the first embodiment, when the mode is a puncture mode (Yes at Step S101), the control unit 38 displays a CT image (for example, three orthogonal cross sections). And the like are displayed on the display device 32 (step S102). Then, the angle calculation unit 381 determines whether the target and the entry point are set via the input device 31 (step S103).

  Here, when the target and the entry point are set (Yes at Step S103), the angle calculation unit 381 calculates the angle of the puncture route that connects the target and the entry point (Step S104). When the indicator controller 382 notifies the indicator 200 of the angle calculated by the angle calculator 381, the rotation controller of the base 210 controls the angle of the indicator (step S105).

  As described above, according to the first embodiment, the instruction unit 220a and the instruction unit 220b indicate the insertion angle of the insertion object of the subject. The base unit 210 controls the angles of the instruction unit 220a and the instruction unit 220b based on the information on the three-dimensional insertion angle of the insert with respect to the subject. Therefore, the indicator 200 according to the first embodiment can physically indicate, for example, the three-dimensional insertion angle of the puncture needle by the instruction unit 220a and the instruction unit 220b, and can efficiently perform the puncture treatment. to enable.

  Further, according to the first embodiment, the subject insert is any one of a puncture needle, a suction catheter, and a cautery treatment needle. Therefore, the indicator 200 according to the first embodiment can cope with various inserts.

  Further, according to the first embodiment, the instruction unit 220a and the instruction unit 220b have two or more rotation axes. Then, the base 210 controls the rotation shafts at two or more locations, respectively, to cause the instruction unit 220a and the instruction unit 220b to indicate the three-dimensional insertion angle of the puncture needle with respect to the subject. Therefore, the indicator 200 according to the first embodiment makes it possible to indicate any three-dimensional angle.

  Further, according to the first embodiment, the base unit 210 controls the angles of the instruction unit 220a and the instruction unit 220b based on the path information of the puncture needle designated on the medical image generated from the three-dimensional data. To do. Therefore, the indicator 200 according to the first embodiment makes it possible to efficiently perform a three-dimensional puncture treatment using a conventional puncture path setting.

  Further, according to the first embodiment, the input device 31 receives a designation operation for designating the path of the puncture needle on the medical image generated from the three-dimensional data. The angle calculation unit 381 calculates the insertion angle of the puncture needle with respect to the subject based on the path of the puncture needle received by the input device 31. The indicator control unit 382 controls the indicator 200 by transmitting information on the insertion angle calculated by the angle calculation unit 381 to the indicator 200. Therefore, the X-ray CT apparatus 1 according to the first embodiment makes it possible to efficiently perform puncture treatment even when performing three-dimensional puncture treatment.

  Further, according to the first embodiment, the input device 31 accepts designation of an entry point and a target of a puncture needle as a puncture needle path. Therefore, the X-ray CT apparatus 1 according to the first embodiment makes it possible to calculate an accurate puncture path angle.

  Further, according to the first embodiment, the control unit 38 displays the entry point on the subject by the slice plane projector and the midline projector. Therefore, the X-ray CT apparatus 1 according to the first embodiment makes it possible to easily recognize the entry point.

  Further, according to the first embodiment, the control unit 38 stops the rotating frame 15 in the gantry device 10 at an angle at which the entry point is displayed by the slice plane projector and the midline projector. Therefore, the X-ray CT apparatus 1 according to the first embodiment makes it possible to indicate entry points stably.

  According to the first embodiment, the control unit 38 displays the slice plane projector and the midline projector only at an angle at which the entry point is displayed during the rotation of the rotary frame 15 in the gantry device 10. Therefore, the X-ray CT apparatus 1 according to the first embodiment makes it possible to perform control so that unnecessary visible light is not irradiated even when the rotating frame 15 is rotating.

(Second Embodiment)
The first embodiment has been described so far, but may be implemented in various different forms other than the first embodiment described above.

  In the above-described embodiment, the indicator 200 having two rotating portions (rotating shafts) has been described. However, the embodiment is not limited to this. For example, the indicator 200 may have three or more rotating parts (rotating shafts).

  In the above-described embodiment, the case where the instruction units 220a and 220b are provided on the upper surface of the base 210 has been described. However, the embodiment is not limited to this. For example, the indication units 220a and 220b may be provided on the lower surface of the base 210. FIG. 8 is a diagram illustrating an example of the configuration of the indicator 200 according to the second embodiment. As shown in FIG. 8, the indicator 200 according to the second embodiment is provided with an instruction unit 220a and an instruction unit 220b on the lower surface of the base 210, and the instruction unit 220b instructs the angle of the puncture path. The operator inserts the puncture needle in parallel with the angle indicated by the instruction unit 220b from the entry point on the body surface of the subject indicated by the projector 17.

  Further, in the above-described embodiment, the case where the indicator 200 is used in a state where it can be freely carried by itself has been described. However, the embodiment is not limited to this. For example, the X-ray CT apparatus 1 may be installed at a predetermined location. In such a case, for example, the couch device 20 or the gantry device 10 may be installed at any position as long as it does not interfere with image capturing and puncturing procedures. Here, the indicator 200 is provided with the instruction parts 220a and 220b on the upper surface of the base 210 or the instruction parts 220a and 220b on the lower surface of the base 210 depending on the installation position. Moreover, the indicator 200 can also change the number of rotation parts according to the position installed.

  In the above-described embodiment, the case where the X-ray CT apparatus calculates the angle of the path of the puncture needle and notifies the indicator 200 for control is described. However, the embodiment is not limited to this. For example, a medical information processing apparatus such as a workstation may calculate the angle of the path of the puncture needle and notify the indicator 200 for control. . In such a case, the control unit of the medical information processing apparatus has the angle calculation unit 381 and the indicator control unit 382 shown in FIG. 3, and calculates the indicator of the puncture path set on the CT image, for example. 200 is notified.

  As described above, according to the first embodiment and the second embodiment, puncture treatment can be performed efficiently.

  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. 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.

DESCRIPTION OF SYMBOLS 1 X-ray CT apparatus 31 Input device 32 Display apparatus 38 Control part 200 Indicator 210 Base part 220a, 220b Instruction part 230a, 230b Rotation part 381 Angle calculation part 382 Indicator control part

Claims (10)

An indicator that indicates the insertion angle of the subject's insert;
A control mechanism for controlling the angle of the indicator based on information on a three-dimensional insertion angle of the insert relative to the subject;
An indicator characterized by comprising.   The indicator according to claim 1, wherein the insertion object is one of a puncture needle, a suction catheter, and a cautery needle. The indicator has two or more rotation axes,
The control mechanism controls the two or more rotation axes, respectively, to cause the instruction unit to indicate a three-dimensional insertion angle of the insert with respect to the subject. Indicator as described in.   The said control mechanism controls the angle of the said instruction | indication part based on the information of the path | route of the said insert designated on the medical image produced | generated from three-dimensional data. The indicator according to item 1. The indicator according to any one of claims 1 to 4,
A receiving unit that receives a designation operation for designating a path of an insertion object of a subject on a medical image generated from three-dimensional data;
A calculation unit that calculates an insertion angle of the insert relative to the subject based on the path of the subject insert received by the reception unit;
A control unit for controlling the indicator by transmitting information on the insertion angle calculated by the calculation unit to the indicator;
An X-ray CT apparatus comprising:   The X-ray CT apparatus according to claim 5, wherein the reception unit receives designation of an insertion position and a target position of the insert as the path of the insert.   The X-ray CT apparatus according to claim 5, wherein the control unit displays an insertion position on the subject by a slice plane projector and a midline projector.   The X-ray CT apparatus according to claim 7, wherein the control unit stops the rotating frame in the gantry device at an angle at which the insertion position is displayed by the slice plane projector and the midline projector.   The X-ray CT apparatus according to claim 7, wherein the control unit displays the midline projector only at an angle at which the insertion position is displayed during rotation of the rotating frame in the gantry device. The indicator according to any one of claims 1 to 4,
A receiving unit that receives a designation operation for designating a path of an insertion object of a subject on a medical image generated from three-dimensional data;
A calculation unit that calculates an insertion angle of the insert relative to the subject based on the path of the subject insert received by the reception unit;
A control unit for controlling the indicator by transmitting information on the insertion angle calculated by the calculation unit to the indicator;
A medical information processing apparatus comprising:

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