JP2016150151A - Medical image processing apparatus, x-ray computer tomography apparatus, magnetic resonance diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical image processing apparatus that enables simple and accurate puncture guiding.SOLUTION: An alignment unit 531 aligns regular dose volume data generated by a CT scan on a subject using a regular dose with low dose volume data generated by a CT scan using a low X-ray dose on a subject with a medical appliance inserted therein. A determination unit 532 determines a position in the regular dose volume data that corresponds to a position of the medical appliance included in the low dose volume data. An image generation unit 533 generates a cross-sectional image relating to a cross section including the determined position on the basis of the regular dose volume data.SELECTED DRAWING: Figure 1

Description

  Embodiments described herein relate generally to a medical image processing apparatus, an X-ray computed tomography apparatus, and a magnetic resonance diagnostic apparatus.

  When performing a puncture technique on the abdomen or the like, real-time puncture guides using X-ray fluoroscopy with an X-ray computed tomography (CT) apparatus are performed. The puncture technique is performed with the subject placed on the top plate of the X-ray CT apparatus. The X-ray CT apparatus performs X-ray fluoroscopy on a target site of a subject and generates a fluoroscopic image regarding the target site. The surgeon performs a procedure with reference to the organ, blood vessel, puncture device, and the like depicted in the fluoroscopic image.

  However, since the detector of the X-ray CT apparatus has a lower resolution than that of the detector of the X-ray diagnostic apparatus or the like, it is not possible to clearly depict fine parts such as blood vessels and puncture devices in an image. Therefore, when performing a puncture technique, an X-ray diagnostic apparatus and an ultrasonic diagnostic apparatus are mainly used. However, since an image generated by the X-ray diagnostic apparatus is a two-dimensional image, it is often difficult to see an organ hidden by various devices. Although CT-like imaging can be used to obtain a three-dimensional image (volume data), it is not realistic to perform the procedure while rotating the arm many times in view of the danger of the operator hitting the arm. In addition, a three-dimensional image can be obtained with an ultrasonic diagnostic apparatus, but it is necessary for the operator to apply the probe to an appropriate location of the subject at an appropriate angle each time depending on the location to be viewed.

  An object is to provide a medical image processing apparatus and an X-ray computed tomography apparatus that enable a simple and highly accurate puncture guide.

  The medical image information apparatus according to this embodiment includes normal dose volume data generated by a normal dose CT scan for a subject, and a low X-ray dose for the subject into which a medical instrument is inserted. An alignment unit that aligns the low-dose volume data generated by the CT scan, and a specifying unit that specifies a position corresponding to the position of the medical device included in the low-dose volume data in the normal dose volume data; An image generation unit that generates a cross-sectional image related to a cross-section including the specified position based on the normal dose volume data.

The figure which shows the structure of the X-ray computed tomography apparatus which concerns on 1st Embodiment. The figure which shows the typical flow of the real-time image display regarding the front-end | tip vicinity of the puncture device in the puncture technique performed under control of the system control part of FIG. A diagram schematically showing a part of the flowchart of FIG. It is the figure which showed a part of flowchart of FIG. 2, and is a figure for demonstrating another example of the display method FIG. 3 is a diagram schematically showing a part of the flowchart of FIG. 2 for explaining an example of displaying a volume image in which a mark corresponding to the tip position of the puncture device is superimposed on imaging volume data. The figure which shows the structure of the X-ray computed tomography apparatus which concerns on 2nd Embodiment. The figure for demonstrating an example which displays the cross-sectional image containing the front-end | tip position of the front-end | tip position of a puncture device in imaging | photography volume data in the arbitrary positions on the insertion path | route of a puncture device based on 2nd Embodiment. The figure for demonstrating an example which displays the CPR image centering on the insertion path | route of a puncture device based on 2nd Embodiment The figure for demonstrating an example which displays the cross-sectional image containing the position corresponding to the front-end | tip position of the puncture device contained in fluoroscopic volume data in imaging | photography volume data based on 3rd Embodiment.

  Hereinafter, a medical image processing apparatus and an X-ray computed tomography apparatus according to embodiments will be described with reference to the drawings. In the following description, it is assumed that the medical image processing apparatus is incorporated in an X-ray computed tomography apparatus. The medical image processing apparatus may be incorporated in a modality other than the X-ray computed tomography apparatus, or may be used alone. Specifically, the medical image processing apparatus may be incorporated in, for example, an X-ray diagnostic apparatus, an ultrasonic diagnostic apparatus, magnetic resonance imaging (Magnetic_Resonance_Imaging: MRI), or the like. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

(First embodiment)
FIG. 1 is a diagram showing a configuration of an X-ray computed tomography apparatus according to the first embodiment. As shown in FIG. 1, the X-ray computed tomography apparatus 1 according to this embodiment includes a gantry 10 and an image processing apparatus 50. The gantry 10 supports a rotating frame 11 having a cylindrical shape so as to be rotatable around a rotation axis Z. An X-ray generator 13 and an X-ray detector 15 are attached to the rotating frame 11 so as to face each other with the rotation axis Z in between. An FOV (field_of_view) is set in the opening (bore) of the rotating frame 11. A top plate 17 is inserted into the opening of the rotating frame 11. A subject S is placed on the top board 17. The top plate 17 is positioned so that the imaging part of the subject S placed on the top plate 17 is included in the FOV. The rotating frame 11 receives power from the rotation driving unit 19 and rotates around the rotation axis Z at a constant angular velocity. The rotation drive unit 19 generates power for rotating the rotating frame 11 in accordance with a control signal from the gantry control unit 21.

  The X-ray generation unit 13 generates X-rays according to a control signal from the gantry control unit 21. Specifically, the X-ray generator 13 includes an X-ray tube 131 and a high voltage generator 133. The X-ray tube 131 generates X-rays in response to application of a high voltage from the high voltage generator 133 and supply of a filament current. The high voltage generator 133 applies a high voltage according to the control signal from the gantry control unit 21 to the X-ray tube 131 and supplies a filament current according to the control signal from the gantry control unit 21 to the X-ray tube 131.

  The X-ray detection unit 15 includes an X-ray tube 151 and a data acquisition circuit (Data_Acquisition_System: DAS) 153. The X-ray tube 151 detects X-rays generated from the X-ray tube 131 and transmitted through the subject S. The X-ray tube 151 includes a plurality of radiation detection elements arranged in a two-dimensional manner. The data acquisition circuit 153 converts a signal corresponding to the intensity of transmitted X-rays output from each channel of the X-ray tube 151 into a digital signal. This digital signal is called raw data.

  The gantry control unit 21 includes, as hardware resources, a calculation device (processor) such as a CPU (Central_Processing_Unit) or an MPU (Micro_Processing_Unit), and a storage device (memory) such as a ROM (Read_Only_Memory) or a RAM (Random_Access_Memory). The gantry controller 21 supervises control of various devices mounted on the gantry 10. For example, the gantry control unit 21 controls the X-ray generation unit 13, the X-ray detection unit 15, and the rotation drive unit 19 in order to execute CT imaging for the subject S. The rotation drive unit 19 rotates at a constant angular velocity according to the control by the gantry control unit 21. In the case of CT imaging, the gantry controller 21 controls the high voltage generator 133 to generate a normal dose of X-rays in the X-ray tube 151. On the other hand, in the case of CT fluoroscopy, the gantry control unit 21 controls the high voltage generator 133 to cause the X-ray tube 151 to generate a lower dose of X-rays than during CT imaging. Here, it is assumed that CT imaging and CT fluoroscopy are performed on the same part of the same subject. For clarity of explanation, CT fluoroscopy is performed during the puncture procedure. In the puncture technique, an operator inserts a medical instrument into a subject with reference to an image generated by CT fluoroscopy. Here, the medical instrument is a puncture device, that is, a catheter, a guide wire, a puncture needle, or the like. Further, CT imaging is performed on the same part of the same subject as the subject of the procedure prior to the procedure. That is, the volume data generated by photographing does not include data related to the puncture device or the hand of the operator related to the procedure.

  The image processing apparatus 50 includes a reconstruction unit 51, an image processing unit 53, an I / F (Interface) unit 55, a display unit 57, an input unit 59, a storage unit 61, and a system control unit 63.

  The reconfiguration unit 51 includes, as hardware resources, a processor such as a CPU, MPU, or GPU (Graphics_Processing_Unit) and a memory such as a ROM or RAM. The reconstruction unit 51 includes a preprocessing unit 511, a normal dose volume data generation unit 512, and a low dose volume data generation unit 513 in terms of functionality or software. The preprocessing unit 511 preprocesses the raw data output from the data collection circuit 153 and converts it into projection data. The normal dose volume data generation unit 512 generates normal dose volume data based on the raw data collected by the X-ray detection unit 15 by the normal dose CT scan. That is, the normal dose volume data is volume data generated by the normal dose CT scan in the previous stage of the low X-ray dose CT scan. The normal dose volume data is generated prior to the low X-ray dose CT scan. The normal dose CT scan is specifically, for example, CT imaging. The low-dose volume data generation unit 513 generates low-dose volume data based on the raw data collected by the X-ray detection unit 15 by a CT scan with a low X-ray dose. That is, the low dose volume data is time series volume data generated by a CT scan with a low X-ray dose. Specifically, the CT scan with a low X-ray dose is, for example, CT fluoroscopy. In order to make the explanation easy to understand, the normal dose volume data is hereinafter referred to as imaging volume data, and the low dose volume data is referred to as fluoroscopic volume data.

  The image processing unit 53 includes, as hardware resources, a processor such as a CPU, MPU, or GPU and a memory such as a ROM or RAM. The image processing unit 53 includes an alignment unit 531, a specification unit 532, and an image generation unit 533 in terms of functionality or software. The alignment unit 531 aligns the imaging volume data and the fluoroscopic volume data. The fluoroscopic volume data includes data relating to a part of the subject into which a puncture device or the like has been inserted. The specifying unit 532 specifies a position corresponding to the position of the puncture device included in the fluoroscopic volume data in the imaging volume data. The image generating unit 533 generates a cross-sectional image related to a cross section including the position specified by the specifying unit 532 based on the imaging volume data. The superimposing unit 536 generates a superimposed volume image in which position marks corresponding to the positions specified by the specifying unit 532 in the volume image based on the normal dose volume data are superimposed.

  The I / F unit 55 is an interface for communication between the image processing apparatus 50 and the gantry 10. For example, the I / F unit 55 supplies an imaging start signal, an imaging stop signal, and the like from the system control unit 63.

  The display unit 57 displays various images on a display device. The display unit 57 displays a mark, a line table, etc. in alignment with the image. As the display device, for example, a CRT display, a liquid crystal display, an organic EL display, a plasma display, or the like can be used as appropriate.

  The input unit 59 receives various commands and information input from the user by the input device. As an input device, a keyboard, a mouse, various switches, and the like can be used.

  The storage unit 61 is a storage device that stores various information. For example, the storage unit 61 stores an image processing program according to the present embodiment.

  The system control unit 63 functions as the center of the X-ray computed tomography apparatus according to the present embodiment. The system control unit 63 reads out the imaging program according to the present embodiment from the storage unit 61 and controls various components according to the imaging program. Thereby, CT imaging and image processing for image generation such as a cross-sectional image according to the present embodiment are performed.

  Next, an operation example of real-time image display near the tip of the puncture device during the puncture procedure according to the present embodiment will be described. FIG. 2 is a diagram showing a typical flow of real-time image display regarding the vicinity of the tip of the puncture device during the puncture procedure, which is performed under the control of the system control unit 63.

  As shown in FIG. 2, the system control unit 63 causes the normal dose volume data generation unit 512 to generate imaging volume data by CT imaging (step S11). In step S11, the normal dose volume data generation unit 512 generates imaging volume data based on projection data obtained by CT imaging.

  When step S11 is performed, the system control unit 63 causes the input unit 59 to wait for an input of the start of fluoroscopy from the operator (step S12). When an instruction to start fluoroscopy is input from the operator to the input unit 59 in step S12, the gantry control unit 21 controls the X-ray generation unit 13, the X-ray detection unit 15, and the rotation drive unit 19 to perform X-ray fluoroscopy. Start.

  When step S12 is performed, the system control unit 63 causes the low-dose volume data generation unit 513 to generate fluoroscopic volume data for the subject into which the puncture device has been inserted by fluoroscopy (step S13). In step S13, the low-dose volume data generation unit 513 generates time-series fluoroscopic volume data based on projection data obtained by CT fluoroscopy. Steps S13 to S17 are repeated for each fluoroscopic volume data.

  When step S13 is performed, the system control unit 63 causes the alignment unit 531 to align the imaging volume data and the fluoroscopic volume data (step S14). As described above, the imaging volume data and the fluoroscopic volume data are volume data for the same part of the same subject. That is, in step S14, the alignment unit 531 aligns the imaging volume data and the fluoroscopic volume data based on the same anatomical points. The alignment unit 531 performs alignment between one imaging volume data generated by CT imaging in step S11 and each of a plurality of time-series fluoroscopic volume data generated by CT fluoroscopy during the procedure.

  When step S14 is performed, the system control unit 63 causes the specifying unit 532 to specify a position corresponding to the tip position of the puncture device included in the fluoroscopic volume data in the imaging volume data (step S15). FIG. 3 is a diagram schematically showing a part of the flowchart of FIG. In step S15, as shown in FIG. 3, the specifying unit 532 performs image processing on the imaging volume data and fluoroscopic volume data aligned in step S14, thereby corresponding to the tip position of the puncture device in the imaging volume data. Identify the location. Specifically, the position specification by the image processing is performed in the following steps, for example. The specifying unit 532 extracts the tip of the puncture device in the fluoroscopic volume data by image processing, and specifies the coordinates of the extracted tip as the tip position. The identifying unit 532 pairs at least one anatomical point in the fluoroscopic volume data with the same number of points in the imaging volume data based on the result of the alignment. The specifying unit 532 determines the relationship between the coordinates of the fluoroscopic volume data and the coordinates of the imaging volume data based on at least one paired anatomical point. For example, in the case of simple linear movement, the relationship that coordinates (x, y, z) in fluoroscopic volume data correspond to coordinates (x + 1, y + 1, z + 1) in imaging volume data is determined. Based on the determined coordinate relationship, the specifying unit 532 specifies a position corresponding to the tip position of the puncture device in the imaging volume data. A marker that can be easily extracted by image processing may be provided at the tip of the puncture device.

  When step S15 is performed, the system control unit 63 causes the image generation unit 533 to generate a cross-sectional image relating to the cross-section including the tip position specified in step S15 (step S16). In step S16, the image generation unit 533 generates a cross-sectional image by performing arbitrary multi-section reconstruction (Multi-Planar_Reconstruction: MPR) or the like based on the tip position of the puncture device specified in step S17. The cross section of the cross section image may have any orientation as long as it includes the tip position. The direction of the cross section may be specified by the operator via the input unit 59.

  When step S16 is performed, the system control unit 63 causes the display unit 57 to display the cross-sectional image generated in step S16 (step S17). Note that the display method of the cross-sectional image may be other than the display method shown in FIG. For example, FIG. 4 is a diagram schematically showing a part of the flowchart of FIG. 2, and is a diagram for explaining another example of the display method. In step S16, the image generation unit 533 can generate cross-sectional images regarding a plurality of cross-sections including the tip position of the puncture device and having different directions (corresponding to step S26 in FIG. 4). Specifically, for example, as shown in step S <b> 26 of FIG. 4, the image generation unit 533 generates an orthogonal three-section image (orthogonal three-section image) including the tip position of the puncture device. As shown in step S27 in FIG. 4, the display unit 57 can display a plurality of cross-sectional images side by side. The display unit 57 may display the cross-sectional image and the display image based on the perspective volume data side by side. A display image based on the fluoroscopic volume data is generated by the image processing unit 53. The display image based on the fluoroscopic volume data has the same cross section as the cross section image. The means for generating a display image based on the perspective volume data may be volume rendering, MPR, curved surface arbitrary multi-section reconstruction (Curved_Multi_Planer_Reconstruction: CPR), maximum value projection method (Maximum_Intensity_Projection: MIP), or minimum value projection method (Minimum_Injection_Intensity_Intensity_Intensity_Injection_Intensity_Injection_Intensity_Injection_Intensity_Injection_Intensity_Intensity_Injection) MinIP) or the like may be used.

  The above steps S13 to S17 are performed for the volume data to be processed. When new volume data is generated by fluoroscopy, steps S13 to S17 are performed on the generated new volume data. By repeating step S13 to step S17, a real-time image display near the tip of the puncture device during the puncture procedure is possible.

  Further, when the operator gives an instruction to end fluoroscopy via the input unit 59, the system control unit 63 causes the gantry control unit 21 to end X-ray fluoroscopy (step S18).

  In the typical flowchart described above, the display unit 57 displays a cross-sectional image, but the display unit 57 can also display other images. FIG. 5 is a diagram schematically showing a part of the flowchart of FIG. 2, and is a diagram for explaining an example of displaying a volume image in which marks corresponding to the tip position of the puncture device are superimposed on the imaging volume data. It is.

  After step S11 to step S15 in FIG. 2 are performed, the system control unit 63 causes the superposition unit 536 to generate a superposition volume image in which marks are superposed at specified positions in the photographing volume data (step S36). . Specifically, the superimposing unit 536 superimposes the mark on the position coordinates specified in the imaging volume data, for example. The operator can grasp the position of the puncture device in the fluoroscopic target part three-dimensionally by using the superimposed volume image. The volume image is, for example, pixel value projection processing such as MIP and MinIP, volume rendering, surface rendering, and the like based on the imaging volume data and the position corresponding to the tip position of the puncture device in the imaging volume data specified in step S15. Generated by.

  When step S36 is performed, the system control unit 63 causes the display unit 57 to display the superimposed volume image (step S37).

  As described above, according to the X-ray computed tomography apparatus according to the present embodiment, imaging volume data is generated by CT imaging before performing a puncture procedure. During the puncture procedure, fluoroscopic volume data including data related to the puncture device is generated in real time by CT fluoroscopy. Based on the imaging volume data and the fluoroscopic volume data, the tip position of the puncture device in the imaging volume data can be specified. A high-quality cross-sectional image can be generated as compared to a normal dose including the identified tip position, that is, a fluoroscopic image. Therefore, the surgeon can perform a puncture technique with reference to a high-quality and real-time cross-sectional image related to the vicinity of the tip of the puncture device. In order to further improve the accuracy of the puncture guide, an X-ray CT apparatus equipped with a high-resolution X-ray detector may be used. By using an X-ray CT apparatus equipped with a high-resolution X-ray detector, the accuracy of specifying the tip position of the puncture device is improved, and a higher-quality cross-sectional image can be generated. Therefore, the surgeon can perform a puncture technique with reference to a higher-quality real-time cross-sectional image related to the vicinity of the tip of the puncture device.

(Second Embodiment)
In the above embodiment, the image generation unit 533 generates a cross-sectional image related to a cross section including the tip position of the puncture device. However, the present application is not limited thereto. The X-ray computed tomography apparatus according to the second embodiment generates a cross-sectional image corresponding to the insertion path of the puncture device. Specifically, the X-ray computed tomography apparatus according to the second embodiment extracts the path of the puncture device, and generates a cross-sectional image including the tip position of the puncture device at an arbitrary position related to the extracted path.

  FIG. 6 is a diagram showing a configuration of an X-ray computed tomography apparatus according to the second embodiment. As shown in FIG. 6, the image processing unit 53 in the X-ray computed tomography apparatus 1 ′ according to the second embodiment includes a path determination unit 534 in addition to the configuration of the X-ray computed tomography apparatus according to the first embodiment. And a route prediction unit 535.

  The route determining unit 534 determines the route through which the puncture device has passed based on the tip position specified by the specifying unit 532.

  The route prediction unit 535 determines the predicted route of the puncture device based on the past route of the puncture device. Similar to the route determination unit 534, the route prediction unit 535 determines a route through which the puncture device has passed by performing regression analysis or the like on a plurality of tip position coordinates in the imaging volume data. Note that the passage route determination by the route prediction unit 535 and the passage route prediction by the route determination unit 534 may be performed by different analysis methods.

  Next, an operation example of real-time image display near the tip of the puncture device during the puncture procedure according to the second embodiment will be described. FIG. 7 is a diagram for explaining an example of displaying a cross-sectional image including the tip position of the tip position of the puncture device in the imaging volume data at an arbitrary position on the insertion path of the puncture device according to the second embodiment. is there.

  After step S11 to step S14 of FIG. 2 are performed, the system control unit 63 causes the specifying unit 532 to specify a plurality of positions corresponding to the tip position of the puncture device included in the fluoroscopic volume data in the imaging volume data (step). S45). In step S45, the specifying unit 532 specifies a plurality of positions corresponding to the tip position of the time-series puncture device related to the inserted puncture device.

  When step S45 is performed, the system control unit 63 causes the route determination unit 534 to determine the insertion route of the puncture device (step S46). In step S46, the route determination unit 534 specifically determines, for example, the route through which the puncture device has passed by performing regression analysis or the like on a plurality of tip position coordinates in the imaging volume data. For example, the route determination unit 534 uses linear interpolation or the like for regression analysis.

  When step S46 is performed, the system control unit 63 causes the image generation unit 533 to generate a cross-sectional image related to the cross-section including the tip position of the puncture device orthogonal to the insertion path determined in step S46 (step S47). In step S47, the image generation unit 533 generates a cross-sectional image related to a cross section orthogonal to the insertion path determined in step S46 (hereinafter referred to as an orthogonal cross section) among cross sections including an arbitrary tip position on the path. Here, the arbitrary tip position is a tip position selected by the operator via the input unit 59.

  When step S47 is performed, the system control unit 63 displays the cross-sectional image on the display unit 57 (step S48).

  Further, the X-ray computed tomography apparatus 1 ′ according to the second embodiment can generate and display a cross-sectional image other than the orthogonal cross-section at the tip position of the puncture device. Hereinafter, a display operation example related to a CPR image with the insertion path of the puncture device during the puncture procedure as the central axis according to the second embodiment will be described. FIG. 8 is a diagram for explaining an example of displaying a CPR image with the insertion path of the puncture device as the central axis according to the second embodiment.

  After the insertion path of the puncture device is determined in step S46 of FIG. 7, the system control unit 63 sends a CPR image with the insertion path determined in step S46 as the central axis to the image generation unit 533 based on the imaging volume data. (Step S57). CPR is a kind of MPR reconstruction method described above, and is a reconstruction method in which a cross-section is reconstructed by MPR along a meandering surface or curved surface, and developed and displayed on a plane. The image generation unit 533 can generate cross-sectional images by CPR (hereinafter referred to as CPR cross-sectional images) in different directions with the insertion path as the central axis. Specifically, for example, the image generation unit 533 can generate a cross-sectional image of 360 ° with the insertion path as the central axis.

  When step S57 is performed, the system control unit 63 displays the CPR image on the display unit 57 (step S48). The display unit 57 can display a CPR cross-sectional image oriented at 360 ° with the insertion path as the central axis. Here, the displayed CPR cross-sectional image can be rotated by an instruction from the operator via the input unit 59.

  As described above, according to the X-ray computed tomography apparatus according to the present embodiment, it is possible to generate a cross-sectional image related to a cross section including the tip position of the puncture device that is orthogonal to the insertion path of the puncture device. Similarly, a cross-sectional image can be generated in the predicted path of the puncture device. In addition, a CPR cross-sectional image with the insertion path as the central axis can be generated in a 360 ° orientation. The generated CPR cross-sectional image can be displayed in a 360 ° orientation. By rotating the CPR cross-sectional image displayed on the display unit 57, the surgeon can uniformly grasp the periphery of the insertion path of the puncture device. For example, the surgeon can grasp the periphery of the insertion path of the puncture device. For example, the surgeon can grasp the tip and the organ around the insertion path, and can advance the puncture device without damaging the organ. For example, the surgeon can grasp the tumor around the tip of the puncture device and the insertion path, and can burn the tumor. Therefore, the surgeon can perform a puncture technique with reference to a high-quality real-time cross-sectional image regarding the tip of the puncture device and the periphery of the insertion path.

(Third embodiment)
In the above embodiment, one-shot imaging has been described as CT imaging, but dynamic imaging in which CT imaging is repeatedly performed may be used. Dynamic imaging is performed by injecting a contrast medium into a subject for observation of hemodynamics. The X-ray computed tomography apparatus according to the third embodiment performs dynamic imaging in order to generate imaging volume data.

  Next, an operation example of real-time image display near the tip of the puncture device during the puncture procedure according to the third embodiment will be described. FIG. 9 is a diagram for explaining an example of displaying a cross-sectional image including a position corresponding to the distal end position of the puncture device included in the fluoroscopic volume data in the imaging volume data according to the third embodiment.

  As described above, in the third embodiment, time series imaging volume data is generated by dynamic imaging using an X-ray CT apparatus before fluoroscopy. That is, as shown in FIG. 9, not only the perspective volume data but also the imaging volume data is time-series plural volume data. The time-series imaging volume data is stored in association with the cardiac phase or the respiratory phase for each volume data.

  After the processing corresponding to steps S11 to S13 in FIG. 2 is performed, the system control unit 63 causes the alignment unit 531 to align the fluoroscopic volume data and the imaging volume data for each phase (step S64). In step S64, the alignment unit 531 aligns the fluoroscopic volume data and the imaging volume data for each time phase.

  When step S64 is performed, the system control unit 63 causes the specifying unit 532 to specify the position corresponding to the tip position of the puncture device included in the fluoroscopic volume data in the imaging volume data for each phase (step S65).

  When step S65 is performed, the system control unit 63 causes the image generation unit 533 to generate a cross-sectional image regarding the cross-section including the tip position specified in step S65 for each phase (step S66).

  When step S16 is performed, the system control unit 63 causes the display unit 57 to display the cross-sectional image generated in step S16 (step S17).

  As described above, according to the X-ray computed tomography apparatus according to this embodiment, time-series imaging volume data generated by dynamic imaging at the time of diagnosis and fluoroscopic volume data generated by X-ray fluoroscopy during the puncture procedure Based on the above, a high-quality cross-sectional image including the tip position of the puncture device can be generated for each phase. Therefore, the surgeon can perform a puncture technique with reference to a high-quality real-time cross-sectional image regarding the tip of the puncture device and the periphery of the insertion path.

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

  DESCRIPTION OF SYMBOLS 1 ... X-ray computed tomography apparatus, 10 ... Mount, 11 ... Rotating frame, 13 ... X-ray generation part, 15 ... X-ray detection part, 17 ... Top plate, 19 ... Rotation drive part, 21 ... Mount control part, 33 ... Setting unit, 50 ... Image processing device, 51 ... Reconstruction unit, 53 ... Image processing unit, 55 ... I / F unit, 57 ... Display unit, 59 ... Input unit, 61 ... Storage unit, 63 ... System control unit

Claims (17)

Normal dose volume data generated by a normal dose CT scan for the subject, low dose volume data generated by a low X-ray dose CT scan for the subject into which a medical instrument is inserted, and An alignment section for aligning the
In the normal dose volume data, a specifying unit for specifying a position corresponding to a position of a medical instrument included in the low dose volume data;
Based on the normal dose volume data, an image generator that generates a cross-sectional image related to a cross-section including the specified position;
A medical image processing apparatus comprising:   The low dose volume data is time-series volume data generated by the low X-ray dose CT scan, and the normal dose volume data is obtained by a normal dose CT scan in a previous stage of the low X-ray dose CT scan. The medical image processing apparatus according to claim 1, wherein the medical image processing apparatus is generated volume data.   The low-dose volume data is time-series volume data generated by X-ray fluoroscopy, and the normal dose volume data is volume data generated by X-ray imaging in a previous stage of the X-ray fluoroscopy. The medical image processing apparatus described.   The medical image processing apparatus according to claim 2, further comprising a path determination unit that determines a path through which the medical instrument has passed based on the specified position.   The medical image processing apparatus according to claim 4, wherein the image generation unit generates a CPR image having the path as a central axis based on the normal dose volume data.   The medical image processing apparatus according to claim 4, wherein the image generation unit generates a cross-sectional image related to a cross section orthogonal to the path at an arbitrary position in the path.   The medical image processing apparatus according to claim 2, further comprising a path prediction unit that determines a predicted path of the medical instrument based on a past path of the medical instrument.   The medical image processing apparatus according to claim 7, wherein the image generation unit generates a cross-sectional image related to a cross section orthogonal to the determined path at an arbitrary position in the predicted path. The normal dose volume data is time-series volume data generated by the CT scan of the normal dose,
The medical image processing apparatus according to claim 2, wherein the alignment unit aligns the low dose volume data and the normal dose volume data for each phase.   The medical image processing apparatus according to claim 2, wherein the specifying unit specifies a position corresponding to a position of a marker provided on the medical instrument included in the low-dose volume data in the normal dose volume data.   The medical image processing apparatus according to claim 10, wherein the marker is provided at a distal end portion of the medical instrument. A display unit;
The image generation unit generates a display image based on the low-dose volume data,
The medical image processing apparatus according to claim 2, wherein the display unit displays the display image side by side on the cross-sectional image.   The medical image processing apparatus according to claim 1, further comprising a display unit configured to display cross-sectional images regarding a plurality of cross-sections including the specified position and having different directions.   The medical image processing apparatus according to claim 1, further comprising a superimposing unit that generates a volume image based on normal dose volume data in which a mark is attached at a position corresponding to the specified position.   The medical image processing apparatus according to claim 14, further comprising a display unit that displays the superimposed volume image. An X-ray tube that generates X-rays;
An X-ray detector provided to face the X-ray tube and detecting the X-ray transmitted through the subject;
A data collection circuit for collecting digital data indicating attenuation of X-rays by the subject via the X-ray detector;
A normal dose volume data generating unit for generating normal dose volume data based on the digital data generated by a normal dose CT scan for the subject;
A low-dose volume data generation unit that generates low-dose volume data based on the digital data generated by a low-X-ray dose CT scan for the subject into which a medical instrument is inserted;
An alignment unit for aligning the low dose volume data and the normal dose volume data;
In the normal dose volume data, a specifying unit for specifying a position corresponding to a position of a medical instrument included in the low dose volume data;
Based on the normal dose volume data, an image generator that generates a cross-sectional image related to a cross-section including the specified position;
An X-ray computed tomography apparatus comprising: A magnetic field application unit that individually applies a static magnetic field and a gradient magnetic field to the subject;
A transmitter for transmitting a high-frequency magnetic field for exciting specific nuclei in the subject;
A receiving unit that receives the high-frequency magnetic field and receives an MR signal corresponding to an electromagnetic wave generated from the specific nucleus in the subject;
The magnetic field applying unit, the transmitting unit, and the receiving unit are controlled to image the subject into which angiographic particles for imaging a blood vessel and lesioned tissue imaging particles for imaging a diseased tissue are injected. An imaging control unit to
A normal dose volume data generating unit for generating normal dose volume data based on the MR signal received by the receiving unit generated by imaging the subject;
A low-dose volume data generating unit that generates low-dose volume data based on the MR signal received by the receiving unit generated by fluoroscopy for the subject;
An alignment unit for aligning the low dose volume data and the normal dose volume data;
In the normal dose volume data, a specifying unit for specifying a position corresponding to a position of a medical instrument included in the low dose volume data;
Based on the normal dose volume data, an image generator that generates a cross-sectional image related to a cross-section including the specified position;
A magnetic resonance diagnostic apparatus comprising: