JP2017140365A - Image processing apparatus and medical diagnostic imaging apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an image processing apparatus and a medical diagnostic imaging apparatus each capable of determining a therapeutic effect on hematogenous disorder in advance.SOLUTION: The image processing apparatus related to an embodiment includes a calculation part, a setting part, a change part and a display control part. The calculation part calculates index values related to blood flows in a blood vessel by a fluid analysis using data on an image including the blood vessel. The setting part sets a plurality of target sites in the blood vessel in image data. The change part changes an analysis condition in the fluid analysis corresponding to a place of the objective portion. The display control part causes the index value related to the blood flow calculated by the calculation part to be displayed, in a comparative manner, for each analysis condition changed by the change part for the plurality of target sites.SELECTED DRAWING: Figure 1

Description

  Embodiments described herein relate generally to an image processing apparatus and a medical image diagnostic apparatus.

  Conventionally, it is known that the causes of an ischemic disease of an organ are roughly classified into a blood circulation disorder and an organ dysfunction. For example, stenosis, which is an example of coronary artery circulation disorder, is a serious lesion that leads to ischemic heart disease. In such ischemic heart disease, whether drug treatment or stent treatment should be performed, etc. It is necessary to judge. In recent years, as a diagnosis for evaluating ischemic ischemia of a coronary artery, a method of measuring a myocardial blood flow reserve ratio (FFR) using a pressure wire in a coronary angiography (CAG) using a catheter is used. It is being recommended.

  On the other hand, for example, coronary artery ischemic ischemia using medical images of the heart collected by a medical image diagnostic apparatus such as an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, or an ultrasonic diagnostic apparatus. A technique for non-invasive evaluation is also known. As described above, hematogenous ischemia is evaluated by various methods, and treatment according to the evaluation is performed. In recent years, it has been desired to determine an actual therapeutic effect before treatment.

International Publication No. 2013/031744 JP 2014-188323 A JP 2014-079649 A JP-A-2015-134196 JP 2014-1000024 A

  The problem to be solved by the present invention is to provide an image processing apparatus and a medical image diagnostic apparatus that can determine a therapeutic effect on a blood circulation disorder in advance.

  The image processing apparatus according to the embodiment includes a calculation unit, a setting unit, a changing unit, and a display control unit. The calculation unit calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel. The setting unit sets a plurality of target sites in the blood vessel in the image data. The changing unit changes the analysis condition of the fluid analysis corresponding to the location of the target part. The display control unit causes the index value related to the blood flow calculated by the calculation unit to be displayed for comparison for each of the analysis conditions changed by the changing unit for a plurality of the target regions.

FIG. 1 is a diagram illustrating an example of the configuration of the image processing apparatus according to the first embodiment. FIG. 2 is a diagram for explaining an example of processing according to the first embodiment. FIG. 3A is a diagram for explaining an example of a pressure change according to the first embodiment. FIG. 3B is a diagram illustrating an example of display information displayed by the display control function according to the first embodiment. FIG. 4A is a diagram for explaining an example of a cross-sectional area change according to the first embodiment. FIG. 4B is a diagram illustrating an example of a cross-sectional area changing operation according to the first embodiment. FIG. 4C is a diagram illustrating an example of display information displayed by the display control function according to the first embodiment. FIG. 5A is a diagram for explaining an example of a diameter change according to the first embodiment. FIG. 5B is a diagram illustrating an example of a diameter changing operation according to the first embodiment. FIG. 5C is a diagram illustrating an example of display information displayed by the display control function according to the first embodiment. FIG. 6A is a diagram for explaining an example of a range change according to the first embodiment. FIG. 6B is a diagram illustrating an example of display information displayed by the display control function according to the first embodiment. FIG. 7 is a flowchart illustrating a processing procedure performed by the image processing apparatus according to the first embodiment. FIG. 8A is a diagram for explaining a change in the condition of the stent by the changing function according to the second embodiment. FIG. 8B is a diagram for explaining a change in the condition of the stent by the changing function according to the second embodiment. FIG. 9 is a flowchart illustrating a processing procedure performed by the image processing apparatus according to the second embodiment.

  Exemplary embodiments of an image processing apparatus and a medical image diagnostic apparatus according to the present application will be described below in detail with reference to the accompanying drawings. The image processing apparatus and the medical image diagnostic apparatus according to the present application are not limited to the embodiments described below.

(First embodiment)
First, the first embodiment will be described. In the first embodiment, an example in which the technology disclosed in the present application is applied to an image processing apparatus will be described. In the following, an example in which 3D CT image data is used as 3D image data will be described. In the following, an example in which a cardiac blood vessel is an analysis target will be described as an example.

  FIG. 1 is a diagram illustrating an example of the configuration of the image processing apparatus according to the first embodiment. For example, as illustrated in FIG. 1, the image processing apparatus 300 according to the first embodiment is connected to an X-ray CT (Computed Tomography) apparatus 100 and an image storage apparatus 200 via a network 400. Note that the image processing apparatus 300 may be further connected to another medical image diagnostic apparatus such as an MRI apparatus, an ultrasonic diagnostic apparatus, or a PET (Positron Emission Tomography) apparatus via the network 400.

  The X-ray CT apparatus 100 collects CT image data of a subject. Specifically, the X-ray CT apparatus 100 collects projection data by detecting the X-rays transmitted through the subject by rotating the X-ray tube and the X-ray detector around the subject. Then, the X-ray CT apparatus 100 generates time-series three-dimensional CT image data based on the collected projection data.

  The image storage device 200 stores image data collected by various medical image diagnostic apparatuses. For example, the image storage device 200 is realized by a computer device such as a server device. In the present embodiment, the image storage device 200 acquires CT image data from the X-ray CT apparatus 100 via the network 400, and stores the acquired CT image data in a storage circuit provided inside or outside the apparatus.

  The image processing apparatus 300 acquires image data from various medical image diagnostic apparatuses via the network 400, and processes the acquired image data. For example, the image processing apparatus 300 is realized by a computer device such as a workstation. In the present embodiment, the image processing apparatus 300 acquires CT image data from the X-ray CT apparatus 100 or the image storage apparatus 200 via the network 400, and performs various image processing on the acquired CT image data. The image processing apparatus 300 displays CT image data before or after performing image processing on a display or the like.

  For example, as illustrated in FIG. 1, the image processing apparatus 300 includes an I / F (interface) circuit 310, a storage circuit 320, an input circuit 330, a display 340, and a processing circuit 350.

  The I / F circuit 310 is connected to the processing circuit 350 and controls transmission and communication of various data performed with various medical image diagnostic apparatuses or image storage apparatuses 200 connected via the network 400. For example, the I / F circuit 310 is realized by a network card, a network adapter, a NIC (Network Interface Controller), or the like. In the present embodiment, the I / F circuit 310 receives CT image data from the X-ray CT apparatus 100 or the image storage apparatus 200 and outputs the received CT image data to the processing circuit 350.

  The storage circuit 320 is connected to the processing circuit 350 and stores various data. For example, the storage circuit 320 is realized by a semiconductor memory device such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like. In the present embodiment, the storage circuit 320 stores CT image data received from the X-ray CT apparatus 100 or the image storage apparatus 200.

  The input circuit 330 is connected to the processing circuit 350, converts an input operation received from the operator into an electrical signal, and outputs the electrical signal to the processing circuit 350. For example, the input circuit 330 is realized by a trackball, a switch button, a mouse, a keyboard, a touch panel, or the like. For example, the input circuit 330 receives an input operation for setting a target part.

  The display 340 is connected to the processing circuit 350 and displays various information and various image data output from the processing circuit 350. For example, the display 340 is realized by a liquid crystal monitor, a CRT (Cathode Ray Tube) monitor, a touch panel, or the like.

  The processing circuit 350 controls each component included in the image processing apparatus 300 in accordance with an input operation received from the operator via the input circuit 330. For example, the processing circuit 350 is realized by a processor. In the present embodiment, the processing circuit 350 causes the storage circuit 320 to store CT image data output from the I / F circuit 310. Further, the processing circuit 350 reads out CT image data from the storage circuit 320 and displays it on the display 340.

  With such a configuration, the image processing apparatus 300 according to the present embodiment makes it possible to determine in advance the therapeutic effect on a blood circulation disorder. Specifically, the image processing apparatus 300 calculates an index value related to blood flow by fluid analysis using a medical image including blood vessels (for example, three-dimensional CT image data). Then, the image processing apparatus 300 changes the analysis condition used for the fluid analysis based on the treatment, and recalculates the index value related to the blood flow under the changed analysis condition. Therefore, the image processing apparatus 300 makes it possible to determine the treatment effect in advance by comparing the index values before and after the change of the analysis condition.

  Here, the image processing apparatus 300 calculates, for example, a myocardial blood flow reserve ratio (FFR: Fractional Flow Reserve), a mechanical index in a blood vessel, an index related to blood flow, and the like as index values related to blood flow. . FFR is the ratio of the pressure at the proximal part near the heart in the blood vessel to the pressure at the distal part far from the heart, eg, “FFR = Pd (distal pressure) / Pa (proximal pressure) ) ”. For example, when a stenosis (target site) occurs in a blood vessel, the FFR value decreases because the pressure in the distal portion decreases due to the stenosis. The image processing apparatus 300 makes it possible to determine the treatment effect in advance by calculating how the FFR value changes when a treatment is performed on such a target part by simulation. . Note that the image processing apparatus 300 can calculate, for example, a pressure, a vector, a shear stress, and the like as a dynamic index in the blood vessel. Further, the image processing apparatus 300 can calculate a flow rate, a flow rate, and the like as an index related to the blood flow rate.

  Hereinafter, in the first embodiment, a case where the therapeutic effect of stenosis occurring in the coronary artery is determined will be described as an example. The processing circuit 350 according to this embodiment includes an acquisition function 351, an extraction function 352, a setting function 353, a change function 354, a calculation function 355, and a display control function 356. Here, the change function 354 is an example of a change unit in the claims. The calculation function 355 is an example of a calculation unit in the claims. The display control function 356 is an example of a display control unit in the claims.

  The acquisition function 351 acquires time-series three-dimensional CT image data in which the blood vessels of the subject are depicted. Specifically, the acquisition function 351 acquires 3D CT image data from the X-ray CT apparatus 100 or the image storage apparatus 200 via the network 400 and stores the acquired 3D CT image data in the storage circuit 320.

  The extraction function 352 extracts time-series blood vessel shape data representing the shape of the blood vessel from the 3D CT image data acquired by the acquisition function 351. Specifically, the extraction function 352 reads out three-dimensional CT image data from the storage circuit 320 and performs image processing on the read-out three-dimensional CT image data to extract blood vessel shape data.

  Here, the extraction function 352 sets a target region for calculating an index value in a blood vessel region included in the three-dimensional CT image data. Specifically, the extraction function 352 sets a target region in the blood vessel region by an instruction from the operator via the input circuit 330 or image processing. The extraction function 352 uses, for example, the blood vessel shape data of the set target region as a blood vessel core line (coordinate information of the core line), a cross-sectional area of blood vessels and lumens in a cross section perpendicular to the core line, and a cross section perpendicular to the core line. The distance from the core wire to the inner wall and the distance from the core wire to the outer wall in the cylindrical direction are extracted from the three-dimensional CT image data. The extraction function 352 can extract other various blood vessel shape data according to the analysis method.

  The setting function 353 sets analysis conditions for fluid analysis. Specifically, the setting function 353 sets a physical property value of blood, an iterative calculation condition, an initial value of analysis, and the like as analysis conditions. For example, the setting function 353 sets the viscosity, density, etc. of blood as the physical property value of blood. The setting function 353 sets the maximum number of iterations in the iterative calculation, a relaxation coefficient, an allowable value of the residual, and the like as conditions for the iterative calculation. The setting function 353 sets the initial value of the analysis, such as the flow rate, pressure, fluid resistance, and initial value of the pressure boundary. Various values used by the setting function 353 may be incorporated in the system in advance, may be defined interactively by the operator, or may be set by using some functions of the calculation function 355. Also good.

  The setting function 353 sets a target site (for example, a treatment target site) in a blood vessel in the image data. Specifically, the setting function 353 sets a plurality of target sites in the blood vessel manually or automatically. For example, the setting function 353 sets the range received via the input circuit 330 as the target part. In such a case, the input circuit 330 receives a range (target part) in which the analysis condition is changed, and sets the range in which the setting function 353 is received as the target part. In addition, the setting function 353 automatically sets a target part based on the shape in the target area set by the extraction function 352. For example, the setting function 353 extracts a stenosis portion based on the shape in the target region, and sets a stenosis portion having a certain degree of stenosis or more as a target portion among the extracted stenosis portions. Note that any method can be used to extract the stenosis.

  The change function 354 changes the analysis conditions of the fluid analysis for the target site in the blood vessel. Specifically, the change function 354 changes the blood vessel shape data extracted by the extraction function 352 and the analysis conditions set by the setting function 353. For example, the change function 354 includes a pressure applied to the target site, a condition of the stent placed in the target site, a cross-sectional area in the target site, a shape in the target site, an analysis target range, or a procedure performed on the target site. Change it. That is, the change function 354 changes a parameter that will change when treatment is performed on a target site such as stenosis, and causes the calculation function 355 described later to recalculate the index value. Details of the processing by the change function 354 will be described later.

  The calculation function 355 calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel. Specifically, the calculation function 355 performs fluid analysis using the blood vessel shape data extracted by the extraction function 352 and the analysis conditions set by the setting function 353, and an index relating to blood flow in the target region of the blood vessel. Calculate the value. For example, the calculation function 355 is based on blood vessel shape data such as blood vessel lumen and outer wall contours, blood vessel cross-sectional area and core line, and blood physical property values, iterative calculation conditions, and analysis initial values. For each predetermined position of the blood vessel, index values such as pressure, blood flow rate, blood flow rate, vector, and shear stress are calculated. Then, the calculation function 355 further calculates an index value such as FFR from the calculated index value.

  FIG. 2 is a diagram for explaining an example of processing according to the first embodiment. As illustrated in FIG. 2, for example, the extraction function 352 extracts blood vessel shape data including coordinates of the core line and cross-sectional information for the LAD that is the target region from the three-dimensional CT image data including the aorta and the coronary artery. The setting function 353 sets analysis conditions for the analysis on the extracted LAD. The calculation function 355 performs a fluid analysis using the extracted LAD blood vessel shape data and the set conditions, for example, a predetermined position along the core line from the entrance boundary to the exit boundary of the target region LAD. Each time, index values such as pressure, blood flow rate, blood flow rate, vector, and shear stress are calculated. That is, the calculation function 355 calculates distributions such as pressure, blood flow rate, blood flow rate, vector, and shear stress for the target region. And the calculation function 355 calculates FFR of each position in an object area | region based on the calculated pressure distribution, for example.

  As described above, the calculation function 355 calculates an index value related to blood flow by performing fluid analysis using the blood vessel shape data extracted by the extraction function 352 and the conditions set by the setting function 353. Here, the calculation function 355 according to the present embodiment executes the fluid analysis again using the conditions changed by the change function 354. That is, the calculation function 355 performs a simulation on the index value after treatment by performing fluid analysis under a changed condition assuming treatment for a target site such as stenosis.

  The display control function 356 causes the display 340 to display the index value related to the blood flow calculated by the calculation function 355. Specifically, the display control function 356 causes the display 340 to display the result of the fluid analysis before the change of the condition by the change function 354 and the result of the fluid analysis after the change of the condition by the change function 354.

  As described above, the image processing apparatus 300 according to the present embodiment changes the analysis condition in the fluid analysis using the image data according to the treatment content, performs the fluid analysis again under the changed condition, and calculates the index value. And display. Thereby, the observer can determine the effect of treatment by confirming the index value displayed by the image processing apparatus 300. Here, in the present embodiment, as the analysis condition, the pressure at the target site, the cross-sectional area at the target site, the shape at the target site, or the analysis target range is changed. That is, the input circuit 330 receives information on the treatment content for the target site and transmits it to the change function 354. The change function 354 changes the above-described condition according to the treatment content received via the input circuit 330, and the calculation function 355 calculates the index value under the changed condition. Hereinafter, the change of each condition will be described in order.

(Change of pressure)
First, a case where the pressure is changed will be described. In this case, the change function 354 changes the initial value of the fluid analysis pressure according to the treatment content received by the input circuit 330. For example, when information indicating that treatment is performed for a stenosis at a predetermined position in a blood vessel of the target region is received, the change function 354 changes the pressure at the predetermined position to a predetermined value. FIG. 3A is a diagram for explaining an example of a pressure change according to the first embodiment. In FIG. 3A, the target region of the blood vessel is shown in the upper stage, the pressure distribution graph from the inlet to the outlet before the condition change is shown in the middle stage, and the graph of the pressure distribution from the inlet to the outlet after the condition change is shown in the lower stage.

  For example, as shown in the upper part of FIG. 3A, when there are “stenosis 1” and “stenosis 2” as target sites in the blood vessel of the target region, the change function 354 changes the pressure To change. For example, in the case of performing a treatment in which a stent is placed on “stenosis 1” in FIG. 3A, the change function 354 changes the pressure at the position of “stenosis 1” in the target region to a value corresponding to the treatment. For example, the change function 354 changes the pressure value based on information on pressure loss in a blood vessel without stenosis. That is, the change function 354 changes the pressure value at the position of “stenosis 1” based on the pressure loss information when there is no stenosis at the distance from the entrance to “stenosis 1” in the same blood vessel as the target region. To do.

  For example, the change function 354 changes the pressure distribution enclosed by the middle ellipse in FIG. 3A to the pressure distribution shown in the corresponding position in the lower part of FIG. 3A. The calculation function 355 calculates an index value in the target region under the pressure condition changed by the change function 354. In other words, the calculation function 355 calculates various index values by performing fluid analysis so that the pressure at the position of “stenosis 1” becomes the pressure after the change. The display control function 356 causes the display 340 to display the index value calculated by the calculation function 355. For example, as shown in FIG. 3A, the display control function 356 changes the pressure at the position corresponding to “stenosis 1” to a predetermined value and causes the display 340 to display the recalculated FFR.

  Here, the change function 354 can change the pressure for each target part when a plurality of target parts are included. For example, the change function 354 can change the pressure for “stenosis 1” and “stenosis 2” shown in FIG. 3A and calculate an index value for each changed condition. That is, the change function 354 can change the conditions for each of the plurality of target parts, and the calculation function 355 can calculate an index value for each condition. The display control function 356 compares and displays the index value related to the blood flow calculated by the calculation function 355 for each analysis condition changed by the change function 354 for a plurality of target sites in the blood vessel.

  FIG. 3B is a diagram illustrating an example of display information displayed by the display control function 356 according to the first embodiment. In FIG. 3B, the FFR simulation result in each condition at the time of treating with respect to two stenosis of the blood vessel shown to FIG. 3A is shown. For example, as shown in FIG. 3B, the display control function 356 displays the FFR analysis result before the change “stenosis 1 (pressure: no change), stenosis 2 (pressure: no change)” and “stenosis 1 (pressure) : No change), FFR analysis result for stenosis 2 (pressure: b), FFR analysis result for changed stenosis 1 (pressure: a), stenosis 2 (pressure: no change), and The FFR analysis results for “stenosis 1 (pressure: a), stenosis 2 (pressure: b)” are compared and displayed.

  Here, the observer refers to the analysis result of FFR shown in FIG. 3B, and shows “stenosis 1 (pressure: a), stenosis rather than“ stenosis 1 (pressure: no change), stenosis 2 (pressure: b) ”. Since “2 (pressure: no change)” has an improved FFR value, it can be determined that treating “stenosis 1” is more effective. Furthermore, the observer can easily determine whether treatment of “stenosis 1” alone or both “stenosis 1” and “stenosis 2” should be treated based on the value of FFR. Can do.

(Changing the cross-sectional area)
Next, a case where the cross-sectional area is changed will be described. In this case, the change function 354 changes the value of the cross-sectional area of the fluid analysis according to the treatment content received by the input circuit 330. For example, when information indicating that treatment is performed for a stenosis at a predetermined position in the blood vessel of the target region is received, the change function 354 changes the cross-sectional area at the predetermined position to a predetermined value. FIG. 4A is a diagram for explaining an example of a cross-sectional area change according to the first embodiment. In FIG. 4A, the target region of the blood vessel is shown in the upper stage, the cross-sectional area of the blood vessel from the inlet to the outlet before the condition change is shown in the middle stage, and the cross-sectional area of the blood vessel from the inlet to the outlet after the condition change is shown in the lower stage. A graph is shown.

  For example, as shown in the upper part of FIG. 4A, when there are “stenosis 1” and “stenosis 2” as target regions in the blood vessel of the target region, the change function 354 has a cross-sectional area corresponding to the treatment for these stenosis. Change the condition. For example, in the case of performing a treatment in which a stent is placed on “stenosis 1” in FIG. 4A, the change function 354 sets the cross-sectional area at the position of “stenosis 1” in the target region to a value corresponding to the cross-sectional area of the stent. Change to For example, the change function 354 acquires the cross-sectional area in the radial cross section of the stent used for treatment, and changes the cross-sectional area at the position corresponding to “stenosis 1” to the acquired cross-sectional area. That is, the change function 354 changes the cross-sectional area of the cross section perpendicular to the core line at the position corresponding to “stenosis 1” to the acquired cross-sectional area in the blood vessel shape data.

  For example, the change function 354 changes the cross-sectional area of the region enclosed by the middle ellipse in FIG. 4A to the cross-sectional area shown in the corresponding position in the lower stage of FIG. 4A. The calculation function 355 calculates an index value in the target region under the cross-sectional area condition changed by the change function 354. That is, the calculation function 355 calculates various index values by performing fluid analysis by changing the cross-sectional area of the position of “stenosis 1” in the blood vessel shape data. The display control function 356 causes the display 340 to display the index value calculated by the calculation function 355. For example, as shown in FIG. 4A, the display control function 356 changes the cross-sectional area at the position corresponding to “stenosis 1” to a value corresponding to the treatment, and displays the recalculated FFR on the display 340.

  Here, the change of the cross-sectional area may be a change based on the above-described stent size, but the change operation may be executed on the image by the observer. FIG. 4B is a diagram illustrating an example of a cross-sectional area changing operation according to the first embodiment. Here, FIG. 4B shows a CPR (Curved Multi Planar Reconstruction) image of the target region of the blood vessel. For example, as illustrated in FIG. 4B, the extraction function 352 extracts a core line from the 3D CT image data acquired by the acquisition function 351, and generates a CPR image in which blood vessels are developed along the extracted core line. Here, the extraction function 352 generates a CPR image so that the stenosis is depicted, as shown in FIG. 4B. Then, the display control function 356 displays the generated CPR image on the display 340, and the input circuit 330 receives an operation for changing the cross-sectional area. For example, as illustrated in FIG. 4B, the input circuit 330 receives an operation for setting a straight line L1 and a straight line L2 on the CPR image.

  The extraction function 352 corrects the blood vessel shape data based on the straight line L1 and the straight line L2 received via the input circuit 330, and re-extracts the cross-sectional area. That is, the extraction function 352 re-extracts the cross-sectional area using the straight line L1 and the straight line L2 as the walls of the lumen of the blood vessel (removing the stenosis region by the straight line L1 and the straight line L2). Note that the CPR image shown in FIG. 4B may be displayed on the display 340 together with the analysis result of the index value. That is, the display control function 356 displays an image showing the shape after changing the cross-sectional area together with the analysis result. Although FIG. 4B shows a CPR image from one direction, the embodiment is not limited to this. For example, when a CPR image developed from a plurality of directions is displayed and used for a cross-sectional area changing operation, for example. It may be.

  Moreover, the change function 354 can change a cross-sectional area about each object part, when the object part contains two or more similarly to the change of a pressure. For example, the change function 354 can change the cross-sectional areas of “stenosis 1” and “stenosis 2” shown in FIG. 4A and calculate an index value for each changed condition. FIG. 4C is a diagram illustrating an example of display information displayed by the display control function 356 according to the first embodiment. FIG. 4C shows the FFR simulation result under each condition when treatment is performed on the two stenosis of the blood vessel shown in FIG. 4A. For example, as shown in FIG. 4C, the display control function 356 displays the FFR analysis result in “stenosis 1 (cross-sectional area: no change), stenosis 2 (cross-sectional area: no change)” before the change and “stenosis 1 after the change”. (Cross sectional area: no change), FFR analysis results for stenosis 2 (cross sectional area: d), and FFR analysis for "stenosis 1 (cross sectional area: c), stenosis 2 (cross sectional area: no change)" after the change The result and the analysis result of FFR in “stenosis 1 (cross-sectional area: c), stenosis 2 (cross-sectional area: d)” after the change are compared and displayed. Here, the observer can determine the effect of the treatment with reference to the FFR analysis result shown in FIG. 4C as in the case of pressure.

(Diameter change)
Next, a case where the diameter is changed will be described. In this case, the change function 354 changes the value of the diameter of the fluid analysis according to the treatment content received by the input circuit 330. For example, when information indicating that treatment is performed for a stenosis at a predetermined position in the blood vessel of the target region is received, the change function 354 changes the diameter at the predetermined position to a predetermined value. FIG. 5A is a diagram for explaining an example of a diameter change according to the first embodiment. In FIG. 5A, the target region of the blood vessel is shown in the upper stage, the graph of the diameter of the blood vessel from the inlet to the outlet before the condition change is shown in the middle stage, and the graph of the blood vessel diameter from the inlet to the outlet after the condition change is shown in the lower stage. Show.

  For example, as shown in the upper part of FIG. 5A, when there are “stenosis 1” and “stenosis 2” as target sites in the blood vessel of the target region, the change function 354 changes the diameter condition according to the treatment for these stenosis. To change. For example, in the case of performing a treatment in which a stent is placed on “stenosis 1” in FIG. 5A, the change function 354 changes the diameter at the position of “stenosis 1” in the target region to a value corresponding to the diameter of the stent. To do. For example, the change function 354 acquires the diameter of the stent used for treatment, and changes the diameter of the position corresponding to “stenosis 1” to the acquired diameter. That is, the change function 354 changes the diameter of the cross section perpendicular to the core line at the position corresponding to “stenosis 1” to the acquired diameter in the blood vessel shape data.

  For example, the change function 354 changes the diameter of the area enclosed by the middle ellipse in FIG. 5A to the diameter shown in the corresponding position in the lower stage of FIG. 5A. The calculation function 355 calculates an index value in the target region under the diameter condition changed by the change function 354. That is, the calculation function 355 calculates various index values by performing fluid analysis by changing the diameter of the position of “stenosis 1” in the blood vessel shape data. The display control function 356 causes the display 340 to display the index value calculated by the calculation function 355. For example, as shown in FIG. 5A, the display control function 356 changes the diameter at the position corresponding to “stenosis 1” to a value corresponding to the treatment, and displays the recalculated FFR on the display 340.

  Here, the change of the diameter may be a change based on the above-described stent size, but the change operation may be executed on the image by the observer. FIG. 5B is a diagram illustrating an example of a diameter changing operation according to the first embodiment. Here, FIG. 5B shows an MPR (Multi Planar Reconstruction) image of a cross section perpendicular to the core line corresponding to the position of “stenosis 1”. For example, as shown in FIG. 5B, the extraction function 352 extracts a core line from the 3D CT image data acquired by the acquisition function 351, and generates an MPR image of a cross section perpendicular to the core line at the position of “stenosis 1”. . Then, the display control function 356 displays the generated MPR image on the display 340, and the input circuit 330 receives a diameter changing operation. For example, as illustrated in FIG. 5B, the input circuit 330 receives an operation for setting a circle L3 on the MPR image.

  The extraction function 352 corrects the blood vessel shape data based on the circle L3 received via the input circuit 330, and re-extracts the diameter. That is, the extraction function 352 re-extracts the diameter with the circle L3 as the wall of the blood vessel lumen. Note that the MPR image shown in FIG. 5B may be displayed on the display 340 together with the analysis result of the index value. FIG. 5B shows an MPR image of one cross section at a position corresponding to “stenosis 1”, but the embodiment is not limited to this, and for example, a plurality of cross sections at a position corresponding to “stenosis 1”. The MPR image may be displayed and used for a diameter changing operation. Further, in the diameter changing operation, the CPR image shown in FIG. 4B may be used. Conversely, the MPR image shown in FIG. 5B may be used in the cross-sectional area changing operation.

  Moreover, the change function 354 can change the diameter for each target part when a plurality of target parts are included. For example, the change function 354 can change the diameter of “stenosis 1” and “stenosis 2” shown in FIG. 5A and calculate an index value for each changed condition. FIG. 5C is a diagram illustrating an example of display information displayed by the display control function 356 according to the first embodiment. FIG. 5C shows the FFR simulation result under each condition when treatment is performed on the two stenosis of the blood vessel shown in FIG. 5A. For example, as shown in FIG. 5C, the display control function 356 displays the FFR analysis result before the change “stenosis 1 (diameter: no change), stenosis 2 (diameter: no change)” and the change “stenosis 1 (diameter). : No change), FFR analysis result in “Stenosis 2 (diameter: f)”, FFR analysis result in “Stenosis 1 (diameter: e), Stenosis 2 (diameter: no change)” after change, and “ The FFR analysis results for “stenosis 1 (diameter: e), stenosis 2 (diameter: f)” are displayed in comparison. Here, the observer can determine the effect of treatment with reference to the FFR analysis result shown in FIG. 5C.

(Change of range)
Next, a case where the range is changed will be described. In this case, the change function 354 changes the analysis range of the fluid analysis according to the treatment content received by the input circuit 330. For example, when information indicating that treatment is performed for a stenosis at a predetermined position in a blood vessel of the target region is received, the change function 354 changes the analysis range so as to delete the predetermined position. FIG. 6A is a diagram for explaining an example of a range change according to the first embodiment. In FIG. 6A, the target area | region of the blood vessel is shown and the analysis range before and behind a change is shown.

  For example, as shown in FIG. 6A, when there are “stenosis 1” and “stenosis 2” as target portions in the blood vessel of the target region, the change function 354 changes the analysis range according to the treatment for these stenosis. . For example, in the case of performing a treatment in which a stent is placed on “stenosis 1” in FIG. 6A, the change function 354 excludes a range corresponding to “stenosis 1” in the target region, as shown in FIG. 6A. The analysis range is changed so that the other range is the target range.

  The calculation function 355 calculates the index value using the range changed by the change function 354 as the analysis target range. That is, the calculation function 355 calculates various index values by performing fluid analysis excluding the position of “stenosis 1” in the blood vessel shape data. For example, in FIG. 6A, the calculation function 355 calculates the pressure value at the left end of the target range on the outlet side using the pressure value at the right end of the target range on the inlet side. That is, the calculation function 355 calculates an index value related to blood flow in the target range on the outlet side, using a value in the target range on the inlet side. The display control function 356 causes the display 340 to display the index value calculated by the calculation function 355. For example, as illustrated in FIG. 6A, the display control function 356 causes the display 340 to display the recalculated FFR excluding the range corresponding to “stenosis 1”.

  Moreover, the change function 354 can change the range for each target part when a plurality of target parts are included. For example, the change function 354 can change the ranges for “stenosis 1” and “stenosis 2” shown in FIG. 6A and calculate an index value for each changed condition. FIG. 6B is a diagram illustrating an example of display information displayed by the display control function 356 according to the first embodiment. FIG. 6B shows the FFR simulation result under each condition when treatment is performed on the two stenosis of the blood vessel shown in FIG. 6A. For example, as shown in FIG. 6B, the display control function 356 displays the FFR analysis result in “stenosis 1 (no change), stenosis 2 (no change)” before the change, and “stenosis 1 (no change), stenosis after the change”. 2 (exclusion) ", FFR analysis result after change, and" Frequency Stenosis 1 (exclusion), stenosis 2 (no change) "FFR analysis result, and after change" stenosis 1 (exclusion), stenosis 2 (exclusion) " The FFR analysis result at is compared and displayed. Here, the observer can determine the effect of treatment with reference to the FFR analysis result shown in FIG. 6B.

  The processing functions of the processing circuit 350 have been described above. Here, for example, each processing function described above is stored in the storage circuit 320 in the form of a program executable by a computer. The processing circuit 350 reads each program from the storage circuit 320 and executes each read program, thereby realizing a processing function corresponding to each program. In other words, the processing circuit 350 in a state where each program is read out has each processing function shown in FIG.

  In addition, although the example in case each processing function is implement | achieved by the single processing circuit 350 was demonstrated in FIG. 1, embodiment is not restricted to this. For example, the processing circuit 350 may be configured by combining a plurality of independent processors, and each processor may implement each processing function by executing each program. In addition, each processing function of the processing circuit 350 may be realized by being appropriately distributed or integrated into a single or a plurality of processing circuits.

  Next, a processing procedure performed by the image processing apparatus 300 according to the first embodiment will be described. FIG. 7 is a flowchart illustrating a processing procedure performed by the image processing apparatus 300 according to the first embodiment. Here, step S101 in FIG. 7 is realized by, for example, the processing circuit 350 calling and executing a program corresponding to the acquisition function 351 from the storage circuit 320. Moreover, step S102 and step S104 are implement | achieved when the processing circuit 350 calls and executes the program corresponding to the calculation function 355 from the memory circuit 320, for example. Moreover, step S103 and step S104 are implement | achieved when the processing circuit 350 calls and executes the program corresponding to the change function 354 from the memory circuit 320, for example. Further, step S105 is realized by the processing circuit 350 calling and executing a program corresponding to the display control function 356 from the storage circuit 320, for example.

  In the image processing apparatus 300 according to the present embodiment, first, the processing circuit 350 acquires time-series three-dimensional CT image data (step S101). Then, the processing circuit 350 calculates an index value for the target range (step S102). Subsequently, the processing circuit 350 determines whether or not a change operation has been accepted (step S103). Here, when the change operation is accepted (Yes at Step S103), the processing circuit 350 changes the condition of the fluid analysis and calculates the index value again (Step S104). Furthermore, the processing circuit 350 compares and displays the index value for each condition (step S105).

  As described above, according to the first embodiment, the calculation function 355 calculates an index value related to blood flow of a blood vessel by fluid analysis using image data including the blood vessel. The change function 354 changes the analysis conditions of the fluid analysis for the target site in the blood vessel. The display control function 356 compares and displays the index value related to the blood flow calculated by the calculation function 355 for each analysis condition changed by the change function 354 for a plurality of target sites in the blood vessel. Therefore, the image processing apparatus 300 according to the first embodiment makes it possible to determine in advance the therapeutic effect on the blood circulation disorder with respect to a plurality of target parts.

  In addition, according to the first embodiment, the display control function 356 displays a plurality of index values calculated for each analysis condition in association with information indicating the analysis condition used for the calculation. Therefore, the image processing apparatus 300 according to the first embodiment makes it possible to easily determine the therapeutic effect on a plurality of target parts.

  Further, according to the first embodiment, the change function 354 includes, as analysis conditions, the pressure at the target site, the condition of the stent placed in the target site, the cross-sectional area at the target site, the shape at the target site, and the analysis target range. Alternatively, the procedure applied to the target part is changed. Therefore, the image processing apparatus 300 according to the first embodiment can execute the fluid analysis reflecting the change due to the treatment.

  Further, according to the first embodiment, the calculation function 355 uses at least one of FFR, pressure, blood flow rate, blood flow rate, vector, and shear stress at each position of the blood vessel as an index value related to blood flow. calculate. Therefore, the image processing apparatus 300 according to the first embodiment can determine the therapeutic effect using various index values related to blood flow.

  As described above, the image processing apparatus 300 according to the first embodiment changes the analysis condition, calculates an index value related to blood flow, and displays the index value for comparison. Can be determined in advance. Furthermore, since the image processing apparatus 300 calculates the index value by changing information related to blood flow such as pressure, for example, the processing load and processing time related to fluid analysis can be reduced. That is, the image processing apparatus 300 can perform the fluid analysis without changing the shape of the blood vessel by calculating the index value by changing the blood flow system information. In recent years, the volume of data has been increased with the increase in definition of volume data, so that the processing load related to fluid analysis increases and the processing time can be longer. On the other hand, the image processing apparatus 300 according to the first embodiment corrects blood flow information such as pressure and performs fluid analysis without changing the shape of the blood vessel, thereby processing load and processing. Time can be reduced.

(Second Embodiment)
Next, a second embodiment will be described. Note that the configuration of the image processing apparatus according to the present embodiment is basically the same as the configuration of the image processing apparatus 300 shown in FIG. Therefore, in the following, differences from the image processing apparatus 300 according to the first embodiment will be mainly described, and components having the same functions as those illustrated in FIG. Detailed description is omitted.

  In 1st Embodiment mentioned above, the case where the treatment effect was determined by changing conditions according to treatment was demonstrated. In the second embodiment, a case where a highly effective treatment is presented will be described. For example, when placing a stent against a stenosis, the image processing apparatus 300 according to the second embodiment executes a simulation by switching the position where the stent is placed, the size of the stent, and the like, and presents the result.

  The change function 354 according to the second embodiment changes at least one of the position where the stent is disposed, the length of the stent, and the diameter of the stent as a condition of the stent. FIG. 8A and FIG. 8B are diagrams for explaining stent condition change by the change function 354 according to the second embodiment. Here, FIG. 8A shows a case where the position of the stent is changed. FIG. 8B shows a case where the length of the stent is changed.

  For example, as shown in FIG. 8A, the change function 354 changes the placement of the stent relative to the stenosis little by little, and the calculation function 355 calculates the FFR value in each placement. As an example, the change function 354 calculates the FFR value at each position while keeping the size of the stent constant and shifting the placement position. The display control function 356 presents information on the position where the FFR value is the highest to the observer. For example, as shown in FIG. 8A, the display control function 356 causes the display 340 to display a CPR image in which the stent image is arranged at the position where the FFR value is the highest. Thereby, the observer can grasp | ascertain easily the indwelling position of the stent with a high effect.

  Further, as shown in FIG. 8B, the change function 354 gradually changes the size of the stent to be placed for the stenosis, and the calculation function 355 calculates the FFR value at each size. Here, when the stent is placed in the body, the smaller the size, the less the influence on the subject. Therefore, the change function 354 changes the size of the stent in ascending order to calculate the FFR value. For example, the change function 354 changes the stent size from a short stent to a predetermined length in order, and calculates the FFR value at each size. In addition, the change function 354 changes the stent size from a stent having a smaller diameter to a predetermined size, for example, and calculates the FFR value at each size.

  Here, the upper limit of the length and diameter may be determined based on the size of the indwelling blood vessel. That is, the change function 354 sets the lower limit and the upper limit range of the length and diameter of the stent to be placed based on the size of the blood vessel in which the stent is placed (for example, the diameter and the thickness of the blood vessel wall). Then, the change function 354 changes the stent in order from the shortest or the smallest diameter in the set range to calculate the FFR value.

  In the display control function 356 according to the second embodiment, when at least one of the length and the diameter of the stent is changed as an analysis condition, the shortest length and the minimum of the stent in which the FFR in the blood vessel exceeds a predetermined value. Display at least one of the diameters. That is, the display control function 356 displays information on a stent having the least influence on the subject among stents having a high therapeutic effect. For example, the display control function 356 causes the display 340 to display the stent condition when the FFR value exceeds a predetermined threshold (for example, 0.9).

  Next, a processing procedure performed by the image processing apparatus 300 according to the second embodiment will be described. FIG. 9 is a flowchart illustrating a processing procedure performed by the image processing apparatus 300 according to the second embodiment. Here, step S201 in FIG. 9 is realized, for example, when the processing circuit 350 calls and executes a program corresponding to the acquisition function 351 from the storage circuit 320. Further, step S202 is realized, for example, when the processing circuit 350 calls and executes a program corresponding to the change function 354 and the calculation function 355 from the storage circuit 320. Further, step S203 and step S204 are realized, for example, when the processing circuit 350 calls and executes a program corresponding to the display control function 356 from the storage circuit 320.

  In the image processing apparatus 300 according to the present embodiment, first, the processing circuit 350 acquires time-series three-dimensional CT image data (step S201). Then, the processing circuit 350 calculates an index value for each stent condition (step S202). Subsequently, the processing circuit 350 determines whether or not the index value exceeds a predetermined threshold (step S203). Here, when the predetermined threshold value is exceeded (Yes at Step S203), the processing circuit 350 displays the condition of the stent whose index value exceeds the predetermined threshold value (Step S204).

  As described above, according to the second embodiment, the changing function 354 changes at least one of the position where the stent is placed, the length of the stent, and the diameter of the stent as the stent condition. Therefore, the image processing apparatus 300 according to the second embodiment makes it possible to present conditions for a stent having a high therapeutic effect.

  In addition, according to the second embodiment, the display control function 356 is configured so that when at least one of the length and the diameter of the stent is changed as an analysis condition, the shortest of the stent in which the FFR in the blood vessel exceeds a predetermined value. At least one of the length and the minimum diameter is displayed. Therefore, the image processing apparatus 300 according to the second embodiment makes it possible to present a condition for a stent that has a small influence on a subject and has a high therapeutic effect.

(Third embodiment)
Although the first and second embodiments have been described so far, the present invention may be implemented in various different forms other than the first and second embodiments described above.

  In the above-described embodiment, the case where FFR is calculated as an index value related to blood flow has been described as an example. However, the embodiment is not limited to this, for example, pressure, flow velocity, flow rate, vector, and shear stress. May be calculated. For example, when the cross-sectional area and the diameter are changed, the pressure, the flow rate, the flow velocity, and the like may be calculated. In addition, when the range, shape, or the like is changed, pressure, flow velocity, flow rate, vector, shear stress, and the like may be calculated.

  In the above-described embodiment, the case where the cross-sectional area and the diameter of the blood vessel are changed has been described. However, the embodiment is not limited thereto, and for example, the shape of the blood vessel may be changed. . For example, FFR, pressure, flow velocity, flow rate, vector, shear stress, etc. may be calculated when a bypass is formed in a blood vessel.

  In the above-described embodiment, the case where the coronary artery is a target has been described. However, the embodiment is not limited to this, and for example, for determining a therapeutic effect when a stent is placed in a carotid artery or a femoral artery. It may be used.

  Moreover, in embodiment mentioned above, the case where a stent was detained was mentioned as an example as a technique with respect to an object site | part, and was demonstrated. However, the embodiment is not limited to this, and various techniques can be applied. Specifically, the change function 354 changes the procedure performed on the target part. Hereinafter, an example in which the image processing apparatus 300 described in the first embodiment and the image processing apparatus 300 described in the second embodiment change the technique applied to the target part will be described.

  For example, when changing the condition according to the treatment described in the first embodiment, the change function 354 in the image processing apparatus 300 changes the procedure to be performed on the selected target region, and changes the procedure to the changed procedure. Accordingly, the pressure at the target site, the cross-sectional area at the target site, the shape at the target site, or the analysis target range is changed. That is, the change function 354 changes the above-described conditions according to the procedure content (treatment content) received via the input circuit 330, and the calculation function 355 calculates the index value under the changed condition.

  Here, the input circuit 330, as a technique, in addition to the placement of the above-described stent, drug therapy, DCA (Directional Coronary Atherectomy), rotablator (Rotational Coronary Atherectomy) )) And other specified operations are accepted. For example, when the input circuit 330 accepts a drug therapy designation operation, the change function 354 changes the pressure at the target site, the cross-sectional area at the target site, the shape at the target site, or the analysis target range according to the effect of the drug. Change it. For example, the change function 354 changes the pressure at the target site to a value corresponding to the content of the drug therapy plan input by the user (for example, a pressure value based on pressure loss information in a blood vessel without stenosis). .

  Similarly, the change function 354 can change the cross-sectional area and shape at the target site, and the analysis target range to values corresponding to the content of the drug therapy plan. Note that the degree of change according to drug therapy can be arbitrarily set. For example, the degree of change is set in advance for each type and amount of the drug, sex and age of the subject to be administered, and the state of the target region, and the change function 354 receives those input via the input circuit 330. Based on the information, the pressure at the target part, the cross-sectional area at the target part, the shape at the target part, or the analysis target range is changed. When the technique for the target site is drug therapy and the change function 354 changes the analysis target range, the analysis target range is changed for all target sites (treatment target sites) in the blood vessel. .

  Further, for example, when the input circuit 330 accepts a DCA or rotabrator designation operation, the change function 354 causes the pressure at the target site to be changed according to the effect of the blood vessel shape change estimated by simulating the DCA or rotablator procedure. The cross-sectional area in the target part, the shape in the target part, or the analysis target range is changed. For example, the change function 354 may change the pressure at the target site to a value corresponding to DCA or a rotablator (for example, a pressure value estimated when a calcification region scheduled to be excised at the target site is excluded). change. For example, the change function 354 changes the pressure value according to the ratio of the calcified region cut by the DCA or the rotablator.

Similarly, the change function 354 can change the cross-sectional area and shape of the target part and the analysis target range to values corresponding to the procedure contents of the DCA or rotablator. Note that the degree of change according to DCA or rotablator can be appropriately adjusted by receiving information such as the proportion of the calcified region to be excised and the position to be excised.
As described above, when the change function 354 changes the condition, the calculation function 355 calculates the index value again under the changed condition. Then, the display control function 356 compares and displays the index value for each condition.

  Next, an example will be described in which the image processing apparatus 300 described in the second embodiment changes the technique applied to the target part. In this case, the image processing apparatus 300 switches the content of the technique applied to the target part, executes the simulation, and presents the result.

  For example, the input circuit 330 accepts a DCA and rotablator designation operation as the type of procedure for which a simulation is desired for the target part. The change function 354 changes the pressure value at the target site to a pressure value according to DCA and a pressure value according to the rotablator, respectively. The calculation function 355 calculates the FFR value for each of the pressure value corresponding to the DCA and the pressure value corresponding to the rotablator. The display control function 356 presents to the observer information on a procedure that increases the degree of improvement in the FFR value. Thereby, the observer can easily grasp a highly effective procedure.

  Further, the above-described embodiment is not limited to three-dimensional fluid analysis, and may be applied to two-dimensional or one-dimensional fluid analysis.

  In each of the above-described embodiments, an example has been described in which 3D CT image data collected by an X-ray CT apparatus is used as time-series 3D medical image data in which a blood vessel of a subject is depicted. The embodiment is not limited to this. For example, medical images collected by other medical image diagnostic apparatuses may be used as time-series three-dimensional medical image data. For example, a medical image collected by an MRI apparatus, an ultrasonic diagnostic apparatus, or the like may be used.

  In the above-described embodiment, the case where the image processing apparatus 300 executes various processes has been described. However, the embodiment is not limited to this, and for example, various processes may be executed in the medical image diagnostic apparatus. In such a case, a medical image diagnostic apparatus such as an X-ray CT apparatus, an MRI apparatus, or an ultrasonic diagnostic apparatus has a processing circuit similar to the processing circuit 350 and performs the above-described processing using the collected medical image data. Run.

  The term “processor” used in the description of each embodiment described above is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC). Circuits such as programmable logic devices (for example, Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)) Means. Here, instead of storing the program in the storage circuit, the program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit. In addition, each processor of the present embodiment is not limited to being configured as a single circuit for each processor, but may be configured as a single processor by combining a plurality of independent circuits to realize its function. Good.

  Here, the program executed by the processor is provided by being incorporated in advance in a ROM (Read Only Memory), a storage unit, or the like. This program is a file in a format installable or executable in these apparatuses, such as a CD (Compact Disk) -ROM, an FD (Flexible Disk), a CD-R (Recordable), a DVD (Digital Versatile Disk), or the like. It may be provided by being recorded on a computer-readable storage medium. The program may be provided or distributed by being stored on a computer connected to a network such as the Internet and downloaded via the network. For example, this program is composed of modules including each functional unit described later. As actual hardware, the CPU reads a program from a storage medium such as a ROM and executes it, whereby each module is loaded on the main storage device and generated on the main storage device.

  According to at least one embodiment described above, it is possible to determine in advance the therapeutic effect on a blood circulation disorder.

  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.

300 Image Processing Device 320 Storage Circuit 350 Processing Circuit 354 Change Function 355 Calculation Function 356 Display Control Function

Claims (11)

A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing the analysis conditions of the fluid analysis corresponding to the location of the target part;
A display control unit for comparing and displaying an index value related to the blood flow calculated by the calculation unit for each of the analysis conditions changed by the changing unit for a plurality of the target sites;
An image processing apparatus comprising:   The image processing apparatus according to claim 1, wherein the display control unit displays a plurality of index values calculated for each analysis condition in association with information indicating the analysis condition used for the calculation.   The changing unit includes, as the analysis conditions, pressure in the target site, conditions of a stent placed in the target site, a cross-sectional area in the target site, a shape in the target site, an analysis target range, or the target site The image processing apparatus according to claim 1, wherein a procedure performed on the image processing apparatus is changed.   The image processing apparatus according to claim 3, wherein the changing unit changes at least one of a position where the stent is disposed, a length of the stent, and a diameter of the stent as the conditions of the stent.   The calculation unit calculates at least one of a myocardial blood flow reserve ratio, a pressure, a blood flow rate, a blood flow rate, a vector, and a shear stress at each position of the blood vessel as an index value related to the blood flow. Item 5. The image processing apparatus according to any one of Items 1 to 4.   The display control unit, when at least one of the length and diameter of the stent is changed as the analysis condition, the shortest length of the stent in which the myocardial blood flow reserve ratio in the blood vessel exceeds a predetermined value The image processing apparatus according to claim 4, wherein at least one of the minimum diameter and the minimum diameter is displayed. A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing a pressure condition used for the fluid analysis related to the target part;
A display control unit for comparing and displaying an index value related to the blood flow before and after the change of the pressure condition;
An image processing apparatus comprising: A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing an analysis range of the fluid analysis so as to exclude the target portion;
A display control unit for comparing and displaying index values related to the blood flow before and after the change of the analysis range;
An image processing apparatus comprising: A collection unit for collecting image data including blood vessels;
A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing the analysis conditions of the fluid analysis corresponding to the location of the target part;
A display control unit for comparing and displaying an index value related to the blood flow calculated by the calculation unit for each of the analysis conditions changed by the changing unit for a plurality of the target sites;
A medical image diagnostic apparatus comprising: A collection unit for collecting image data including blood vessels;
A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing a pressure condition used for the fluid analysis related to the target part;
A display control unit for comparing and displaying an index value related to the blood flow before and after the change of the pressure condition;
A medical image diagnostic apparatus comprising: A collection unit for collecting image data including blood vessels;
A calculation unit that calculates an index value related to blood flow of the blood vessel by fluid analysis using image data including the blood vessel;
A setting unit for setting a plurality of target sites in the blood vessel in the image data;
A changing unit for changing an analysis range of the fluid analysis so as to exclude the target portion;
A display control unit for comparing and displaying index values related to the blood flow before and after the change of the analysis range;
A medical image diagnostic apparatus comprising: