JP2018075080A - Image diagnostic device, and control method and program of image diagnostic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To acquire supplementary information in appropriately inserting a guide wire through a desired region of interest.SOLUTION: An image diagnostic device includes an image acquisition part for acquiring ultrasonic tomographic images and optical tomographic images using a probe equipped with an ultrasonic transmission/reception part and a light transmission/reception part, a generation part for generating an image used for determining a region of interest based on the optical tomographic image, a determination part for determining the region of interest in the image, and a specification part for specifying an ultrasonic tomographic interest image corresponding to the region of interest of the ultrasonic tomographic images.SELECTED DRAWING: Figure 5

Description

  The present invention relates to an image diagnostic apparatus, a control method for the image diagnostic apparatus, and a program.

  Ultrasound for observing the nature of the stenosis, or for observing the condition after treatment, during percutaneous treatment of a stenosis that causes myocardial infarction that occurs in a body lumen such as blood vessels and vessels Alternatively, a diagnostic catheter that acquires an image of a living body lumen using a test wave such as light is used.

  In intravascular ultra sound (IVUS), an imaging core having an ultrasonic transducer is rotatably provided at the distal end of an insertion portion, and is inserted into a body cavity and then extends from a driving portion on the hand side. In general, scanning (radial scanning) is performed while rotating through a drive shaft or the like.

  Further, in optical coherence tomography (OCT) using wavelength sweep, an optical probe section in which an imaging core having an optical lens and an optical mirror (transmission / reception section) attached to the tip of an optical fiber is inserted into a blood vessel. It is inserted into the tube, and while the imaging core is rotated, measurement light is emitted from the transmitting / receiving unit at the tip into the blood vessel, and reflected light from the living tissue is received to perform radial scanning in the blood vessel. In general, a blood vessel cross-sectional image is drawn based on interference light generated by causing interference between the received reflected light and reference light.

  OCT can obtain a high-resolution image with respect to the luminal surface of the blood vessel, but only an image from the luminal surface of the blood vessel to a relatively shallow tissue can be obtained. On the other hand, in the case of IVUS, the image resolution obtained is lower than that of OCT, but conversely, an image of vascular tissue deeper than that of OCT can be obtained. Therefore, recently, an image diagnostic apparatus having an imaging core equipped with a dual sensor combining an IVUS function and an OCT function (an ultrasonic transmission / reception unit capable of transmitting / receiving ultrasonic waves, and an optical transmission / reception unit capable of transmitting / receiving light) Has been proposed (see Patent Document 1).

  In endovascular treatment using a high-function catheter, a stent may be placed at a blood vessel bifurcation. Then, for the purpose of securing blood flow from the main trunk of the blood vessel to the side branch and placing the stent on the side branch, secondary treatment may be performed on the stent placed on the main trunk. At that time, the guide wire may be inserted into the side branch through one of the cells of the stent placed on the main trunk. On the other hand, Patent Document 2 discloses a technique for presenting a guideline indicating which cell should be passed through a cell using an OCT image.

  On the other hand, using IVUS that does not require blood removal at the time of image acquisition, a guide wire is inserted into a cell while observing the IVUS image.

JP 11-56752 A International Publication No. 2015-044987 Specification

  However, the current situation is that it still depends on the user's experience and skill to identify the desired cell for the IVUS image and insert the guide wire.

  The present invention has been made in view of the above-described problems, and an object of the present invention is to provide a technique for assisting in appropriately inserting a guide wire through a desired region of interest.

In order to achieve the above object, an image diagnostic apparatus according to an aspect of the present invention comprises the following arrangement. That is,
An image acquisition means for acquiring an ultrasonic tomographic image and an optical tomographic image using a probe comprising an ultrasonic transmission / reception unit and an optical transmission / reception unit;
Generating means for generating an image used to determine a region of interest based on the optical tomographic image;
Determining means for determining the region of interest on the image;
A specifying means for specifying an ultrasonic tomographic image of interest corresponding to the region of interest in the ultrasonic tomographic image;
It is characterized by providing.

  ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to assist at the time of inserting a guide wire appropriately through a desired region of interest. By appropriately presenting information for assisting, for example, at the bifurcation of a blood vessel in which a stent is placed, assistance for inserting a guide wire into a side branch can be realized for an IVUS image.

1 is a diagram illustrating an external configuration of an image diagnostic apparatus according to an embodiment of the present invention. It is a figure which shows the structure of the diagnostic imaging apparatus (a control apparatus and its peripheral device) which concerns on one Embodiment of this invention. It is a figure for demonstrating the reconstruction process of the cross-sectional image which concerns on one Embodiment of this invention. It is a figure which shows the example of the three-dimensional model data of the reconfigure | reconstructed blood vessel which concerns on one Embodiment of this invention. It is a flowchart which shows the procedure of the process which the diagnostic imaging apparatus which concerns on one Embodiment of this invention implements. It is a figure which shows an example of the image used for determination of the region of interest based on one Embodiment of this invention, an optical tomography interest image, and an ultrasonic tomography interest image. It is a figure which shows an example of a display of the ultrasonic tomographic image which is a real-time image and the ultrasonic tomographic image of interest image which is a reference image based on one Embodiment of this invention. It is a figure which shows an example of the display of the similarity degree of the ultrasonic tomographic image which is a real-time image, and the ultrasonic tomographic image of interest which is a reference image based on one Embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. The embodiment described below is a preferred specific example of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.

<1. External configuration of diagnostic imaging apparatus>
The diagnostic imaging apparatus according to this embodiment will be described as having an IVUS function and an OCT function. FIG. 1 is a diagram showing an external configuration of an image diagnostic apparatus 100 according to an embodiment of the present invention. As shown in FIG. 1, the diagnostic imaging apparatus 100 includes a probe 101, a scanner and pullback unit 102, a control device 103, and a display device 113, and the scanner and pullback unit 102 and control device 103 include a connector 105. Via a cable 104 containing a signal line or an optical fiber. In the present embodiment, the control device 103 and the display device 113 are described as separate units. However, the control device 103 may include the display device 113.

  The probe 101 is inserted directly into a blood vessel, transmits an ultrasonic wave based on a pulse signal and receives a reflected wave from the blood vessel, and transmitted light (measurement light). Is inserted into a blood vessel, and a catheter that houses an imaging core including an optical transmission / reception unit that continuously receives reflected light from the blood vessel is inserted. The diagnostic imaging apparatus 100 measures the state inside the blood vessel by using the imaging core.

  The scanner and pullback unit 102 is detachably attached to the probe 101, and operates in the axial direction and rotational direction in the blood vessel of the imaging core in the catheter inserted into the probe 101 by driving a built-in motor. Is stipulated. In addition, the scanner and pullback unit 102 acquires the reflected wave signal received by the ultrasonic transmission / reception unit in the imaging core and the reflected light received by the optical transmission / reception unit, and transmits them to the control device 103.

  The control device 103 has a function for inputting various set values when performing measurement, and a function for processing ultrasonic data and optical interference data obtained by the measurement and displaying various blood vessel images.

  In the control device 103, reference numeral 111 denotes a main body control unit. The main body control unit 111 generates line data from an ultrasonic reflected wave signal obtained by measurement, and generates an ultrasonic tomographic image (IVUS image) through interpolation processing. Further, the main body control unit 111 generates interference light data by causing interference between reflected light from the imaging core and reference light obtained by separating light from the light source, and based on the interference light data Line data is generated, and an optical tomographic image of a blood vessel based on optical interference is generated through interpolation processing.

  Reference numeral 111-1 denotes a printer and a DVD recorder, which prints processing results in the main body control unit 111 or stores them as data. Reference numeral 112 denotes an operation panel, and the user inputs various setting values and instructions via the operation panel 112. Reference numeral 113 denotes an LCD monitor as a display device, which displays various cross-sectional images generated by the main body control unit 111. Reference numeral 114 denotes a mouse as a pointing device (coordinate input device).

<2. Functional configuration of diagnostic imaging device (mainly control device)>
Next, the functional configuration of the diagnostic imaging apparatus 100 (mainly the control apparatus 103) will be described. FIG. 2 is a block configuration diagram of the diagnostic imaging apparatus 100. Hereinafter, the functional configuration for realizing wavelength-sweep optical coherence tomographic image diagnosis will be described with reference to FIG.

  In the figure, reference numeral 201 denotes a signal processing unit that controls the entire diagnostic imaging apparatus, and is composed of several circuits including a microprocessor. Reference numeral 210 denotes a non-volatile storage device represented by a hard disk, which stores various programs and data files executed by the signal processing unit 201. Reference numeral 202 denotes a memory (RAM) provided in the signal processing unit 201. A wavelength swept light source 203 is a light source that repeatedly generates light having a wavelength that changes within a preset range along the time axis. Here, an image acquisition unit 2010 acquires an ultrasonic tomographic image (IVUS image) or an optical tomographic image captured by an imaging core 250 described later. Reference numeral 2011 denotes a control unit that performs various processes and controls display on the display device 113. Reference numeral 2012 denotes a selection receiving unit. When the operation panel 112 and the display device 113 have a touch function, an input from the user is received through the display device 113, the mouse 114, and the like, and various selection processes are performed.

  The light output from the wavelength swept light source 203 is incident on one end of the first single mode fiber 271 and transmitted toward the distal end side. The first single mode fiber 271 is optically coupled to the fourth single mode fiber 275 at an intermediate optical fiber coupler 272.

  The light incident on the first single mode fiber 271 and emitted from the optical fiber coupler 272 toward the tip side is guided to the second single mode fiber 273 via the connector 105. The other end of the second single mode fiber 273 is connected to the optical rotary joint 230 in the pullback unit 102.

  On the other hand, the probe 101 has an adapter 101 a for connecting to the pullback unit 102. And the probe 101 is stably hold | maintained at the pull back part 102 by connecting the probe 101 to the pull back part 102 with the adapter 101a. Further, the end of the third single mode fiber 274 rotatably accommodated in the probe 101 is connected to the optical rotary joint 230. As a result, the second single mode fiber 273 and the third single mode fiber 274 are optically coupled. An imaging core equipped with an optical transmission / reception unit including a mirror and a lens that emits light in a direction substantially orthogonal to the rotation axis at the other end of the third single mode fiber 274 (on the leading portion side of the probe 101). 250 is provided.

  As a result, the light emitted from the wavelength swept light source 203 passes through the first single mode fiber 271, the second single mode fiber 273, and the third single mode fiber 274 to the end of the third single mode fiber 274. Guided to an imaging core 250 provided in the section. The optical transmission / reception unit of the imaging core 250 emits this light in a direction substantially perpendicular to the axis of the fiber, receives the reflected light, and the received reflected light is led backwards this time to the control device 103. returned.

  On the other hand, an optical path length adjustment mechanism 220 for finely adjusting the optical path length of the reference light is provided at the opposite end of the fourth single mode fiber 275 coupled to the optical fiber coupler 272. The optical path length adjusting mechanism 220 functions as an optical path length changing unit that changes the optical path length corresponding to the variation in length so that the variation in length of each probe 101 can be absorbed when the probe 101 is replaced. Therefore, the collimating lens 225 located at the end of the fourth single mode fiber 275 is provided on the movable uniaxial stage 224 as indicated by an arrow 226 that is the optical axis direction.

  Specifically, when the probe 101 is replaced, the uniaxial stage 224 functions as an optical path length changing unit having a variable range of the optical path length that can absorb variations in the optical path length of the probe 101. Further, the uniaxial stage 224 also has a function as an adjusting means for adjusting the offset. For example, even when the tip of the probe 101 is not in close contact with the surface of the living tissue, the optical path length can be minutely changed by the uniaxial stage so as to interfere with the reflected light from the surface position of the living tissue. Is possible.

  The optical path length is finely adjusted by the uniaxial stage 224, and the light reflected by the mirror 223 via the grating 221 and the lens 222 is again guided to the fourth single mode fiber 275, and the second optical fiber coupler 272 performs the second operation. Are mixed with light obtained from the single mode fiber 273 side and received by the photodiode 204 as interference light.

  The interference light received by the photodiode 204 in this manner is photoelectrically converted, amplified by the amplifier 205, and then input to the demodulator 206. The demodulator 206 performs a demodulation process for extracting only the signal portion of the interfered light, and its output is input to the A / D converter 207 as an interference light signal.

  The A / D converter 207 samples the interference light signal for 2048 points at 90 MHz, for example, and generates one line of digital data (interference light data). The sampling frequency of 90 MHz is based on the assumption that about 90% of the wavelength sweep cycle (25 μsec) is extracted as 2048 digital data when the wavelength sweep repetition frequency is 40 kHz. There is no particular limitation.

  The line-by-line interference light data generated by the A / D converter 207 is input to the signal processing unit 201 and temporarily stored in the memory 202. In the signal processing unit 201, the interference light data is subjected to frequency decomposition by FFT (Fast Fourier Transform) to generate data in the depth direction (line data), and this is coordinate-converted to obtain data at each position in the blood vessel. An optical tomographic image is constructed and output to the display device 113 at a predetermined frame rate.

  The signal processing unit 201 is further connected to an optical path length adjustment driving unit 209 and a communication unit 208. The signal processing unit 201 controls the position of the uniaxial stage 224 (optical path length control) via the optical path length adjustment driving unit 209.

  The communication unit 208 incorporates several drive circuits and communicates with the pullback unit 102 under the control of the signal processing unit 201. Specifically, an encoder unit for supplying a drive signal to the radial scanning motor for rotating the third single mode fiber 274 by the optical rotary joint 230 in the pull-back unit 102 and detecting the rotational position of the radial motor. It is used for receiving a signal from 242 and supplying a drive signal to the linear drive unit 243.

  Note that the above processing in the signal processing unit 201 is also realized by a predetermined program being executed by a computer.

  In the above configuration, the probe 101 is positioned at a blood vessel position (such as a coronary artery) to be diagnosed by the patient, and a transparent flush liquid is emitted into the blood vessel through a guiding catheter or the like toward the tip of the probe 101 by a user operation. Let This is to exclude the influence of blood. When the user inputs an instruction to start scanning, the signal processing unit 201 drives the wavelength swept light source 203 to drive the radial scanning motor 241 and the linear driving unit 243 (hereinafter, the radial scanning motor 241 and the linear driving unit). (Light irradiation and light reception processing by driving 243 is also referred to as scanning). As a result, the wavelength swept light is supplied from the wavelength swept light source 203 to the imaging core 250 through the path as described above. At this time, since the imaging core 250 at the distal end position of the probe 101 moves along the rotation axis while rotating, the imaging core 250 moves while moving along the blood vessel axis while rotating. The light is emitted to the surface and the reflected light is received.

  Here, a process for generating one optical tomographic image will be briefly described with reference to FIG. This figure is a view for explaining the reconstruction processing of the tomographic image of the lumen surface 301 of the blood vessel in which the imaging core 250 is located. While the imaging core 250 makes one rotation (360 degrees), the measurement light is transmitted and received a plurality of times. With one transmission / reception of light, data of one line in the direction of irradiation with the light can be obtained. Accordingly, 512 line data extending radially from the rotation center 302 can be obtained by transmitting and receiving light 512 times, for example, during one rotation. The 512 line data are dense in the vicinity of the rotation center position and become sparse with each other as they move away from the rotation center position. Therefore, the pixels in the vacant space of each line are generated by performing a well-known interpolation process to generate a two-dimensional tomographic image that can be seen by humans.

  Then, as shown in FIG. 4, a three-dimensional blood vessel image 402 can be obtained by connecting the generated two-dimensional tomographic images 401 to each other along the blood vessel axis. It should be noted that the center position of the two-dimensional tomographic image coincides with the rotation center position of the imaging core 250, but is not the center position of the blood vessel cross section. In addition, although it is weak, since light is reflected by the lens surface of the imaging core 250, the surface of the catheter, etc., as shown by the reference numeral 303 in the figure, several concentric circles are generated with respect to the rotation center axis.

  Next, a configuration related to image formation using ultrasonic waves and its processing contents will be described. Scanning using ultrasonic waves is performed simultaneously with the above-described scanning of optical interference. That is, while scanning and rotating the imaging core 250 while moving in the catheter sheath of the probe 101, the ultrasonic wave is emitted from the ultrasonic transmission / reception unit accommodated in the imaging core 250 and the reflected wave is detected. I do. For this reason, it is necessary to generate a drive signal for driving the ultrasonic transmission / reception unit accommodated in the imaging core 250 and to receive an ultrasonic detection signal output from the ultrasonic transmission / reception unit. The ultrasonic transmission / reception control unit 232 performs transmission of the drive signal and reception of the detected signal. The ultrasonic transmission / reception control unit 232 and the imaging core 250 are connected via signal line cables 281, 282, and 283. Since the imaging core 250 rotates, the signal line cables 282 and 283 are electrically connected via the slip ring 231 provided in the pullback unit 102. In the figure, the signal line cables 281 to 283 are shown as being connected by a single line, but actually, a plurality of signal lines are accommodated.

  The ultrasonic transmission / reception control unit 232 operates under the control of the signal processing unit 201, drives the ultrasonic transmission / reception unit accommodated in the imaging core 250, and generates ultrasonic pulse waves. The ultrasonic transmission / reception unit converts the reflected wave from the vascular tissue into an electric signal and supplies the electric signal to the ultrasonic transmission / reception control unit 232. The ultrasonic transmission / reception control unit 232 outputs the received ultrasonic signal to the amplifier 233 for amplification. Thereafter, the amplified ultrasonic signal passes through the detector 234 and the A / D converter 235, is supplied to the signal processing unit 201 as ultrasonic data, and is temporarily stored in the memory 202. The A / D converter 235 samples the ultrasonic signal output from the detector 234 for 200 points at 30.6 MHz to generate one line of digital data (ultrasound data). Here, 30.6 MHz is assumed, but this is calculated on the assumption that 200 points are sampled at a depth of 5 mm when the sound speed is 1530 m / sec. Therefore, the sampling frequency is not particularly limited to this.

  The signal processing unit 201 generates an ultrasound image at each position in the blood vessel by converting the ultrasound data stored in the memory 202 into a gray scale.

<3. Processing>
Next, a procedure of processing performed by the diagnostic imaging apparatus 100 according to an embodiment of the present invention will be described with reference to the flowchart of FIG. When performing a procedure of passing a guide wire through a part of the cells forming the stent toward the side branch of the blood vessel while the stent is placed at the bifurcation of the blood vessel, an appropriate ultrasound image should be presented. An example of assisting the user will be described.

  In step S <b> 501, the diagnostic imaging apparatus 100 acquires an ultrasonic tomographic image and an optical tomographic image using the probe 101 including the ultrasonic transmission / reception unit and the optical transmission / reception unit. At that time, normally, a substance that inhibits ultrasonic transmission / reception to the blood vessel by the ultrasonic transmission / reception unit (gas such as air) is excluded using a priming solution such as physiological saline, and optical transmission / reception to the blood vessel by the optical transmission / reception unit After removing (flashing) the substance (blood) that inhibits (flash) using a flush solution such as physiological saline or contrast medium, an ultrasonic tomographic image and an optical tomographic image are acquired.

  In S502, the diagnostic imaging apparatus 100 generates an image used for determining the region of interest based on the optical tomographic image acquired in S501. The region of interest here is, for example, a region in which cells used when a guide wire is inserted into the side branch through the guide wire and a region in the closed curve representing the side branch 605 overlap among the cells forming the stent.

  The image used for determining the region of interest is a three-dimensional image based on the optical tomographic image or a substantially two-dimensional image obtained by expanding the three-dimensional image on a plane. Alternatively, it may be a cross-sectional image of a three-dimensional image or a substantially two-dimensional image, or a planar projection image of a three-dimensional image or a substantially two-dimensional image. At least any one of these may be sufficient.

  Here, reference numeral 601 in FIG. 6 is a diagram illustrating an example of an image used for determining a region of interest according to the present embodiment, and a substantially two-dimensional image in which a three-dimensional image reconstructed from an optical tomographic image is developed on a plane. Is shown. Reference numeral 602 denotes a stent strut, and 603 denotes a cell. A region indicated by white dots 604 indicates a region of interest. The region of interest here is a region overlapping with the side branch 605 of the blood vessel among the plurality of cells, but may be the entire cell.

  The stent has a structure in which a thin metal wire is knitted into a cylindrical shape, and the diameter is thin until it is placed in the blood vessel, and when positioned, the diameter expands by the action of a balloon or the like. Yes. The stent generally has a structure including a large number of cells 603 that are hollow portions formed by the stent struts 602, and the stent link 606 generally has a structure that restrains the axial movement of the blood vessels of the stent struts. .

  In S503, the diagnostic imaging apparatus 100 determines a region of interest on the image generated in S502. The region of interest can be determined by automatically extracting the stent cell to be used when inserting the guide wire into the side branch of the blood vessel, or by the user specifying the region of interest on the image. May be. For the automatic extraction of stent cells, for example, the technique disclosed in Patent Document 2 can be used. In Patent Document 2, as an image used for determining a region of interest, for example, a substantially two-dimensional image obtained by developing a three-dimensional image on a plane is used, and a cell is created by extracting stent struts. Then, by specifying the blood vessel bifurcation, the area of the overlapping portion of the cell and the bifurcation region and the relative position of the cell with respect to the bifurcation region are calculated, and the guide wire is inserted from the scored result A suitable cell is extracted.

  Furthermore, stent link information may be acquired together with automatic cell extraction, and the relative positions of the stent link and the bifurcation region may be calculated and reflected in scoring.

  More specifically, the stent strut 602 and the stent link 606 may be extracted, and the region of interest may be determined based on the extracted information and stent design information held in advance. For example, when stent struts are not sufficiently extracted from the acquired optical tomographic image, it is possible to interpolate and create stent struts that are not sufficiently extracted using the stent design information, and similarly, it is unclear. Since it can also be used for the identification of the stent link, the region of interest can be determined more appropriately.

  In S504, the diagnostic imaging apparatus 100 specifies the ultrasonic tomographic image frame at the position corresponding to the region of interest determined in S503 among the ultrasonic tomographic images acquired in S501, and specifies the ultrasonic tomographic image of interest. To do. For example, in the image used when the region of interest is determined in advance, counter information based on the encoder signal of the rotation or pullback motor is linked, and when the region of interest is determined, the corresponding counter is determined, and the corresponding frame An acoustic tomographic image is identified as an ultrasonic tomographic image of interest. Further, for example, among the optical tomographic images acquired in S501, an optical tomographic image of interest at a position corresponding to the region of interest determined in S503 is specified, and an ultrasonic tomographic image of interest corresponding to the optical tomographic image of interest is determined in S501. It identifies from the ultrasonic tomographic image acquired by (1). That is, an optical tomographic image frame including a cell that is a region of interest is specified, and a corresponding ultrasonic tomographic image frame is specified. In any specific example, there is a certain difference between the frame number of the optical tomographic image acquired at substantially the same spatial position and the frame number of the ultrasonic tomographic image. It is assumed that the position is determined in advance from the positional relationship of the transmission / reception unit and the rotation and pullback speeds.

  Here, reference numeral 611 in FIG. 6 indicates each frame (optical tomographic image of interest) of the identified optical tomographic image, and reference numeral 621 indicates a frame of the corresponding ultrasonic tomographic image (ultrasonic tomographic image of interest). Reference numerals 612 and 622 denote stents. Further, at 612 and 622, it can be seen that the side branch of the blood vessel exists in the left direction of the drawing.

  Note that the direction of interest on the ultrasonic tomographic image of interest (for example, the direction in which the side branch of the blood vessel exists) may be further specified. The ultrasonic tomographic image of interest specified by the processing and information indicating the direction of interest on the ultrasonic tomographic image of interest may be displayed on the display device 113 to be presented to the user. These pieces of information regarding the ultrasonic tomographic image of interest may be presented to the user by displaying them on the display device 113 together with the real-time ultrasonic tomographic image acquired in the subsequent processing. Thereby, the convenience in the case of the procedure which inserts the said guide wire to a side branch through a guide wire improves. Thus, the series of processes in FIG. 5 ends.

  Specifically, in the subsequent processing, the diagnostic imaging apparatus 100 acquires a real-time ultrasonic tomographic image after the ultrasonic tomographic image of interest is specified in S504. Then, the real-time ultrasonic tomographic image is displayed on the display device 113 and presented to the user.

  Reference numeral 701 in FIG. 7 denotes an ultrasonic tomographic image that is a real-time image. At that time, a reference image 702 that is at least one of the ultrasonic tomographic images of interest is displayed side by side. Furthermore, as indicated by 711 and 712, a display indicating a direction of interest (a direction in which a guide wire should be inserted) may be performed. In the longitudinal cross-sectional image 703, 721 corresponds to the cross-sectional position of the reference image 702, and each frame of the ultrasonic tomographic image of interest is included between the cross-sectional position 722 and the cross-sectional position 723.

  Furthermore, as shown in FIG. 8, display control for presenting the display device 113 with a similarity 803 between the ultrasonic tomographic image 801 that is a real-time image and the reference image 802 that is at least one of the ultrasonic tomographic images of interest. You may go. The reference image 802 displayed here may be an image having the highest similarity to the current ultrasonic tomographic image 801 among the ultrasonic tomographic images of interest. That is, the similarity between any one frame of the ultrasonic tomographic image of interest corresponding to the region of interest and the acquired real-time ultrasonic tomographic image is calculated, and the calculated similarity is presented. Also, the similarity between the ultrasonic tomographic image at the target position where the probe 101 is to be placed (details will be described later) and the real-time ultrasonic tomographic image is calculated, and the probe is moved to the target position based on the calculated similarity. You may let them. Further, the degree of similarity may be presented.

  Further, the thumbnail image 804 of each frame of the ultrasonic tomographic image of interest in the axial direction of the probe 101 and the similarity 805 between the ultrasonic tomographic image 801 and each thumbnail image may be presented side by side in the range from proximal to distant.

  Prior to the acquisition of the real-time ultrasonic tomographic image, the diagnostic imaging apparatus 100 determines a target position where the probe 101 should be placed based on the region of interest determined in S503, and sets the probe according to the target position. It may be moved. The target position here is, for example, the original position of the probe 101, and, for example, the position in the axial direction of the rotation axis of the probe 101 that matches any one of the frames of the ultrasonic tomographic image of interest. .

  More specifically, the diagnostic imaging apparatus 100 acquires the position along the rotation axis of the probe 101 as probe information, determines the probe movement amount from the probe information and the target position, and based on the probe movement amount Move the probe.

  The diagnostic imaging apparatus 100 may further acquire, as probe information, an in-plane direction intersecting (orthogonal) with the rotation axis of the probe, and may adjust the in-plane direction to move the probe 101 to the target position. It may be semi-automated so that the user can manually adjust the position of the probe 101 (in response to pressing of a switch such as a button for moving the probe 101 forward or backward in the direction of the rotation axis). It may be used as a fine adjustment after being moved by or may be moved from the beginning to the target position using this semi-automated function.

  The position along the rotation axis of the probe 101 can be acquired from the encoder signal of the drive device 240 (linear drive unit 243) that moves the probe 101 along the axial direction of the rotation axis. Similarly, the in-plane direction orthogonal to the rotation axis of the probe 101 can be obtained from the encoder signal of the driving device 240 (radial scanning motor 241) that rotates the probe 101. In addition to the driving device 240, a device that detects a change in the position or orientation of the probe 101 may be provided.

  The diagnostic imaging apparatus 100 adjusts the probe 101 so that the ultrasonic tomographic image of interest and the ultrasonic tomographic image acquired in real time are aligned in the plane intersecting the rotation axis of the probe 101. Alternatively, common features of the ultrasonic tomographic image and the real-time ultrasonic tomographic image are extracted by image processing, and the orientation is adjusted by rotating at least one of the images so that the common features are aligned. It may be configured.

  Common features here are vascular lumens, vascular surfaces, vascular bifurcations, organs other than vascular vessels, artificially placed objects in the body or body surface (stents, etc.), or derived from such objects The feature may be based on at least one of shadows or artifacts. Note that “rotation” of the image (tomographic image) here means not only rotating the generated tomographic image but also changing the start line of the A line constituting the tomographic image before generating the tomographic image. To include. The tomographic image is composed of a predetermined number of A lines. For example, consider a case in which one frame of a tomographic image is generated by arranging 512 lines from the 513th line to the 1024th line in a radial pattern. By changing the start line of the A line to the 501st line instead of the 513th line and generating the tomographic image using the 512th line from the 501st line to the 1012th line, the tomographic image is actually rotated. Similar effects can be obtained.

  It may also be determined whether the guidewire has been properly inserted into the side branch via the region of interest (the desired cell of the stent). Obtain an ultrasonic tomographic image, detect the guide wire in each cross-sectional image before and after the insertion position of the guide wire into the side branch, and if the guide wire is no longer detected before and after the insertion position, it is appropriately placed on the side branch. It may be determined that it has been inserted. The determination result may be presented to the user.

  As described above, according to the present embodiment, assistance for appropriately inserting a guide wire through a desired region of interest (desired cell of a stent suitable for inserting the guide wire into the side branch) is provided for the IVUS image. Can also be realized.

  By appropriately displaying the auxiliary information, for example, displaying the acquired ultrasonic tomographic image and real-time ultrasonic tomographic image, and further displaying information indicating the direction of interest (the direction in which the desired cell exists), for example, a stent In the branch portion of the blood vessel where the indwelling is placed, it is possible to realize assistance when the guide wire is inserted into the side branch.

  The present invention is not limited to the above embodiment, and various changes and modifications can be made without departing from the spirit and scope of the present invention. Therefore, in order to make the scope of the present invention public, the following claims are attached.

100: diagnostic imaging apparatus, 101: probe, 102: pullback unit, 103: control device, 104: cable, 105: connector, 111: main body control unit, 112: operation panel,
113: Display device, 114: Mouse, 201: Signal processing unit, 202: Memory, 2010: Image acquisition unit, 2011: Control unit, 2012: Selection receiving unit

Claims (20)

An image acquisition means for acquiring an ultrasonic tomographic image and an optical tomographic image using a probe comprising an ultrasonic transmission / reception unit and an optical transmission / reception unit;
Generating means for generating an image used to determine a region of interest based on the optical tomographic image;
Determining means for determining the region of interest in the image;
A specifying means for specifying an ultrasonic tomographic image of interest corresponding to the region of interest in the ultrasonic tomographic image;
An image diagnostic apparatus comprising:   The image diagnostic apparatus according to claim 1, further comprising a second image acquisition unit configured to acquire a real-time ultrasonic tomographic image after the ultrasonic tomographic image of interest is specified by the specifying unit.   After the ultrasonic tomographic image of interest is specified by the specifying means, a moving means for determining a target position for arranging the probe based on the region of interest and moving the probe according to the target position is further provided. The diagnostic imaging apparatus according to claim 1, wherein the diagnostic imaging apparatus is an image diagnostic apparatus. Probe information acquisition means for acquiring the position along the rotation axis of the probe as probe information,
The diagnostic imaging apparatus according to claim 3, wherein the moving unit further determines a probe movement amount from the probe information and the target position, and moves the probe based on the probe movement amount.   5. The diagnostic imaging apparatus according to claim 4, wherein the probe information acquisition unit further acquires, as the probe information, an in-plane direction intersecting a rotation axis of the probe.   The said image acquisition means acquires the said ultrasonic tomographic image and the said optical tomographic image, after removing the substance which inhibits the transmission / reception by the said optical transmission / reception part, The said any one of Claim 1 thru | or 5 characterized by the above-mentioned. The diagnostic imaging apparatus described.   The image used for determining the region of interest includes a three-dimensional image based on the optical tomographic image, a substantially two-dimensional image obtained by expanding the three-dimensional image on a plane, a cross-sectional image of the three-dimensional image or the substantially two-dimensional image, The diagnostic imaging apparatus according to claim 1, wherein the diagnostic imaging apparatus is at least one of a three-dimensional image or a planar projection image of the substantially two-dimensional image.   The specifying unit specifies an optical tomographic image of interest corresponding to the region of interest in the optical tomographic image, and specifies an image corresponding to the specified optical tomographic image of interest as the ultrasonic tomographic image of interest. The diagnostic imaging apparatus according to any one of claims 1 to 7. Calculating means for calculating the similarity between the ultrasonic tomographic image acquired by the image acquiring means and the real-time ultrasonic tomographic image acquired by the second image acquiring means;
The image diagnostic apparatus according to claim 2, further comprising: After the ultrasonic tomographic image of interest is specified by the specifying means, it further comprises a moving means for determining a target position where the probe is arranged based on the region of interest and moving the probe according to the target position,
The said moving means moves the said probe based on the similarity degree of the ultrasonic tomographic image of the said target position calculated by the said calculating means, and the said real-time ultrasonic tomographic image. Diagnostic imaging equipment.   The image diagnosis apparatus according to claim 9, further comprising a similarity degree presentation unit that presents the similarity degree.   The apparatus further comprises display control means for displaying on the display device the ultrasonic tomographic image of interest specified by the specifying means and the real-time ultrasonic tomographic image acquired by the second image acquisition means. The diagnostic imaging apparatus according to any one of claims 9 to 11.   The image diagnostic apparatus according to claim 1, wherein the specifying unit further specifies a direction of interest on the ultrasonic tomographic image of interest corresponding to the region of interest.   The diagnostic imaging apparatus according to claim 13, further comprising a presentation unit that presents information indicating a direction of interest on the ultrasonic tomographic image of interest. An extraction means for extracting a stent strut and a stent link from the image generated by the generation means;
The said determination means determines the said region of interest on the said image based on the information extracted by the said extraction means, and the stent design information currently hold | maintained, The any one of Claims 1 thru | or 14 characterized by the above-mentioned. The diagnostic imaging apparatus according to claim 1.   In-plane intersecting the rotation axis of the probe between the ultrasonic tomographic image of interest corresponding to the region of interest specified by the specifying means and the real-time ultrasonic tomographic image acquired by the second image acquiring means The diagnostic imaging apparatus according to claim 2, further comprising an adjusting unit that adjusts the probe so that the directions of the probes are aligned. Feature extraction means for extracting a common feature between the ultrasonic tomographic image of interest corresponding to the region of interest specified by the specifying means and the real-time ultrasonic tomographic image acquired by the second image acquisition means;
Adjusting means for adjusting the orientation by rotating at least one of the images so that the orientations of the common features are aligned;
The image diagnostic apparatus according to claim 2, further comprising:   The common features include a vascular cavity, a vascular surface, a vascular bifurcation, an organ other than a vascular vessel, an artificially placed object in the body or body surface, or a shadow or an artifact derived from the object. The diagnostic imaging apparatus according to claim 17, wherein the diagnostic imaging apparatus is based on at least one of the characteristics. A method for controlling a diagnostic imaging apparatus, comprising:
An image acquisition step of acquiring an ultrasonic tomographic image and an optical tomographic image using a probe including an ultrasonic transmission / reception unit and an optical transmission / reception unit;
A generation step of generating an image used for determining a region of interest based on the optical tomographic image;
Determining a region of interest on the image;
A specifying step of specifying an ultrasonic tomographic image of interest corresponding to the region of interest in the ultrasonic tomographic image;
A method for controlling an image diagnostic apparatus, comprising:   The program for functioning a computer as an image diagnostic apparatus of any one of Claims 1 thru | or 18.