JP2018102666A - X-ray fluoroscopic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray fluoroscopic apparatus which prevents the excessive compression force from being applied by a compression device even in a case where management information on a subject is not previously known.SOLUTION: A system control unit 2 controls a compression device 5, an X-ray irradiation condition determination unit 9 of a high voltage generator 8 and the like. Transparent image data detected by an X-ray detector 6 is processed by an image processing unit 3. A transparent image is displayed on an image display unit 4. At the inspection start, the image processing unit 3 measures the bone density of a subject 12 by using the transparent image data. The system control unit 2 determines the restriction value of the compression force to the compression device 5 on the basis of the measurement value of the bone density, and controls the compression device 5 on the basis of the restriction value. The image processing unit 3 calculates the coordinates of the shape of a portion where the measurement value of the bone density is low, detects the shape of the bone by transparent image processing, acquires the coordinates of the shape of the bone corresponding to the portion where the measurement value of the bone density is low with pattern matching of both, and controls the restriction value in accordance with the region of the portion where the measurement value of the bone density is low.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an X-ray fluoroscopic apparatus, and more particularly to an X-ray fluoroscopic technique for controlling the compression force of a compression apparatus from a measured value of bone density.

  There is an X-ray fluoroscopic apparatus that has an inspection method in which a subject is compressed by a compression device, and there is an apparatus that controls the compression force so that an excessive compression force is not applied to the subject.

  In the conventional method, a method of mechanically controlling the compression force or a sensor is installed to detect the compression force, and control is performed so that excessive compression force is not applied. Patent Document 1 discloses an example of a method for controlling the compression force. However, this method controls the operation support means so that the compression force pressing the subject is limited to a predetermined maximum compression force or less while it is determined that the compression is performed. It cannot be determined whether the maximum compression force is a compression force suitable for the subject to be examined. As another solution, Patent Document 2 discloses a method for controlling a compression force based on compression force setting information managed for each subject. However, it is effective if the management information of the subject is known in advance, but if the management information of the subject is not known in advance, excessive pressure may be applied to each subject. There was a system.

JP 2001-37753 A JP 2014-239818 A International publication number WO2013 / 114708

  In conventional compression force control, it is necessary to know the information of the subject in advance. Based on this information, the maximum compression force is set, and the method of mechanically controlling the compression force, sensors, etc. It is installed to detect the compression force, and control is performed so that excessive compression force is not applied. Was a system that could be added.

  An object of the present invention is to provide an X-ray fluoroscopic apparatus in which an excessive compression force is not applied to a subject even when the management information of the subject is not known in advance.

  In order to achieve the above object, in the present invention, an X-ray fluoroscopic apparatus is provided that detects a high voltage generator that generates a high voltage based on X-ray irradiation conditions and a fluoroscopic X-ray that has passed through a subject. An X-ray detector, a compression device that compresses the subject, an image processing unit that processes detection data detected by the X-ray detector, an image display unit that displays a fluoroscopic image output by the image processing unit, A high voltage generator, a compression device, and a control unit that controls the image processing unit, the image processing unit measures the bone density of the subject using the detection data, and the control unit measures the bone density Based on the above, an X-ray fluoroscopic apparatus for determining the limit value of the compression force of the compression apparatus is provided.

  According to the present invention, even when the management information of the subject is not known in advance, the compression force is limited for each subject by measuring the bone density of the subject during the examination. Can do.

It is a figure which shows an example of the whole structure of the X-ray fluoroscopic apparatus which concerns on each Example. FIG. 3 is a diagram illustrating an example of a flowchart representing an operation of the apparatus according to the first embodiment. FIG. 10 is a diagram illustrating an example of a flowchart representing an operation of the apparatus according to the second embodiment. In Example 2, it is a schematic diagram which shows the area | region of the site | part with a low bone density. FIG. 6 is a schematic diagram for explaining the operation of the apparatus according to the second embodiment.

  DESCRIPTION OF EMBODIMENTS Hereinafter, embodiments for carrying out the present invention will be sequentially described with reference to the drawings. First, a configuration example of an X-ray fluoroscopic apparatus common to each embodiment of the present invention will be described with reference to FIG.

  The operation unit 1 shown in FIG. 1 is operated by the operator 13 so that the X-ray conditions of the high voltage generator 8 and the position information of the X-ray diaphragm 11, the X-ray detector 6, the compression device 5, and the top plate 7 are displayed. Is transmitted to the system control unit 2. In accordance with these conditions and information, the system control unit 2 controls each unit such as controlling the compression device 5 with the positional information of the compression device. The operation unit 1 also informs the image processing unit 3 of information on the examination site. The system control unit 2 which is a control unit can be configured by a program operation of a central processing unit (CPU) of a personal computer (PC), for example. The image processing unit 3 can also be configured by the same or separate CPU program operation.

  The X-ray irradiation condition determination unit 9 functions as a control unit for the high voltage generator 8 and determines and controls the tube voltage, tube current, and irradiation time of fluoroscopic X-rays from feedback signals from the system control unit 2 and the image processing unit 3. To do. The high voltage generator 8 controls the high voltage under the fluoroscopic X-ray condition determined by the X-ray irradiation condition determining unit 9 and irradiates the fluoroscopic X-ray with the X-ray tube 10. The fluoroscopic X-ray irradiated from the X-ray tube 10 passes through the subject 12 and the top plate 7 and is detected by the X-ray detector 6 such as FPD. The detection data detected by the X-ray detector 6 is transferred to the image processing unit 3, and the image processing unit 3 performs various image processing, and the image processing unit 4 displays the image processing result as a fluoroscopic image.

  Further, the image processing unit 3 calculates a feedback signal for controlling the tube voltage of the fluoroscopic X-ray from the luminance value of the detection data of the region of interest. The feedback signal is a signal for converting the average luminance value of the region of interest into a voltage value and controlling the tube voltage so that the region of interest approaches the target luminance value. Further, the X-ray irradiation condition determining unit 9 determines an imaging condition from the fluoroscopic condition, and performs imaging by X-ray irradiation having a higher dose than the fluoroscopic X-ray. Furthermore, in the system of FIG. 1, the image processing unit 3 has a function for measuring the bone density using the detection data detected by the X-ray detector 6 as described in the following embodiments. Thus, the bone density can be measured by this function, and an X-ray fluoroscopic image and an image of a portion having a low bone density can be displayed on the image display unit 4.

  Subsequently, as Example 1, an example of an X-ray fluoroscopic apparatus including a control unit that controls the compression force of the compression device based on the measured value of bone density will be described. That is, Example 1 is an X-ray fluoroscopic apparatus, which is a high-voltage generator that generates a high voltage based on X-ray irradiation conditions, and an X-ray detector that detects fluoroscopic X-rays that have passed through a subject. A compression device that compresses the subject, an image processing unit that processes detection data detected by the X-ray detector, an image display unit that displays a fluoroscopic image output from the image processing unit, a high voltage generator, and a compression A control unit that controls the apparatus and the image processing unit, the image processing unit measures the bone density of the subject using the detection data, and the control unit compresses the compression device based on the measurement value of the bone density It is an Example of the X-ray fluoroscopic apparatus of the structure which determines the limiting value of force.

  FIG. 2 is a flowchart illustrating the operation of the apparatus according to the first embodiment. In the configuration of this embodiment, the operation subject of the flowchart shown in FIG. 2 is the system control unit 2 that is a control unit, the image processing unit 3 that performs fluoroscopic image processing, and the units of FIG. The operator 13. After the examination of the subject 12 is started by the operation of the operator 13, in the process S102, the bone density of the subject 12 is first measured, and the image processing unit 3 determines the bone density obtained by the fluoroscopic image processing as the system control unit. Send to 2. The system control unit 2 sets the limit value of the compression force corresponding to the bone density from the measurement result of the bone density that has been sent, so that the compression force on the subject does not exceed the set limit value. To. Further, when the bone density of the subject 12 is low, the operator 13 is warned to inform that the bone density of the subject 12 is low.

  The bone density is measured by using, for example, a DEXA (dual-energy X-ray absorptiometry) method, and the system control unit 2 controls the X-ray irradiation condition determination unit 9 to obtain two types of X-rays having different energy distributions. This can be performed by irradiating the subject and processing the output of the X-ray detector 6 by the image processing unit 3. An example of a specific configuration of the bone density measuring device is disclosed in Patent Document 3 described above.

  Thereafter, the inspection by the normal fluoroscopic imaging is continued in the process S104, and it is determined whether or not the compression device 5 is used in the process S105. When the compression device 5 is used (Yes), the subject is compressed within the limit value of the compression force in processing S106. If the compression device is not used (No), the process proceeds to step S107. If further inspection is to be performed, the process returns to step S104 to continue the inspection. If the inspection is to be ended, the process proceeds to step S109 to end the inspection.

  According to the configuration of the present embodiment, using the technique for measuring bone density, the bone density of the subject can be measured during the examination, and the compression force can be controlled based on the measurement value of the bone density. The operator can be warned that the bone density of the subject is low. As a result, even when the management information of the subject is not known in advance, it is possible to eliminate an excessive compression force being applied to the subject.

  Example 2 is an implementation of an X-ray fluoroscopic imaging apparatus that detects the position of a low bone density part by fluoroscopic image processing of an image processing unit and restricts the compression force only when the area around the low bone density part is actually compressed. It is an example. That is, the image processing unit extracts the position information of the subject's bone from the detection data, compares the coordinates of the shape of the low bone density portion of the subject with the bone position information, and compares the bone position information of the low bone density portion. When the coordinates of the shape of the bone closest to the shape coordinates are obtained, it is determined whether or not the compression region by the compression device is within the coordinates of the shape of the bone, and the control unit is when the compression region is within the coordinates of the bone This is an embodiment of an X-ray fluoroscopic apparatus configured to set a compression force limit value or output a warning.

  The configuration and operation of the apparatus according to the second embodiment will be described with reference to FIGS. 3, 4, and 5. When the compression force is limited based on the measurement value of the bone density in the first embodiment, the compression force necessary for the examination by X-ray fluoroscopy may be insufficient. Therefore, in Example 2, the position of a low bone density part is detected by fluoroscopic image processing, and the compression force is limited only when the periphery of the low bone density part is actually compressed. It is set as the structure which controls by normal compression force without applying.

  As shown in the operation flowchart of FIG. 3, in the configuration of the second embodiment, after the examination is started, the bone density measurement of the compression site is performed in S202, and then the image processing unit 3 displays the range displayed by the image display unit 4, that is, fluoroscopy. The coordinates of the region 17 of the site having a low bone density in the X-ray irradiation region 16 are obtained. FIG. 4 shows an example of the coordinates P1 to P6 of the region 17 of the low bone density region.

  FIG. 4 schematically shows a stomach 14, a fluoroscopic X-ray irradiation region 16 including a part of a bone (rib) 15, and a region 17 having a low bone density determined by bone density measurement. The coordinates P1 to P6 of the region 17 of the low bone density region in FIG. 4 may be set more finely than six points.

  Subsequently, in S204, the operator 13 is warned and warned of the compression force based on the bone density of the subject 12 being low, and proceeds to S205 to continue the examination. In S206, it is determined whether the test uses the compression device 5, and if the compression device is used (Yes), the process proceeds to S207. The image processing unit 3 outputs a fluoroscopic image in S207, and acquires position information of the bone 15 using the fluoroscopic image displayed on the image display unit 4 in real time in S208. Acquisition of bone position information by the image processing unit 3 is performed using an existing image processing technique such as edge extraction.

  Next, the coordinate P indicating the shape of the part having a low bone density in S209 and the bone position information detected by the fluoroscopic image processing in S208 are compared by image processing pattern matching in the image processing unit 3. Then, as shown in FIG. 5, the coordinates R (R1 to R6) of the bone-shaped region 19 closest to the region of the low bone density determined by pattern matching are acquired. Further, in S210, the distance between the compression center C of the compression device 18 such as the compression cylinder and the coordinate R is acquired, and the coordinate R is inside the compression region 20 extending from the compression center C with a predetermined diameter. To determine.

  In the case of (a) in FIG. 5, since the coordinate R is outside the compression region 20 of the compression device, the process proceeds to S212, the compression force at the time of normal inspection is set, and the process proceeds to S213 to perform an inspection with the normal compression force. I do. In S 214, it is determined whether or not the compression is to be ended. If it is to be ended, the process proceeds to S 215. If the inspection is not to be ended in S 215, the process proceeds to S 205, and the inspection is continued.

  When the inspection is continued, the position of the top 7 of the fluoroscopic table and the subject 12 moves, and the relative positional relationship between the compression devices 5 and 18 and the subject 12 changes as indicated by the movement amount 21 In S207, S208, and S209, the coordinates R ′ (R1 ′ to R6 ′) of the region 22 having the shape closest to the region of the low bone density region are newly acquired. In S210, the distance between the compression center C of the compression device 18 and the coordinate R ′ is acquired, and it is determined whether the coordinate R ′ is inside the compression region 20.

  In the case of FIG. 5B, since the coordinate R ′ is inside the compression region 20, the process proceeds to S211 to set a compression force limit value corresponding to the measured bone density value or output a sound or image warning. To do. The subject is pressed with the pressing force set in S212 and the examination proceeds. In step S214, it is determined whether or not the compression is to be ended. If the compression is to be ended, the process proceeds to step S215. In the case of ending, the process proceeds to S216 and the inspection is ended.

  In the configuration of the second embodiment described above, the shape of the low bone density region extracted based on the bone density measurement value measured during the examination and the fluoroscopic image displayed in real time during the examination are processed by image processing. In comparison, obtain the positional relationship between the compression area and the low bone density area. The compression device can be controlled with a compression force corresponding to the density, and a more appropriate compression force can be applied to the subject when examining the subject.

  In addition, this invention is not limited to an above-described Example, Various modifications are included. For example, the above-described embodiments have been described in detail for better understanding of the present invention, and are not necessarily limited to those having all the configurations described. Further, a part of the configuration of one embodiment can be replaced with the configuration of another embodiment, and the configuration of another embodiment can be added to the configuration of one embodiment. Further, it is possible to add, delete, and replace other configurations for a part of the configuration of each embodiment. For example, in the above-described embodiment, the image processing unit extracts the bone position information from the fluoroscopic image. At this time, the image processing unit and the system extract the bone thickness information from the fluoroscopic image by the edge extraction method. The control unit may control the compression force of the compression device by using the bone thickness information together with the bone density measurement value as a compression force control parameter.

  Further, the above-described configuration, function, control unit, and the like have been described with reference to an example of creating a CPU program that realizes a part or all of them. Needless to say, it may be realized by hardware. That is, all or a part of the functions of the processing unit may be realized by an integrated circuit such as an application specific integrated circuit (ASIC) or a field programmable gate array (FPGA) instead of the program.

DESCRIPTION OF SYMBOLS 1 Operation part 2 System control part 3 Image processing part 4 Image display parts 5 and 18 Compression apparatus 6 X-ray detector 7 Top plate 8 High voltage generator 9 X-ray irradiation condition determination part 10 X-ray tube 11 X-ray aperture 12 Subject 13 Operator 14 Stomach 15 Bone (radius)
16 Fluoroscopic X-ray irradiation region 17 Low-density bone region 19, 22 Bone-shaped region 20 closest to low bone-density region 20 Compression region 21 Movement amount

Claims (7)

X-ray fluoroscopic apparatus,
A high voltage generator that generates a high voltage based on X-ray irradiation conditions;
An X-ray detector for detecting fluoroscopic X-rays transmitted through the subject;
A compression device for compressing the subject;
An image processing unit for processing detection data detected by the X-ray detector;
An image display unit for displaying a fluoroscopic image output by the image processing unit;
A control unit for controlling the high voltage generator, the compression device, and the image processing unit,
The image processing unit
Measuring the bone density of the subject using the detection data;
The controller is
Determine a compression force limit value of the compression device based on the bone density measurement.
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 1,
The image processing unit
Extracting the position information of the subject's bone from the detection data;
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 2,
The image processing unit
Compare the coordinates of the shape of the low bone density portion of the subject with the position information of the bone, and obtain the coordinates of the bone closest to the shape coordinates of the low bone density portion,
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 3,
The image processing unit
Determining whether the compression area by the compression device is within the coordinates of the bone;
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 4,
The controller is
If the compression area is within the coordinates of the bone, determine a limit value for the compression force;
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 4,
The controller is
If the compression area is within the coordinates of the bone, output a warning;
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 1,
The image processing unit
Extracting bone thickness information from the detection data,
The control unit sets a limit value of the compression force of the compression device based on the bone thickness information.
X-ray fluoroscopic apparatus characterized by the above.

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