JP2020065685A - Endoscope system - Google Patents

Abstract

To provide an endoscope system which can highly accurately determine the seriousness or progress of a disease in an endoscopic examination.SOLUTION: An image signal acquisition unit 54 acquires a normal image signal by normal light and a special image signal by special light. A symptom score calculation unit 71 calculates a symptom score expressing the symptom of an observation object on the basis of each of the normal image signal and the special image signal. A symptom comparison unit 73 compares each symptom score by the instruction of a comparison object selection unit 72. A display processing unit 74 generates a high score display image by the special image when the symptom score by the special image is higher than the symptom score by the normal image. A display control unit 62 controls the display of the high score display image.SELECTED DRAWING: Figure 11

Description

  The present invention relates to an endoscope system.

  In the medical field, an endoscope system for photographing an observation target in a living body is widely used. The endoscope system is an endoscope that is inserted into a living body, captures an observation target and outputs an image signal, and an endoscope that generates an observation image of the observation target based on the image signal and outputs the observation image to a monitor. Processor device (hereinafter, referred to as a processor device).

  In the diagnosis using the observation image, the severity of the disease or the degree of progression of the disease (stage, stage, etc.) may be determined. The severity of the disease is an index showing the degree of the disease, and the degree of progression of the disease is an index showing the progress of the disease. The criteria for these indicators are set according to each disease or each viewpoint.

  Examples of the severity of a disease associated with diagnosis using an observation image include Mayo Score, which is one of the endoscopic indexes in ulcerative colitis. The Mayo score determines whether the disease is grade 0 or 1 mild, grade 2 moderate, or grade 3 based on the presence or absence of disease features and the degree of disease based on the findings of the large intestine using an endoscope. . Moreover, examples of the degree of progression of a disease associated with diagnosis using an observation image include a stage in gastric cancer. The stages in gastric cancer are classified into stages I to IV by comprehensively determining the depth of the tumor and the state of metastasis by observing lesions and biopsy. The severity or the degree of progression of the disease is an important criterion for determining the treatment policy. In particular, for ulcerative colitis, etc., which mainly involves medical treatment according to the severity, it is important to make an accurate diagnosis in the early stage of onset, so it is useful to determine the severity with endoscopy with high accuracy. is there.

  The endoscope system irradiates the observation site in the living body with white normal light to observe the overall properties of the surface of the living tissue, and the special light is irradiated to the observation region to perform observation. Some have special modes. In the special mode, as a special light, for example, by irradiating the affected area with a narrow band of light with a limited wavelength, it is possible to capture disease features such as unique blood vessel shape or mucous membrane uneven shape that could not be seen with white normal light. Is possible.

  Therefore, depending on the case, this special mode allows detailed observation of the condition of the affected area or the characteristics of the disease, which is the basis for determining the severity or progression of the disease. Therefore, with the special mode, it is possible to provide a more accurate determination result of severity or progress than in the normal mode of observing under normal light. Note that “high accuracy” specifically means that the actual severity or progress of the affected area and the severity or progress determined by endoscopy are highly consistent.

  As an example of using the special mode, there is disclosed an image processing device that analyzes the progress of a disease by using a normal mode and a special mode to obtain a fluorescence image with less blurring (Patent Document 1). Further, there is disclosed an endoscope system that performs more accurate and detailed diagnosis by displaying information based on a medical condition score regarding oxygen saturation on a display unit in a special mode (Patent Document 2).

International Publication No. 2017/175452 JP, 2005-085152, A

  In endoscopy, the normal mode that can be seen in natural colors is usually used, and the doctor may use the special mode as described above for the part to be observed with particular attention. Many. However, in this case, switching to the special mode is not performed unless the doctor intends. Therefore, even when the observation site is capable of capturing the disease feature when observing in the special mode, the disease feature cannot be captured by the observation in the normal mode. There was a problem that a part with low accuracy in determining the degree of progress or progress occurs.

  Therefore, it is an object of the present invention to provide an endoscope system capable of highly accurately determining the severity or progress of a disease in endoscopy.

  The endoscope system of the present invention captures a first image signal by capturing an image of an observation target illuminated with the first illumination light and a light source unit that emits first illumination light and second illumination light having emission spectra different from each other. An image signal acquisition unit that acquires and acquires a second image signal by imaging an observation target that is being illuminated by the second illumination light, and calculates a first feature amount based on the first image signal, and A feature amount calculator that calculates a second feature amount based on the two image signals, a first medical condition score that indicates the medical condition of the observation target based on the first image signal, and an observation based on the second image signal A medical condition score calculation unit that calculates a second medical condition score representing the medical condition of the target, and a medical condition comparison unit that compares the first characteristic amount and the second characteristic amount, or that compares the first medical condition score and the second medical condition score. And the second feature amount is larger than the first feature amount, or the second medical condition score If There is larger than the first condition score comprises a display processor for generating a high-score display image using the second image signal, and a display control unit for controlling the display of high-score display image.

  It is preferable that the first illumination light is white light and the second illumination light is special light.

  The medical condition comparing unit includes a comparison target selecting unit that specifies either the first characteristic amount and the second characteristic amount, or the first medical condition score and the second medical condition score, as targets to be compared. It is preferable.

  The first medical condition score and the second medical condition score preferably include disease severity or disease progression.

  It is preferable that the first characteristic amount and the second characteristic amount include a value based on a blood vessel, a duct, or a mucous membrane.

  The high score display image is preferably the second image based on the second image signal.

  The high score display image is preferably a first emphasized image generated by processing the first image signal with the second image signal.

  The high score display image is preferably a second emphasized image generated by processing the second image signal with the second image signal.

  It is preferable that the display control unit gives a notification regarding the existence of the high score display image before displaying the high score display image.

  The notification is preferably a warning display.

  It is preferable that a notification unit that generates sound, light, or vibration is provided, and that the notification is generation of sound, light, or vibration by the notification unit.

  It is preferable that the display control unit includes an instruction unit that receives an instruction to display the high score display image, and the display control unit displays the high score display image in accordance with the instruction from the instruction unit after the notification.

  It is preferable that the display control unit displays the high score display image when the second medical condition score is higher than the first medical condition score.

  The display control unit displays the first image based on the first image signal. When the second medical condition score is higher than the first medical condition score, it is preferable to switch from the first image signal to the high score display image for display.

  The display control unit displays the first image based on the first image signal. It is preferable to continuously display the first image based on the first image signal when the first medical condition score is equal to or higher than the second medical condition score.

  The display control unit preferably displays both the first image based on the first image signal and the high score display image.

  The display control unit preferably displays the first image based on the first image signal in a display area larger than the high score display image.

  The display control unit preferably displays the first image based on the first image signal in a display area smaller than the high score display image.

  It is preferable that the display control unit switches the image based on the first image signal to the high score display image when the second medical condition score is higher than the first medical condition score.

  INDUSTRIAL APPLICABILITY The endoscopic system of the present invention can accurately determine the severity or progression of a disease in endoscopy.

It is an external view of an endoscope system. It is a block diagram showing a function of an endoscope system. It is a graph which shows the spectrum of normal light. It is a graph which shows the spectrum of normal light. It is a graph which shows the spectrum of special light. It is a block diagram which shows the function of an image processing part. It is a block diagram which shows the function of the process part for determination modes. It is a block diagram showing a function of a feature quantity calculation unit. It is a block diagram which shows the function of a medical condition score calculation part. It is a block diagram which shows the function of a display processing part. It is explanatory drawing which shows the relationship between an image, a feature value, and a medical condition score. It is explanatory drawing which shows the relationship between an image, a feature value, and a medical condition score. It is explanatory drawing which shows the relationship between the acquired image and a display image. It is explanatory drawing which shows the relationship between the acquired image and a display image. It is explanatory drawing which shows the relationship between the acquired image and a display image. It is explanatory drawing of the image displayed on a monitor. It is explanatory drawing of the image displayed on a monitor. It is explanatory drawing of the image displayed on a monitor. It is explanatory drawing of the image displayed on a monitor. It is explanatory drawing of the image displayed on a monitor. It is a flow figure showing the flow of the processing procedure in judgment mode.

  As shown in FIG. 1, the endoscope system 10 includes an endoscope 12, a light source device 14, a processor device 16, a monitor 18, and a user interface 19. The endoscope 12 illuminates an observation target in the living body with illumination light, photographs the observation target illuminated with the illumination light, and outputs an image signal. The light source device 14 supplies the endoscope 12 with the illumination light with which the observation target is irradiated. The processor device 16 generates an observation image of the observation target based on the image signal, and performs system control and image processing of the endoscope system 10. The monitor 18 is a display unit that displays the image output from the processor device 16. The user interface 19 is an input device for inputting settings to the processor device 16 and the like, and includes a keyboard KB, a mouse MS, and the like. The processor device 16 is electrically connected to the monitor 18 and the user interface 19.

  The endoscope 12 includes an insertion portion 12a to be inserted into a subject, an operation portion 12b provided at a proximal end portion of the insertion portion 12a, a bending portion 12c provided at a distal end side of the insertion portion 12a, and a distal end portion 12d. Have. The bending portion 12c is bent by operating the angle knob 13a of the operation portion 12b. By bending the bending portion 12c, the tip portion 12d faces in a desired direction. The tip 12d is provided with an ejection port (not shown) for ejecting air, water, or the like toward the observation target.

  In addition to the angle knob 13a, the operation unit 12b includes a mode switching unit 13b used for switching the observation mode, a display instructing unit 13c that is an instructing unit that receives an instruction of an image to be displayed on the monitor 18, and other various selections or A scope switch 13e and a zoom operation unit 13d for performing operations such as instructions are provided.

  By pressing the mode switching unit 13b, the normal mode, the special mode, and the determination mode of the endoscope system 10 are sequentially switched. When the observation mode is the normal mode, the normal light obtained by combining the light of a plurality of colors with the light amount ratio Lc for the normal mode to emit normal light, and imaging the observation target illuminated with the normal light is used. The image is displayed on the monitor 18. Further, when the observation mode is the special mode, it is obtained by combining the plural colors of light with the light amount ratio Ls for the special mode to emit special light, and imaging the observation target being illuminated with the special light. The special image is displayed on the monitor 18. Since the light amount ratio Lc and the light amount ratio Ls are different, the emission spectra of the normal light and the special light are different from each other. The image displayed on the monitor 18 can be set appropriately.

  When the observation mode is the determination mode, normal light and special light are emitted alternately. Then, a normal image obtained by picking up the observation target being illuminated by the normal light is obtained, and a special image obtained by picking up the observation target being illuminated by the special light is obtained. In the judgment mode, the normal image is first displayed on the monitor 18. In addition, the endoscope system 10 controls the image displayed on the monitor 18 according to the respective feature amounts or the medical condition scores calculated based on the normal image and the special image, respectively. The feature amount is a value that is digitized or classified so that predetermined image features of the image signal can be compared. The medical condition score is an index indicating the medical condition of the observation target, and includes the severity of the disease or the progress of the disease.

  By operating the display instruction section 13c, it is possible to give an instruction such as switching the image displayed on the monitor 18. By operating the zoom operation unit 13d, the observation target can be magnified or reduced to capture an image. Further, a forceps channel (not shown) for inserting a treatment tool or the like is provided from the insertion portion 12a to the tip portion 12d. The treatment tool is inserted into the forceps channel from the forceps inlet 12e. The endoscope 12 is optically connected to the light source device 14 and electrically connected to the processor device 16.

  As shown in FIG. 2, the light source device 14 includes a light source unit 20 that emits illumination light used to illuminate an observation target, and a light source control unit 22 that controls the light source unit 20. The light source unit 20 is a semiconductor light source of LEDs (Light Emitting Diodes) of a plurality of colors. The light source control unit 22 controls the light emission amount of the illumination light by turning on / off the LED and adjusting the drive current and drive voltage of the LED.

  The light source unit 20 is a V-LED (Violet Light Emitting Diode) 20a, a B-LED (Blue Light Emitting Diode) 20b, a G-LED (Green Light Emitting Diode) 20c, and an R-LED (Red Lighting) Emitting Light. It has LEDs of four colors and a wavelength cut filter 23.

  As shown in FIG. 3, the V-LED 20a emits violet light V having a wavelength band of 380 nm to 420 nm. The B-LED 20b emits blue light B having a wavelength band of 420 nm to 500 nm. The wavelength cut filter 23 cuts at least a long wavelength side of the peak wavelength of 450 nm of the blue light B emitted from the B-LED 23b. As a result, the blue light Bx after passing through the wavelength cut filter 23 has a wavelength range of 420 to 460 nm. In this way, the light in the wavelength range longer than 460 nm is cut off because the light in the wavelength range longer than 460 nm is a factor that reduces the blood vessel contrast of the blood vessel to be observed. Because there is. The wavelength cut filter 23 may reduce the light in the wavelength range longer than 460 nm instead of cutting the light in the wavelength range longer than 460 nm.

  The G-LED 20c emits green light G whose wavelength band extends from 480 nm to 600 nm. The R-LED 20d emits red light R in a wavelength band of 600 nm to 650 nm. The light emitted from each of the LEDs 20a to 20d may have the same central wavelength or the same peak wavelength, or may have different peak wavelengths.

  The light source control unit 22 adjusts the light emission timing of the illumination light, the light emission period, the light amount, and the spectrum by independently controlling the lighting and extinguishing of each of the LEDs 20a to 20d, the light emitting amount at the time of lighting, and the like. The control of turning on and off in the light source control unit 22 is different for each observation mode. The reference brightness can be set by the user interface 19 or the like.

  In the normal mode, the light source control unit 22 turns on all of the V-LED 20a, the B-LED 20b, the G-LED 20c, and the R-LED 20d. At that time, as shown in FIG. 4, in the light amount ratio Lc among the violet light V, the blue light Bx, the green light G, and the red light R, the peak of the light intensity of the blue light Bx is the violet light V and the green light G. , And the light intensity of the red light R is set to be larger than the peak of the light intensity. As a result, in the normal mode, the light source device 14 emits the normal mode polychromatic light including the violet light V, the blue light Bx, the green light G, and the red light R as the normal light. The ordinary light is almost white white light because it has a certain intensity or more from the blue band to the red band. It should be noted that white light is not only wide band light including all wavelength bands of blue component, green component, and red component, like white light emitted from a xenon lamp, but also at least three colors of blue component, green component, and red component. It also includes illumination light that is a mixture of light in the wavelength band of.

  In the special mode, the light source control unit 22 turns on all of the V-LED 20a, the B-LED 20b, the G-LED 20c, and the R-LED 20d. At that time, as shown in FIG. 5, in the light amount ratio Ls among the violet light V, the blue light Bx, the green light G, and the red light R, the peak of the light intensity of the violet light V is the blue light Bx, the green light G. , And the light intensity of the red light R is set to be larger than the peak of the light intensity. As a result, in the special mode, the light source device 14 emits polychromatic light for the special mode including the purple light V, the blue light Bx, the green light G, and the red light R as the special light. The special light is bluish light because a large proportion of the purple light V occupies it. The special light does not have to include all four colors of light as long as it includes light from at least one of the four colors of LEDs 20a to 20d. The light intensity is a density of a light flux within a unit solid angle, and the light amount is a value obtained by evaluating the radiant energy of light based on human sense (visual sensitivity).

  In the determination mode, the light source control unit 22 controls the V-LED 20a, the B-LED 20b, the G-LED 20c, and the R-LED 20d so that the normal light and the special light are alternately emitted for each frame. That is, the light source control unit 22 turns on all of the V-LED 20a, the B-LED 20b, the G-LED 20c, and the R-LED 20d, and at that time, between the purple light V, the blue light Bx, the green light G, and the red light R. The light amount ratio Lc and the light amount ratio Ls are alternately switched for each frame. The number of frames (the number of still images) per second is, for example, 60 fps (Frame per second). Therefore, in the determination mode, the light source control unit 22 controls so that the normal light and the special light are switched every 1/60 seconds. As described above, the light source unit 20 emits normal light (white light (first illumination light)) and special light (second illumination light) having different emission spectra.

  As shown in FIG. 2, the illumination light emitted by the light source unit 20 enters the light guide 41. The light guide 41 is built in the endoscope 12 and a universal cord (not shown), and propagates the illumination light to the tip portion 12d of the endoscope 12. The universal cord is a cord that connects the endoscope 12, the light source device 14, and the processor device 16. A multimode fiber can be used as the light guide 41. As an example, it is possible to use a thin fiber cable having a core diameter of 105 μm, a clad diameter of 125 μm, and a diameter of φ0.3 to 0.5 mm including a protective layer serving as an outer cover.

  An illumination optical system 30a and an imaging optical system 30b are provided at the tip portion 12d of the endoscope 12. The illumination optical system 30a has an illumination lens 45, and the illumination light is emitted toward the observation target via the illumination lens 45. The imaging optical system 30b has an objective lens 46, a zoom lens 47, and an image sensor 48. The image sensor 48 reflects the illumination light returning from the observation target through the objective lens 46 and the zoom lens 47 (in addition to the reflected light, the scattered light, the fluorescence emitted from the observation target, or the drug administered to the observation target). The observation target is imaged using (including fluorescence or the like caused by the above).

  The zoom lens 47 moves by operating the zoom operation unit 13d, and enlarges or reduces the observation target imaged using the image sensor 48.

  The image sensor 48 is, for example, a color sensor having a primary color filter, and has a B pixel (blue pixel) having a blue color filter, a G pixel (green pixel) having a green color filter, and an R pixel having a red color filter. It has three types of pixels (red pixels). The blue color filter mainly transmits purple to blue light. The green color filter mainly transmits green light. The red color filter mainly transmits red light. When the observation target is imaged using the primary color image sensor 48 as described above, the maximum is obtained from the B image (blue image) obtained from the B pixel, the G image (green image) obtained from the G pixel, and the R pixel. It is possible to simultaneously obtain three types of R images (red images).

  As the image sensor 48, a CCD (Charge Coupled Device) sensor or a CMOS (Complementary Metal Oxide Semiconductor) sensor can be used. Further, although the image sensor 48 of the present embodiment is a primary color type color sensor, a complementary color type color sensor can also be used. The complementary color sensor includes, for example, a cyan pixel provided with a cyan color filter, a magenta pixel provided with a magenta color filter, a yellow pixel provided with a yellow color filter, and a green pixel provided with a green color filter. Have. An image obtained from the pixels of each color when a complementary color sensor is used can be converted into a B image, a G image, and an R image by performing complementary color-primary color conversion. Further, instead of the color sensor, a monochrome sensor without a color filter can be used as the image sensor 48. In this case, the image of each color can be obtained by sequentially capturing the observation target using illumination light of each color such as BGR.

  The processor device 16 includes a central control unit 52, an image signal acquisition unit 54, an image processing unit 61, and a display control unit 62. The central control unit 52 performs overall control of the endoscope system 10, such as synchronous control of illumination light irradiation timing and image pickup timing by controlling the light source control unit 22 and the image sensor 48. In the normal mode, normal light is emitted as illumination light and a normal image signal is input to the image signal acquisition unit 54. In the special mode, special light is emitted as illumination light and a special image signal is input to the image signal acquisition unit 54. In the determination mode, a normal image signal for capturing the observation target being illuminated with the normal light as the illumination light is input to the image signal acquisition unit 54, and the observation target being illuminated with the special light is used as the illumination light to generate the special image signal. The input to the image signal acquisition unit 54 is switched for each frame. When various settings are input using the endoscope 12, the user interface 19, or the like, the central control unit 52 changes the input settings to the light source control unit 22, the image sensor 48, or the image. Input to each part of the endoscope system 10 such as the processing part 61.

  The image signal acquisition unit 54 acquires, from the image sensor 48, an image signal of the observation target. Specifically, under the control of the central control unit 52, a normal image signal for capturing an observation target being illuminated with normal light is acquired, and an observation target being illuminated with special light is used as illumination light to capture a special image. Get the signal. The acquisition of the normal image signal and the acquisition of the special image signal are switched for each frame. The image signal acquisition unit 54 has a DSP (Digital Signal Processor) 56, a noise reduction unit 58, and a conversion unit 59, and uses these to perform various processes on the acquired image signal as necessary. The DSP 56 performs various processes such as a defect correction process, an offset process, a gain correction process, a linear matrix process, a gamma conversion process, a demosaic process, and a YC conversion process on the acquired image signal as needed.

  The defect correction process is a process of correcting the pixel value of the pixel corresponding to the defective pixel of the image sensor 48. The offset process is a process of reducing the dark current component from the image signal subjected to the defect correction process and setting an accurate zero level. The gain correction process is a process of adjusting the signal level of each image by multiplying the offset-processed image signal by a gain. The linear matrix process is a process for enhancing the color reproducibility of the offset-processed image signal, and the gamma conversion process is a process for adjusting the brightness and saturation of the image signal after the linear matrix process.

  If the image sensor 48 is a color sensor, demosaicing processing is performed. The demosaic process (also referred to as an isotropic process or a simultaneous process) is a process of interpolating the pixel value of a missing pixel, and is performed on the image signal after the gamma conversion process. The missing pixel is a pixel having no pixel value due to the arrangement of the color filters (because the pixels of other colors are arranged in the image sensor 48). For example, since the B image is an image obtained by imaging the observation target at the B pixel, the pixel at the position corresponding to the G pixel or the R pixel has no pixel value. In the demosaic process, the B image is interpolated to generate pixel values of pixels located at the G pixel and R pixel positions of the image sensor 48. The YC conversion process is a process of converting the image after the demosaic process into a luminance channel Y, a color difference channel Cb, and a color difference channel Cr.

  The noise reduction unit 58 performs noise reduction processing on the luminance channel Y, the color difference channel Cb, and the color difference channel Cr using, for example, the moving average method or the median filter method. The conversion unit 59 reconverts the luminance channel Y, the color difference channel Cb, and the color difference channel Cr after the noise reduction processing into image signals of each color of BGR again.

  As shown in FIG. 6, the image processing unit 61 includes a normal mode processing unit 63, a special mode processing unit 64, and a determination mode processing unit 65. The normal mode processing unit 63 operates when the normal mode is set, and performs color conversion processing, color enhancement processing, and structure enhancement processing on the received normal image signal. In the color conversion processing, color conversion processing is performed on the RGB image by 3 × 3 matrix processing, gradation conversion processing, three-dimensional LUT (Look Up Table) processing, and the like.

  The color enhancement processing is performed on the RGB image signal that has undergone the color conversion processing. The structure emphasizing process is a process of emphasizing the structure of the observation target, and is performed on the RGB image signal after the color emphasizing process. A normal image can be obtained by performing the various image processing as described above. Since the normal image is an image obtained based on the normal light in which the violet light V, the blue light Bx, the green light G, and the red light R are emitted in a well-balanced manner, the image has a natural hue. The normal image is input to the display control unit 62.

  The special mode processing unit 64 operates when the special mode is set. The special mode processing unit 64 performs color conversion processing, color enhancement processing, and structure enhancement processing on the received special image signal. The processing contents of the color conversion processing, the color enhancement processing, and the structure enhancement processing are the same as those of the normal mode processing unit 63. A special image is obtained by performing the various image processing as described above. The special image is obtained based on the special light in which the purple light V having a high hemoglobin absorption coefficient of blood vessels has a larger light emission amount than the blue light Bx, the green light G, and the red light R of the other colors. Therefore, the resolution of the blood vessel structure and the ductal structure is higher than that of other structures. The special image is input to the display control unit 62.

  As illustrated in FIG. 7, the determination mode processing unit 65 includes a feature amount calculation unit 70, a medical condition score calculation unit 71, a comparison target selection unit 72, a medical condition comparison unit 73, and a display processing unit 74. The determination mode processing unit 65 operates when the determination mode is set.

  The feature quantity calculation unit 70 calculates the feature quantity (first feature quantity and second feature quantity) based on the normal image signal (first image signal) and the special image signal (second image signal). Be responsible for the calculation function. The medical condition score calculation unit 71 calculates a medical condition score (first medical condition score and second medical condition score) representing the medical condition of the observation target based on the feature amounts calculated based on the normal image signal and the special image signal, respectively. The comparison target selection unit 72 selects and specifies either a feature amount or a medical condition score as a target to be compared by the medical condition comparison unit 73.

  The medical condition comparing unit 73 compares the characteristic amount of the normal image signal with the characteristic amount of the special image signal, or compares the medical condition score of the normal image signal with the medical condition score of the special image signal according to the instruction from the comparison target selecting unit 72. To do. As a result of the comparison by the medical condition comparison unit 73, the display processing unit 74 determines that the characteristic amount of the special image signal is larger than the characteristic of the normal image signal, or the medical condition score of the special image signal is larger than the medical condition score of the normal image signal. In this case, an image based on the special image signal is used, and in some cases, image processing such as emphasis processing is performed to generate a high score display image. When the feature amount or the medical condition score of the normal image signal is larger than the feature amount or the medical condition score of the special image signal, the high score display image is generated using the image of the normal image signal. Further, these processes in the determination mode processing unit 65 are automatically performed.

  As shown in FIG. 8, the feature amount calculation unit 70 includes a normal image feature amount calculation unit 75 and a special image feature amount calculation unit 76. The normal image feature amount calculation unit 75 calculates the feature amount of the normal image signal (hereinafter, referred to as normal feature amount). The special image feature amount calculation unit 76 calculates the feature amount of the special image signal (hereinafter referred to as the special feature amount). The feature amount is used to calculate a medical condition score and to create a high score display image by comparing the normal feature amount and the special feature amount.

  Regarding the characteristic amount, specifically, in the present embodiment, for example, a lower endoscope is used as the endoscope 12, and the observation target is ulcerative colitis, which is an inflammatory bowel disease of the large intestine. In the present embodiment, the feature amount includes a feature based on a blood vessel, a duct, or a mucous membrane as the predetermined image feature of the image signal. As the characteristic amount based on the blood vessel, duct or mucous membrane, a value obtained by digitizing or classifying the state of blood vessel, the state of duct or the state of mucous membrane is used. The state of the blood vessel includes the degree of seeing through the blood vessel, the thickness of the blood vessel, the density of the blood vessel, the shape of the blood vessel, the degree of branching of the blood vessel, the color of the blood vessel, or the distribution thereof. The state of the duct includes the see-through degree of the duct, the thickness of the duct, the density of the duct, the shape of the duct, the degree of branching of the duct, the color of the duct or their distribution. The state of the mucous membrane includes the color of the mucous membrane, the roughness of the surface of the mucous membrane, the unevenness of the surface of the mucous membrane, or their distribution.

  In the present embodiment, three types of feature amounts, that is, the degree of see-through of blood vessels, the color of mucous membranes, and the roughness or unevenness of mucous membranes are calculated. The feature amount is obtained by image processing of the normal image signal (first image signal) or the special image signal (second image signal). The feature amount of the degree of see-through of the blood vessel is obtained by detecting the blood vessel in the normal image signal or the special image signal. The color feature amount of the mucous membrane is obtained from the color itself and the area occupied by the color in the normal image signal or the special image signal. Further, the feature amount of the roughness or unevenness of the mucous membrane is obtained by matching with a previously prepared pattern in the normal image signal or the special image signal.

  These feature amounts are calculated by digitizing the features, or a template of a specific feature amount is stored in advance as an image feature of the observation target, and the extracted image feature amount is the feature amount of the template. It is calculated by, for example, determining whether or not they match. Here, “matching” includes that the feature amounts to be compared match each other and that the difference between the feature amounts to be compared is within a certain range. By digitizing the degree of matching, the feature amount can be obtained. In the present embodiment, in order to make it easier to recognize the above-mentioned feature amount in the special image signal, the illumination light is selected so that the resolution of the blood vessel structure or the duct structure is higher than that of other structures.

  The number of types of the feature amount may be, for example, the number of types capable of calculating the medical condition score, and can be appropriately determined depending on the difference of the observation target or the difference of the disease, and may be one type or a plurality of two or more types. good. In addition, the emission spectrum of the illumination light can be changed so that the characteristic amount can be clearly understood depending on the type of the characteristic amount. Further, after calculating a plurality of types of feature amounts, these may be summed and used as the feature amount of each image, or each feature amount may be weighted and then summed to obtain the feature amount of each image. Good. Also, the same type of feature amount may be calculated for each image, or different types of feature amount may be calculated. Further, the calculation of the feature amount may be performed by image recognition processing by machine learning instead of image processing.

  As shown in FIG. 9, the medical condition score calculation unit 71 includes a normal image score calculation unit 77, a normal score table 78, a special image score calculation unit 79, and a special score table 80. The normal image score calculation unit 77 calculates the medical condition score (first medical condition score) of the normal image based on the characteristic amount of the normal image obtained by the normal image characteristic amount calculation unit 75 and the normal score table 78. Similarly, the special image score calculation unit 79 calculates the medical condition score (second medical condition score) of the special image based on the special characteristic amount and the special score table 80 obtained by the special image characteristic amount calculation unit 76.

  The medical condition score of the normal image (hereinafter referred to as the normal score) may be calculated directly from the normal feature amount, or directly using the pixel value of the normal image signal or the like. Similarly, the medical condition score of the special image (hereinafter, referred to as a special score) may be calculated directly from the pixel value of the special image signal or the like, instead of being calculated from the special feature amount.

  As described above, the medical condition score is, for example, the Mayo Score, which is one of the endoscopic indexes in the severity of ulcerative colitis. The normal image score calculation unit 77 uses the normal feature amount and the normal score table 78 to set the Mayo score of the normal image, which is a normal score, to either 0 or 1, mild, grade 2 moderate, or grade 3 severe. To judge. Similarly, the special image score calculation unit 79 uses the special feature amount and the special score table 80 to set the Mayo score of the special image, which is the special score, to 0 or 1 as mild, grade 2 as moderate, or grade 3 as severe. It is classified as one of the following.

  The comparison target selection unit 72 specifies whether to use the feature amount or the medical condition score as the target to be compared by the medical condition comparison unit 73. The designation is performed by the scope switch 13e (see FIG. 1) or the user interface 19. It should be noted that this designation can be appropriately set such that either one is designated when the endoscope system is started up, or once designated, the designation is not changed until the next designation is changed. It is also possible to specify both the feature amount and the medical condition score as a target for comparison. In this case, the medical condition comparison unit 73 performs both the comparison of the normal characteristic amount and the special characteristic amount and the comparison of the normal medical condition score and the special medical condition score, and sends the result to the medical condition comparison unit 73.

  The medical condition comparing unit 73 compares the normal feature amount with the special feature amount or compares the normal score with the special score according to the selection of the comparison target selecting unit 72. Alternatively, when both the feature amount comparison and the medical condition score comparison are selected, both the normal characteristic amount and the special characteristic amount are compared, and the normal medical condition score and the special medical condition score are both compared. The result of the comparison is used to generate a high score display image in the display processing unit 74.

  The display processing unit 74, when there is a difference between the normal feature amount and the special feature amount as a result of the comparison between the normal feature amount and the special feature amount by the medical condition comparison unit 73 or the comparison between the normal score and the special score, or the difference. When is higher than a predetermined range, or when the normal score and the special score are different, a high score display image is created. The high score display image is an image for prompting the observer to recognize an image having a high feature amount or a medical condition score when the feature amount or the medical condition score calculated in each of the normal image and the special image is different. Therefore, the high score display image can be the image itself having the higher feature amount or medical condition score, of the normal image and the special image.

  When the comparison target selection unit 72 designates both the feature amount and the medical condition score as a target to be compared, and as a result of the comparison by the medical condition comparison unit 73, a difference occurs in either one or both of the characteristic amount and the medical condition score, The high score display image is generated based on the image having the higher feature amount or the medical condition score among the images or the special images. If the image with a high feature amount and the image with a high medical condition score are different, for example, the normal feature amount for the feature amount is higher than the special feature amount, and the special score for the medical condition score is higher than the normal score. It is possible to specify whether to generate the high score display image based on the image or the special image.

  As shown in FIG. 10, the display processing unit 74 includes a normal image generation unit 81, a special image generation unit 82, a first emphasized image generation unit 83, and a second emphasized image generation unit 84. As a result of the comparison by the medical condition comparison unit 73, for example, a high level created when the special medical condition score based on the special image signal (second image signal) is larger than the normal medical condition score based on the normal image signal (first image signal). The score display image is generated by the special image generation unit 82, the first emphasized image generation unit 83, and the second emphasized image generation unit 84. The special image generation unit 82 has the same function as the special mode processing unit 64 and generates a special image as a high score display image. The first emphasized image generation unit 83 generates, as a high score display image, an image (first emphasized image) in which a normal image is emphasized by a special image signal. The second emphasized image generating unit 84 generates an image (second emphasized image) in which the special image is emphasized by the normal image signal as the high score display image. If the normal score is equal to or higher than the special score, the high score display image is not generated. The high score display image will be described later.

  Generation of the high score display image will be specifically described with reference to FIG. FIG. 11 illustrates a case where a feature amount and a medical condition score are calculated for each of a normal image and a special image, and it is determined that a high score image exists and a case where a high score image does not exist. It is a figure. The normal image 85 and the special image 86 are images obtained by photographing the same observation site. This observation site is a site where actual MayoScore (hereinafter referred to as Mayo) is mild. The feature amount of the normal image 85 was 30, and the medical condition score was calculated as Mayo0 as described as "Mayo0" in FIG. For the same observation site, the feature amount of the special image 86 was calculated to be 30, and the medical condition score was calculated to be Mayo0. The comparison target selection unit 72 sets the comparison target as a medical condition score. In this case, since the medical condition score does not differ between the normal image 85 and the special image 86, the high score display image is not created. Therefore, the normal image is displayed on the monitor 18 unchanged.

  Next, for another observation site that is actually mild and has Mayo 1, the feature amount of the normal image 85 was calculated to be 30, and the medical condition score was calculated to be Mayo 0. For the same observation site, the feature amount of the special image 86 was calculated to be 40, and the medical condition score was calculated to be Mayo1. The comparison target selection unit 72 sets the comparison target as a medical condition score. In this case, since the medical condition score differs between the normal image 85 and the special image 86, a high score display image is created. In this way, the irregularities of the surface that are not displayed in the image in the normal image and cannot be grasped are displayed as images in the special image, so the calculation result of the characteristic amount is different, and the medical condition score based on the characteristic amount is also different from the normal image. Calculated by value. By creating the high score display image, the observer can accurately determine the severity of the disease.

  Next, for another observation site that is actually moderate and has Mayo of 2, the feature amount of the normal image 85 was calculated to be 60 and the medical condition score was calculated to be Mayo2. For the same site, the feature amount of the special image 86 was calculated to be 65, and the medical condition score was calculated to be Mayo2. Similarly, for another observation site that is severe and has Mayo of 3, the feature amount of the normal image 85 was calculated to be 90, and the medical condition score was calculated to be Mayo3. For the same site, the feature amount of the special image 86 was calculated to be 95, and the medical condition score was calculated to be Mayo3. The comparison target selection unit 72 sets the comparison target as a medical condition score. In this case, since the medical condition score does not differ between the normal image and the special image in both cases, the high score display image is not created. Therefore, the normal image is displayed on the monitor 18 unchanged.

  A case will be described in which the comparison target selection unit 72 sets the comparison target as a feature amount. As shown in FIG. 12, since the feature amount of the normal image 85 is calculated as 60 and the feature amount of the special image 86 is calculated as 65 for the other observed region that is moderate and has Mayo of 2. A high score display image based on the special image is created. Similarly, for another observation site that is severe and has Mayo of 3, the feature amount of the normal image 85 is 90, and the feature amount of the special image 86 is 95 for the same region. A high score display image based on is created.

  The high score display image will be specifically described. As shown in FIG. 13, when the special score is high among the normal image 85 and the special image 86, the special image 86 (second image) generated by the special image generation unit 82 is set as the high score display image. The high score display image is displayed on the monitor 18.

  The high-score display image is a normal image and a special image having a higher medical condition score (hereinafter referred to as a high-score image), and an image having a lower medical condition score (hereinafter referred to as a low-score image) is processed. Can be generated by

  The first emphasized image generation unit 83 (see FIG. 10) creates an image that emphasizes and displays the feature amount that is the basis of the calculation of the medical condition score of the high score image, and the high score display image is superimposed on the low score image. (First emphasized image) is generated to be a high score display image. As shown in FIG. 14, when the special score is high among the normal image 85 and the special image 86, first, an image in which the feature amount that is the basis of the calculation of the special score is emphasized and displayed is created. Then, by superimposing this image on the normal image 85, the first emphasized image 87 having the characteristic portion 87a for emphasizing and displaying the feature amount in the normal image 85 is created. This image is a high score display image. The high score display image is displayed on the monitor 18.

  Similarly, the high score display image can be generated by processing the high score image with the high score image of the normal image and the special image. The second emphasized image generation unit 84 (see FIG. 10) creates an image that emphasizes and displays the feature amount that is the basis of the calculation of the medical condition score of the high score image, and superimposes it on the low score image. (Second emphasized image) is generated and is set as a high score display image. As shown in FIG. 15, when the special score is high among the normal image 85 and the special image 86, first, an image is displayed in which the feature amount that is the basis of the calculation of the special score is emphasized and displayed. Then, by superimposing this image on the special image 86, a second emphasized image 88 having a characteristic portion 88a for further emphasizing and displaying the characteristic amount in the special image 86 is created. This image is a high score display image. The high score display image is displayed on the monitor 18.

  The display control unit 62 controls the display of the high score display image generated by the display processing unit 74. The display is performed by displaying on the monitor 18. The control of display is to determine whether or not to display the high score display image or the display mode of the high score display image, and to instruct the display on the monitor 18.

  As for the presence / absence of display, whether the display control unit 62 displays the high score display image based on both the high score image and the image displayed on the monitor 18 when the high score display image is created. Can be determined. Specifically, for example, if the special image is a high-score image and the normal image is displayed on the monitor 18 when the high-score display image is created from the special image, the display control unit 62 displays The score display image is displayed on the monitor 18. On the other hand, when the special image is displayed on the monitor 18, the display on the monitor 18 is not changed. Further, for example, when the normal image is a high score image and the special image is displayed on the monitor 18 when the high score display image is created from the normal image, the display control unit 62 causes the high score display image to be displayed. Is displayed on the monitor 18. On the other hand, when the normal image is displayed on the monitor 18, the display on the monitor 18 is not changed. That is, in this case, when the normal image (first image) is being displayed, the display control unit 62 continuously displays the normal image (first image).

  The display mode of the high score display image may be any mode in which the high score display image is displayed on the monitor 18. For example, when the high score display image is created, the image displayed on the monitor 18 (hereinafter referred to as the original image) can be switched to the high score display image. Further, both the original image and the high score display image can be displayed. In this case, the original image and the high-score display image may have the same display area on the monitor 18 and may be displayed side by side on the monitor 18, or the original image and the high-score display image may be displayed. May be changed to display two screens. That is, the original image and the high score display image may be sorted and displayed in the so-called main image and sub image.

  Specifically, as shown in FIG. 16, the display control unit 62 displays the normal image 85 (first image) on the monitor 18 and displays the special image among the normal image 85 and the special image 86. When the medical condition score of 86 is high, the screen displayed on the monitor 18 is switched to the special image 86. Further, as shown in FIG. 17, in the same case, the screens displayed on the monitor 18 are displayed on the monitor 18 with the same display area in the normal image 85 (first image) and the special image 86. Display them side by side on the screen. Further, as shown in FIG. 18, in the same case, the screen displayed on the monitor 18 includes a normal image 85 (first image) as a main image with a large display area, and a special image 86 as a sub image with a small display area. The two screens are displayed side by side on the monitor 18. Further, as shown in FIG. 19, in the same case, the screen displayed on the monitor 18 includes the special image 86 as the main image having a large display area, and the normal image 85 (first image) as the sub image having a small display area. The two screens are displayed side by side on the monitor 18.

  The display control unit 62 notifies the observer of the presence of the high-score display image before the display control unit 62 controls the display of the high-score image. The notification regarding the existence of the high score display image is a notification for making the observer recognize that the high score display image is generated. The notification is performed in a manner that an observer can recognize that the high score display image is generated.

  The notification is performed by displaying a warning on the monitor 18. The warning can be displayed, for example, by displaying a sentence or a drawing for the warning in the display area of the monitor 18, or by changing the color tone in the image of the monitor 18.

  Further, the notification can be performed by causing the notification unit 17 (see FIG. 2) to generate sound, light, or vibration. The notification unit 17 notifies the observer of the presence of the high-score display image by generating sound, light, or vibration. The notification unit 17 can be specifically a speaker included in the monitor 18. In addition, a small wireless device which emits light or vibration can be used.

  The notification will be specifically described. As shown in FIG. 20, a warning is displayed on the monitor 18 to notify the observer that a high-score display image exists. When the high score display image is generated while the normal image 85 is being displayed, a warning display 89 in characters is displayed on the monitor 18. The warning display 89 is based on a sentence such as “High-score image exists, change observation mode”.

  The display control unit 62 automatically displays the high score display image after giving a notification regarding the presence of the high score display image for a predetermined time. After the high-score display image is automatically displayed, after a predetermined time has elapsed, the image may be automatically switched to the image displayed before the high-score display image is displayed, or may be switched after the instruction. good. Further, after giving the notification, the high score display image can be displayed according to the instruction from the instruction unit. The instruction unit receives an instruction from the observer to display the high score display image on the monitor 18. Therefore, for example, the instruction unit is the display instruction unit 13c of the endoscope 12. Specifically, the display control unit 62 does not display the high-score display image on the monitor 18 after the above notification is made and until the display instruction unit 13c gives an instruction. On the other hand, when the display instruction unit 13c gives an instruction after the above notification, the high score display image is displayed on the monitor 18.

  As shown in FIG. 21, the flow of the processing procedure in the determination mode will be described with reference to a flow chart. As shown in steps S100 and S140, the image signal acquisition unit 54 sequentially acquires the normal image signal and the special image signal. First, in step S110, a normal image is displayed on the monitor 18. The normal image feature amount calculation unit 75 calculates the normal feature amount from the normal image signal (step S120). The normal image score calculation unit 77 calculates a normal score from the normal feature amount (step S130). Similarly, the special image feature amount output unit 76 calculates the special feature amount from the special image signal (step S150). The special image score calculation unit 79 calculates a special score from the special feature amount (step S160). When the normal score and the special score are calculated, since the medical condition score is selected by the comparison target selection unit 72 in the present embodiment, both medical condition scores are compared by the medical condition comparison unit 73 (step S170). As a result of the comparison, it is determined whether or not there is a high-score image (step S180). If a high score image exists (YES in step S180), the process proceeds to high score display image creation in step S190. If there is no high-score image (NO in step S180), the process returns to image acquisition in step S100.

  In step S190, the display processing unit 74 creates a high score display image. Then, in step S200, the presence or absence of display and the display mode are determined by the display control unit 62. If the normal score is higher than the special score, it is determined in step S200 whether or not there is a display. Since the normal image is displayed on the monitor 18, if the normal image is a high score image, the high score image is not displayed and the process returns to the image acquisition in step S100. If the special image is a high-score image (NO in step S200), the process proceeds to step S210 to determine the display mode. In step S220, the notification unit 74 notifies the viewer that the high score image has been generated. After the notification is given, it is determined in step S230 whether a display instruction has been given. If there is a display instruction, the high score display image in step S240 is displayed on the monitor 18. If there is no display instruction, the process returns to the normal image acquisition in step S100. When the observer ends the display of the high score display image (YES in step S240), the display of the high score display image ends.

  It should be noted that the notification of step S220 and the determination of the presence / absence of the display instruction of step S230 may be omitted. In that case, after determining the display mode in step S210, the process proceeds to high score image display in step S240.

  As described above, by configuring the endoscope system 10, even when observing by displaying a normal image, a special image that is an image having an emission spectrum different from that of the normal image is always acquired. Since the feature amount and the medical condition score are calculated for each of the image and the special image, it is possible to observe without missing the image with a high feature amount of the observation site or the image with a high degree of disease severity or disease progression. It is possible to prevent deterioration of diagnostic accuracy such as disease severity. In addition, since the medical condition score, which is the severity of the disease or the degree of progression of the disease, is calculated, it is possible to prevent variations in the diagnosis by the observer and to make an objective diagnosis. Further, when the high score display image is automatically displayed on the monitor 18 when the high score display image is generated, the instruction of the observer is unnecessary. On the other hand, in the case where the display of the monitor 18 is not switched, the display of the high score display image can be controlled by the instruction of the observer.

  In the present embodiment, the medical condition score is calculated based on the calculated characteristic amount in the normal image and the special image, but the medical condition score may be calculated by image processing without using the characteristic amount. For example, an image recognition technique based on machine learning may be used to directly calculate the medical condition score from each of the normal image and the special image. Further, the feature amount itself may be calculated by an image recognition technique by machine learning.

  In the operation method of the endoscope system 10 described above, the light source unit 20 emits the first illumination light and the second illumination light whose emission spectra are different from each other, and the image signal acquisition unit 54 uses the first illumination light. An image signal acquisition step of capturing an observation target being illuminated to acquire a first image signal and capturing an observation target being illuminated with a second illumination light to acquire a second image signal; The unit 70 calculates a first characteristic amount based on the first image signal and calculates a second characteristic amount based on the second image signal, and a medical condition score calculation unit 71 calculates the first image signal. A medical condition score calculation step of calculating a first medical condition score representing the medical condition of the observation target based on the above, and calculating a second medical condition score representing the medical condition of the observation target based on the second image signal; , The first medical condition score and the second medical condition score A medical condition comparing step of comparing, and a display processing unit 74, when the second medical condition score is larger than the first medical condition score, a high score display image generating step of generating a high score display image using the second image signal, Display control unit 62

  In the above, the hardware structure of the processing unit (processing unit) that executes various processes such as the image signal acquisition unit 54, the central control unit 52, the image processing unit 61, the display control unit 62, etc. is as follows. Various processors. The circuit configuration of various processors is changed after manufacturing such as CPU (Central Processing Unit) and FPGA (Field Programmable Gate Array), which are general-purpose processors that execute software (programs) and function as various processing units. A programmable logic device (PLD), which is a possible processor, and a dedicated electric circuit (Graphical Processing Unit: GPU), which is a processor having a circuit configuration specifically designed to execute various processes, are included. .

  One processing unit may be configured by one of these various processors, or a combination of two or more processors of the same type or different types (for example, a plurality of FPGAs, a combination of CPU and FPGA, a GPU and the like). CPU combination). Further, the plurality of processing units may be configured by one processor. As an example of configuring a plurality of processing units with one processor, firstly, one processor is configured with a combination of one or more CPUs and software, as represented by a computer such as a client or a server. There is a form in which this processor functions as a plurality of processing units. Secondly, as represented by a system on chip (SoC), etc., there is a form using a processor that realizes the function of the entire system including a plurality of processing units by one IC (Integrated Circuit) chip. is there. As described above, the various processing units are configured using one or more of the above various processors as a hardware structure.

  Furthermore, the hardware structure of these various processors is, more specifically, an electrical circuit in the form of a combination of circuit elements such as semiconductor elements.

10 endoscope system 12 endoscope 12a insertion part 12b operation part 12c bending part 12d tip part 13a angle knob 13b mode switching part 13c display instruction part 13d zoom operation part 12e forceps entrance 14 light source device 16 processor device 17 notification part 18 monitor 19 User Interface 20 Light Source 20a V-LED
20b B-LED
20c G-LED
20d R-LED
22 Light Source Control Section 23 Wavelength Cut Filter 30a Illumination Optical System 30b Imaging Optical System 41 Light Guide 45 Illumination Lens 46 Objective Lens 47 Zoom Lens 48 Image Sensor 52 Central Control Section 54 Image Signal Acquisition Section 61 Image Processing Section 62 Display Control Section 63 Normal Mode processing unit 64 Special mode processing unit 65 Judgment mode processing unit 70 Feature amount calculation unit 71 Medical condition score calculation unit 72 Comparison target selection unit 73 Medical condition comparison unit 74 Display processing unit 75 Normal image characteristic amount calculation unit 76 Special image feature Quantity calculation unit 77 Normal image score calculation unit 78 Normal score table 79 Special image score calculation unit 80 Special score table 81 Normal image generation unit 82 Special image generation unit 83 First emphasized image generation unit 84 Second emphasized image generation unit 85 Normal image 86 Special image 87 Normal image emphasized image (first emphasized image)
87a Features 88 Enhanced image of special image (second enhanced image)
88a Characteristic portion 89 Warning display S100 to S250 steps

Claims (18)

A light source unit that emits first illumination light and second illumination light having emission spectra different from each other;
An image signal for capturing an observation target being illuminated with the first illumination light to obtain a first image signal, and for capturing an observation target being illuminated with the second illumination light to obtain a second image signal. The acquisition part,
A feature quantity calculation unit that calculates a first feature quantity based on the first image signal and a second feature quantity based on the second image signal;
A medical condition score calculation that calculates a first medical condition score that represents the medical condition of the observation target based on the first image signal, and calculates a second medical condition score that represents the medical condition of the observation target based on the second image signal Department,
A medical condition comparison unit that compares the first characteristic amount and the second characteristic amount, or that compares the first medical condition score and the second medical condition score,
When the second feature amount is larger than the first feature amount or when the second medical condition score is larger than the first medical condition score, a high score display image is generated using the second image signal. A display processing unit,
A display control unit for controlling the display of the high score display image,
An endoscope system including.   The endoscope system according to claim 1, wherein the first illumination light is white light, and the second illumination light is special light.   A comparison that specifies either the first characteristic amount and the second characteristic amount or the first medical condition score and the second medical condition score are used as targets to be compared by the medical condition comparing unit. The endoscope system according to claim 1, further comprising a target selection unit.   The endoscope system according to any one of claims 1 to 3, wherein the first medical condition score and the second medical condition score include a severity of a disease or a progression of the disease.   The endoscope system according to any one of claims 1 to 4, wherein the first characteristic amount and the second characteristic amount include values based on blood vessels, gland ducts, or mucous membranes.   The endoscope system according to any one of claims 1 to 5, wherein the high-score display image is a second image based on the second image signal.   The endoscope system according to any one of claims 1 to 5, wherein the high-score display image is a first emphasized image generated by processing the first image signal with the second image signal.   The endoscope system according to any one of claims 1 to 5, wherein the high-score display image is a second emphasized image generated by processing the second image signal with the second image signal.   The endoscope system according to any one of claims 1 to 8, wherein the display control unit performs a notification regarding the presence of the high score display image before displaying the high score display image.   The endoscope system according to claim 9, wherein the notification is a warning display. Equipped with a notification unit that generates sound, light or vibration,
The endoscope system according to claim 9 or 10, wherein the notification is generation of sound, light, or vibration by the notification unit. An instruction unit for receiving an instruction to display the high score display image,
The endoscope system according to any one of claims 9 to 11, wherein the display control unit displays the high score display image according to the instruction from the instruction unit after the notification.   The endoscope system according to any one of claims 1 to 12, wherein the display control unit displays the high score display image when the second medical condition score is higher than the first medical condition score.   In the case where the display control unit is displaying the first image based on the first image signal. The endoscope system according to claim 13, wherein when the second medical condition score is higher than the first medical condition score, the first image signal is switched to the high score display image for display.   In the case where the display control unit is displaying the first image based on the first image signal. The endoscope according to any one of claims 1 to 12, wherein the first image based on the first image signal is continuously displayed when the first medical condition score is equal to or higher than the second medical condition score. system.   The endoscope system according to claim 13, wherein the display control unit displays both the first image based on the first image signal and the high-score display image.   The endoscope system according to claim 16, wherein the display control unit displays the first image based on the first image signal in a display area larger than the high score display image. The endoscope system according to claim 16, wherein the display control unit displays the first image based on the first image signal in a display area smaller than the high score display image.

Images