JP2020074972A - Ultrasound diagnostic device and pressure index generation program - Google Patents

Abstract

To improve repeatability of a pressure condition in a past elastography inspection.SOLUTION: An ultrasound diagnostic device according to an embodiment comprises an acquisition unit and an index generation unit. The acquisition unit acquires patient identification information on a patient to be subjected to an elastography inspection and inspection information on the patient's part on which the elastography inspection is to be performed to acquire pressure information on pressure application and pressure reduction performed on the patient's part in a past elastography inspection. The index generation unit generates a pressure index on the basis of the pressure information.SELECTED DRAWING: Figure 2

Description

  Embodiments of the present invention relate to an ultrasonic diagnostic apparatus and a compression index generation program.

  2. Description of the Related Art Ultrasonic diagnostic apparatuses having an elastography function for measuring the relative hardness of a living tissue from the displacement caused by pressurizing or depressurizing the living tissue by the operation of an operator such as an inspection technician are widely used. According to such an ultrasonic diagnostic apparatus, a strain image representing the hardness of the tissue based on the strain distribution when the tissue is manually pressed is acquired by, for example, strain elastography.

  In such an ultrasonic diagnostic apparatus, an appropriate technique is required to obtain a good strain image. In order to assist the procedure, for example, it is known to display a guide on a display device based on recommended conditions set in advance regarding the degree of compression and the cycle. The operator can press the tissue according to the displayed guide.

  However, even if the guide based on the recommended conditions is followed, a good distorted image is not always obtained. The operator can obtain a good strain image for each tissue by appropriately pressurizing or depressurizing the tissue while referring to the recommended conditions.

  At the time of re-examination of elastography for the purpose of follow-up observation of the same subject, it is important to obtain an image under the same compression condition as in the past examination. For example, if an image was acquired in a past examination under a compression condition different from the recommended condition, even if the operator presses the tissue according to the guideline based on the recommended condition at the time of the re-inspection, the same compression condition as in the past examination is used. I can't get the image.

JP, 2005-13109, A

  The problem to be solved by the present invention is to enhance the reproducibility of compression conditions in past elastography examinations.

  The ultrasonic diagnostic apparatus according to the embodiment includes an acquisition unit and an index generation unit. The acquisition unit acquires the patient identification information regarding the patient undergoing the elastography test and the inspection information regarding the site where the patient undergoes the elastography test, and provides the site of the patient with a past elastography test. The compression information regarding the applied pressurization and decompression is acquired. The index generation unit generates a compression index based on the compression information.

FIG. 1 is a block diagram showing an example of the configuration of a system in a hospital including the ultrasonic diagnostic apparatus according to the first embodiment. FIG. 2 is a block diagram showing an example of the configuration of the ultrasonic diagnostic apparatus shown in FIG. FIG. 3 is a flowchart showing an example of the elastography inspection process of the ultrasonic diagnostic apparatus according to the first embodiment. FIG. 4 is a diagram showing an example of a waveform and a graphic relating to current compression information and a compression index. FIG. 5 is a diagram showing an example of a waveform regarding past compression information, a waveform regarding current compression information, a figure regarding current compression information, and a compression index. FIG. 6 is a flowchart showing an example of the elastography inspection process of the ultrasonic diagnostic apparatus according to the second embodiment. FIG. 7 is a flowchart showing an example of the elastography inspection process of the ultrasonic diagnostic apparatus according to the third embodiment.

  Hereinafter, each embodiment will be described with reference to the drawings. The ultrasonic diagnostic apparatus according to the embodiment relates to measurement of a clinical image using an ultrasonic probe and is used for elastography inspection. According to the following embodiment, in the ultrasonic diagnostic apparatus, as a guide for reproducing the compression condition when the subject is compressed or released in the past elastography examination, the compression information acquired during the past elastography examination is used. A compression index generated based on the compression index is presented.

(First embodiment)
FIG. 1 is a block diagram showing an example of the configuration of an in-hospital system 100 including the ultrasonic diagnostic apparatus 1 according to the first embodiment. The system 100 includes an ultrasonic diagnostic apparatus 1, a medical image management system (PACS: Picture Archiving and Communication System) 110, and a hospital information system (HIS: Hospital Information System) 120. The ultrasonic diagnostic apparatus 1, the medical image management system 110, and the hospital information system 120 are connected to each other via a network 101 in a hospital, which is a LAN (Local Area Network), for data communication. The connection to the network 101 may be wired connection or wireless connection. Further, the line to be connected is not limited to the network 101 in the hospital as long as security is ensured. For example, a public communication line such as the Internet may be connected via a VPN (Virtual Private Network) or the like.

  The hospital information system 120 is a system that stores in-hospital information such as medical care information, patient information, and order information, and manages the stored in-hospital information. The medical information includes, for example, finding information, disease name information, vital information, examination stage information, treatment content information, examination information (study information), and past examination results, and other information relating to electronic medical records. If there is compression information used in the past elastography examination, that is, past compression information, typically the compression information used in the first elastography examination, the medical care information is Compression information can be included. Here, the past compression information refers to an amplitude and a cycle relating to a velocity of at least one cycle with respect to a cyclical pressurization and depressurization to a living tissue actually performed in a past elastography examination, that is, a subject. It is the information to include. The patient information includes, for example, patient ID, patient name, sex, age and the like. The order information is, for example, information that a medical doctor or the like requests for a radiological examination, a specimen examination, a physiological examination, a prescription, medication, an image interpretation, or the like. Further, the order information includes, for example, the examination date, the examination site, the type of the medical image diagnostic apparatus, the requesting doctor, and the like.

  The hospital information system 120 has, for example, a server device 121 and a communication terminal 126. The server device 121 and the communication terminal 126 are connected via the network 101 so that data communication is possible.

  The server device 121 includes, for example, a communication interface 122, a processor 123, a memory 124, and a storage 125. The server device 121 stores, in the hospital information system 120, the above-described medical care information, patient information, order information, and the like, and manages the stored medical care information, patient information, order information, and the like. Is.

  The communication interface 122 is connected to an external device such as the ultrasonic diagnostic apparatus 1 and the medical image management system 110 via the network 101, for example, and performs data communication with the external device. The processor 123 is a processing circuit in the server apparatus 121, and executes a program stored in the memory 124 or the storage 125 to realize a function corresponding to the program. The memory 124 includes a ROM (Read Only Memory) that is a read-only data memory or a RAM (Random Access Memory) that temporarily stores data. The storage 125 may be a large-capacity storage such as a HDD (Hard Disk Drive) or SSD (Solid State Drive). The memory 124 or the storage 125 stores the control program of the server device 121 and various data. The various data stored in the memory 124 or the storage 125 includes the medical care information, the patient information, and the order information as described above.

  In particular, the server apparatus 121, in response to the inquiry from the ultrasonic diagnostic apparatus 1, stores the past compression information of the elastography examination of the specific patient, which is stored in the memory 124 or the storage 125, in the ultrasonic diagnostic apparatus 1. To provide. The past compression information may be provided from the hospital information system 120 to the ultrasonic diagnostic apparatus 1 via the network 101 and further via an external device (not shown) such as a physiological examination system.

  Although FIG. 1 illustrates the case where the hospital information system 120 includes only the server device 121, the present invention is not limited to this. A plurality of server devices may be provided as needed. For example, the server device 121 may be provided for each piece of managed information. Specifically, for example, the hospital information system 120 may include a plurality of systems such as an electronic medical record system that manages medical information and patient information, and an order entry system that issues order information to a medical department. A server device may be provided in each system. The server device 121 may be, for example, an electronic medical record system.

  The communication terminal 126 is, for example, a terminal for medical staff such as a medical doctor to input an instruction to the server device 121.

  The medical image management system 110 is a system that stores medical image data generated by a medical image diagnostic apparatus such as the ultrasonic diagnostic apparatus 1 and manages the stored medical image data. The medical image management system 110 includes, for example, a server device (not shown) and a communication terminal, which are connected to each other via the network 101 so that data communication is possible.

  FIG. 2 is a block diagram showing an example of the configuration of the ultrasonic diagnostic apparatus 1 according to the first embodiment. The ultrasonic diagnostic apparatus 1 has an apparatus body 10 and an ultrasonic probe 20. The apparatus body 10 is connected to the medical image management system 110 and the hospital information system 120 via the network 101. Further, the device body 10 is connected to the input device 30 and the display device 40.

  The ultrasonic probe 20 performs an ultrasonic scan on a scan region in the living body P, which is the subject, under the control of the apparatus body 10, for example. The ultrasonic probe 20 includes, for example, a plurality of piezoelectric vibrators, a matching layer provided on the piezoelectric vibrators, and a backing material that prevents ultrasonic waves from propagating backward from the piezoelectric vibrators. The ultrasonic probe 20 is, for example, a one-dimensional array linear probe in which a plurality of ultrasonic transducers are arranged in a predetermined direction. The ultrasonic probe 20 is detachably connected to the apparatus body 10. The ultrasonic probe 20 may be provided with a button that is pressed during offset processing, ultrasonic image freeze, and the like.

  The plurality of piezoelectric vibrators generate ultrasonic waves based on the drive signal supplied from the ultrasonic wave transmission circuit 11 included in the apparatus body 10. As a result, ultrasonic waves are transmitted from the ultrasonic probe 20 to the living body P. When ultrasonic waves are transmitted from the ultrasonic probe 20 to the living body P, the transmitted ultrasonic waves are successively reflected by the discontinuity surface of the acoustic impedance in the body tissue of the living body P, and a plurality of piezoelectric vibrators are provided as reflected wave signals. Will be received at. The amplitude of the reflected wave signal that is received depends on the difference in acoustic impedance at the discontinuous surface where the ultrasonic waves are reflected. Further, the reflected wave signal when the transmitted ultrasonic pulse is reflected by the moving blood flow or the surface such as the heart wall depends on the velocity component of the moving body in the ultrasonic transmitting direction due to the Doppler effect. Receive a frequency shift. The ultrasonic probe 20 receives the reflected wave signal from the living body P and converts it into an electric signal.

  Note that FIG. 2 illustrates only the connection relationship between the ultrasonic probe 20 used for imaging and the apparatus body 10. However, it is possible to connect a plurality of ultrasonic probes to the device body 10. Which of the plurality of connected ultrasonic probes is to be used for imaging can be arbitrarily selected by a switching operation.

  The device body 10 is a device that generates an ultrasonic image based on the reflected wave signal received by the ultrasonic probe 20. The device body 10 includes an ultrasonic wave transmission circuit 11, an ultrasonic wave reception circuit 12, an internal storage circuit 13, an image memory 14 (cine memory), a compression information memory 15, an input interface 16, an output interface 17, and a communication interface. 18 and a processing circuit 19.

  The ultrasonic transmission circuit 11 is a processor that supplies a drive signal to the ultrasonic probe 20. The ultrasonic wave transmission circuit 11 is realized by, for example, a trigger generation circuit, a delay circuit, a pulser circuit, and the like. The trigger generation circuit repeatedly generates a rate pulse for forming a transmission ultrasonic wave at a predetermined rate frequency. The delay circuit collects the delay time for each piezoelectric vibrator necessary for focusing the ultrasonic waves generated from the ultrasonic probe 20 into a beam shape and determining the transmission directivity for each rate pulse generated by the trigger generation circuit. Give to The pulsar circuit applies a drive signal (drive pulse) to the plurality of ultrasonic transducers provided in the ultrasonic probe 20 at a timing based on the rate pulse. By changing the delay time given to each rate pulse by the delay circuit, the transmission direction from the piezoelectric vibrator surface can be arbitrarily adjusted.

  The ultrasonic receiving circuit 12 is a processor that performs various processes on the reflected wave signal received by the ultrasonic probe 20 to generate a received signal. The ultrasonic wave reception circuit 12 is realized by, for example, an amplifier circuit, an A / D converter, a reception delay circuit, and an adder. The amplifier circuit amplifies the reflected wave signal received by the ultrasonic probe 20 for each channel and performs gain correction processing. The A / D converter converts the gain-corrected reflected wave signal into a digital signal. The reception delay circuit gives a delay time necessary for determining the reception directivity to the digital signal. The adder adds a plurality of digital signals given delay times. By the addition processing of the adder, a reception signal in which the reflection component from the direction corresponding to the reception directivity is emphasized is generated.

  The internal storage circuit 13 has, for example, a magnetic or optical storage medium, a storage medium readable by a processor such as a semiconductor memory, or the like. The internal storage circuit 13 stores a program or the like for realizing ultrasonic transmission / reception. Further, the internal storage circuit 13 stores diagnostic information (for example, patient ID, doctor's findings, etc.), diagnostic protocol, transmission conditions, reception conditions, signal processing conditions, image generation conditions, image processing conditions, and an initial elastography examination. Various data such as a conversion table that presets a recommended condition regarding the compression or release of the subject by the operator, a display condition, and a range of color data used for visualization for each diagnostic region is stored. The program and various data may be stored in advance in the internal storage circuit 13, for example. Further, for example, it may be stored in a non-transitory storage medium and distributed, read from the non-transitory storage medium, and installed in the internal storage circuit 13.

  Further, the internal storage circuit 13 stores the two-dimensional B-mode image data and the distorted image data generated by the processing circuit 19 in accordance with the storage operation input via the input interface 16. The internal storage circuit 13 can also transfer the stored data to the medical image management system 110 or the like via the communication interface 18.

  The internal storage circuit 13 may be a drive device for reading / writing various information from / to a portable storage medium such as a CD-ROM drive, a DVD drive, and a flash memory. The internal storage circuit 13 can also write the stored data in a portable storage medium and store the data in an external device via the portable storage medium.

  The image memory 14 has, for example, a magnetic or optical storage medium, a storage medium readable by a processor such as a semiconductor memory, or the like. The image memory 14 stores image data corresponding to a plurality of frames immediately before the freeze operation, which is input via the input interface 16. The image data stored in the image memory 14 is continuously displayed (cine display), for example.

  The compression information memory 15 has, for example, a magnetic or optical storage medium, a storage medium readable by a processor such as a semiconductor memory, or the like. The compression information memory 15 may store past compression information.

  The internal storage circuit 13, the image memory 14, and the compression information memory 15 do not necessarily have to be realized by independent storage devices. The internal storage circuit 13, the image memory 14, and the compression information memory 15 may be realized by a single storage device. Further, each of the internal storage circuit 13, the image memory 14, and the compression information memory 15 may be realized by a plurality of storage devices.

  The input interface 16 receives various instructions from the operator via the input device 30. The input device 30 is, for example, a mouse, a keyboard, a panel switch, a slider switch, a trackball, a rotary encoder, an operation panel, and a touch command screen (TCS). The input interface 16 is connected to the processing circuit 19 via, for example, a bus, converts an operation instruction input by an operator into an electric signal, and outputs the electric signal to the processing circuit 19. It should be noted that in the present embodiment, the input interface 16 is not limited to one that is connected to a physical operation component such as a mouse and a keyboard. For example, the input interface 16 is also a circuit that receives an electrical signal corresponding to an operation instruction input from an external input device provided separately from the ultrasonic diagnostic apparatus 1 and outputs the electrical signal to the processing circuit 19. include.

  The output interface 17 is an interface for outputting an electric signal from the processing circuit 19 to the display device 40, for example. The display device 40 is any display such as a CRT display, a liquid crystal display, an organic EL display, an LED display, and a plasma display. The output interface 17 is connected to the processing circuit 19 via, for example, a bus, and outputs an electric signal from the processing circuit 19 to the display device 40.

  The communication interface 18 is connected to an external device such as the medical image management system 110 and the hospital information system 120 via the network 101, and performs data communication with the external device. The standard for communication with the external device may be any standard, and examples thereof include DICOM (Digital Imaging and COmmunications in Medicine) which is a standard for medical image data and a communication protocol.

  The processing circuit 19 is, for example, a processor that functions as the center of the ultrasonic diagnostic apparatus 1. The processing circuit 19 executes the program stored in the internal storage circuit 13 to realize the function corresponding to the program. The processing circuit 19 includes, for example, a B-mode processing function 1901, a Doppler processing function 1902, a strain distribution calculation function 1903, an image generation function 1904, an image processing function 1905, a compression information generation function 1906, a compression information acquisition function 1907, and an index information generation function. 1908, an index information comparison function 1909, a display control function 1910, a storage control function 1911, an initial determination function 1912, and a notification function 1913.

  The B-mode processing function 1901 is a function of generating B-mode data based on the reception signal received from the ultrasonic receiving circuit 12. Specifically, in the B-mode processing function 1901, the processing circuit 19 performs, for example, envelope detection processing and logarithmic amplification processing on the received signal received from the ultrasonic receiving circuit 12, and the signal strength is brightness with brightness. Data (B-mode data) represented by The generated B-mode data is stored in a RAW data memory (not shown) as B-mode RAW data on a two-dimensional ultrasonic scanning line (raster).

  The Doppler processing function 1902 frequency-analyzes the received signal received from the ultrasonic receiving circuit 12, and thereby the motion information based on the Doppler effect of the moving body in the ROI (Region Of Interest) set in the scan region. Is a function to generate data (Doppler information) extracted from. The generated Doppler information is stored in a RAW data memory (not shown) as Doppler RAW data on a two-dimensional ultrasonic scanning line.

  The strain distribution calculation function 1903 is based on the echo signal output by the ultrasonic wave reception circuit 12 and is pressurized or depressurized by the operator using the ultrasonic probe 20, in other words, compressed or released within the subject. It is a function to calculate the relative hardness of the tissue. For example, in the distortion distribution calculation function 1903, the processing circuit 19 extracts the velocity component from the Doppler information generated in the Doppler processing function 1902, and sets the velocity component as the velocity distribution information. In the strain distribution calculation function 1903, the processing circuit 19 generates strain distribution information indicating the strain of the tissue caused by the compression or release by the operator, based on the velocity distribution information. Further, in the strain distribution calculation function 1903, the processing circuit 19 calculates the average velocity of the tissue corresponding to the strain distribution information as the strength of the compression or release by the operator.

  The image generation function 1904 is a function of generating B-mode image data based on the data generated by the B-mode processing function 1901. The image generation function 1904 is a function that generates strain image data based on the strain distribution information obtained by the strain distribution calculation function 1903. For example, in the image generation function 1904, the processing circuit 19 converts a scanning line signal sequence of ultrasonic scanning into a scanning line signal sequence of a video format typified by a television or the like (scan conversion) to generate image data for display. To do. Specifically, the processing circuit 19 performs RAW-pixel conversion on the B-mode RAW data stored in the RAW data memory, for example, coordinate conversion according to the scanning form of ultrasonic waves by the ultrasonic probe 20. Then, two-dimensional B-mode image data composed of pixels is generated.

  The image processing function 1905 is a function of performing predetermined image processing on the two-dimensional B-mode image data and the distorted image data. Specifically, in the image processing function 1905, the processing circuit 19 reproduces an average brightness image using a plurality of image frames in the two-dimensional B-mode image data or the distorted image data generated by the image generation function 1904, for example. Image processing to be performed (smoothing processing), image processing using a differential filter in the image (edge emphasis processing), and the like are performed.

  The compression information generation function 1906 is a function of generating compression information indicating the situation of compression or release of the living body P by the operator based on the velocity distribution information extracted by the strain distribution calculation function 1903. In the compression information generation function 1906, the processing circuit 19 outputs information about periodic pressurization and depressurization to the tissue that is actually performed in the elastography examination each time the elastography examination is performed by the ultrasonic diagnostic apparatus 1. Generate compression information to represent. That is, the processing circuit 19 functions as a compression information generation unit that generates compression information based on the pressurization and depressurization given to the subject in the elastography examination.

  The compression information acquisition function 1907 is, for example, a function of acquiring past compression information stored in the hospital information system 120 from the hospital information system 120 connected to the ultrasonic diagnostic apparatus 1 via the network 101. That is, the processing circuit 19 acquires the patient identification information (for example, the patient ID) regarding the patient who undergoes the elastography examination and the examination information regarding the site (for example, the liver) where the patient undergoes the elastography examination, and the corresponding site for the patient. On the other hand, it functions as an acquisition unit that acquires compression information regarding pressurization and depressurization given in the past elastography inspection.

  The index information generation function 1908 is a function that generates a compression index based on the past compression information acquired by the processing circuit 19 in the compression information acquisition function 1907. That is, the processing circuit 19 functions as an index generation unit that generates a compression index based on compression information regarding pressurization and depressurization given to the subject in the past elastography examination. The details of the compression index will be described later. In addition, the index information generation function 1908 is a function that, based on the current compression information generated by the processing circuit 19 in the compression information generation function 1906, corresponds to the compression index regarding the current compression information, for example, a function that generates a corresponding figure. is there. Further, the index information generation function 1908 is a function of generating a recommended index that is a guide based on recommended conditions regarding pressurization and depressurization preset in the internal storage circuit 13.

  The index information comparison function 1909 is a function of comparing the compression index generated by the processing circuit 19 in the index information generation function 1908 with the corresponding compression information, such as a figure. That is, the processing circuit 19 functions as a comparison unit that compares the compression index with the graphic generated based on the current compression information.

  The display control function 1910 is a function of controlling the display of the two-dimensional B-mode image data processed by the image processing function 1905 and the distortion image data on the display device 40. For example, in the display control function 1910, the processing circuit 19 synthesizes, for example, the two-dimensional B-mode image data with a display representing the ROI for collecting Doppler data. The processing circuit 19 synthesizes the two-dimensional Doppler image data with the corresponding part in the two-dimensional B-mode image data according to the instruction from the operator input from the input device 30. At this time, the processing circuit 19 may adjust the opacity of the two-dimensional Doppler image data to be combined according to an instruction from the operator.

  Further, the processing circuit 19 executes various processes such as dynamic range, brightness (brightness), contrast, γ-curve correction, and RGB conversion on the two-dimensional B-mode image data or the distorted image data, thereby processing the image data. Convert to video signal. The processing circuit 19 causes the display device to display the video signal. The processing circuit 19 may generate a user interface (GUI: Graphical User Interface) for the operator to input various instructions using the input device 30, and display the GUI on the display device 40. The processing circuit 19 also functions as a display control unit that causes the display device 40 to display the compression index.

  The storage control function 1911 is, for example, a function of controlling storage of past compression information in the memory 124 or the storage 125, which is the storage unit of the server apparatus 121 of the hospital information system 120. In the storage control function 1911, the processing circuit 19 stores the compression information generated by the processing circuit 19 in the compression information generation function 1906 (for example, compression information in the first elastography examination) in the hospital information system 120 via the network 101 or the like. Let That is, the processing circuit 19 functions as a storage control unit that associates the compression information with the identification information (patient ID) regarding the subject and stores the information in the hospital information system 120 as the medical treatment information regarding the subject.

  The initial determination function 1912 is a function of determining whether or not the elastography test by the ultrasonic diagnostic apparatus 1 is the first time on the living body P that is the subject. Here, the first time of the elastography inspection means that the system 100 does not have past compression information when the elastography inspection is performed on the same site of the same living body P. Therefore, even if there is past compression information when performing the elastography examination on the non-identical site of the same living body P, if the site is different, it is determined that the elastography examination is the first time.

  In some cases, the system 100 includes two or more ultrasonic diagnostic apparatuses, and the ultrasonic diagnostic apparatus that performs the initial examination and the ultrasonic diagnostic apparatus that performs the reexamination are different from each other. Alternatively, the initial examination is performed by the ultrasonic diagnostic apparatus outside the system 100 and the reexamination is performed by the ultrasonic diagnostic apparatus 1 inside the system 100, and vice versa. In such a case, the initial determination function 1912 may be a function of determining whether or not the elastography test for the living body P that is the subject is the first time. That is, it is determined whether or not the elastography test is the first time based on the presence or absence of past compression information at the time of the elastography test by the same or another ultrasonic diagnostic apparatus for the living body P.

  The informing function 1913 is a function of informing the operator or the like that the compression condition serving as a guide and the current compression substantially match, visually or audibly, or both. In the notification function 1913, the processing circuit 19 generates a sound, a display or the like to be output from the display device 40 or the like. That is, the processing circuit 19 functions as a notification unit.

  An example of elastography inspection processing by the ultrasonic diagnostic apparatus 1 according to the first embodiment will be described with reference to FIG. In the following, in order to make the description concrete, the past compression information managed in the server device 121 of the hospital information system 120 is the compression information used in the first elastography examination of the patient. To do.

  In step S100, the processing circuit 19 receives a patient ID and examination information relating to the patient, for example, information such as “liver ultrasound elastography examination” and “examination date and time”.

  In step S101, the processing circuit 19 accesses the medical care information of the patient stored in the server device 121 of the hospital information system 120 via the network 101 or the like based on the patient ID received in step S100. Then, the processing circuit 19 analyzes the medical care information of the patient and determines whether or not the elastography examination is the first examination. If it is determined to be the first inspection (step S101-Yes), the process proceeds to step S102.

  In step S102, the processing circuit 19 controls the guide based on the recommended condition for compression or release preset in the internal storage circuit 13, that is, the display of the recommended index. The recommended index is displayed on the display device 40 as, for example, a rectangular figure having a side length corresponding to the speed or cycle of pressurization or depressurization.

  In step S103, the processing circuit 19 generates distortion distribution information.

  In step S104, the processing circuit 19 generates a graphic corresponding to the recommended index from the current compression information. For example, a figure which is a rectangle whose side length corresponds to the speed and cycle of pressurization or depressurization is generated.

  In step S105, the processing circuit 19 controls the display so that the recommended index and the figure generated in step S104 are displayed in a superimposed manner. The processing circuit 19 causes the display device 40 to superimpose and display the rectangle that is the recommended index and the rectangle that is based on the current compression information.

  In step S106, the processing circuit 19 stores the B-mode image data and the distorted image data in, for example, the image memory 14. The image saving instruction is, for example, when the operator presses or releases the living body P, and when the rectangle of the recommended index and the rectangle based on the current compression information substantially match, the operator performs an input operation of the input device 30. Accepted by an input signal.

  In step S107, the processing circuit 19 generates initial compression information. The processing circuit 19 generates the initial compression information including the compression information when the B-mode image data and the strained image data were saved in step S106.

  In step S108, the processing circuit 19 stores the initial compression information in the memory 124 or the storage 125 which is the storage unit of the server device 121 of the hospital information system 120.

  In step S109, the processing circuit 19 determines whether the inspection is completed. The instruction to end the inspection is received by, for example, an input signal by an input operation of the input device 30 by the operator. If it is determined that the inspection has ended (step S109-Yes), the process ends. When it is not determined that the inspection is completed (step S109-No), the process returns to step S103.

  On the other hand, when it is determined in step S101 that the inspection is not the initial inspection (step S101-No), the process proceeds to step S110.

  In step S110, the processing circuit 19 acquires the first compression information from the memory 124 or the storage 125, which is the storage unit of the server apparatus 121 of the hospital information system 120, via the network 101 or the like.

  In step S111, the processing circuit 19 generates a compression index based on the initial compression information acquired in step S110. Here, the compression index is an index for reproducing the amplitude and the cycle related to pressurization and depressurization included in the initial compression information in this time, that is, the second or subsequent elastography examination, for example, pressurization or It is a figure such as a rectangle having a vertical side corresponding to the speed of pressure reduction and a horizontal side corresponding to the cycle.

  In step S112, the processing circuit 19 controls the display of the compression index generated in step S111. The compression index is displayed on the display device 40.

  In step S113, the processing circuit 19 generates strain distribution information.

  In step S114, the processing circuit 19 generates a graphic corresponding to the compression index from the current compression information. For example, a figure which is a rectangle whose side length corresponds to the speed and cycle of pressurization or depressurization is generated.

  In step S115, the processing circuit 19 controls the display so that the compression index and the graphic generated in step S114 are displayed in a superimposed manner. For example, as shown in FIG. 4, the processing circuit 19 causes the display device 40 to superimpose and display a rectangle that is a compression index and a rectangle that is based on the current compression information.

  FIG. 4 is a diagram showing an example of a graph and a figure of the current compression information and a compression index, which are superimposed and displayed in step S115. In FIG. 4, a waveform 50 is a graph of current compression information in which the horizontal axis represents the compression cycle and the vertical axis represents the compression speed (compression section and release section), and a compression index 51 by past elastography examination, A graphic 52 based on the current compression information is shown. The compression index 51 and the graphic 52 are, for example, rectangles whose side lengths are determined according to the velocity distribution and the period calculated from the echo signal of the subject. Since the compression index 51 is based on past compression information, it remains unchanged during display. On the other hand, the graphic 52 changes in real time with the compression or release of the procedure, that is, the pressurization or decompression. The operator presses or releases the living body P so that the figure 52 matches the pressing index 51. Thereby, the compression condition in the past elastography examination, for example, the initial compression condition is reproduced, and the strain image can be acquired under the same condition as the initial compression condition.

  As shown in FIG. 5, the first waveform 53, which is a graph of past compression information, may be displayed together with the second waveform 54, which is a graph of current compression information. Also in this case, the compression index 55 and the graphic 56 based on the current compression information are displayed. It is not necessary that the second waveform 54 trace all phases of the first waveform 53. It suffices to be able to reproduce the compression condition for one cycle in which an image was acquired in the past elastography inspection, that is, the compression index 55 and the graphic 56 match.

  In step S116, the processing circuit 19 stores the B-mode image data and the distorted image data in, for example, the image memory 14. The instruction to save the image is accepted by an input signal by the input operation of the input device 30 by the operator, for example, when the operator presses or releases the living body P and the compression index 51 and the figure 52 substantially match.

  In step S117, the processing circuit 19 determines whether the inspection is finished. The instruction to end the inspection is received by, for example, an input signal by an input operation of the input device 30 by the operator. When it is determined that the inspection has ended (step S117-Yes), the process ends. When it is not determined that the inspection is completed (step S117-No), the process returns to step S113.

  As described above, in the first elastography examination, a graphic having a size corresponding to the speed and cycle of the recommended condition preset in the ultrasonic diagnostic apparatus is displayed as the recommended index. On the other hand, in the second and subsequent elastography examinations, a graphic having a size corresponding to the speed and the cycle when the image is saved in the first examination is displayed as a compression index. In the second and subsequent elastography examinations, the operator simply presses or releases the subject so as to match the compression index based on the compression information when the image was acquired during the first elastography examination, and the first examination can be performed easily. The pressure condition of time can be reproduced.

  For example, even if the subject is pressed according to the recommended index, if the patient is obese, the region to be examined does not distort properly, and the elasticity value used to generate the strain image data may not be accurate. In that case, it is necessary to compress the subject more strongly than the recommended index. In this way, the recommended index is just a guideline, and actual compression varies from patient to patient. For example, it is extremely important for follow-up observation to reproduce the compression condition derived from the individual difference in the second and subsequent elastography examinations.

  Although it has been described that the compression index is created based on the compression information at the time of the first examination, the compression index may be created not only at the first time but based on the compression information at the previous examination. That is, a compression index that can reproduce the compression condition given to the subject in the past elastography examination may be created.

(Modification 1)
In the above embodiment, the case where past compression information is stored and managed in the server device 121 of the hospital information system 120 has been illustrated. However, it is not limited to this. As a first modification, for example, past compression information may be stored and managed in the compression information memory 15 of the ultrasonic diagnostic apparatus 1. In this case, the past compression information may be managed by a table associated with the patient ID and the examination information (information such as “liver ultrasound elastography examination” and “examination date / time”).

  Hereinafter, three modifications of the processing shown in FIG. 3 in the first modification from the above embodiment will be described. In step S101, the processing circuit 19 determines, based on the patient ID received in step S100, whether or not the elastography examination is the initial examination based on the presence or absence of the initial compression information stored in the compression information memory 15. Becomes

  Further, in step S108, the processing circuit 19 stores the initial compression information in the compression information memory 15 of the ultrasonic diagnostic apparatus 1.

  Further, in step S110, the processing circuit 19 acquires the initial compression information from the compression information memory 15 of the ultrasonic diagnostic apparatus 1.

(Modification 2)
Alternatively, as a second modification, past compression information may be stored and managed in a storage unit (not shown) of the medical image management system 110. In this case, the past compression information may be stored and managed as supplementary information (tag information) of the image data stored in the medical image management system 110.

  Hereinafter, three points of modification of the processing shown in FIG. 3 in the second modification from the above embodiment will be described. In step S101, the processing circuit 19 accesses the medical treatment information of the server device 121 of the hospital information system 120 via the network 101 or the like, identifies the past elastography examination of the patient, and acquires the examination ID thereof. The processing circuit 19 further accesses the medical image management system 110 via the network 101 to determine whether the elastography inspection is the first inspection based on the presence or absence of the incidental information of the image data with the acquired inspection ID. judge.

  In addition, in step S108, the processing circuit 19 causes the medical image management system 110 to store the initial compression information as supplementary information of the image data.

  Further, in step S110, the processing circuit 19 acquires the initial compression information from the incidental information of the image data with the examination ID acquired in step S101.

  In this way, the past compression information may be stored and managed in any of the devices connected via the network 101 or the like in the system 100.

(Second embodiment)
An example of an elastography inspection process performed by the ultrasonic diagnostic apparatus 1 according to the second embodiment will be described with reference to FIG. 6. The ultrasonic diagnostic apparatus 1 according to the present embodiment notifies that when the compression index and the figure based on the current compression information match in the second and subsequent elastography examinations. The configuration of the ultrasonic diagnostic apparatus 1 is the same as that of the first embodiment, and thus the description thereof is omitted. Hereinafter, differences from the first embodiment will be mainly described.

  Steps S201 to S209 are the same as steps S101 to S109 in the first embodiment, respectively. That is, in step S201, the processing circuit 19 determines whether it is the first inspection. When it is determined that the inspection is the first inspection (Yes in step S201), the processes in step S202 and subsequent steps are performed. On the other hand, when it is determined that the inspection is not the initial inspection (step S201-No), the process proceeds to step S210.

  Steps S210 to S215 are the same as steps S110 to S115 in the first embodiment, respectively. In step S216, the processing circuit 19 determines whether the compression index and the figure generated in step S214 match. Not only in the case where the figures match perfectly, but in the case where the figures are within a certain range from the compression index, it may be determined that the figures match. When it is determined that they match (step S216-Yes), the process proceeds to step S217. In step S217, the processing circuit 19 notifies the operator. That is, when the compression condition at the time of the past elastography examination and the current compression condition match, the display of the message on the display device 40, the change in the color of the compression index or the graphic displayed on the display device 40, the generation of sound, etc. The operator is informed that the compression condition matches the compression condition when the image was acquired during the past elastography examination. On the other hand, if it is determined that they do not match (No in step S216), the process proceeds to step S218.

  In step S218, the processing circuit 19 determines whether to save the image. If it is determined to save the image (step S218-Yes), the process proceeds to step S219. In step S219, the processing circuit 19 saves the image. On the other hand, if it is determined not to save the image (step S218-No), the process returns to step S213.

  In step S220, the processing circuit 19 determines whether the inspection is finished. If it is determined that the inspection has ended (step S220-Yes), the process ends. When it is not determined that the inspection is completed (step S220-No), the process returns to step S213.

  In the second embodiment, since the operator can be notified by notification that the compression condition in the past elastography examination has been reproduced, the freeze timing for the operator to obtain the same image as in the past examination. It becomes possible to grasp.

(Third Embodiment)
An example of an elastography inspection process performed by the ultrasonic diagnostic apparatus 1 according to the third embodiment will be described with reference to FIG. 7. The ultrasonic diagnostic apparatus 1 according to the present embodiment temporarily stores an image when the compression index and the figure based on the current compression information match in the second and subsequent elastography examinations. The configuration of the ultrasonic diagnostic apparatus 1 is the same as that of the first embodiment, and thus the description thereof is omitted. Hereinafter, differences from the first embodiment will be mainly described.

  Steps S301 to S309 are the same as steps S101 to S109 in the first embodiment, respectively. That is, in step S301, the processing circuit 19 determines whether it is the first inspection. When it is determined that the inspection is the first inspection (Yes in step S301), the processes in step S302 and subsequent steps are performed. On the other hand, when it is determined that the inspection is not the initial inspection (step S301-No), the process proceeds to step S310.

  Steps S310 to S315 are the same as steps S110 to S115 in the first embodiment, respectively. In step S316, the processing circuit 19 determines whether the compression index and the graphic generated in step S314 match. If it is determined that they match (Yes in step S316), the process proceeds to step S317. In step S317, the processing circuit 19 temporarily stores the image in the image memory 14. That is, when the compression condition at the time of the past elastography examination and the current compression condition match, the ultrasonic diagnostic apparatus 1 automatically stores the B-mode image data and the strain image data in the image memory 14. On the other hand, if it is determined that they do not match (No in step S316), the process proceeds to step S318.

  In step S318, the processing circuit 19 determines whether the inspection is completed. When it is not determined that the inspection is completed (step S318-No), the process returns to step S213. When it is determined that the inspection is completed (step S318-Yes), the process proceeds to step S319. In step S319, the processing circuit 19 stores the B-mode image data and the distorted image data. Here, the processing circuit 19 causes the display device 40 to display a list of the images temporarily stored in the image memory 14. The operator selects an image to be left in the image memory 14 using the input device 30, and inputs an operation to discard the other images. The process ends after step S319.

  In the third embodiment, since the image when the compression condition in the past examination is reproduced is temporarily stored without the operator's judgment, the image acquisition under the compression condition in the past examination is acquired. Will be easier.

  According to at least one embodiment described above, reproducibility of the compression condition at the time of reexamination is improved. In other words, the ultrasonic diagnostic apparatus 1 displays a recommended index based on the recommended conditions preset in the ultrasonic diagnostic apparatus 1 as a guide at the time of the first inspection, but in the second and subsequent inspections, the compression at the time of performing a past inspection is performed. The strength, the cycle, and the compression index that is a figure whose size changes according to them are displayed as a guide. The operator can easily reproduce the initial compression condition by performing compression or release according to the compression index. Even when a past examination is performed using a compression condition other than the recommended condition preset in the ultrasonic diagnostic apparatus, it is possible to reproduce the past compression condition and acquire an image.

  According to each embodiment, the operator can easily refer to the compression condition at the time of the elastography examination in the past, so that the workflow for reproducing the compression condition is shortened. That is, the time required for the elastography inspection can be shortened.

  Even when an operator such as an inspection technician who is different from the past elastography examination performs the elastography examination this time, the compression condition at the time of the past elastography examination and the compression condition at this time of the elastography examination And can be easily aligned. For example, in an elastography examination for the same site of the same patient, the initial compression condition can be always reproduced, which is effective at the time of follow-up observation.

  The term “processor” used in the description of the embodiments includes, for example, a CPU (central processing unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC), and a programmable logic. A circuit such as a device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)) is meant. . The processor realizes the function by reading and executing the program stored in the memory circuit. Instead of storing the program in the memory circuit, the program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit. It should be noted that each processor of each of the above-described embodiments is not limited to a case where each processor is configured as a single circuit, and a plurality of independent circuits are combined to configure one processor so as to realize the function thereof. Good. Furthermore, a plurality of constituent elements in each of the above-described embodiments may be integrated into one processor to realize its function.

  Although some embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. The embodiments and their modifications are included in the scope of the invention and the scope thereof, and are included in the invention described in the claims and the scope of equivalents thereof.

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic device 10 ... Device main body 11 ... Ultrasonic transmission circuit 12 ... Ultrasonic receiving circuit 13 ... Internal memory circuit 14 ... Image memory 15 ... Compression information memory 16 ... Input interface 17 ... Output interface 18 ... Communication interface 19 ... Processing circuit 1906 ... Pressure information generation function 1907 ... Pressure information acquisition function 1908 ... Index information generation function 1909 ... Index information comparison function 1910 ... Display control function 1911 ... Memory control function 20 ... Ultrasonic probe 30 ... Input device 40 ... Display device 100 ... system 101 ... network 110 ... medical image management system 120 ... hospital information system

Claims (10)

The patient identification information regarding the patient undergoing the elastography test and the examination information regarding the site where the patient undergoes the elastography test are acquired, and the pressure applied to the site of the patient by the past elastography test is applied. And an acquisition unit that acquires compression information regarding decompression,
An index generation unit that generates a compression index based on the compression information,
An ultrasonic diagnostic apparatus comprising:   The ultrasonic diagnosis according to claim 1, further comprising a compression information generation unit that generates the compression information based on pressurization and depressurization given to the part of the patient in the past elastography examination. apparatus.   3. The compression information according to claim 1, wherein the compression information includes an amplitude and a cycle related to a speed for at least one cycle regarding a pressurization and a decompression applied to the part of the patient in the past elastography examination. Ultrasonic diagnostic device.   The ultrasonic diagnostic apparatus according to claim 1, further comprising a storage controller that associates the compression information with the patient identification information and stores the information in the hospital information system as medical information about the patient. . Storage part,
A storage control unit that stores the compression information in the storage unit;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 3, further comprising: A transmitting / receiving unit that transmits ultrasonic waves to the site and receives an echo signal from within the site,
An image generation unit that generates a distortion image based on the echo signal,
A storage control unit that stores the compression information along with the strain image in the medical image management system;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 3, further comprising: Further comprising a display control unit for displaying the compression index on a display device,
The ultrasonic diagnostic apparatus according to any one of claims 1 to 6, wherein the compression index is a figure generated based on the compression information. The compression information generation unit generates current compression information regarding pressurization and decompression given to the region of the patient in an elastography examination,
The index generation unit generates a graphic corresponding to the compression index based on the current compression information,
Ultrasonic diagnostic equipment
A comparison unit that compares the compression index and the figure,
An informing unit for informing that the compression index and the figure match in the comparison,
The ultrasonic diagnostic apparatus according to claim 2, further comprising: A transmitting / receiving unit that transmits ultrasonic waves to the site and receives an echo signal from within the site,
An image generation unit that generates a distortion image based on the echo signal,
Further comprising,
The compression information generation unit generates current compression information regarding pressurization and depressurization given to the site in an elastography examination,
The index generation unit generates a graphic corresponding to the compression index based on the current compression information,
Ultrasonic diagnostic equipment
A comparison unit that compares the compression index and the figure,
A storage control unit that stores the strained image in a storage unit when the compression index and the graphic match in the comparison,
The ultrasonic diagnostic apparatus according to claim 2, further comprising: The patient identification information regarding the patient undergoing the elastography test and the examination information regarding the site where the patient undergoes the elastography test are acquired, and the pressure applied to the site of the patient by the past elastography test is applied. And obtain pressure information about decompression,
Generating a compression index based on the compression information,
A compression index generation program that causes a computer to execute such a thing.