JP2022023826A - Medical image processing device, system, and method - Google Patents

Abstract

To reduce time and efforts of a user in executing diagnosis, formulation of a treatment plan, etc. on a heart disease.SOLUTION: A medical image processing device of the present invention includes an acquisition unit, a display control unit, and an input operation reception unit. The acquisition unit acquires a three-dimensional image of a blood vessel of a subject and spatial distribution of wall shearing stress values at each position of the blood vessel. The display control unit causes a display image in which the wall shearing stress values are assigned to the three-dimensional image to be displayed from an arbitrary angle. The input operation reception unit receives an input operation for changing the angle. In the display of the display image in which the wall shearing stress values are assigned to the three-dimensional image, the display control unit changes a display mode of the display image at the time of rotation display in which the display image is displayed while changing the angle with a lapse of time, and at the time of non-rotation display in which the angle is not changed.SELECTED DRAWING: Figure 1

Description

The embodiments disclosed herein and in the drawings relate to medical image processing devices, systems and methods.

Conventionally, as a technique for supporting diagnosis related to a heart disease and formulation of a treatment plan, a technique for presenting various information regarding blood flow in the blood vessel of the subject based on a medical image of the blood vessel of the heart of the subject has been known. There is. For example, as one of the information regarding blood flow, there is known a technique of calculating and displaying Wall Shear Stress (WSS) at each position of a blood vessel.

Special Table 2020-518362 Japanese Unexamined Patent Publication No. 2011-62358 Special Table 2016-533815 Gazette

One of the problems to be solved by the embodiments disclosed in the present specification and the drawings is to reduce the time and effort of the user when diagnosing a heart disease and formulating a treatment plan. However, the problems to be solved by the embodiments disclosed in the present specification and the drawings are not limited to the above problems. It is also possible to position the problem corresponding to each effect by each configuration shown in the embodiment described later as another problem.

The medical image processing apparatus according to the embodiment includes an acquisition unit, a display control unit, and an input operation reception unit. The acquisition unit acquires a three-dimensional image of the blood vessel of the subject and a spatial distribution of the value of the wall shear stress at each position of the blood vessel. The display control unit displays a display image in which the value of the wall shear stress is assigned to the three-dimensional image from an arbitrary angle. The input operation receiving unit receives an input operation for changing the angle. In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, the display control unit displays the display image while changing the angle with the passage of time, and changes the angle. The display form of the displayed image is changed depending on whether the display is non-rotating.

FIG. 1 is a diagram showing a configuration example of a medical image processing system and a medical image processing apparatus according to the first embodiment. FIG. 2 is a flowchart showing a processing procedure of processing performed by each processing function included in the processing circuit of the medical image processing apparatus according to the first embodiment. FIG. 3A is a diagram showing an example of a list according to the first embodiment. FIG. 3B is a diagram showing an example of a list according to the first embodiment. FIG. 4A is a diagram showing an example of a WSS display image according to the first embodiment. FIG. 4B is a diagram showing an example of a WSS display image according to the first embodiment. FIG. 5 is a diagram for explaining an example of switching the display form of the display image according to the first embodiment. FIG. 6 is a diagram for explaining an example of speed adjustment of the rotation speed according to the first embodiment. FIG. 7 is a diagram for explaining an example of display control by the display control function according to the first embodiment. FIG. 8A is a diagram showing an example of display of additional information according to the first embodiment. FIG. 8B is a diagram for explaining an example of speed control of the rotation speed based on the additional information according to the first embodiment. FIG. 9 is a diagram for explaining an example of information transfer by the control function according to the first embodiment. FIG. 10 is a flowchart showing a processing procedure of processing performed by each processing function included in the processing circuit of the medical image processing apparatus according to the second embodiment. FIG. 11 is a diagram for explaining an example of display control by the display control function according to the third embodiment. FIG. 12 is a diagram for explaining an example of display control by the display control function according to the third embodiment.

Hereinafter, embodiments of the medical image processing apparatus, system, and method will be described in detail with reference to the drawings. The medical image processing apparatus and the medical image processing method according to the present application are not limited to the embodiments shown below. Further, the embodiment can be combined with other embodiments or conventional techniques as long as the processing contents do not conflict with each other.

(First Embodiment)
FIG. 1 is a diagram showing a configuration example of a medical image processing system and a medical image processing apparatus according to the first embodiment.

For example, as shown in FIG. 1, the medical image processing system 100 according to the present embodiment includes an X-ray CT (Computed Tomography) device 110, a medical image storage device 120, each department system 130, and a medical information display device 140. And the medical image processing apparatus 150. Here, each device and system are communicably connected via the network 160.

In addition to the X-ray CT apparatus 110, the medical image processing system 100 includes a magnetic resonance imaging (MRI) apparatus, an ultrasonic diagnostic apparatus, a PET (Positron Emission Tomography) apparatus, and a SPECT (Single Photon Emission Computed Tomography). ) Other medical diagnostic imaging devices such as devices may be further included.

The X-ray CT apparatus 110 generates a CT image of the subject. Specifically, the X-ray CT apparatus 110 collects projection data showing the distribution of X-rays transmitted through the subject by swirling the X-ray tube and the X-ray detector in a circular orbit surrounding the subject. do. Then, the X-ray CT apparatus 110 generates a CT image based on the collected projection data.

The medical image storage device 120 stores various medical images related to the subject. Specifically, the medical image storage device 120 acquires a CT image from the X-ray CT device 110 via the network 160, stores the CT image in a storage circuit in the device, and stores the CT image. For example, the medical image storage device 120 is realized by a computer device such as a server or a workstation. Further, for example, the medical image storage device 120 is realized by a PACS (Picture Archiving and Communication System) or the like, and stores CT images in a format compliant with DICOM (Digital Imaging and Communications in Medicine).

Each department system 130 includes a hospital information system (HIS: Hospital Information System), a radiation information system (RIS), a diagnostic report system, a clinical examination information system (LIS: Laboratory Information System), a rehabilitation department system, and a dialysis department. Various systems such as systems, surgical department systems, etc. are included. The medical image processing system 100 is connected to each of these systems and transmits and receives various information to and from each other. For example, the medical image processing system 100 mutually transmits and receives patient information, examination information, treatment information, information on analysis results, and the like to and from each system included in each department system 130.

The medical information display device 140 displays various medical information regarding the subject. Specifically, the medical information display device 140 acquires medical information such as CT images and image processing processing results from the medical image storage device 120 via the network 160, and displays the medical information on a display in the device. do. For example, the medical information display device 140 is realized by a computer device such as a workstation, a personal computer, or a tablet terminal.

The medical image processing apparatus 150 performs various image processing on the subject. Specifically, the medical image processing device 150 acquires a CT image from the X-ray CT device 110 or the medical image storage device 120 via the network 160, and performs various image processing using the CT image. Further, the medical image processing apparatus 150 acquires various information from each department system 130 via the network 160 and executes various processes. For example, the medical image processing device 150 is realized by a computer device such as a server or a workstation.

For example, the medical image processing apparatus 150 includes a network (NetWork: NW) interface 151, a storage circuit 152, an input interface 153, a display 154, and a processing circuit 155.

The NW interface 151 controls the transmission and communication of various data transmitted and received between the medical image processing device 150 and other devices connected via the network 160. Specifically, the NW interface 151 is connected to the processing circuit 155, and outputs the data received from the other device to the processing circuit 155, or transmits the data output from the processing circuit 155 to the other device. .. For example, the NW interface 151 is realized by a network card, a network adapter, a NIC (Network Interface Controller), or the like.

The storage circuit 152 stores various data and various programs. Specifically, the storage circuit 152 is connected to the processing circuit 155, and stores the data input from the processing circuit 155, or reads out the stored data and outputs the stored data to the processing circuit 155. For example, the storage circuit 152 is realized by a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like.

The input interface 153 receives various instructions and input operations of various information from the user. Specifically, the input interface 153 is connected to the processing circuit 155, converts the input operation received from the user into an electric signal, and outputs the input operation to the processing circuit 155. For example, the input interface 153 includes a trackball, a switch button, a mouse, a keyboard, a touch pad for performing an input operation by touching an operation surface, a touch screen in which a display screen and a touch pad are integrated, and a non-optical sensor. It is realized by a contact input interface, a voice input interface, and the like. In the present specification, the input interface 153 is not limited to the one provided with physical operating parts such as a mouse and a keyboard. For example, an example of the input interface 153 includes an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the device and outputs the electric signal to a control circuit.

For example, the input interface 153 accepts an input operation for changing the angle of the displayed image displayed from an arbitrary angle. The input interface 153 is an example of an input operation receiving unit.

The display 154 displays various information and various data. Specifically, the display 154 is connected to the processing circuit 155 and displays various information and various data output from the processing circuit 155. For example, the display 154 is realized by a liquid crystal display, a CRT (Cathode Ray Tube) display, a touch panel, or the like.

The processing circuit 155 controls the entire medical image processing apparatus 150. For example, the processing circuit 155 performs various processes according to the input operation received from the user via the input interface 153. For example, the processing circuit 155 inputs data transmitted from another device from the NW interface 151, and stores the input data in the storage circuit 152. Further, for example, the processing circuit 155 outputs the data input from the storage circuit 152 to the NW interface 151, so that the data is transmitted to another device. Further, for example, the processing circuit 155 displays the data input from the storage circuit 152 on the display 154.

The configuration example of the medical image processing system 100 and the medical image processing device 150 according to the present embodiment has been described above. For example, the medical image processing system 100 and the medical image processing device 150 according to the present embodiment are installed in medical facilities such as hospitals and clinics, and diagnosis and treatment plans for heart diseases performed by users such as doctors are formulated. To support.

Specifically, the medical image processing apparatus 150 calculates and displays Wall Shear Stress (WSS) at each position of the blood vessel based on the medical image of the blood vessel of the heart of the subject. Here, the medical image processing device 150 is a user for diagnosing a heart disease and formulating a treatment plan by automatically changing the display form in consideration of the calculation cost of WSS and the visibility by a doctor. Reduce the effort of.

Since the calculation cost and accuracy of WSS differ depending on the calculation method, there is a possibility that unnecessary calculation cost will be incurred and WSS cannot be calculated with the accuracy required by the user unless it is appropriately controlled in consideration of the purpose of use of the user. there is a possibility. However, it takes time and effort for the user to manually set the calculation method in consideration of various situations.

Therefore, the medical image processing apparatus 150 according to the present embodiment is configured to reduce the time and effort of the user by appropriately controlling the calculation and display of the WSS in consideration of the purpose of use of the user. ing.

Specifically, the medical image processing apparatus 150 changes the display form of the WSS according to the difference in the display method of the WSS. For example, the medical image processing apparatus 150 changes the display form between the rotation display and the non-rotation display when displaying a three-dimensional image of a blood vessel showing WSS. Hereinafter, the medical image processing apparatus 150 having such a configuration will be described in detail. In the following, an example of using a coronary artery CT image as a medical image relating to a blood vessel will be described.

For example, as shown in FIG. 1, in the present embodiment, the processing circuit 155 of the medical image processing apparatus 150 has an acquisition function 155a, a determination function 155b, a calculation function 155c, a display information generation function 155d, and a display control function. 155e and the control function 155f are executed. Here, the acquisition function 155a is an example of the acquisition unit. Further, the determination function 155b is an example of the determination unit. Further, the calculation function 155c is an example of the calculation unit. Further, the display information generation function 155d is an example of a generation unit. Further, the display control function 155e is an example of the display control unit. Further, the control function 155f is an example of a control unit.

The acquisition function 155a acquires a coronary CT image of a subject from the X-ray CT device 110 or the medical image storage device 120 via the NW interface 151. Specifically, the acquisition function 155a acquires a three-dimensional coronary artery CT image that can be used for calculating WSS. Further, the acquisition function 155a can acquire an index value related to blood flow from a device connected to the medical image processing system 100 via the NW interface 151. That is, the acquisition function 155a can acquire an index value related to blood flow calculated by an apparatus connected to the medical image processing system 100. For example, the acquisition function 155a acquires the WSS value at each position of the coronary artery calculated by the device connected to the medical image processing system 100, the blood flow reserve ratio (FFR), and the like. In this embodiment, a case where the calculation function 155c calculates the above-mentioned index value related to blood flow by using the three-dimensional coronary artery CT image acquired by the acquisition function 155a will be described.

The determination function 155b performs determination processing regarding the calculation target and the calculation result of WSS. Specifically, the determination function 155b executes a determination process regarding the validity of the WSS calculation target and a determination process regarding the validity of the WSS calculation result. The processing by the determination function 155b will be described in detail later.

The calculation function 155c extracts the core line of the coronary artery included in the coronary artery CT image of the subject acquired by the acquisition function 155a. In addition, the calculation function 155c calculates an index value related to blood flow in the coronary artery based on the coronary CT image of the subject acquired by the acquisition function 155a. For example, the calculation function 145b uses a known method using CFD (Computational Fluid Dynamics), machine learning, etc. from the coronary artery CT image of the subject to obtain the WSS value at each position of the coronary artery and the blood flow reserve ratio (Fractional). Flow Reserve: FFR) etc. are calculated.

For example, when calculating the index value by CFD, the calculation function 155c uses the physical property value of blood (for example, hematocrit, blood viscosity, density, etc.), the elasticity value of the blood vessel wall, and the condition of iterative calculation (maximum number of iterations in the iterative calculation). , Relaxation coefficient, tolerance of residuals, etc.), initial values of analysis (blood flow, pressure, fluid resistance, initial values of pressure boundary, etc.), and fluid analysis using blood vessel shape data Then, the index value regarding the blood flow in the target area of the blood vessel is calculated. As an example, the calculation function 155c calculates index values such as pressure, blood flow, blood flow velocity, vector, and wall shear stress for each position of the coronary artery.

The display information generation function 155d generates display information including various images for display and various information. For example, the display information generation function 155d generates a three-dimensional image of the coronary artery by three-dimensionally reconstructing the vascular region of the coronary artery in the coronary CT image. As an example, the display information generation function 155d has a VR (Volume rendering) image, an SR (Surface rendering) image, a CPR (Curved Planer Reconstruction) image, an MPR (Multi Planer Reconstruction) image, and an SPR (Stretched Multi Planer Reconstruction) image. And so on.

Further, for example, the display information generation function 155d generates various display information indicating subject information, calculation results by the calculation function 155c, and the like. The display information generated by the display information generation function 155d will be described in detail later.

The display control function 155e displays the display information generated by the display information generation function 155d on the display 154 and controls the display state. Specifically, the display control function 155e controls a display in which a display image to which a WSS value is assigned to a three-dimensional image is displayed from an arbitrary angle. For example, the display control function 155e controls the rotation display of the display image indicating the WSS calculated by the calculation function 155c. The processing by the display control function 155e will be described in detail later.

The control function 155f transfers the calculation result of WSS to a predetermined transfer destination and executes various processes. The processing by the control function 155f will be described in detail later.

The processing circuit 155 described above is realized by, for example, a processor. In that case, each of the above-mentioned processing functions is stored in the storage circuit 152 in the form of a program that can be executed by a computer. Then, the processing circuit 155 realizes a function corresponding to each program by reading and executing each program stored in the storage circuit 152. In other words, the processing circuit 155 has each processing function shown in FIG. 1 in a state where each program is read out.

The processing circuit 155 may be configured by combining a plurality of independent processors, and each processor may execute a program to realize each processing function. Further, each processing function of the processing circuit 155 may be appropriately distributed or integrated into a single processing circuit or a plurality of processing circuits. Further, each processing function of the processing circuit 155 may be realized by mixing hardware such as a circuit and software. Further, here, an example in which a program corresponding to each processing function is stored in a single storage circuit 152 has been described, but the embodiment is not limited to this. For example, a program corresponding to each processing function may be stored in a distributed manner in a plurality of storage circuits, and the processing circuit 155 may read and execute each program from each storage circuit.

As described above, the medical image processing apparatus 150 changes the display form between the rotated display and the non-rotated display when displaying a three-dimensional image of a blood vessel showing WSS. Here, first, the procedure of processing by the medical image processing apparatus 150 will be described with reference to FIG. FIG. 2 is a flowchart showing a processing procedure of processing performed by each processing function included in the processing circuit 155 of the medical image processing apparatus according to the first embodiment. Note that FIG. 2 shows an example in which the WSS is calculated in advance before receiving the WSS calculation instruction from the user.

For example, as shown in FIG. 2, in the present embodiment, the acquisition function 155a acquires a coronary artery CT image of a subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 (step S101). For example, the acquisition function 155a acquires a coronary artery CT image every time a coronary artery CT image is collected by the X-ray CT device 110 or every time a coronary artery CT image is stored in the medical image storage device 120. This processing is realized, for example, by the processing circuit 155 calling the program corresponding to the acquisition function 155a from the storage circuit 152 and executing it.

Subsequently, the determination function 155b determines whether or not the condition is satisfied when the acquired coronary artery CT image is targeted (step S102). Specifically, the determination function 155b determines whether or not the acquired coronary artery CT image is appropriate as a calculation target of WSS. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the determination function 155b from the storage circuit 152 and executing it.

Here, if the determination function 155b determines that the condition is satisfied (step S102, affirmative), the medical image processing apparatus 150 proceeds to step S103. On the other hand, when the determination function 155b determines that the condition is not satisfied (step S102, negative), the medical image processing apparatus 150 returns to step S101 to acquire image data.

Subsequently, the calculation function 155c calculates an index value related to blood flow based on the coronary artery CT image of the subject acquired by the acquisition function 155a (step S103). For example, the calculation function 155c calculates WSS. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the calculation function 155c from the storage circuit 152 and executing it.

Subsequently, the determination function 155b determines the calculation result and stores the determination result in the storage circuit 152 (step S104). Specifically, the determination function 155b determines whether or not the calculation result of WSS calculated by the calculation function 155c is appropriate. Then, the determination function 155b stores the determination result in the storage circuit 152 in association with the identification information for identifying the subject. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the determination function 155b from the storage circuit 152 and executing it.

Subsequently, it is determined whether or not the display control function 155e has accepted the display operation for displaying the index value via the input interface 153 (step S105). Here, when the display control function 155e accepts the display operation (step S105, affirmative), the medical image processing apparatus 150 proceeds to step S106. On the other hand, when the display control function 155e does not accept the display operation (step S105, negation), the medical image processing apparatus 150 returns to step S101 and continues to acquire the image data. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display information generation function 155d generates a list showing the index value for each subject, and the display control function 155e causes the generated list to be displayed on the display 154 (step S106). This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display information generation function 155d and a program corresponding to the display control function 155e from the storage circuit 152 and executing the processing.

Subsequently, it is determined whether or not the display control function 155e has accepted the selection operation for the list via the input interface 153 (step S107). Here, when the display control function 155e accepts the selection operation (step S107, affirmative), the medical image processing apparatus 150 proceeds to step S108. On the other hand, when the display control function 155e does not accept the selection operation (step S107, negation), the medical image processing apparatus 150 continues to display the list. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display information generation function 155d generates display information related to the selected information, and the display control function 155e causes the generated display information to be displayed on the display 154 (step S108). This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display information generation function 155d and a program corresponding to the display control function 155e from the storage circuit 152 and executing the processing.

Subsequently, the display control function 155e and a display image (1D-WSS) showing the spatial distribution of the WSS value at each cross-sectional position of the blood vessel with respect to the core line of the blood vessel on the image of the coronary artery according to the display method. , The spatial distribution of the WSS value at each position in the blood vessel or the blood vessel wall is displayed by switching from the display image (3D-WSS) shown on the image of the coronary artery (step S109). For example, the display control function 155e displays 1D-WSS at the time of rotation display in which the display image is displayed while changing the angle with the passage of time, and displays 3D-WSS at the time of non-rotation display in which the angle is not changed. Change the display form. As an example, when the operation for changing the display angle of the display image is accepted by the input interface 153, the display control function 155e displays 1D-WSS. Further, the display control function 155e displays 3D-WSS when the operation for changing the display angle is not accepted. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display control function 155e determines whether or not the display condition has been changed (step S110). For example, the display control function 155e determines the rotation condition and whether or not the display condition has been changed. As an example, the display control function 155e determines whether or not the rotation condition including at least one of the rotation speed and the rotation speed and the display condition including enlargement or reduction have been changed. Here, when the display condition is changed (step S110, affirmative), the display control function 155e further changes the display form (step S111).

As an example, the display control function 155e changes the display image from 1D-WSS to 3D-WSS when the rotation speed of the display image is reduced while displaying 1D-WSS in the rotation display. .. Further, for example, the display control function 155e changes the type of the image to display the WSS when the display image is enlarged while the 1D-WSS is displayed in the rotation display. On the other hand, if the display condition has not been changed (step S110, negation), the display control function 155e proceeds to step S112. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display control function 155e determines whether or not the end operation has been accepted via the input interface 153 (step S112), and if the end operation has been accepted (step S112, affirmative), it is for medical use. The image processing device 150 ends the processing. On the other hand, if the end operation is not accepted (step S112, negation), the medical image processing apparatus 150 returns to step S106 and displays the list again.

Hereinafter, the details of each process executed by the medical image processing device 150 will be described.

(Judgment processing regarding calculation target)
As described in step S102 of FIG. 2, the determination function 155b determines the validity of the calculation target in the calculation of WSS. Specifically, the determination function 155b determines the validity of the calculation target using preset conditions.

For example, the determination function 155b determines whether or not the WSS can be calculated with respect to the coronary artery CT image acquired in step S101. As an example, the determination function 155b has "1: the heart is included in the imaging range", "2: contrast-enhanced", and "3: electrocardiographic synchronous imaging" with respect to the coronary artery CT image. It is determined whether or not the four conditions of "4: Heart rate is collected at 70 or less" are satisfied.

In this case, the determination function 155b may, for example, acquire information corresponding to the above four conditions from the DICOM header of the coronary artery CT image and perform the determination process, or may perform the determination process by communicating with each department system 130. The determination process may be performed by acquiring the information corresponding to the four conditions.

Further, the determination function 155b can also be determined by using an image processing technique. For example, the determination function 155b does not satisfy the condition of "1: the heart is included in the imaging range" if the anatomical structure of the heart is searched from the image by the image processing technique and the corresponding anatomical structure cannot be detected. Can be determined. Similarly, the determination function 155b determines that the condition of "2: imaged" is not satisfied if the anatomical structure of the coronary artery cannot be detected from the image by the image processing technique or the pixel value at the position of the coronary artery is small. Can be done.

The conditions for determining whether or not WSS can be calculated are not limited to the above four conditions, and various other conditions may be used.

For example, the determination function 155b determines whether or not the protocol of the acquired CT image is included in the range of the recommended protocol for collecting the coronary CT image used for calculating the index value related to blood flow. , Determine whether WSS can be calculated. As an example, the determination function 155b determines whether or not the slice thickness and the matrix size in the acquired CT image are within the range of the recommended protocol.

Further, for example, the determination function 155b detects the movement of the subject at the time of imaging and noise of the image due to a metal (stent or pacemaker), and determines whether or not the amount of the detected noise exceeds the threshold value. , Determine whether WSS can be calculated. As an example, the determination function 155b calculates the S / N (signal-to-noise ratio) in the acquired coronary artery CT image, and compares the calculated S / N with the threshold value to obtain the acquired coronary artery. It is determined whether or not the WSS can be calculated from the CT image.

Further, for example, the determination function 155b can also perform determination processing by combining a plurality of conditions. For example, conditions are set for the discrepancy between the examination date and the imaging date and the validity of the subject information. As an example, in the determination function 155b, when the inspection date of the acquired coronary artery CT image is "2020", while the imaging date is "2019", the WSS using the coronary artery CT image is used. Is judged to be impossible. Further, for example, when the determination function 155b has an age of "30 years" and a body weight of "10 kg", the determination function 155b determines that the validity of the information regarding the subject is low, and determines that the validity of the information regarding the subject is low. Judge that the calculation is not possible.

Further, for example, the determination function 155b can also perform the determination process based on the information regarding the medication history of the subject. As an example, the determination function 155b acquires information on the medication history of the subject from each department system 130, and when aspirin or a vasodilator is administered immediately before image imaging, the calculation is different from the usual one. Since the result is likely to be calculated, it is determined that the WSS cannot be calculated.

(Calculation process of index value)
As described in step S103 of FIG. 2, the calculation function 155c calculates an index value related to blood flow. Specifically, the calculation function 155c calculates the value of WSS at each position of the coronary artery.

For example, as described above, the calculation function 155c calculates the WSS value in the acquired coronary artery CT image by a known method using CFD, machine learning, or the like. Here, the calculation function 155c can calculate a one-dimensional WSS (hereinafter, 1D-WSS) and a three-dimensional WSS (hereinafter, 3D-WSS). Specifically, the calculation function 155c calculates 1D-WSS indicating WSS at each cross-sectional position of the blood vessel with respect to the core line of the blood vessel and 3D-WSS indicating WSS at each position in the blood vessel or at each position of the blood vessel wall. ..

The calculation function 155c can also calculate the index values related to blood flow other than WSS in one-dimensional and three-dimensional. For example, the calculation function 155c can calculate 1D-FFR indicating the FFR at each cross-sectional position of the blood vessel with respect to the core line of the blood vessel and 3D-FFR indicating the FFR at each position in the blood vessel.

Here, 3D-FFR and 3D-WSS have an advantage that more accurate information can be provided because the WSS and FFR of the local position are calculated, but on the other hand, the calculation time, the processing by the computer, and the storage area are increased. It has the disadvantage that the calculation cost such as the amount used is high. On the other hand, 1D-FFR and 1D-WSS have a demerit that the accuracy of information is lower than that of 3D-FFR and 3D-WSS, but on the other hand, the calculation time, processing by a computer, and storage area are reduced. It has the advantage of low calculation cost such as usage amount.

The medical image processing apparatus 150 can accept manual setting of CFD parameters via the input interface 153 in the calculation of the index value by the calculation function 155c.

(Judgment processing related to calculation results)
As described in step S104 of FIG. 2, the determination function 155b determines the validity of the WSS calculation result. Specifically, the determination function 155b determines the validity of the calculation result using preset conditions.

For example, when the determination function 155b cannot calculate the WSS due to a calculation abnormality in the calculation of the WSS by the calculation function 155c, or when the calculation result or the calculation process deviates from the preset standard. Judge that the calculation result is not valid. As an example, the determination function 155b performs a determination process regarding the calculation result of WSS for each position of the coronary artery or each blood vessel branch, and stores the determination result in association with the position or the blood vessel branch.

In the determination process of such a calculation result, for example, a standard coronary artery shape model generated by using a large amount of image data in advance, a preset reference value of WSS, or the like is used. As an example, the determination function 155b calculates the degree of dissociation between the shape of the coronary artery calculated in the WSS calculation process and the standard coronary artery shape model, and the calculated degree of dissociation exceeds the threshold value. In addition, it is determined that the calculation result is not valid. Further, for example, the determination function 155b calculates the degree of deviation between the calculated WSS value and the reference value, and determines that the calculation result is not valid when the calculated degree of deviation exceeds the threshold value.

Further, the determination function 155b can also make a determination using the calculated fluid. In such a case, the determination function 155b determines that the calculation result is not valid when there is a fluid distribution that cannot be a normal subject such as backflow occurring over a wide range of blood vessels.

Further, in the case of WSS, stress is usually generated in a direction according to the traveling direction of the blood vessel. Therefore, the determination function 155b can also determine that the calculation result is not valid when the stress is generated in a predetermined region or more in the inward / outward direction of the blood vessel in the calculation result of WSS.

Further, when the determination function 155b has a contradiction in the parameters manually set via the input interface 153 (for example, the mesh size 50 * 50 and the mesh number 100 are set for the image size 100 * 100). Or, if the manually set parameters are not valid (for example, out of the range of the recommended protocol), it can be determined that the calculation result is not valid.

(List display processing)
As described in step S106 of FIG. 2, when the display control function 155e receives a display operation from the user, it first displays a list of WSS calculation results for each subject. Specifically, the display information generation function 155d generates a list in which the WSS calculation results are summarized for each subject by using various calculation results calculated by the calculation function 155c and the subject information. The display control function 155e causes the display 154 to display the list generated by the display information generation function 155d. 3A and 3B are diagrams showing an example of a list according to the first embodiment.

For example, when the display control function 155e receives a display operation from the user, as shown in FIG. 3A, the display control function 155e has an "ID", a "Patient name", an "Average WSS", a "Max WSS", and a "Min WSS". , And a list associated with "Calcium Score" is displayed on the display 154. Here, "ID" indicates an identifier for uniquely identifying the subject. Further, "Patient name" indicates the name of the subject. In addition, "Average WSS" indicates the calculated average value of WSS. Further, "Max WSS" indicates the calculated maximum value in WSS. Further, "Min WSS" indicates the calculated minimum value in WSS. Further, "Calcium Score" indicates the calcium score in the blood vessel for which WSS was calculated.

Here, the display control function 155e emphasizes the result of deviation from the reference value in the list. Specifically, the display control function 155e compares the preset reference value with the value calculated by the calculation function 155c, and highlights the result having a deviation of the threshold value or more. For example, as shown in FIG. 3A, the display control function 155e highlights "Max WSS: 9" of "ID: 100001".

Further, the display control function 155e can further display the analysis results other than WSS in the list. For example, the display control function 155e displays a calcium score in addition to the WSS value, as shown in FIG. 3A. In the list shown in FIG. 3A, only the calcium score is shown as the analysis result other than WSS, but the embodiment is not limited to this, and for example, the presence or absence of plaque, the value of FFR, and the like are further described. It may be displayed in association with each other.

The display control function 155e can display various lists other than the list shown in FIG. 3A. For example, when "Max WSS: 9" of "ID: 100001" highlighted in the list shown in FIG. 3A is selected, the display control function 155e shows the details of WSS in each vascular branch shown in FIG. 3B. Switch the display information to display the list.

Here, the list shown in FIG. 3B shows "Average WSS", "Max WSS", and "Min WSS" for each vascular branch in "RCA", "LAD", and "LCX" of the coronary artery. For example, the display control function 155e displays "RCA", "LAD" and "LCX" in tabs as shown in FIG. 3B, and "Average WSS" and "Average WSS" and "Average WSS" for the blood vessel branches included in the selected tab. Display a list containing "Max WSS" and "Min WSS". In FIG. 3B, since "Max WSS: 9" highlighted in FIG. 3A was selected, the "RCA" tab containing the result of "Max WSS: 9" was automatically selected and "RCA". "Average WSS", "Max WSS", and "Min WSS" were shown for the blood vessel branches "SN", "CB", "RVB", "AM", "AVN", and "PD" in The list is displayed.

Here, when the user selects the tab of "LAD" or "LCX", the display control function 155e displays "Average WSS" for the blood vessel branch included in the selected tab ("LAD" or "LCX"). , And a list showing "Max WSS" and "Min WSS" respectively.

(WSS display processing)
As described in step S108 of FIG. 2, when the selection operation for the list is accepted, the display control function 155e controls to display the WSS in the selected subject (or blood vessel branch). Specifically, first, the display information generation function 155d generates a three-dimensional image of the blood vessel in which the value of the wall shear stress is calculated for each position of the blood vessel. Then, the display control function 155e displays a display image in which the value of the wall shear stress is reflected in the three-dimensional image.

For example, the display information generation function 155d generates a VR image of the selected coronary artery of the subject. Then, the display control function 155e displays a color image in which a color corresponding to the value of WSS is mapped to the VR image of the coronary artery. In such a case, the display control function 155e acquires the WSS values of all the positions of the coronary arteries calculated by the calculation function 155c, and sets the range that WSS can take from the maximum and minimum values of the acquired WSS values. Identify. Then, the display control function 155e sets a color array (color lookup table) for the specified range, and maps the color corresponding to the WSS value at each position to each position of the coronary artery.

FIG. 4A is a diagram showing an example of a WSS display image according to the first embodiment. For example, as shown in FIG. 4A, the display control function 155e displays a color image in which a color corresponding to the value of WSS is mapped to a VR image of the entire coronary artery of the selected subject. Here, the display control function 155e displays a color image colorized based on the result of 1D-WSS and a color image colorized based on the result of 3D-WSS on the VR image of the coronary artery. Can be made to.

For example, the display control function 155e extracts the core wire of the blood vessel, assigns the spatial distribution of the wall shear stress value at each position of the blood vessel, and assigns the one-dimensional information assigned to each position of the core wire to the three-dimensional image. Display image (1D-WSS) and a second display image (3D-WSS) in which the three-dimensional information assigned to each position in the space of the blood vessel is assigned to the three-dimensional image are generated and displayed. That is, the display control function 155e color-maps the spatial distribution of WSS, which is calculated by 1D-WSS and has no direction dependence in the blood vessel axis direction, into a three-dimensional blood vessel image in the display of 1D-WSS. indicate. Further, in the display of 3D-WSS, the display control function 155e color-maps the spatial distribution of the local WSS expressed in the form of a three-dimensional vector calculated by the 3D-WSS to the three-dimensional blood vessel image. To display.

Here, the display state at the start of display can be arbitrarily set. Specifically, the display control function 155e starts displaying the display image at a preset angle, enlargement ratio, or the like at the start of display. For example, the display control function 155e starts displaying a display image at a display angle set based on the calculation result of WSS and the properties of blood vessels. As an example, the display control function 155e starts the display at a display angle at which the position where the WSS value indicates the maximum value or the position where the WSS value indicates the minimum value is displayed.

Further, the display control function 155e can change the display form of the display image according to the size of the display area for displaying the display image. Specifically, the display control function 155e can switch between the 1D-WSS display and the 3D-WSS display according to the size of the display area for displaying the display image.

For example, the display control function 155e displays a colorized color image based on the result of 3D-WSS when the size of the display area is larger than the predetermined size. On the other hand, when the size of the display area is smaller than the predetermined size, the display control function 155e displays a colorized color image based on the result of 1D-WSS.

Further, the display control function 155e can change the blood vessel image to be displayed according to the size of the display area. For example, the display control function 155e displays a color image reflecting the WSS result in the CPR image for each blood vessel branch when the size of the display area is smaller than the predetermined size.

In such a case, first, the display information generation function 155d generates a CPR image for each blood vessel branch using the coronary artery CT image. Then, the display control function 155e displays a display image in which the WSS value is reflected in the CPR image. As an example, the display control function 155e arranges the CPR images generated for each vascular branch in the "RCA", "LAD", and "LCX" of the coronary artery as shown in FIG. 4B, and arranges the CPR images of each vascular branch. Displays a display image that reflects the WSS value.

The size of the display area may be the size of the area allocated for displaying the display image on the display, or may be the size of the display on which the display image is displayed. For example, when displaying on a medical information display device such as a tablet terminal or a smartphone, the size of the display of each device may be used as the size of the display area.

(WSS rotation display processing)
As described in step S109 of FIG. 2, when the display image is displayed, the display control function 155e can switch between the display by 1D-WSS and the display by 3D-WSS according to the display method of the display image. can.

For example, the display control function 155e switches between display by 1D-WSS and display by 3D-WSS according to a user's operation (for example, browsing, rotation, etc.) for changing the display position of the display image. .. As an example, the display control function 155e displays by 1D-WSS when the display position of the display image is changed, and displays by 3D-WSS when the display image is stationary.

For example, when the display control function 155e rotates the display image, the spatial distribution of the WSS value at each position of the blood vessel is displayed on the image of the blood vessel by 1D-WSS indicated by one-dimensional information, and the display image is displayed. Is displayed in a non-rotating manner, the spatial distribution of the WSS value at each position of the blood vessel is displayed by 3D-WSS shown by three-dimensional information on the image of the blood vessel.

FIG. 5 is a diagram for explaining an example of switching the display form of the display image according to the first embodiment. Here, FIG. 5 shows a display form when the displayed image is rotated and displayed, and a display form when the displayed image is displayed in a non-rotated manner. For example, as shown in the left figure of FIG. 5, the display control function 155e displays by 1D-WSS while the rotation operation is performed by the user's operation and the display position is changed. That is, the display control function 155e sequentially displays a color image reflecting the result of 1D-WSS on the VR image of the coronary artery rendered from the direction facing the user in response to the rotation operation by the user. To control.

On the other hand, as shown in the right figure of FIG. 5, the display control function 155e displays by 3D-WSS while the color image is still without being operated by the user. That is, the display control function 155e controls to continuously display a color image reflecting the result of 3D-WSS on the VR image of the coronary artery rendered from the direction facing the user.

For example, it is important to grasp the overall tendency while the displayed image is being manipulated, and it is necessary to carry out a detailed examination when it is stationary. Therefore, the display control function 155e can display an appropriate display image according to the situation by performing the above-mentioned switching display, and can reduce the time and effort of the user.

Further, in general, the display in 3D-WSS has a larger amount of data, so that the drawing speed may be slower. However, when operating the display image, it is necessary to switch the drawing at high speed in order to improve usability. Therefore, as described above, the display control function 155e can suppress a decrease in drawing speed by displaying the displayed image in 1D-WSS when operating the display image.

In the above-mentioned example, the case where the display mode is switched according to the operation of the display image by the user has been described, but the display control function 155e can also be automatically rotated and displayed by using a cine display or the like. For example, the display control function 155e controls to start the display in step S108 of FIG. 2 and at the same time to start the rotation display of the color image by 1D-WSS. Then, when the operation for stopping the rotation display is received from the user, the display control function 155e stops the rotation display and switches to the display of the color image by 3D-WSS.

Here, the display control function 155e can change the display form of the displayed image based on various conditions. Specifically, the display control function 155e can change the display form of the display image in various ways based on the rotation condition of the display image, the display condition of the display image, or the calculation result of WSS.

For example, when the rotation condition of the display image is used, the display control function 155e switches between the display by 1D-WSS and the display by 3D-WSS according to the number of rotations of the display image and the rotation speed. As an example, the display control function 155e displays the displayed image by 3D-WSS when the number of rotations or the rotation speed is equal to or less than the threshold value. On the other hand, the display control function 155e displays by 1D-WSS when the number of rotations of the displayed image or the rotation speed exceeds the threshold value.

Here, the display control function 155e can perform display control by combining the control by rotation / non-rotation and the control by the rotation condition described above. For example, the display control function 155e switches to the display of 3D-WSS when the rotation speed is changed to the threshold value or less while displaying by 1D-WSS at the time of rotation display. Further, the display control function 155e continues the display by 3D-WSS when the condition is changed so as to start the rotation at the rotation speed equal to or less than the threshold value when displaying by 3D-WSS at the time of non-rotation display. .. Further, for example, the display control function 155e can change the type of the medical image (for example, CT image) used for the display image according to the number of rotations and the rotation speed at the time of rotation display. As an example, the display control function 155e displays a display image using a predetermined type of medical image when at least one of the rotation speed and the rotation speed is equal to or less than a threshold value.

Further, for example, the display control function 155e can switch between the display by 1D-WSS and the display by 3D-WSS according to the rotation angle at the time of rotation display. As an example, the display control function 155e displays the coronary arteries located near the center in the displayed image by 3D-WSS while rotating the coronary arteries, and 1D displays the coronary arteries located far from the center in the displayed image. -Displayed by WSS. For example, the coronary artery runs so that three blood vessels, LAD, LCX, and RCA, surround the heart. Therefore, the display control function 155e displays one of the above three lines near the center by 3D-WSS while rotating the coronary artery, and displays the position far from the center in the display image. Other blood vessels in are displayed by 1D-WSS. That is, the display control function 155e switches to the 3D-WSS display when the blood vessels of the coronary arteries are near the center of the display image due to the rotation of the display image, and the 1D-WSS display is displayed when the blood vessels deviate from the center. Switch.

In this way, the coronary arteries near the central position that you want to pay attention to are displayed in detailed 3D display, and conversely, the coronary arteries displayed on the side are displayed in 1D instead of detailed display so that the general trend can be easily understood. Since it can be displayed in a simplified manner, it is possible to prevent it from being overlooked even when the distribution of the coronary artery values displayed on the side is not good.

Further, for example, when the display condition of the display image is used, the display control function 155e switches between the display by 1D-WSS and the display by 3D-WSS according to the enlarged display and the reduced display of the color image. As an example, the display control function 155e displays a color image by 3D-WSS when it is enlarged at an enlargement ratio exceeding a threshold value. On the other hand, the display control function 155e displays by 1D-WSS when the color image is reduced at a reduction rate exceeding the threshold value.

Here, the display control function 155e can perform display control by combining the control by rotation / non-rotation and the control by the display condition described above. For example, the display control function 155e switches to 3D-WSS display when the displayed image is enlarged at an enlargement ratio exceeding the threshold value while being displayed by 1D-WSS at the time of rotation display. Further, the display control function 155e switches to the 1D-WSS display when the display image is reduced at a reduction rate exceeding the threshold value when the display is displayed by the 3D-WSS during the non-rotation display. Further, for example, the display control function 155e can change the image type of the medical image (for example, CT image) used for the display image when the display image is enlarged or reduced during the rotation display and the non-rotation display. can. As an example, the display control function 155e uses a predetermined type of medical image when the displayed image is enlarged at a magnification exceeding the threshold value or when the displayed image is reduced at a reduction ratio exceeding the threshold value. Display the displayed image.

Further, for example, when using the calculation result of WSS, the display control function 155e uses 3D-WSS for a position (a position having a characteristic WSS or a position where a plaque exists) that is likely to be watched by the user. Display. As an example, the display control function 155e is used when the position where the WSS value is equal to or higher than the threshold value and the position where the value is lower than the threshold value approaches the front of the screen when the rotation display is performed by 1D-WSS. Switch to 3D-WSS display. Further, for example, the display control function 155e identifies the position of plaque or calcification in the coronary artery, and switches to the display by 3D-WSS when the specified position approaches the front of the screen. The display control function 155e can appropriately use an existing method as a method for specifying the position of plaque or calcification in the coronary artery. For example, there are a method by image processing based on the distribution of pixel values and a method using machine learning.

(Rotational speed)
The rotation speed in the above-mentioned rotation display can be appropriately changed according to various conditions. Specifically, the display control function 155e can arbitrarily change the rotation speed during rotation display based on the calculation result of WSS, the properties of blood vessels, and the like.

For example, when the WSS calculation result is used, the display control function 155e controls the rotation speed so as to decrease the rotation speed at the timing when the position of the blood vessel in which the maximum value and the minimum value of WSS are calculated is displayed in the rotation display. That is, the display control function 155e slows down the rotation speed when the position showing the characteristic WSS value approaches the front of the screen.

FIG. 6 is a diagram for explaining an example of speed adjustment of the rotation speed according to the first embodiment. Here, in FIG. 6, a graph is shown in which the vertical axis is the rotation speed and the horizontal axis is the rotation angle. Further, in FIG. 6, the rotation speed when the calculated WSS spatial distribution includes a characteristic WSS value is shown by the curve L1, and the calculated WSS spatial distribution includes a characteristic WSS value. The rotation speed in the case where the rotation speed is not shown is shown by the curve L2.

For example, as shown in the curve L1 of FIG. 6, the display control function 155e reduces the rotation speed as the position showing the maximum value of WSS approaches the front of the screen, and the position showing the maximum value of WSS moves away from the front of the screen. The rotation speed is increased as it goes. Further, as shown in the curve L1 of FIG. 6, the display control function 155e reduces the rotation speed as the position showing the minimum value of WSS approaches the front of the screen, and the position showing the minimum value of WSS moves away from the front of the screen. The rotation speed is increased as it goes, and it is controlled to recover to the original speed.

The speed adjustment of the rotation speed described above may be performed at the maximum value and the minimum value in the entire coronary artery, or may be performed at the maximum value and the minimum value for each vascular branch of the coronary artery. Further, the speed adjustment of the rotation speed described above is performed not only at the position indicating the maximum value and the position indicating the minimum value, but also at the position indicating the WSS value above the threshold value and the position indicating the WSS value below the threshold value, respectively. May be good.

Further, when the calculated WSS spatial distribution does not include the characteristic WSS value, the display control function 155e rotates and displays the displayed image at a constant rotation speed as shown by the curve L2 in FIG. Let me.

When the properties of the blood vessel are used, the display control function 155e controls the rotation speed so as to decrease the rotation speed at the timing when the position of the lesion site of the blood vessel is displayed in the rotation display. As an example, the display control function 155e slows down the rotation speed as the position where plaque or calcification is detected approaches the front of the screen, and rotates as the position where plaque or calcification is detected moves away from the front of the screen. Control to increase the speed and restore it to the original speed.

Further, the display control function 155e can perform control by combining the above-mentioned adjustment of the rotation speed and switching of the display form (switching between the display by 1D-WSS and the display by 3D-WSS). FIG. 7 is a diagram for explaining an example of display control by the display control function according to the first embodiment. Here, FIG. 7 shows a case where switching of the display form is combined with the speed adjustment on the curve L1 shown in FIG.

For example, as shown in FIG. 7, a reference speed is set with respect to the rotation speed. Here, the reference speed is arbitrarily set, and is set in advance for each user or each inspection content, for example. Then, the display control function 155e displays by 1D-WSS when the rotation speed is faster than the reference speed, and displays by 3D-WSS when the rotation speed is slower than the reference speed.

(Display direction control process)
In the above-mentioned rotation display, the display direction can be appropriately changed according to various conditions. Specifically, the display control function 155e can arbitrarily change the display direction of the displayed image during rotation display based on the calculation result of WSS, the properties of blood vessels, and the like.

For example, in the display control function 155e, as the position of the blood vessel from which the maximum value and the minimum value of WSS are calculated and the position of the lesion site of the blood vessel approach the front of the screen in the rotation display, the blood vessel traveling direction at those positions is displayed on the screen. Adjust the rendering up and down so that it is approximately parallel to.

(Display of additional information)
In the display of the display image described above, various additional information can be added to the image. Specifically, the display control function 155e can display a display image to which additional information regarding the WSS calculation result is added. More specifically, the display control function 155e displays information indicating the validity at a position where the validity of the calculation result is low in the display image in which the WSS value at each position of the blood vessel is reflected in the three-dimensional image of the blood vessel. Add and display.

For example, in the calculation of WSS, WSS may not be calculated in a part of the image due to the influence of noise contained in the image. Therefore, the display control function 155e adds and displays additional information indicating that the WSS calculation has failed at the position where the WSS could not be calculated in the display image.

FIG. 8A is a diagram showing an example of display of additional information according to the first embodiment. For example, the display control function 155e displays "E" indicating an error at a position where WSS could not be calculated, as shown in FIG. 8A.

Here, the display control function 155e can control the display of the above-mentioned additional information in combination with the rotation display. For example, the display control function 155e displays "E" indicating an error at the positions where the WSS could not be calculated approaches the front of the screen while rotating the display image. Then, the display control function 155e controls to erase the "E" displayed at the position where the WSS could not be calculated moves away from the front of the screen when the display image is rotated and displayed. ..

Further, the display control function 155e can control the display of the above-mentioned additional information in combination with the rotation speed. For example, the display control function 155e changes the rotation speed as the position where the WSS could not be calculated approaches the front of the screen while rotating the display image.

FIG. 8B is a diagram for explaining an example of speed control of the rotation speed based on the additional information according to the first embodiment. Here, in FIG. 8B, a graph is shown in which the vertical axis is the rotation speed and the horizontal axis is the rotation angle. For example, the display control function 155e increases the rotation speed as the position where the error exists approaches the front of the screen, and decreases the rotation speed as the position where the error exists moves away from the front of the screen to restore the original speed. To control.

(Output of calculation result and judgment result)
The medical image processing apparatus 150 can output the calculation result and the determination result of the above-mentioned index value to various output destinations. Specifically, the control function 155f transfers the calculation result of the index value and the determination result to a predetermined transfer destination.

For example, the control function 155f can transfer information about the WSS of the blood vessel position designated by the user to various transfer destinations. FIG. 9 is a diagram for explaining an example of information transfer by the control function 155f according to the first embodiment. Here, FIG. 9 shows a case where the control function 155f transfers information on the blood vessel position designated by the user to the interpretation report.

For example, as shown in FIG. 9, first, the display control function 155e causes the VR image to be displayed on the display 154. Here, the display control function 155e displays, for example, a color image reflecting the color corresponding to the value of WSS on the VR image of the coronary artery, and performs the above-mentioned rotation display and the like. Then, when the user executes a designation operation for designating a position in the color image via the input interface 153, the display control function 155e displays an enlarged image in which the designated position (area) is enlarged.

Here, as shown in FIG. 9, the display control function 155e displays a cross-sectional image (for example, an MPR image in a CT image) of the original image corresponding to the designated position (region) side by side with the enlarged image. As described above, the display control function 155e causes the display 154 to display various information in response to various operations from the user.

Then, when the user performs the transfer operation via the input interface 153, the information to be the target of the transfer operation is transferred to the transfer destination. For example, as shown in FIG. 9, the control function 155f provides an enlarged image, a cross-sectional image, and information indicating the WSS value of the specified blood vessel position for the interpretation report, “The maximum WSS at the plaque position of RCE is 8 Pa. Is output. "

The information shown in FIG. 9 is merely an example, and the control function 155f can transfer various other information. For example, the control function 155f has other characteristic WSS values (high WSS value, low WSS value, etc.), WSS-related information obtained from coronary artery morphology information, etc. (for example, coronary artery in a specified region). Distances from bifurcations, distances from large calcifications, etc.) can be transferred to the interpretation report.

Further, the control function 155f can transfer the calculated WSS and the determination result to the medical image storage device 120, each department system 130, and the medical information display device 140. For example, the control function 155f transfers the calculated WSS value to a viewer viewed by the user, a workstation, an electronic medical record system, or the like. Each device holds the transferred WSS value in the storage circuit of its own device. The control function 15f may transfer only characteristic values of the calculated WSS to each of the above-mentioned devices. Further, when the control function 155f knows the position where the plaque exists in advance or records the coordinate information of the plaque by obtaining it by the existing technology, the control function 155f determines the position where the plaque exists based on the information. Only WSS may be transferred. Further, for example, the control function 155f may transfer the above-mentioned color image to the PACS.

Here, the control function 155f can also transfer each of the above-mentioned information separately for each blood vessel branch. For example, the control function 155f transmits the maximum value and the minimum value of WSS to various devices on the network 160 for each vascular branch of the coronary artery.

Further, the control function 155f can also switch the transfer destination of the WSS calculation result according to the index value regarding the blood flow in the blood vessel. In such a case, the calculation function 155c also calculates an index value other than WSS (for example, FFR) at the same time. The control function 155f switches the WSS transfer destination device according to the index value calculated at the same time.

As an example, the control function 155f transfers the calculation result of WSS to the workstation for image interpretation when the value of FFR is larger than the threshold value. On the other hand, when the FFR value is smaller than the threshold value, the control function 155f transfers the WSS calculation result to an electronic medical record, a doctor's mobile phone, an email address, or the like. As a result, the control function 155f can promptly inform the doctor of the calculation result when the value of FFR is small and the degree of urgency is considered to be high.

Further, the control function 155f can transfer information regarding the calculation of the wall shear stress to the 3D printer. In such a case, for example, a 3D printer is connected to the network 160, and the control function 155f transmits the coronary artery morphology information calculated in the process of calculating WSS and the calculation result of WSS to the 3D printer. At this time, it may be determined and controlled whether or not to transfer to the 3D printer according to the value of WSS. For example, if the maximum value of WSS is higher than a predetermined reference value, it may be transferred to a 3D printer, and if it is lower, it may be controlled not to be transferred.

The 3D printer uses the received morphological information and the WSS calculation result to generate a coronary artery model peculiar to the subject. For example, a 3D printer generates a model of a coronary artery using a predetermined material (resin or the like) based on the received morphological information. At that time, the 3D printer generates a model using materials and colors corresponding to the WSS value. The materials and colors corresponding to the WSS values are preset in the 3D printer.

Further, the control function 155f transfers the calculation result of WSS to the medical image diagnosis device. For example, the control function 155f transfers the calculation result of WSS to an intravascular imaging device by intravascular ultrasound (IVUS) or optical coherence tomography (OCT).

As an example, the control function 155f monitors the registration information in each department system 130 and determines whether or not IVUS or OCT is reserved. Here, when IVUS or OCT is reserved, the control function 155f further determines whether or not information about WSS is stored for the subject to be reserved. When the WSS information is stored for the subject, the control function 155f acquires the stored WSS information and transfers it to the intravascular imaging apparatus.

Further, the control function 155f can acquire an image captured by the intravascular imaging device in response to an operation from the user, and superimpose and display WSS information on the acquired image. In such a case, first, the control function 155f acquires an image from the intravascular imaging device and executes alignment with the coronary artery CT image used for calculating WSS. For example, the control function 155f performs alignment based on the anatomical features contained in each image.

Then, the display control function 155e displays a display image in which the corresponding WSS value is superimposed on each position of the coronary artery of the image received from the intravascular imaging device based on the result of the alignment. Further, the control function 155f transfers the display image on which the WSS value is superimposed to the intravascular imaging device. As a result, the intravascular imaging device can display an image of IVUS or OCT showing the value of WSS.

(Collaboration with other devices)
For example, the medical image processing device 150 can perform processing in cooperation with other devices on the network 160. For example, the control function 155f cooperates with the RIS to control so as to secure a calculation resource for calculating the WSS at the reserved time when the reservation of the coronary artery CT image is made in the RIS. The control function 155f may accept inputs related to the size of the image and various parameters at the time when the reservation is made. Further, the control function 155f can estimate the calculation end time from the reserved information and return the estimated calculation end time to the user.

Further, the control function 155f outputs a reservation of the inspection device or a notification prompting the reservation of the inspection device based on the calculated WSS result. For example, in the control function 155f, if the WSS value at the position where the plaque is present has a very high value, it is assumed that the risk of the patient in the image is high. Automatically make reservations for operating rooms. Further, for example, when the WSS value at the position where the plaque is present has a very high value, the control function 155f gives a notification to the user to prompt the user to make an appointment for an intravascular OCT examination.

In the above-described embodiment, the case where the control function 155f transfers the calculation result of WSS to an external device has been described. However, the embodiment is not limited to this, and for example, the control function 155f can transfer the determination result of the determination function 155b together with the calculation result of the WSS. That is, the control function 155f can transfer the determination result for determining the validity of the calculation target and the determination result for determining the validity of the WSS calculation result together with the WSS calculation result.

Further, in the above-described embodiment, a case where the determination process is performed after the image data is acquired has been described. However, the embodiment is not limited to this, and for example, the determination process may be performed to acquire image data of those satisfying the conditions.

In such a case, when the target image inspection (for example, CT) is imaged, the X-ray CT apparatus 110 transfers the imaging conditions of the captured image to the medical image processing apparatus 150. Alternatively, the imaging conditions set on the RIS may be transferred to the medical image processing device 150. The determination function 155b determines whether or not the condition is satisfied by comparing the transferred imaging condition with a predetermined condition. Depending on the conditions to be set, information may be acquired from the electronic medical record for determination. When it is determined that the imaging condition satisfies the condition, the acquisition function 155a requests the X-ray CT apparatus 110 or the medical image storage apparatus 120 to provide the corresponding image data.

As described above, according to the first embodiment, the display information generation function 155d generates a three-dimensional image of the blood vessel reflecting the value of WSS for each position of the blood vessel. The display control function 155e changes the display form of the display image between the rotation display and the non-rotation display in the display of the display image in which the WSS value is reflected in the three-dimensional image. Therefore, the medical image processing device 150 according to the first embodiment can appropriately display the displayed image according to the situation, and saves the user's time and effort when diagnosing a heart disease and formulating a treatment plan. Allows for reduction.

Further, according to the first embodiment, when the display control function 155e rotates and displays the displayed image, the spatial distribution of the WSS value at each cross-sectional position of the blood vessel with respect to the core line of the blood vessel is displayed on the image of the blood vessel. When the 1D-WSS shown in the above is displayed and the displayed image is displayed in a non-rotating manner, the 3D-WSS showing the spatial distribution of the WSS value at each position in the blood vessel or at each position of the blood vessel wall is displayed on the blood vessel image. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to automatically perform appropriate display during rotation and non-rotation.

Further, according to the first embodiment, the display control function 155e further changes the display form of the display image according to the rotation condition of the display image. Therefore, the medical image processing apparatus 150 according to the first embodiment enables more appropriate display.

Further, according to the first embodiment, the display control function 155e further changes the display form of the display image according to the display condition of the display image. Therefore, the medical image processing apparatus 150 according to the first embodiment enables more appropriate display.

Further, according to the first embodiment, the display control function 155e further changes the display form of the display image according to the size of the display area for displaying the display image. Therefore, the medical image processing apparatus 150 according to the first embodiment enables more appropriate display.

Further, according to the first embodiment, the display control function 155e changes the rotation speed of the displayed image based on the calculation result of WSS. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to perform a rotation display that is easier to observe.

Further, according to the first embodiment, the display control function 155e controls so as to reduce the rotation speed at the timing when the position of the blood vessel in which the maximum value and the minimum value of WSS are calculated is displayed in the rotation display. .. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to display a position to be watched at a rotation speed that is easy to observe.

Further, according to the first embodiment, the display control function 155e controls to increase the rotation speed at the timing when the position of the blood vessel whose WSS calculation result is incorrect is displayed in the rotation display. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to pass a position where observation should be omitted at a high rotation speed.

Further, according to the first embodiment, the display control function 155e changes the rotation speed of the displayed image based on the properties of the blood vessels. Therefore, the medical image processing apparatus 150 according to the first embodiment enables switching of the rotation speed at a position to be watched.

Further, according to the first embodiment, the display control function 155e controls so as to reduce the rotation speed at the timing when the position of the lesion site of the blood vessel is displayed in the rotation display. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to appropriately observe the lesion site to be watched.

Further, according to the first embodiment, the determination function 155b determines the validity of the calculation target in the calculation of WSS. The display control function 155e displays the validity determination result. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to calculate only a highly reliable object.

Further, according to the first embodiment, the determination function 155b determines the validity of the calculation result in the calculation of WSS. The display control function 155e displays the validity determination result regarding the calculation result. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to target only highly reliable results.

Further, according to the first embodiment, the display control function 155e displays a list in which the calculation results of WSS are summarized for each subject, and emphasizes the result of deviation from the reference value in the list. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to make a diagnosis from a high-priority result.

Further, according to the first embodiment, the display control function 155e further displays the analysis results other than WSS in the list. Therefore, the medical image processing apparatus 150 according to the first embodiment enables complex diagnosis.

Further, according to the first embodiment, the display control function 155e is appropriate at a position where the validity of the calculation result is low in the display image in which the value of WSS at each position of the blood vessel is reflected in the three-dimensional image of the blood vessel. Information indicating the sex is added and displayed. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to grasp the position of the unreliable result at a glance.

Further, according to the first embodiment, the calculation function 155c calculates the value of WSS at each position of the blood vessel. The control function 155f transfers the calculation result of WSS to a predetermined transfer destination. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to transfer the result of WSS to various transfer destinations.

Further, according to the first embodiment, the control function 155f transfers the calculation result of WSS to the medical report. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to reduce the time and effort required for creating a medical report.

Further, according to the first embodiment, the control function 155f transfers the information regarding the calculation of WSS to the three-dimensional printer. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to easily generate a model based on the result of WSS.

Further, according to the first embodiment, the control function 155f transfers the calculation result of WSS to the medical diagnostic imaging apparatus. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to reflect the result of WSS in the medical image.

Further, according to the first embodiment, the control function 155f switches the transfer destination of the WSS calculation result according to the index value regarding the blood flow in the blood vessel. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to transfer the WSS result to an appropriate transfer destination according to the index value.

Further, according to the first embodiment, the control function 155f outputs a reservation of the inspection device or a notification prompting the reservation of the inspection device based on the calculation result of the WSS. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to reliably make necessary arrangements thereafter according to the result of WSS.

Further, according to the first embodiment, the control function 155f controls to secure the calculation resource used for the calculation of WSS in response to the reservation of the medical image data collection used for the calculation of WSS. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to smoothly perform the schedule related to the calculation of WSS.

(Second embodiment)
In the first embodiment described above, the case where the WSS is calculated in advance each time the image data is collected has been described. In the second embodiment, a case where the WSS is calculated according to the instruction of the user will be described. The medical image processing apparatus 150 according to the second embodiment has different processing contents by the display control function 155e as compared with the first embodiment. Hereinafter, this point will be mainly described.

First, the procedure of processing by the medical image processing apparatus 150 according to the second embodiment will be described with reference to FIG. FIG. 10 is a flowchart showing a processing procedure of processing performed by each processing function of the processing circuit 155 of the medical image processing apparatus according to the second embodiment. Note that FIG. 10 shows an example in which WSS is calculated in response to a WSS calculation instruction from the user.

For example, as shown in FIG. 10, in the present embodiment, when the start operation is accepted via the input interface 153 (step S201, affirmative), the acquisition function 155a displays the coronary CT image of the designated subject by X-ray. Obtained from the CT device 110 or the medical image storage device 120 (step S202). This processing is realized, for example, by the processing circuit 155 calling the program corresponding to the acquisition function 155a from the storage circuit 152 and executing it. It is in a standby state until a start operation is accepted via the input interface 153 (step S201, negation).

Subsequently, the determination function 155b determines whether or not the condition is satisfied when the acquired coronary artery CT image is targeted (step S203). Specifically, the determination function 155b determines whether or not the acquired coronary artery CT image is appropriate as a calculation target of WSS. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the determination function 155b from the storage circuit 152 and executing it.

Here, if the determination function 155b determines that the condition is satisfied (step S203, affirmative), the medical image processing apparatus 150 proceeds to step S204. On the other hand, if the determination function 155b determines that the condition is not satisfied (step S203, negative), the medical image processing apparatus 150 proceeds to step S205.

When the process proceeds to step S205, the display control function 155e outputs a warning (step S205). For example, the display control function 155e causes the display 154 to display a warning indicating that the acquired coronary artery CT image is not appropriate for WSS calculation. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the calculation function 155c determines whether or not to continue the process (step S206). For example, the calculation function 155c determines whether the continuation is instructed or the stop is instructed via the input interface 153. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the calculation function 155c from the storage circuit 152 and executing it.

Here, if the calculation function 155c determines to continue (step S206, affirmative), the medical image processing apparatus 150 proceeds to step S204. On the other hand, when the calculation function 155c determines that the continuation is not continued (step S206, negative), the medical image processing apparatus 150 returns to step S201 and performs the determination process.

Proceeding to step S204, the calculation function 155c calculates an index value related to blood flow based on the coronary artery CT image of the subject acquired by the acquisition function 155a (step S204). For example, the calculation function 155c calculates WSS. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the calculation function 155c from the storage circuit 152 and executing it.

Subsequently, the determination function 155b determines whether or not the calculation result is appropriate (step S207). Specifically, the determination function 155b determines whether or not the calculation result of WSS calculated by the calculation function 155c is appropriate. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the determination function 155b from the storage circuit 152 and executing it.

Here, if the determination function 155b determines that it is appropriate (step S207, affirmative), the medical image processing apparatus 150 proceeds to step S208. On the other hand, if the determination function 155b determines that it is not appropriate (step S207, negative), the medical image processing apparatus 150 proceeds to step S209.

When the process proceeds to step S2059, the display control function 155e outputs a warning (step S209). For example, the display control function 155e causes the display 154 to display a warning indicating that the calculated WSS value is not valid. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display control function 155e determines whether or not to continue the process (step S210). For example, the display control function 155e determines whether the continuation is instructed or the stop is instructed via the input interface 153. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Here, if the display control function 155e determines to continue (step S210, affirmative), the medical image processing apparatus 150 proceeds to step S208. On the other hand, when the display control function 155e determines that the continuation is not continued (step S210, negative), the medical image processing apparatus 150 returns to step S201 and performs the determination process.

In step S208, the display information generation function 155d generates display information regarding the result, and the display control function 155e causes the generated display information to be displayed on the display 154 (step S208). This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display information generation function 155d and a program corresponding to the display control function 155e from the storage circuit 152 and executing the processing.

Subsequently, the display control function 155e switches between 1D-WSS and 3D-WSS for display according to the display method (step S211). For example, the display control function 155e changes the display form so that 1D-WSS is displayed at the time of rotation and 3D-WSS is displayed at the time of non-rotation. This processing is realized, for example, by the processing circuit 155 calling a program corresponding to the display control function 155e from the storage circuit 152 and executing the program.

Subsequently, the display control function 155e determines whether or not the display condition has been changed (step S212). For example, the display control function 155e determines the rotation condition and whether or not the display condition has been changed. As an example, the display control function 155e determines whether or not the rotation condition including at least one of the rotation speed and the rotation speed and the display condition including enlargement or reduction have been changed. Here, when the display condition is changed (step S212, affirmative), the display control function 155e further changes the display form (step S213). On the other hand, if the display condition has not been changed (step S212, negative), the display control function 155e proceeds to step S214.

Subsequently, the display control function 155e determines whether or not the end operation has been accepted via the input interface 153 (step S212), and if the end operation has been accepted (step S212, affirmative), it is for medical use. The image processing device 150 ends the processing. On the other hand, when the end operation is not accepted (step S212, negative), the medical image processing apparatus 150 returns to step S211 and continues the switching display.

(Warning display)
As described above, the display control function 155e according to the second embodiment outputs a warning according to the result of the determination process by the determination function 155b. For example, the display control function 155e can display a warning according to each determination result and display information notifying whether or not to acquire different image data on the display 154.

Further, for example, the display control function 155e can display a warning when an event that is difficult to predict in advance such as a power failure or an abnormality on the computer occurs and the calculation does not end normally.

Further, the display control function 155e can not only display a warning but also automatically search for an image satisfying the condition from the medical image storage device 120 or the X-ray CT device 110 on the network 160 and present it as a candidate. In such a case, the determination function 155b executes a determination process on the image data of the same subject held in the medical image storage device 120 or the X-ray CT apparatus 110, and extracts the image data satisfying the conditions. Then, the display control function 155e causes the display 154 to display information (candidates for calculation target) regarding the extracted image data. Here, the determination condition used by the determination function 155b may be a case where a condition for presenting a candidate is newly set. For example, the condition for presenting a candidate may be set based on the strength of the influence on the high calculation accuracy in the calculation of WSS.

Further, the display control function 155e can display not only a warning regarding WSS but also a warning regarding other index values. For example, the display control function 155e is likely to cause a problem with the calculation result of the calculated value (for example, FFR) that performs the calculation similar to WSS. implement.

The determination function 155b according to the second embodiment performs the same determination process as that of the first embodiment.

As described above, according to the second embodiment, the display control function 155e displays a warning according to the determination of the validity of the calculation target and the validity of the WSS calculation result. Therefore, the medical image processing apparatus 150 according to the second embodiment makes it possible to efficiently calculate the WSS.

(Third embodiment)
In the third embodiment, various forms for displaying a cross-sectional image showing a cross-sectional image of a blood vessel will be described. For example, the display control function 155e according to the third embodiment displays an image to which the WSS value at the pixel position corresponding to the pixel value of each pixel of the cross-sectional image showing the cross section of the blood vessel is assigned as the display image. The input interface 153 accepts an input operation for moving the position of the cross section to be displayed as a display image. The display control function 155e changes the speed of movement of the position of the cross section based on the input operation based on the calculation result of WSS.

FIG. 11 is a diagram for explaining an example of display control by the display control function according to the third embodiment. Here, FIG. 11 shows a case where a short-axis cross-sectional image (cross-cut image) which is a cross-section orthogonal to the core line of the blood vessel is displayed as a cross-sectional image showing the cross-section of the blood vessel. For example, as shown in FIG. 11, the display control function 155e displays the VR image of the coronary artery in the display area A1 and displays the short-axis cross-sectional image at each position of the coronary artery in the display areas A21 to A26. The display control function 155e can display each pixel of the short-axis cross-sectional image as an image expressed according to the value of WSS corresponding to each pixel position. For example, it is possible to display a color image expressed in a color corresponding to the value of WSS. In addition, an image represented by transparency, lightness, grayscale value, texture, symbol, mark, etc. according to the value of WSS may be displayed. Of course, these are examples, and any image may be displayed as long as it is an image represented by an expression method according to the value of WSS.

The input interface 153 accepts a scroll operation for the scroll bar B1. Here, the scroll bar B1 shown in FIG. 11 is a GUI for switching the short-axis cross-sectional image to be displayed in the display areas A21 to A26 among the plurality of short-axis cross-sectional images generated at positions along the core line of the coronary artery. Is. That is, the user can switch the short-axis cross-sectional image to be displayed in the display areas A21 to A26 along the core line of the coronary artery by operating the scroll bar B1 via the input interface 153. In the following, the switching speed of the short-axis cross-sectional image will be described as being specified by an input operation performed by the user using the input interface 153.

First, switching of the short-axis cross-sectional image by operating the scroll bar B1 will be described. The user operates the mouse pointer displayed on the screen by using the input interface 153. An icon (a part displayed as a rectangle in the scroll bar B1) is displayed on the scroll bar B1, and the short-axis cross-sectional image corresponding to which position of the blood vessels to be displayed is displayed in the display areas A21 to A26. It shows conceptually whether it is done. That is, when the icon is at the upper part of the scroll bar B1, a plurality of short-axis cross-sectional images at positions close to the origin of the blood vessel are displayed, and when the icon is at the lower part of the scroll bar B1, the peripheral part of the blood vessel is displayed. A plurality of short-axis cross-sectional images at positions close to are displayed. The user operates the mouse pointer and drags the icon to specify the destination of the icon. The display control function 155e sequentially switches and displays the short-axis image already displayed in the display areas A21 to A26 to the non-displayed short-axis image according to the movement destination of the designated icon. Specifically, the switching of displaying the image displayed at the position of A22 at the position of A21 and displaying the image displayed at the position of A23 at the position of A22 is repeated, and the input operation is performed on the A26. The short-axis cross-sectional image that was not displayed at the time of starting is displayed. By sequentially repeating this replacement of the display position, the switching display to the short-axis image that was not displayed is advanced, and the short-axis cross-sectional image corresponding to the position of the specified icon is displayed in the display areas A21 to A26. The switching ends when.

Instead of dragging the icon, this operation scrolls the icon to the specified position by specifying the position on the scroll bar B1 with the mouse pointer and clicking the mouse to confirm the position specification. At the same time, the short-axis image may be switched and displayed in conjunction with the scroll movement of the icon.

Next, the switching speed of the short-axis cross-sectional image will be described. As described above, the user performs an operation on the scroll bar B1 to switch to and display a short-axis cross-sectional image that was not displayed at the time when the input operation is started. The speed of this switching display is increased as the distance between the position of the icon at the time when the input operation is started and the position of the destination of the icon specified by the user by dragging or the like increases, and conversely, the closer the distance is. Do it at low speed.

Here, the display control function 155e according to the third embodiment switches the position of the cross section based on the input operation based on the calculation result of WSS in the switching display of the short axis cross section image according to the operation of the scroll bar B1. Change the speed. For example, the display control function 155e determines the switching speed in the display areas A21 to A26 of the short-axis cross-sectional image when the short-axis cross-sectional image of the position of the blood vessel for which the maximum value and the minimum value of WSS are calculated is displayed. Decrease. The display control function 155e according to the third embodiment has the same conditions as the conditions for controlling the rotation speed in the rotation display described in the above embodiment, such as a position where the WSS calculation result has an error, a blood vessel property, and a lesion. The switching speed in the display areas A21 to A26 of the short-axis cross-sectional image can be changed based on the position of the portion and the like.

Further, the display control function 155e according to the third embodiment can change the display form of the displayed image according to the switching speed of the cross-sectional image based on the input operation in the display of the short-axis cross-sectional image. For example, when the user operates the scroll bar B1 via the input interface 153 to switch the short-axis cross-sectional image to be displayed in the display areas A21 to A26 along the core line of the coronary artery, the scroll bar B1 is set to a predetermined threshold value or more. When scrolling at a speed, the display control function 155e displays the short-axis cross-sectional image as an image expressed in a color corresponding to the value of 1D-WSS. On the other hand, when the user scrolls the scroll bar B1 at a speed less than a predetermined threshold value, the display control function 155e displays the short-axis cross-sectional image as an image expressed in a color corresponding to the value of 3D-WSS.

In the above-mentioned example, a case where a short-axis cross-sectional image is displayed as a cross-sectional image showing a cross-section of a blood vessel has been described, but the display control function 155e can also display a CPR image as a cross-sectional image showing a cross-section of a blood vessel. .. FIG. 12 is a diagram for explaining an example of display control by the display control function according to the third embodiment. For example, as shown in FIG. 12, the display control function 155e displays a VR image of a coronary artery in the display area A1 and displays a CPR image of the coronary artery in the display area A3. The display control function 155e can display each pixel of the CPR image as an image expressed according to the value of WSS corresponding to each pixel position, as in the case of the short-axis cross-sectional image.

Here, the display control function 155e changes the switching speed of the cross-sectional position based on the input operation based on the calculation result of WSS in the CPR image as well as the display of the short-axis cross-sectional image. In such a case, for example, the scroll bar B1 is a GUI that switches the position of the CPR image to be displayed in the display area A3 along the traveling direction of the blood vessel.

The display control function 155e changes the position switching speed based on the input operation based on the WSS calculation result in the display position switching display of the CPR image according to the operation of the scroll bar B1 shown in FIG. For example, the display control function 155e reduces the switching speed of the CPR image in the display area A3 when the position where the maximum value and the minimum value of WSS are calculated is displayed in the CPR image. The display control function 155e according to the third embodiment has an error in the WSS calculation result even in the display of the CPR image, as in the condition of the rotation speed control in the rotation display described in the above embodiment. , The switching speed can be changed based on the properties of blood vessels, the position of the lesion site, and the like.

Further, the display control function 155e according to the third embodiment can change the display form of the displayed image according to the position switching speed based on the input operation even in the display of the CPR image. For example, when the user operates the scroll bar B1 via the input interface 153 to switch the position of the CPR image to be displayed in the display area A3, the scroll bar B1 is scrolled at a speed equal to or higher than a predetermined threshold. The 155e displays the CPR image as an image expressed in a color corresponding to the value of 1D-WSS. On the other hand, when the user scrolls the scroll bar B1 at a speed less than a predetermined threshold value, the display control function 155e displays the CPR image as an image expressed in a color corresponding to the value of 3D-WSS.

As described above, according to the third embodiment, the display control function 155e displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross section of the blood vessel. The input interface 153 accepts an input operation for changing the position of the cross section to be displayed as a display image. The display control function 155e changes the speed of changing the position of the cross section based on the input operation based on the calculation result of the wall shear stress. Therefore, the medical image processing apparatus 150 according to the third embodiment makes it possible for the user to easily grasp the position of the cross section to be noted.

Further, according to the third embodiment, the display control function 155e displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross-section of the blood vessel. The input interface 153 accepts an input operation for changing the position of the cross section to be displayed as the display image. The display control function 155e changes the display form of the display image according to the speed of changing the position of the cross section based on the input operation. Therefore, the medical image processing apparatus 150 according to the third embodiment makes it possible to appropriately display the WSS according to the change speed of the display position of the cross-sectional image.

(Other embodiments)
In the above-described embodiment, the case where 1D-WSS indicating WSS at each cross-sectional position of the blood vessel with respect to the core line of the blood vessel is used as the display mode at the time of rotation has been described, but the embodiment is limited to this. do not have. For example, by using the directional mean value of the local WSS obtained from 3D-WSS, the display equivalent to 1D-WSS may be performed.

Further, in the above-described embodiment, an example in which information about the WSS is displayed on the display 144 of the medical image processing apparatus 150 has been described, but the embodiment is not limited to this. For example, information about the WSS may be displayed on the display of the medical information display device 140.

Further, in the above-described embodiment, an example in which the medical image processing apparatus 150 executes the calculation of WSS and the display of the calculation result has been described, but the embodiment is not limited to this. For example, when calculating 1D-WSS and 3D-WSS, a part of the calculation may be performed on the server side by adopting a server-client type computer configuration. For example, 3D-WSS, which requires a large amount of calculation, may be calculated on the server side, and 1D-WSS may be calculated on the client side.

Further, for example, the step of recognizing (extracting) the shape of the blood vessel may be carried out on the client side, and only the step of calculating WSS by CFD or the like may be carried out on the server side. In such a case, instead of transferring the entire image to the server side, only the shape structure extracted on the client side may be transferred to the server side. For example, the server side holds the analysis conditions in advance, and calculates the WSS using the shape structure received from the client side and the holding analysis conditions.

Further, for example, the client side may transfer the blood parameter (hematocrit value, etc.) peculiar to the subject, the boundary condition, and the elasticity value of the blood vessel wall to the server side in addition to the shape information. The server side calculates WSS using these information transferred from the client side.

Here, the structure information of the blood vessel is set to the same value for each structure, and the data size can be extremely reduced by data compression by transmitting the data only associated with the coordinates. For example, when there are two types of structures other than the blood vessel wall and the blood vessel wall, the structure can be expressed by a binary value of 0 or 1. Similarly, when there are 10 types of structures, the structure can be expressed using 10 values from 0 to 9.

By communicating only the data necessary for the calculation between the server side and the client side in this way, the transfer speed and the calculation cost on the server side can be reduced. Further, the blood vessel branch to be calculated on the server side may be specified based on the instruction of the user, and the WSS of only the blood vessel branch may be calculated.

In the above-described embodiment, the determination unit, the calculation unit, the generation unit, the display control unit, and the control unit in the present specification are divided into the determination function, the calculation function, the display information generation function, the display control function, and the control of the processing circuit, respectively. Although an example of the case where it is realized by a function has been described, the embodiment is not limited to this. For example, the determination unit, the calculation unit, the generation unit, the display control unit, and the control unit in the present specification are realized by the determination function, the calculation function, the display information generation function, the display control function, and the control function described in the embodiment. However, the same function may be realized by hardware only, software only, or a mixture of hardware and software.

Further, the word "processor" used in the description of the above-described embodiment is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an integrated circuit for a specific application (Application Specific Integrated Circuit: ASIC). Circuits such as programmable logic devices (eg, Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)) means. Here, instead of storing the program in the storage circuit, the program may be configured to be directly embedded in the circuit of the processor. In this case, the processor realizes the function by reading and executing the program embedded in the circuit. Further, each processor of the present embodiment is not limited to the case where each processor is configured as a single circuit, and a plurality of independent circuits may be combined to be configured as one processor to realize its function. good.

Here, the program executed by the processor is provided by being incorporated in a ROM (Read Only Memory), a storage circuit, or the like in advance. This program is a file in a format that can be installed or executed on these devices, such as CD (Compact Disk) -ROM, FD (Flexible Disk), CD-R (Recordable), DVD (Digital Versatile Disk), etc. It may be recorded and provided on a non-transient storage medium that can be read by a computer. Further, this program may be stored on a computer connected to a network such as the Internet, and may be provided or distributed by being downloaded via the network. For example, this program is composed of modules including each of the above-mentioned processing functions. As actual hardware, the CPU reads a program from a storage medium such as a ROM and executes the program, so that each module is loaded on the main storage device and generated on the main storage device.

Further, in the above-described embodiments and modifications, each component of each of the illustrated devices is functionally conceptual, and does not necessarily have to be physically configured as shown in the figure. That is, the specific form of distribution or integration of each device is not limited to the one shown in the figure, and all or part of them may be functionally or physically dispersed or physically distributed in arbitrary units according to various loads and usage conditions. Can be integrated and configured. Further, each processing function performed by each device may be realized by a CPU and a program analyzed and executed by the CPU, or may be realized as hardware by wired logic.

Further, among the processes described in the above-described embodiments and modifications, all or part of the processes described as being automatically performed can be manually performed, or can be performed manually. It is also possible to automatically perform all or part of the described processing by a known method. In addition, the processing procedure, control procedure, specific name, and information including various data and parameters shown in the above document and drawings can be arbitrarily changed unless otherwise specified.

According to at least one embodiment described above, it is possible to reduce the time and effort of the user when diagnosing a heart disease and formulating a treatment plan.

Although some embodiments 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 embodiments, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and variations thereof are included in the scope of the invention described in the claims and the equivalent scope thereof, as are included in the scope and gist of the invention.

Regarding the above embodiments, the following appendices are disclosed as one aspect and selective features of the invention.

(Appendix 1)
A three-dimensional image of the blood vessel of the subject, an acquisition unit for acquiring the spatial distribution of the wall shear stress value at each position of the blood vessel, and an acquisition unit.
A display control unit that displays a display image in which the value of the wall shear stress is assigned to the three-dimensional image from an arbitrary angle.
An input operation reception unit that accepts input operations that change the angle,
Have,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, the display control unit displays the display image while changing the angle with the passage of time, and the rotation display of the angle. The display form of the displayed image is changed between the non-rotating display without change.
Medical image processing equipment.
(Appendix 2)
The display control unit extracts the core wire of the blood vessel, assigns the spatial distribution of the wall shear stress value at each position of the blood vessel to the three-dimensional image, and assigns the one-dimensional information assigned to each position of the core wire to the three-dimensional image. When the display image of 1 and the second display image in which the three-dimensional information assigned to each position in the space of the blood vessel is assigned to the three-dimensional image are generated and the display image is rotated and displayed, the first When the display image of 1 is displayed and the display image is displayed in a non-rotating manner, the second display image may be displayed.
(Appendix 3)
The display control unit may further change the display form of the display image according to at least one of the number of rotations and the rotation speed of the display image.
(Appendix 4)
The display control unit may further change the display form of the display image according to the enlargement or reduction of the display image.
(Appendix 5)
The display control unit may further change the display form of the display image according to the size of the display area for displaying the display image.
(Appendix 6)
The display control unit may change the rotation speed of the displayed image based on the calculation result of the wall shear stress in the rotation display.
(Appendix 7)
The display control unit may control to reduce the rotation speed at the timing when the position of the blood vessel from which the maximum value and the minimum value of the wall shear stress are calculated is displayed in the rotation display.
(Appendix 8)
The display control unit may control to increase the rotation speed at the timing when the position of the blood vessel in which the calculation result of the wall shear stress is incorrect is displayed in the rotation display.
(Appendix 9)
The display control unit may change the rotation speed of the displayed image based on the properties of the blood vessel in the rotation display.
(Appendix 10)
The display control unit may control the rotation speed so as to decrease the rotation speed at the timing when the position of the lesion site of the blood vessel is displayed in the rotation display.
(Appendix 11)
In the calculation of the wall shear stress, a determination unit for determining the validity of the calculation target is further provided.
The display control unit may display the validity determination result.
(Appendix 12)
In the calculation of the wall shear stress, a determination unit for determining the validity of the calculation result is further provided.
The display control unit may display the validity determination result regarding the calculation result.
(Appendix 13)
The display control unit may display a list in which the calculation results of the wall shear stress are summarized for each subject, and emphasize the result of deviation from the reference value in the list.
(Appendix 14)
The display control unit may further display analysis results other than the wall shear stress in the list.
(Appendix 15)
The display control unit adds information indicating the validity to the position where the validity of the calculation result is low in the display image in which the value of the wall shear stress at each position of the blood vessel is reflected in the three-dimensional image of the blood vessel. May be displayed.
(Appendix 16)
A calculation unit that calculates the value of wall shear stress at each position of the blood vessel,
A control unit that transfers the calculation result of the wall shear stress to a predetermined transfer destination, and
May be further provided.
(Appendix 17)
The control unit may transfer the calculation result of the wall shear stress to a medical report.
(Appendix 18)
The control unit may transfer information regarding the calculation of the wall shear stress to the three-dimensional printer.
(Appendix 19)
The control unit may transfer the calculation result of the wall shear stress to the medical diagnostic imaging apparatus.
(Appendix 20)
The control unit may switch the transfer destination of the calculation result of the wall shear stress according to the index value regarding the blood flow in the blood vessel.
(Appendix 21)
A control unit that outputs a reservation of the inspection device or a notification prompting the reservation of the inspection device based on the calculation result of the wall shear stress may be further provided.
(Appendix 22)
In response to the reservation of medical image data collection used for calculating the wall shear stress, a control unit for controlling to secure the calculation resource used for calculating the wall shear stress may be further provided.
(Appendix 23)
The display control unit displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross section of the blood vessel.
The input operation receiving unit receives an input operation for changing the position of the cross section to be displayed as the display image.
The display control unit may change the speed of changing the position of the cross section based on the input operation based on the calculation result of the wall shear stress.
(Appendix 24)
The display control unit displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross section of the blood vessel.
The input operation receiving unit receives an input operation for changing the position of the cross section to be displayed as the display image.
The display control unit may change the display form of the display image according to the speed of changing the position of the cross section based on the input operation.
(Appendix 25)
A medical image processing system including a medical image processing device and a medical information display device.
The medical image processing apparatus acquires a three-dimensional image of a blood vessel of a subject and a spatial distribution of wall shear stress values at each position of the blood vessel.
The medical information display device
A display image in which the value of the wall shear stress is assigned to the three-dimensional image is displayed from an arbitrary angle.
Accepts the input operation to change the angle,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, there is a rotation display in which the display image is displayed while changing the angle with the passage of time, and a non-rotation in which the angle is not changed. The display form of the displayed image changes depending on the time of display.
Medical image processing system.
(Appendix 26)
A three-dimensional image of the blood vessel of the subject and a spatial distribution of wall shear stress values at each position of the blood vessel are acquired.
A display image in which the value of the wall shear stress is assigned to the three-dimensional image is displayed from an arbitrary angle.
Accepts the input operation to change the angle,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, there is a rotation display in which the display image is displayed while changing the angle with the passage of time, and a non-rotation in which the angle is not changed. The display form of the displayed image changes depending on the time of display.
Medical image processing methods, including.

100 Medical image processing system 140 Medical information display device 150 Medical image processing device 155 Processing circuit 155b Judgment function 155c Calculation function 155d Display information generation function 155e Display control function 155f Control function

Claims (26)

A three-dimensional image of the blood vessel of the subject, an acquisition unit for acquiring the spatial distribution of the wall shear stress value at each position of the blood vessel, and an acquisition unit.
A display control unit that displays a display image in which the value of the wall shear stress is assigned to the three-dimensional image from an arbitrary angle.
An input operation reception unit that accepts input operations that change the angle,
Have,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, the display control unit displays the display image while changing the angle with the passage of time, and the rotation display of the angle. The display form of the displayed image is changed between the non-rotating display without change.
Medical image processing equipment. The display control unit
Extract the core wire of the blood vessel and
The spatial distribution of the wall shear stress value at each position of the blood vessel is assigned to each position of the core wire, and the one-dimensional information is assigned to the three-dimensional image. The 3D information assigned to is generated as a second display image assigned to the 3D image.
The medical image processing apparatus according to claim 1, wherein when the display image is rotated and displayed, the first display image is displayed, and when the display image is non-rotated, the second display image is displayed. The medical image processing device according to claim 1, wherein the display control unit further changes the display form of the displayed image according to at least one of the number of rotations and the rotation speed of the displayed image. The medical image processing device according to claim 1, wherein the display control unit further changes the display form of the displayed image according to the enlargement or reduction of the displayed image. The medical image processing device according to claim 1, wherein the display control unit further changes the display form of the display image according to the size of the display area for displaying the display image. The medical image processing apparatus according to any one of claims 1 to 5, wherein the display control unit changes the rotation speed of the displayed image based on the calculation result of the wall shear stress in the rotation display. The medical use according to claim 6, wherein the display control unit controls the rotation display so as to reduce the rotation speed at the timing when the position of the blood vessel from which the maximum value and the minimum value of the wall shear stress are calculated is displayed. Image processing device. The medical image processing apparatus according to claim 6, wherein the display control unit controls to increase the rotation speed at the timing when the position of the blood vessel in which the calculation result of the wall shear stress is incorrect is displayed in the rotation display. .. The medical image processing apparatus according to any one of claims 1 to 5, wherein the display control unit changes the rotation speed of the displayed image based on the properties of the blood vessel in the rotation display. The medical image processing apparatus according to claim 9, wherein the display control unit controls the rotation speed so as to decrease the rotation speed at the timing when the position of the lesion portion of the blood vessel is displayed in the rotation display. In the calculation of the wall shear stress, a determination unit for determining the validity of the calculation target is further provided.
The medical image processing apparatus according to any one of claims 1 to 10, wherein the display control unit displays the validity determination result. In the calculation of the wall shear stress, a determination unit for determining the validity of the calculation result is further provided.
The medical image processing apparatus according to any one of claims 1 to 11, wherein the display control unit displays a validity determination result regarding the calculation result. The display control unit displays a list of the calculation results of the wall shear stress for each subject, and emphasizes the result of deviation from the reference value in the list according to any one of claims 1 to 12. Medical image processing equipment. The medical image processing apparatus according to claim 13, wherein the display control unit further displays analysis results other than the wall shear stress in the list. The display control unit adds information indicating the validity to the position where the validity of the calculation result is low in the display image in which the value of the wall shear stress at each position of the blood vessel is reflected in the three-dimensional image of the blood vessel. The medical image processing apparatus according to claim 12, wherein the image processing apparatus is displayed. A calculation unit that calculates the value of wall shear stress at each position of the blood vessel,
A control unit that transfers the calculation result of the wall shear stress to a predetermined transfer destination, and
The medical image processing apparatus according to any one of claims 1 to 15, further comprising. The medical image processing apparatus according to claim 16, wherein the control unit transfers the calculation result of the wall shear stress to a medical report. The medical image processing apparatus according to claim 16, wherein the control unit transfers information regarding the calculation of the wall shear stress to a three-dimensional printer. The medical image processing device according to claim 16, wherein the control unit transfers the calculation result of the wall shear stress to the medical image diagnostic device. The medical image processing apparatus according to claim 16, wherein the control unit switches a transfer destination of a calculation result of the wall shear stress according to an index value relating to blood flow in the blood vessel. The medical image processing according to any one of claims 1 to 20, further comprising a control unit that outputs a reservation of an inspection device or a notification prompting the reservation of the inspection device based on the calculation result of the wall shear stress. Device. One of claims 1 to 21, further comprising a control unit that controls to secure a calculation resource used for calculating the wall shear stress in response to a reservation for collecting medical image data used for calculating the wall shear stress. The medical image processing apparatus according to one. The display control unit displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross section of the blood vessel.
The input operation receiving unit receives an input operation for changing the position of the cross section to be displayed as the display image.
The medical image processing apparatus according to claim 1, wherein the display control unit changes the speed of changing the position of the cross section based on the input operation based on the calculation result of the wall shear stress. The display control unit displays a display image in which the value of the wall shear stress is assigned to the cross-sectional image showing the cross section of the blood vessel.
The input operation receiving unit receives an input operation for changing the position of the cross section to be displayed as the display image.
The medical image processing device according to claim 1, wherein the display control unit changes the display form of the displayed image according to the speed of changing the position of the cross section based on the input operation. A medical image processing system including a medical image processing device and a medical information display device.
The medical image processing apparatus acquires a three-dimensional image of a blood vessel of a subject and a spatial distribution of wall shear stress values at each position of the blood vessel.
The medical information display device
A display image in which the value of the wall shear stress is assigned to the three-dimensional image is displayed from an arbitrary angle.
Accepts the input operation to change the angle,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, there is a rotation display in which the display image is displayed while changing the angle with the passage of time, and a non-rotation in which the angle is not changed. The display form of the displayed image changes depending on the time of display.
Medical image processing system. A three-dimensional image of the blood vessel of the subject and a spatial distribution of wall shear stress values at each position of the blood vessel are acquired.
A display image in which the value of the wall shear stress is assigned to the three-dimensional image is displayed from an arbitrary angle.
Accepts the input operation to change the angle,
In the display of the display image in which the value of the wall shear stress is assigned to the three-dimensional image, there is a rotation display in which the display image is displayed while changing the angle with the passage of time, and a non-rotation in which the angle is not changed. The display form of the displayed image changes depending on the time of display.
Medical image processing methods, including.

Images