JP2773357B2 - Angiography imaging device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION A. Industrial Field of the Invention The present invention can switch between a fluoroscopic mode for displaying a fluoroscopic image of a subject and a map mode for displaying a vascular map image for catheter operation. The present invention relates to an angiography apparatus, and more particularly to a technique for switching between the two modes.

B. Prior Art There is a medical method in which a catheter is inserted into a blood vessel of a subject to perform examination and treatment of an affected part of the subject. For example, in the case of treating a patient with vascular stenosis, a so-called balloon catheter in which a balloon is attached to the tip of a catheter, which is a thin tube, is inserted into a blood vessel of a subject. After insertion, the balloon catheter is advanced to reach the stenosis site, and the balloon attached to the distal end is inflated. Thereby, the stenotic blood vessel is restored.

When performing such a treatment using a catheter,
The catheter must be advanced to the affected site. Therefore, the angiographic imaging apparatus can switch between a map mode for collecting and displaying a blood vessel map image for monitoring the entrance of the catheter and a fluoroscopic mode for displaying a fluoroscopic image of the subject. ing. Conventionally, switching between the two modes is performed by an operator in an examination room (a room in which a subject is accommodated) speaking to an X-ray technician in an operation room across an X-ray shielding wall to switch between the two modes. Ask,
Switching between the two modes is performed by an X-ray engineer's button operation.

C. Problems to be Solved by the Invention However, the above-described conventional angiographic imaging apparatus has the following problems.

That is, when switching between a fluoroscopic mode for displaying a fluoroscopic image of a subject and a map mode for displaying a blood vessel map image for catheter monitoring, the operator gives a signal to an X-ray technician in the operation room. This is very inconvenient for the operator who is operating the catheter, because there is a need to request the switching beforehand, and there is a problem that it hinders the smooth progress of the inspection and treatment. .

Inspection and treatment with a catheter are mainly performed mainly on the circulatory system. In the examination and treatment of the circulatory system, it is essential that the examination and treatment be performed promptly, and there is an increasing demand for a mode switching operation by the operator himself.

The present invention has been made in view of such circumstances, and has as its object to provide an angiography apparatus capable of switching between a blood vessel map image and an X-ray fluoroscopic image by an operator himself. I have.

D. Means for Solving the Problems The present invention has the following configuration to achieve the above object.

That is, the angiographic imaging apparatus according to the invention described in claim 1 includes a fluoroscopic mode for displaying a fluoroscopic image obtained by irradiating a subject with X-rays on a monitor; An angiographic imaging apparatus that can be switched to a map mode for displaying a blood vessel map image for monitoring an entry destination of a catheter inserted in the monitor, the apparatus being attached to an apparatus body on which a subject is placed, A foot switch that outputs an ON signal according to an X-ray irradiation command, and when the output time of the ON signal of the foot switch is shorter than a predetermined set time,
ON signal discriminating means for invalidating the X-ray irradiation command by the ON signal, counting means for counting the number of times the invalid ON signal is output, and the fluoroscopic mode and the map based on the count signal from the counting means. And a mode switching means for switching between modes.

The angiographic imaging apparatus according to claim 2, further comprising: a movement detection unit configured to detect a relative movement between the X-ray system that irradiates the subject with X-rays and the subject; a fluoroscopic mode and a map mode. Is switched based on a count signal from the counting means and based on a detection signal from the movement detecting means.

E. Operation Switching between the fluoroscopic mode and the map mode by the angiographic imaging apparatus of claim (1) is performed as follows.

That is, when switching between the two modes, the surgeon depresses the foot switch attached to the apparatus main body for a short time within the set time.

The ON signal of the foot switch due to the depression is output to the ON signal determining means and the counting means. ON signal discrimination means is ON signal output time (foot switch depressing time)
Is within the set time, the X-ray irradiation command related to the ON signal is invalidated. Therefore, X-ray irradiation is not performed. The counting means counts the number of times the invalidated ON signal is output, and sends the counting signal to the mode switching means. The mode switching means performs switching from the fluoroscopic mode to the map mode or switching from the map mode to the fluoroscopic mode based on the count signal. Claim (2)
In the case of the angiographic imaging apparatus, the two modes are switched even when the movement detecting means detects the relative movement between the X-ray system and the subject.

In this way, only by the operator's foot switch operation,
Switching between the two modes is performed.

When the surgeon steps on the foot switch for a set time or more after switching between the two modes, the ON signal determination unit validates the X-ray irradiation command related to the ON signal. As a result, X-rays are emitted from the X-ray system, and images are collected and displayed in the switched mode.

F. Embodiment Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

FIG. 1 is a block diagram schematically showing the configuration of an embodiment of the present invention.

In the figure, reference numeral 1 denotes a bed on which a subject M is placed, and is supported on a base 2 installed on the floor so as to be horizontally movable. The bed 1 is provided with a position detector 7a for detecting the horizontal movement thereof.
Is provided with a drive unit (not shown) for horizontally moving.
An X-ray tube 3 and an X-ray image intensifier 4 are installed so as to face up and down with the subject M and the bed 1 interposed therebetween. On the output side of the X-ray image intensifier 4, a camera 5 that scans the visible light image output from the X-ray image intensifier 4 and outputs a video signal is provided. These X-ray tube 3, X-ray image intensifier 4, and camera 5 are of X-ray type. Reference numeral 6 denotes the X-ray tube 3
And a support arm that supports the X-ray image intensifier 4 and can move in the body axis direction and the vertical direction of the subject M.

The support arm 6 is provided with a movement detector 7b for detecting the movement of the support arm 6, and together with the position detector 7a, corresponds to the movement detection means of the present invention.

On the floor near the subject M, a foot switch 8 that is operated by the operator to depress is arranged. The ON signal a of the foot switch 8 output by the operator's depressing operation is transmitted to the single shot circuit 9 and the counter circuit 10.
The signal is supplied to the ON signal timing circuit 11. When the ON signal a is input, the single shot circuit 9 outputs a single shot pulse signal b having a pulse width of a preset time (for example, one second) to the AND gate 13 through the inverter 12. Is configured. The counter circuit 10 is a counter that counts and records the number of times the ON signal a is output and clears the count with two counts. ON
When the output time of the ON signal a is within a predetermined time (for example, 1 second), the signal timing circuit 11
Count valid signal d which makes the count operation of 10 effective
Is output. Hereinafter, the count number determined to be valid by the count valid signal d is referred to as a valid count number. When the effective count number is “1”, the counter circuit 10 sends a “1” count signal e to the mode switching unit 14,
In the case of "2", a "2" count signal f is output to the OR gate 15. The mode switching unit 14 selects the fluoroscopic mode or the map mode according to the “1” count signal e from the counter circuit 10 and the output signal from the OR gate 15, and switches the output destination of the video signal from the camera 5. The OR gate 15 has the above-described movement detector.
Output signals from the position detector 7b and the position detector 7a are given as other inputs.

The counter circuit 10 and the ON signal timing circuit 11 correspond to the counting means in the present invention, the single shot circuit 9, the inverter 12 and the AND gate 13 correspond to the ON signal discriminating means, and the mode switching section 14 And the OR gate 15 correspond to the mode switching means.

Reference numeral 16 denotes a high-voltage generator that applies a high voltage for X-ray irradiation to the X-ray tube 3 in accordance with the output signal of the AND gate 13. Reference numeral 17 denotes a video signal when the mode switching unit 14 selects the map mode. Is the subtraction processing unit that is the output destination of
Generate a subtraction image that highlights the blood vessel image. Reference numeral 18 denotes a black-and-white image reversing unit that obtains a blood vessel image with a white blood vessel portion by performing a black-and-white reversal process on the subtraction image. An adder that outputs a blood vessel map image serving as an operation index to the monitor 20.

Next, the operation of the above-described angiography apparatus will be described with reference to FIG.

FIG. 2 is a time chart of output signals of various parts in the apparatus.

First, the surgeon incises the body surface of the subject M, for example, the body surface of the thigh, and inserts the catheter 21 into the blood vessel of the subject M. In order to confirm the insertion position of the catheter 21, it is assumed that the mode switching unit 14 has previously selected the fluoroscopic mode. In order to display a fluoroscopic image of the insertion site of the catheter 21 on the monitor 20 in this state, the operator steps on the foot switch 8. Since this operation is not an operation for mode switching but an operation for instructing X-ray exposure, the operator steps on the foot switch 8 for a set time T (see FIG. 2) or more. The output ON signal a of the foot switch 8 at this time is sent to the single shot circuit 9, the counter circuit 10, and the ON signal timing circuit 11.
In this case, the number of times the foot switch 8 is depressed is one.
Times.

As shown in FIG. 2A, the single shot circuit 9 outputs a single shot pulse signal b having a pulse width of the set time T to the inverter 12 in response to the input of the ON signal a. The inverter 12 outputs an inverted pulse signal c obtained by inverting the pulse signal b to one input of the AND gate 13. The ON signal a is given to the other input terminal of the AND gate 13,
When the inversion pulse signal c rises from the “L” level to the “H” level (after the set time T after the foot switch 8 is depressed), if the ON signal a is output, the gate is opened, After delaying the ON signal a for a set time T, the ON signal a is output to the high voltage generator 16 as an X-ray irradiation start command signal g.

The high-voltage generator 16 applies a high voltage to the X-ray tube 3 while the X-ray irradiation start command signal g is given. Thus, X-rays are emitted from the X-ray tube 3. The X-ray image transmitted through the subject M is converted into a visible light image by the X-ray image intensifier 4, converted into a video signal by the camera 5, and sent to the mode switching unit 14. At this time, since the mode switching unit 14 is set to the fluoroscopic mode, the transmitted video signal is output to the monitor 20 as it is, and the fluoroscopic image is displayed.

Further, the counter circuit 10 counts the number of signals (number of pulses) of the ON signal a of the foot switch 8. In this case, since the foot switch 8 is depressed only once, the counter circuit 10 records the count number of "1". At this time
Since the output time of the ON signal a (depression time of the foot switch 8) is operated by the operator so as to be equal to or longer than the set time T, as shown in FIG. Count valid signal d for counter circuit 10
Is not output. Therefore, the counter circuit 10 invalidates the recorded count number, and the mode switching unit 14 and the
No signal is output to the OR gate 15. This allows
The mode switching unit 14 does not perform the mode switching operation,
Continue fluoroscopy mode.

Next, in the process of moving the catheter 21 to the treatment site O, when the operator wants to display a blood vessel map image serving as an index of the distal end of the catheter 21, the operator operates the foot switch 8 in a short time within the set time T, Depress only once.

FIG. 2 (b) shows a time chart of the output signal of each section in the apparatus by operating the foot switch 8.

The output signal of the single shot circuit 9 and the inverter 12 according to the ON signal a of the foot switch 8 is shown in FIG.
Is the same as Therefore, the inverted pulse signal c provided as one input of the AND gate 13 is in the "H" level state, while the ON signal a provided as the other input is in the "L" level state (stepping time of the foot switch 8). Is within the set time T). Therefore, AND
The gate 13 keeps the gate closed, does not output the ON signal a to the high voltage generator 16, and the ON signal a becomes invalid. This allows
The high voltage generator 16 does not apply a high voltage to the X-ray tube 3,
No radiation is emitted.

The counter circuit 10 counts the number of pulses of the ON signal a of the foot switch 8 in the same manner as described above. Also in this case, since the foot switch 8 is depressed only once, the count is recorded as "1". Also, ON signal timing circuit
11 measures the output time of the ON signal a. In this case, since the foot switch 8 is depressed for a short time within the set time T by the surgeon, the ON signal timing circuit 11 determines that the ON signal a time is within the set time T and sends the one-shot pulse to the counter circuit 10. The count valid signal d is output. When receiving the count valid signal d, the counter circuit 10 determines that the recorded count number “1” is valid and outputs a “1” count signal e to the mode switching unit 14. "1"
When the count signal e is given, the mode switching unit 14 switches from the fluoroscopic mode to the map mode. By this mode switching, the fluoroscopic image displayed on the monitor 20 is deleted. Then, the operator determines the subject M
The contrast agent is injected into the blood vessel, and the foot switch 8 is continuously depressed for the set time T or more. Thus, X-rays are emitted, and the obtained video signal is sent to the subtraction processing unit 17 by the mode switching unit 14. Subtraction processing unit
17 performs subtraction arithmetic processing between a mask image (a fluoroscopic image before injection of a contrast agent) collected in advance and a given video signal, and converts the subtraction image into a black-and-white image reversing unit.
Send to 18. The subtraction image in which the blood vessel part is turned white by the black-and-white image inversion unit 18 is displayed on the monitor 20 via the adder 19. When X-ray irradiation is continuously performed by the operator's operation of the foot switch 8, the obtained fluoroscopic image is sent to the adder 19, where the image is superimposed on the subtraction image displayed on the monitor 20. Will be The catheter 21 is formed of a material that does not transmit X-rays, and is black on a fluoroscopic image. That is, the black catheter 21 is displayed in the white blood vessel image, and an image that is convenient for determining the destination of the catheter 21 can be displayed on the monitor 20, which is a blood vessel map image.

While viewing the displayed vascular map image, further advance the approach of the catheter 21, and if the approach range of the catheter 21 extends beyond the displayed vascular map image, the displayed vascular map image is unnecessary. Therefore, the mode is switched, the displayed blood vessel map image is deleted, and the mode is switched to the fluoroscopic mode in which a normal fluoroscopic image is displayed.

FIG. 2C is a time chart at the time of switching from the map mode to the fluoroscopic mode.

This switching operation is performed by the operator depressing the foot switch 8 twice within a short time within the set time T, or when the relative movement between the bed 1 and the support arm 6 shown in FIG. 1 is detected. . This relative movement means a change in the monitoring target part, and the image currently displayed on the monitor 20 at this time becomes invalid.

When the foot switch 8 is depressed twice in the short time by the operator, first, at the time of the first depressing operation,
As described above, since the counter circuit 10 outputs the “1” count signal e, the mode switching unit 14 is in the map mode at this time. Next, when the second stepping operation is performed, the ON signal timing circuit 11 outputs the second count valid signal d to the counter circuit 10 as shown in FIG. Based on the second count valid signal d, the counter circuit 10 determines that the count number “2” is valid.
The output of the “1” count signal e is stopped, and the “2” count signal f is output to the OR gate 15 instead.

As a result, the OR gate 15 opens the gate,
An “H” level signal is sent to the mode switching unit 14. The mode switching unit 14 switches from the map mode to the fluoroscopic mode according to the “H” level signal from the OR gate 15. When the bed 1 or the support arm 6 moves, a detection signal for detecting the movement is output to the OR gate 15, and the OR gate 15 similarly sends an “H” level signal to the mode switching unit 14 to change the mode. Instruct switching.

By switching the fluoroscopic mode, the mode switching unit
14 erases the blood vessel map image displayed on the monitor 20,
Thereafter, the image taken by the X-ray photography is output to the monitor 20 as it is, so that the fluoroscopic image is displayed on the monitor 20.

In this manner, the operation of switching between the fluoroscopic mode and the map mode is performed by operating the foot switch 8 by the operator himself.

In the above-described embodiment, the number of times the foot switch 8 is depressed for mode switching is merely an example, and it is needless to say that the mode can be switched at an arbitrarily set number of times.

G. Effects of the Invention As is apparent from the above description, the angiographic imaging apparatus according to the invention described in claim (1) switches between the fluoroscopic mode and the map mode by depressing a foot switch installed in the examination room. Since the switching is performed, the operator can switch between the two modes. For this reason, unlike the related art, it is not necessary to request the X-ray technician to perform the switching, and the operator can easily perform the mode switching, thereby contributing to prompt examination and treatment of the catheter.

According to the invention described in claim (2), when the X-ray system and the subject move relative to each other, the mode is automatically switched to the fluoroscopic mode, so that the operation of switching the mode for each movement is not required. In other words, examination and treatment can be performed more quickly.

[Brief description of the drawings]

1 and 2 relate to an embodiment of the present invention. FIG. 1 is a block diagram showing a schematic configuration of an angiographic photographing apparatus. FIG. 2 (a) shows a foot switch 8 depressed for a set time or more. (B) is the output signal time chart when switching from the fluoroscopic mode to the map mode, and (c) is the output signal time chart when switching from the map mode to the fluoroscopic mode. It is an output signal time chart. 3 X-ray tube 4 X-ray image intensifier 5 Camera 7a Position detector 7b Movement detector 8 Foot switch 9 Single shot circuit 10 Counter circuit 11 ON signal timing circuit 12 Inverter 13 AND gate 14 Mode switching unit 15 OR gate 20 Monitor

────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Akira Horie 1 at Kuwabaracho, Nishinokyo, Nakagyo-ku, Kyoto-shi, Kyoto Inside the Sanjo Plant, Sanjo Plant (56) References 63-51841 (JP, A) (58) Fields investigated (Int. Cl. ⁶ , DB name) A61B ^6/ 00-6/04

Claims (2)

(57) [Claims] 1. A fluoroscopic mode for displaying a fluoroscopic image obtained by irradiating a subject with X-rays on a monitor, and a vascular map image for monitoring an approach destination of a catheter inserted into a blood vessel of the subject. An angiographic imaging apparatus switchable to a map mode for displaying on the monitor, a foot attached to an apparatus main body on which a subject is mounted, and outputting an ON signal according to an X-ray exposure command. A switch, when the output time of the ON signal of the foot switch is shorter than a predetermined set time, an ON signal discriminating means for invalidating an X-ray exposure command by the ON signal, and the invalid ON signal An angiographic imaging apparatus, comprising: a counting means for counting the number of times of output of the image forming apparatus; and a mode switching means for switching between the fluoroscopic mode and the map mode based on a counting signal from the counting means. 2. The angiographic imaging apparatus according to claim 1, further comprising: a movement detecting unit configured to detect a relative movement between the X-ray system that irradiates the subject with X-rays and the subject; An angiographic imaging apparatus that switches between the map mode and the map mode based on a count signal from a counting unit and based on a detection signal from the movement detecting unit.