JP3446406B2 - X-ray fluoroscopy diagnostic device - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical X-ray fluoroscopic diagnostic apparatus, and more particularly, to an X-ray irradiating means and an X-ray image detecting means which face each other with a top plate interposed therebetween. And an image display means is provided downstream of the X-ray image detection means.
X-ray irradiation is performed on the subject on the tabletop by the X-ray irradiating means, and a fluoroscopic X-ray image of the subject is displayed as an image based on a video signal output from the X-ray image detecting means accompanying the X-ray irradiation. The present invention relates to an X-ray fluoroscopic diagnostic apparatus which is displayed on a means. 2. Description of the Related Art An X-ray fluoroscopic apparatus used for an X-ray examination in a hospital or the like can observe a fluoroscopic X-ray image of an examinee (subject), so that appropriate diagnosis and treatment can be performed. Therefore, it can be said that this is a very useful device. FIG. 6 is a schematic diagram showing a main part configuration of a conventional X-ray fluoroscopic apparatus. The conventional X-ray fluoroscopic apparatus shown in FIG.
An X-ray tube (X-ray irradiating means) 101 and an X-ray image detector (X-ray image detecting means) 102 are arranged so as to face each other with a top plate 103 for mounting the subject 100 therebetween.
A display monitor (image display means) 105 is provided downstream of the X-ray image detector 102. In addition, a film type photographing machine 104 is provided below the top plate 103. X
The line image detector 102 includes an image intensifier (I.
I tube) 102a and a TV imaging tube 102b,
A video signal is output from the X-ray image detector 102 and sent to the display monitor 105 with X-ray irradiation from the X-ray tube 101. The display monitor 105 and the operation unit 106 for remotely controlling the top plate, the X-ray tube, the X-ray detector, the photographing device, and the like are usually placed in another room. In the case of fluoroscopic imaging using an X-ray fluoroscopic apparatus,
The subject 1 is displayed on the screen of the display monitor 105 by the video signal output from the X-ray image detector 102 in accordance with the X-ray irradiation performed on the subject 100 on the top 103 from the X-ray tube 101.
A fluoroscopic X-ray image of 00 is displayed. The doctor or X-ray technician looks at the fluoroscopic X-ray image projected on the display monitor 105,
At an appropriate timing, the photographing machine 104 is remotely operated to photograph a part to be examined, such as a digestive organ (stomach or intestine), on a film. As described above, by performing observation by X-ray fluoroscopy, the condition of the examination site can be well grasped, and thus the X-ray fluoroscopy apparatus is very effective for early detection of a disease and treatment thereof. [0005] However, the conventional X-ray fluoroscopic apparatus has a point to be improved with respect to clear X-ray fluoroscopy of a minute lesion at the examination site, as described below. . When performing fluoroscopy and imaging of digestive organs such as the stomach and intestine using a conventional X-ray fluoroscopic diagnostic apparatus, the state of adhesion of the Ba contrast agent, which is given to the subject 100 in advance, in the digestive organs is a result of the fluoroscopic imaging Has a significant effect. That is, as shown in FIG. 7A, the inner wall of the gastrointestinal tract 110 has folds (folds), and the Ba contrast agent 111 tends to concentrate and accumulate in the concave portions 112 of the folds. In the flat portion 113, the Ba contrast agent does not stay and flows away. As a result, when there is a small lesion 115 on the flat portion 113 and slight unevenness occurs, the Ba contrast agent 111 does not adhere much to the flat portion 113, and as shown in FIG. The lesion 115 is only faintly drawn on the fluoroscopic screen, and, of course, the lesion 115 does not appear in the photograph in a clear form when it is photographed on a film. In order to move the Ba contrast agent 111 in the body by instructing the subject 100 on the table 103 to change the body position, such as leftward, rightward, or rotation, the contrast agent 111 is moved. Since it does not readily adhere to the flat portion 113, the lesion 115 does not clearly appear on the X-ray fluoroscopic screen. Further, while observing the X-ray fluoroscopic image, the top plate moving mechanism unit 103a is driven by remote control from the operation unit 106, and the top plate 103 is repeatedly moved to shake the subject 100 and move the Ba contrast agent 111. In order to clearly draw the lesion 115 on the screen, as shown in FIG.
Since the shake of 0 appears as a blur on the screen as it is, it is not known whether the lesion 115 is actually drawn on the screen. As a result, even if it is determined from experience and intuition that the Ba contrast agent 111 has adhered to the flat portion 113 to some extent, the top plate 103 stops moving, and the screen is kept still, and the lesion 115 is only faintly observed. In many cases, the top plate 103 is not drawn, and the top plate 103 is moved again and the same operation is repeated many times. Flat part 113
When the Ba contrast agent 111 is successfully attached, the lesion 115 can be clearly drawn on the X-ray fluoroscopic screen, as shown in FIG. Clear X for any lesion
Fluoroscopy is not easy to achieve. SUMMARY OF THE INVENTION In view of the above circumstances, an object of the present invention is to provide an X-ray fluoroscopic diagnostic apparatus capable of easily and reliably performing clear X-ray fluoroscopy of a minute lesion at a site to be examined. [0008] In order to achieve the above object, the present invention has the following configuration. That is, in the X-ray fluoroscopic diagnostic apparatus according to the present invention, the X-ray irradiating means and the X-ray image detecting means are arranged so as to face each other with the subject mounting top plate interposed therebetween. Image display means is provided at a stage subsequent to the means, and while the X-ray irradiating means irradiates the subject on the top plate with X-rays, the X-ray irradiating means causes In an X-ray fluoroscopic diagnostic apparatus in which a fluoroscopic X-ray image of the subject is displayed on an image display unit in accordance with an output video signal, the top plate is swung so as to reciprocate a predetermined distance. And an irradiation image system oscillating means for oscillating both the X-ray irradiating means and the X-ray image detecting means so as to reciprocate a predetermined distance. Moving means for moving the X
The top plate and the X-ray irradiating unit and the X-ray image detecting unit are kept relatively stationary even when the positional relationship between the X-ray irradiating unit and the X-ray image detecting unit is rocking. Each swing is performed in synchronization with. The operation of the present invention is as follows. According to the X-ray fluoroscopic diagnostic apparatus of the present invention, when a small lesion is likely to be present in the examination site during X-ray fluoroscopy, the subject is allowed to drink Ba.
The contrast agent is moved inside the body, and the top plate is shaken so that the Ba contrast agent adheres well to the minute lesion area of the examination site, and the subject is shaken well, and at the same time, the X-ray image on the display monitor is observed. And observe whether a small lesion is drawn. When it is confirmed that a minute lesion has been drawn on the display monitor, the swinging is stopped immediately, and the examination site is further observed in detail, or a photograph is taken as necessary. [0010] As a characteristic action of the present invention,
This means that the screen of the display monitor is not blurred while the subject is being shaken, and becomes a still screen as if the subject were still. When the screen of the display monitor is not blurred in this way, the adhesion state of the Ba contrast agent to the minute lesion portion can be grasped well, and the appropriate adhesion state of the Ba contrast agent can be reliably obtained. It will be drawn in a clear and easy-to-understand form. The reason why the screen of the display monitor is not blurred is that the positional relationship between the X-ray irradiating unit and the X-ray image detecting unit with respect to the top plate is maintained even during the swinging of the top plate. From the viewpoint of the image detecting means, the screen is also in a still state because the top plate, that is, the subject remains (relatively) still. During the swing of the tabletop, the irradiation image system swinging means causes the X-ray irradiating means and the X-ray image detecting means to follow the same movement in synchronization with the swinging of the tabletop, so that the positional relationship between the three members is maintained. It is kept. As a result, in the X-ray fluoroscopy diagnostic apparatus of the present invention, a still screen without blur is observed after the operation of operating the top-plate-based rocking means and the irradiation image-based rocking means, and the Ba contrast agent is minute. What is necessary is just to wait for a fine lesion to be clearly attached to a fine lesion portion. Next, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a schematic block diagram illustrating a configuration of the entire X-ray fluoroscopic apparatus according to the embodiment. FIG. 2 is a partial schematic view showing the X-ray tube, the X-ray image detector, and the top plate of the embodiment apparatus. 3A and 3B are partial external views showing the X-ray tube, the X-ray image detector, and the periphery of the top plate of the embodiment device. FIG. 3A is a perspective view, and FIG.
Is a side view. Hereinafter, the configuration of the apparatus will be described first, and thereafter, the fluoroscopy / imaging operation will be described. -Configuration of X-ray fluoroscopic apparatus- The X-ray fluoroscopic apparatus 1 of the embodiment is an X-ray tube 2 (irradiation means).
And an X-ray image detector (X-ray image detecting means) 3 including an image intensifier (II tube) 3a and a TV imaging tube 3b, with a top plate 4 for mounting the subject 5 interposed therebetween. It is arranged so that it may face. The X-ray tube 2 is located above the top plate 4 in a state where it is attached to the tip of a rotating frame 8 extending from a base 7 installed on the floor. Conversely, the X-ray image detector 3 is located below the top plate 4. Located on the side. Then, regarding the X-ray irradiation, according to the irradiation conditions set by the operation unit 23,
Necessary control is performed on the X-ray tube 2 from the X-ray irradiation control unit 24, and the X-ray tube 2 emits X-rays. A display monitor (image display means) 22 is provided at the subsequent stage of the X-ray image detector 3, and a video signal output from the X-ray image detector 3 with X-ray irradiation by the X-ray tube 2. Is amplified by the signal processing unit 21, sent to the display monitor 22, and is projected on the screen of the display monitor 22 as an X-ray fluoroscopic image. A photographing machine 6 for photographing an X-ray fluoroscopic image on a film is also provided below the top plate 4. Regarding photographing, photographing conditions set by the operation unit 23 are set. Accordingly, necessary control is performed from the photographing machine control unit 25 to the photographing machine 6 to appropriately obtain an X-ray photograph. As the photographing machine 6, for example, a cassette telephotography photographing machine is used. In the case of a cassette telephoto camera, an unphotographed film taken out of a film magazine is transferred to a film carriage at a film loading position, and at the time of photographing, after the film carriage is moved to a photographing position and photographing is performed, The film is returned to a film magazine for storing photographed film. On the other hand, the X-ray tube 2, the X-ray image detector 3, and the top 4 can be moved by remote control from the operation unit 23. While keeping the X-ray tube 2 and the X-ray image detector 3 facing each other, as shown in FIG. 2, the X-ray tube 2 and the X-ray image detector 3 are moved in the H direction (the width of the apparatus, that is, the width of the top plate). X-ray tube / X-ray image detector drive mechanism 10 for moving in either direction (direction) or V direction (the longitudinal direction of the apparatus, that is, the top), and the top 4 in the H direction. Alternatively, a top plate driving mechanism 11 for moving in any direction of the V direction is also provided. The drive mechanisms 10, 11 are a drive mechanism using a combination of a motor and a rack and pinion.
Alternatively, each is constituted by a drive mechanism by a combination of a motor and a belt. And the operation unit 2
In response to the instruction from the control unit 3, the top panel system and the irradiation / image system drive control unit 26 perform necessary control on the respective drive mechanism units 10 and 11, and the X-ray tube 2 and the X-ray image detector are controlled. The configuration in which the necessary movements of the top 3 and the top 4 are performed will be described in more detail below mainly with reference to FIG. In the case of the X-ray fluoroscopic apparatus 1 of this embodiment, X
The movement of the tube 2, the X-ray image detector 3, and the top 4 includes a normal movement of moving to a desired position and stopping, and a movement of repeating a short distance reciprocating movement, that is, a swing. In the case of normal movement of the top 4, the operation unit 23
In response to the instruction by, the required control is performed from the top drive control unit 31 to the top drive mechanism 11, and the top 4 is
While moving in the H direction or the V direction, the movement amount (or movement position) of the top 4 is detected by the top movement detection unit 32 and sent to the operation unit 23 as necessary, or the top is driven. It is fed back to the control unit 31. When the top board 4 moves to a desired position while monitoring the movement status of the top board 4 that moves in accordance with an instruction from the operation section 23, the operation section 23 is operated or stopped by the operation of the top board drive control section 31. Or stop it. When the ordinary X-ray tube 2 and X-ray image detector 3 are moved, the X-ray tube
The X-ray image detector drive control unit 35 performs necessary control on the X-ray tube / X-ray image detector drive mechanism unit 10 to move the X-ray tube 2 and X-ray image detector 3 in the H direction or V direction. The X-ray tube 2 and the X-ray image detector 3 are moved (or moved) by the X-ray tube / X-ray image detector movement amount detector 3.
6 and sent to the operation unit 23 as necessary,
Alternatively, it is fed back to the X-ray tube / X-ray image detector drive control unit 35. When the X-ray tube 2 and the X-ray image detector 3 move to desired positions while monitoring the movement state of the X-ray tube 2 and the X-ray image detector 3 that move according to the instruction from the operation unit 23, It is stopped by operating the operation unit 23 or automatically stopped by the operation of the X-ray tube / X-ray image detector drive control unit 35. When the top plate 4 swings, the operation unit 2
In response to the instruction from the top 3, necessary control is performed from the synchronous swing drive control section 38 to the top drive mechanism 11, and the movement amount (or movement position) of the top 4 is determined by the top movement detection section 32. , And is fed back to the synchronous swing drive control unit 38, so that the table 4 swings in the H direction or the V direction. That is, when the top plate movement amount detection unit 32 detects that the top plate 4 has moved by a certain amount, the synchronous swing drive control unit 38 issues a control signal for rotating the motor in reverse to reverse the movement direction of the top plate 4. Repeat. When the X-ray tube 2 and the X-ray image detector 3 oscillate, the synchronous oscillating drive control unit 38 drives the X-ray tube / X-ray image detector in accordance with an instruction from the operation unit 23. Necessary control is performed on the mechanism unit 10, and the moving amount (or moving position) of the X-ray tube 2 and the X-ray image detector 3 is detected by the X-ray tube / X-ray image detector moving amount detecting unit 36. The X-ray tube 2 and the X-ray image detector 3 swing back in the H direction or the V direction. That is, when the X-ray tube / X-ray image detector movement amount detection unit 36 detects that the X-ray tube 2 and the X-ray image detector 3 have moved by a fixed amount, the synchronous swing drive control unit 38 controls the motor to rotate in the reverse direction. A signal is output and the reversal of the moving direction of the X-ray tube 2 and the X-ray image detector 3 is repeated. It should be noted that the table top moving amount detection unit 32 and the X-ray tube / X
As the line image detector movement amount detection unit 36, for example, one configured from a counter circuit that counts pulse signals sent from rotary encoders attached to the respective drive mechanism units 10 and 11 is used. The drive control units 31 and 35 output a control signal for stopping the motor when the count value in the counter circuit reaches a preset value, and the synchronous swing drive control unit 38 sets the count value in the counter circuit in advance. When the value reaches the set value, a control signal for reversing the motor is output. The most characteristic point is that the synchronous drive control unit 38 controls the top plate 4, the X-ray tube 2, and the X-ray image detector 3 to swing the X-ray tube 2 and the X-ray with respect to the top plate 4. That is, both swings are controlled synchronously so that the positional relationship of the image detector 3 is maintained during the swing. That is, when the top 4 moves in the V direction (or H direction), the X-ray tube 2 and the X-ray image detector 3
Follow and move in the same direction by the same amount. Thereby, the top 4, the X-ray tube 2 and the X-ray image detector 3 are
Even during the rocking, it remains relatively stationary. The intensity (amplitude) of the swing from the operation unit 23
Can be controlled. That is, as for the swing in the V direction, as shown in FIG. 4, while the upper side of the triangular display 40 surrounded by the solid line on the operation panel is pressed, the switch 41 is kept closed and the amplitude of the swing is increased. Tiki,
While the lower corner is being pressed, the switch 42 is kept closed to reduce the amplitude of the swing, and the synchronous swing drive control unit is configured to maintain the strength of the swing in the V direction when the hand is released. 38 controls the strength of the rocking. H
As for the swing in the direction, as shown in FIG. 4, while the right side of the triangular display 44 surrounded by the solid line on the operation panel is pressed, the switch 45 continues to be closed, and the amplitude of the swing increases. While the left corner is being pressed, the switch 46 is kept closed to reduce the amplitude of the swing, and the synchronous swing drive control unit is configured to maintain the strength of the swing in the H direction when the hand is released. 38 controls the strength of the rocking. As is apparent from the above description, in this embodiment, the top-panel swinging means comprises the operating section 23, the synchronous swing drive control section 38, the top drive mechanism 11, and the top-plate movement amount detecting section. The irradiation image system rocking means includes an operation unit 23, a synchronous rocking drive control unit 38, an X-ray tube / X-ray image detector driving mechanism unit 10, and an X-ray tube / X-ray image detector. This means that the moving amount detecting unit 36 is configured. -Perspective / Photographing Operation- Next, the operation when performing the fluoroscopic / photographing by the apparatus having the above-described configuration will be described. When performing fluoroscopy / imaging, the subject 5 who has swallowed the Ba contrast agent is placed on the top 4 and X-ray irradiation is performed on the subject 5 from the X-ray tube 2. Then, a fluoroscopic X-ray image of the examination site of the digestive system is displayed on the screen of the display monitor 22 by the video signal output from the X-ray image detector 3 in association with the X-ray irradiation. The doctor or the X-ray technician remotely operates the photographing machine 6 at an appropriate timing while photographing the digestive organs (stomach and intestine) while viewing the fluoroscopic X-ray image projected on the display monitor 22 to obtain an X-ray photograph. Take a picture. As shown in FIG. 8, when a small lesion is likely to be present at the examination site, the operation unit 23 is operated to move the top plate 4, the X-ray tube 2, and the X-ray image detector 3 in the V direction. Or H
The display monitor 22 is observed while swinging in synchronization with the direction. As described above, the top plate 4 and the X-ray tube 2
Since the X-ray image detector 3 and the X-ray image detector 3 remain relatively stationary, the screen of the display monitor 22 is not blurred, and FIG.
As shown in FIG.
15, as shown in FIG.
5 is clearly drawn on the X-ray fluoroscopic screen, the swing is stopped, and the photographing device 6 is remotely operated by the operation unit 23.
To drive an X-ray fluoroscopic image on the film. Since the microscopic lesion is clearly depicted in the obtained X-ray photograph, the doctor can perform appropriate diagnosis and treatment. The present invention is not limited to the above embodiment, but can be modified as follows, for example. (1) In the case of the apparatus according to the embodiment, the swing can be performed in either the V direction or the H direction, but a device that can only swing in one of the V direction and the H direction is a modified embodiment. In addition, a modified embodiment in which the swinging in both the V direction and the H direction can be performed at the same time can be mentioned. (2) In the case of the apparatus of the embodiment, the swing is in the V direction or the H direction, but a swing in the vertical direction or in the direction of an arc of curvature R is a modified embodiment. . (3) The video signal output from the X-ray image detector may be sent to a display monitor as an analog signal as it is, but as shown in FIG.
The analog video signal output from the A / D converter is amplified by the amplifying unit 51, converted into a digital signal by the AD converting unit 52, subjected to signal processing such as contrast adjustment and contour emphasizing by the digital signal processing unit 53, and sent to the display monitor 55. At the same time, the digital signal may be stored in the image signal memory unit 54. In the case of the configuration shown in FIG. 5, the stored digital signal can be read out from the image signal memory unit 54, and the reproduced image can be projected on the display monitor 22 for repetitive fluoroscopic observation. As is apparent from the above description, according to the present invention, the X-ray tube and the X-ray detector follow and swing in synchronization with the swing of the top plate, thereby enabling the X-ray fluoroscopic screen to be displayed. Since blurring is eliminated and clear X-ray fluoroscopy of minute lesions at the examination site can be easily and reliably realized, the accuracy of diagnosis is increased and diseases are easily found, and as a result, the X-ray fluoroscopic diagnostic apparatus of the present invention The screening ability is high, and the usefulness is remarkable.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic block diagram showing a configuration of an entire apparatus according to an embodiment. FIG. 2 is a partial schematic view of an apparatus according to an embodiment. FIG. 3 is a partial external view of the apparatus according to the embodiment. FIG. 4 is a front view showing an operation surface for adjusting the rocking strength of the embodiment device. FIG. 5 is a block diagram showing a modification of the video signal processing system. FIG. 6 is a schematic diagram showing a configuration of a main part of a conventional device. FIG. 7 is an explanatory diagram showing a state of attachment of a Ba contrast agent in a digestive organ. FIG. 8 is an explanatory diagram schematically showing an example of an X-ray fluoroscopic screen of a digestive organ. FIG. 9 is an explanatory view schematically showing a blurred X-ray fluoroscopic screen. FIG. 10 is an explanatory diagram schematically showing an appropriate X-ray fluoroscopic screen. [Description of Signs] 1 ... X-ray fluoroscopic apparatus 2 ... X-ray tube (X-ray irradiating means) 3 ... X-ray image detector (X-ray image detecting means) 4 ... Top plate 5 ... Subject (subject) 6 ... Photographing machine 10 ... X-ray tube / X-ray image detector drive mechanism 11 ... Top drive mechanism 26 ... Top and illumination / video drive control

Claims (1)

(1) An X-ray irradiating means and an X-ray image detecting means are arranged so as to face each other with a top plate for mounting a subject therebetween, and an X-ray image is provided. Image display means is provided at a stage subsequent to the detection means, and the X-ray irradiation means irradiates the subject on the top plate with X-rays, and the X-ray image detection means accompanies the X-ray irradiation. In the X-ray fluoroscopic diagnostic apparatus in which a fluoroscopic X-ray image of the subject is displayed on an image display means in accordance with a video signal output from the camera, the top plate is swung so as to reciprocate a predetermined distance. An X-ray oscillating means for oscillating both the X-ray irradiating means and the X-ray image detecting means so as to reciprocate within a predetermined distance. Rocking means, the X-ray irradiating means for the top plate and X-rays; Wherein even during positional relationship oscillation of both means detection means and the top plate X
An X-ray fluoroscopic diagnostic apparatus, wherein each of the rocking means and the X-ray image detecting means performs each swing synchronously so as to remain relatively stationary.