JP4379211B2 - Ultrasonic diagnostic equipment - Google Patents

Description

  The present invention relates to an ultrasonic diagnostic apparatus, and more particularly to an ultrasonic diagnostic apparatus having a function of measuring an intima-media thickness of a carotid artery wall based on a carotid artery echo image.

  Since arteriosclerosis causes heart disease such as angina pectoris and myocardial infarction, and cerebral infarction, it is desirable to conduct periodic examinations. In proportion to the progression of arteriosclerosis, it is known that the intima and media of the arterial vascular wall consisting of three layers of adventitia, media and intima are thickened. Usually, it is performed by measuring the intima-media thickness of the carotid artery (Intima-Media Thickness, hereinafter referred to as IMT). Here, the carotid artery is the measurement target because the IMT value of the carotid artery becomes larger from the initial stage of arteriosclerosis compared to other sites, and the carotid artery is easily detected. This is because measurement is easy because the depth from the skin is as small as 2 to 3 cm.

Conventionally, the IMT value was measured by imaging the carotid artery with an ultrasound diagnostic device and applying the caliper to the image displayed on the screen or the image printed on paper. An ultrasonic diagnostic apparatus having a function of measuring an IMT value by a computer algorithm based on a luminance value of image data as described in Document 1 has been developed, and the diagnosis is greatly simplified and speeded up.
Japanese Patent No. 2889568

  However, since the annual growth rate of IMT is about 0.01 mm, and IMT diagnosis makes such a very small amount a problem, if the follow-up of IMT values over a long period of time is necessary, If the same part is not reliably photographed, a large error will be given to the measurement result. Conventionally, however, the alignment of the shooting location is the same as the past image while referring to the ultrasonic image taken in the past by printing it on paper or displaying it side by side with the current rendered image on the monitor. This is done by moving the probe so that the position of is displayed on the monitor. For this reason, whether or not the same location can be measured accurately depends on the skill of the measurer, and there is a problem that it takes time for alignment. In particular, it is very difficult to measure the same part every time in a non-planar part such as the neck.

  The problem to be solved by the present invention is to provide an ultrasonic diagnostic apparatus that can easily image the same part as the part imaged in the past and can perform IMT measurement with high reproducibility.

An ultrasonic diagnostic apparatus according to the present invention, which has been made to solve the above problems, transmits ultrasonic waves to an observation target in a body of a subject, and generates ultrasonic waves based on the ultrasonic waves reflected by the observation target. In an ultrasonic diagnostic apparatus for creating an image, a) a measurement range designating unit that designates an arbitrary area in an ultrasonic image as a measurement object by a measurement range designation frame; and b) within an area designated by the measurement range designation unit Data analysis means for performing a predetermined measurement based on the luminance value of the image data, c) storage means for storing the information on the position and size of the measurement range designation frame and the ultrasonic image in association with each other; and d) Position information generating means for detecting the feature position of the observation target from the ultrasonic image captured in the past and generating position information; e) position information display means for displaying the position information superimposed on the current rendered image; f) Location information by the location information display means When a call instruction for a measurement range designation frame is input from the user after the display of, information on the position and size of the measurement range designation frame stored in association with the ultrasound image used to create the position information is displayed. Measurement range designation frame display means for reading out from the storage means and displaying a measurement range designation frame of the same size at the same position on the current rendered image is provided.

  In the present invention, a rendered image refers to a moving image that is displayed in real time on a screen in accordance with transmission / reception of ultrasonic waves by a probe or a still image obtained by freezing it.

Position information is created based on ultrasonic images taken in the past, and superimposed on the current rendered image, so that positioning is easily performed by moving the probe so that the position information and the rendered image overlap. As a result, the time required for alignment can be shortened, and variations between measurers can be reduced.
In addition, if the measurement range can be specified in the measurement range specification frame at the same position and size as in the past IMT measurement, the same area in the ultrasonic image can be used for IMT measurement every time, and the IMT value progresses. The reliability of observation and the like can be further improved.

  Hereinafter, the best mode for carrying out the ultrasonic diagnostic apparatus of the present invention will be described using examples.

[Example]
FIG. 1 is a block diagram illustrating a configuration of a main part of the ultrasonic diagnostic apparatus according to the present embodiment. The ultrasonic probe 11 is in contact with a predetermined position on the surface of the neck of the subject, transmits the transmitted ultrasonic wave into the body of the subject, and receives the ultrasonic wave reflected in the body of the subject. Wave and convert to electrical signal. The ultrasonic transmission / reception unit 12 controls transmission / reception of ultrasonic waves by the ultrasonic probe 11, and the ultrasonic signal processing unit 13 converts an electrical signal output from the ultrasonic probe 11 into image data, and performs phasing. Predetermined data processing such as addition, gain adjustment, logarithmic compression is performed. The display processing unit 14 performs processing for displaying an ultrasonic image on the monitor 15 based on the output of the ultrasonic signal processing unit 13.

  The IMT value measurement unit 16 sets a region to be subjected to IMT measurement in the ultrasonic image and performs a predetermined operation for measuring the IMT value in the set measurement target region. The storage unit 17 stores the acquired ultrasonic image, the measured IMT value, and the like. The position information creation unit 18 creates position information indicating the position of the blood vessel wall based on the captured ultrasonic image, and details thereof will be described later. The control unit 19 controls each unit described above, and an operator's instruction is sent to the control unit 19 by an input unit 20 including a pointing device such as a mouse, a keyboard, and the like.

Hereinafter, the operation of the ultrasonic diagnostic apparatus according to the present embodiment will be described with reference to FIGS.
First, imaging of an ultrasound image at the first visit, measurement of an IMT value based on the image, and storage of the image and the like will be described.

  First, the measurer brings the ultrasonic probe 11 into contact with the neck of the subject. When the measurer performs a predetermined operation using the input unit 20, the probe 11 transmits ultrasonic waves in the body of the subject at a predetermined cycle. The ultrasound reflected in the body of the subject is converted into an electrical signal by the probe 11, and an ultrasound image is generated in the ultrasound signal processing unit 13 and the display processing unit 14. The ultrasonic image is updated according to the period of ultrasonic waves transmitted by the ultrasonic probe 11 and displayed on the monitor 15 as a moving image.

  When the measurer performs a predetermined operation, the ultrasonic image displayed as a moving image on the monitor 15 is frozen. The measurer determines whether or not the frozen image is appropriate as an image for IMT measurement. If the measurer determines that the image is not appropriate, the measurer operates the input unit 20 to exceed the time before the freeze. A sound wave image is displayed on the monitor 15 and an image suitable for IMT measurement is selected. Alternatively, freeze again after displaying the video again. When the measurer performs a predetermined operation, an ultrasonic image used for the IMT measurement is determined.

  When the ultrasonic image for measurement is determined, a frame (template) 22 for setting a measurement target region is displayed in the ultrasonic image 21 as shown in FIG. The measurer operates the mouse or the like to move or enlarge / reduce the template 22 so that the inner membrane 24 and the inner membrane 25 of the blood vessel wall 23 enter the template 22. When the position and size of the template 22 are determined by pressing the “OK” button 27, the IMT value measurement unit 16 calculates the inner wall of the intima 24 (intima and blood flow region from the luminance value of each pixel in the template 22. The IMT value is obtained by detecting the inner wall of the outer membrane 26 and the inner wall of the outer membrane 26 and measuring the distance between them. The detection of each inner wall and the IMT measurement can be performed using existing IMT measurement software using the method described in Patent Document 1.

  The IMT value obtained as described above, other information obtained by measurement, information related to a later-described imaging section, and the like are stored in the storage unit 17. Further, information regarding the position and size of the ultrasonic image 21 and the template 22 used for the measurement are also associated with each other and stored in the storage unit 17.

  By repeating the above operations, imaging at a plurality of cross sections, IMT measurement, and image storage are performed. When measuring the IMT value, usually, ultrasonic images are taken from two directions (side and obliquely forward) for both carotid arteries, one on each side of the neck. In addition, the common carotid artery on the side close to the heart branches into an internal carotid artery supplying blood to the brain and an external carotid artery supplying blood to the face. IMT values are measured for either or both arteries. Therefore, when measuring the IMT value of either the common carotid artery or the internal carotid artery for one subject, the IMT values of both the common carotid artery and the internal carotid artery are calculated using four sections. In the case of measurement, an ultrasonic image is taken with eight cross sections.

Subsequently, the operation of the ultrasonic diagnostic apparatus of the present embodiment at the time of the second and subsequent diagnoses will be described.
First, when the measurer performs a predetermined operation with the input unit 20, as shown in FIG. 3, a plurality of ultrasonic images taken at the first visit are reduced and displayed on the monitor 15. Under each reduced image (hereinafter, thumbnail image) 31, a character string 32 representing the position and direction in which the image was taken is displayed (in FIG. 3, "CCA" at the left end of the character string represents the common carotid artery, “AO” on the right side of the hyphen indicates that the image was taken obliquely from the front, “LV” indicates that the image was taken from the side, and “L” or “R” at the right end of the string indicates the left or right carotid artery. ing). When a desired image is selected from the thumbnail images 31 by double-clicking, the measurement image 21 at the time of the first examination that is the basis of the thumbnail image 31 is displayed on the left side of the screen. When the “Trace” button 33 is pressed in this state, the outer edge of the blood vessel (that is, the outer wall of the outer membrane 26) 34 is detected based on the luminance of the image 21, and a line 35 obtained by tracing the outer edge 34 is superimposed on the image 21. Is done. Further, in the case where the shape has a characteristic such as a branch portion of the carotid artery, a dot 36 is displayed at the position indicating the characteristic.

  The trace line 35 and the dot 36 serve as a reference for alignment at the time of ultrasonic image capturing. The reason for using the outer wall of the outer membrane 26 as a reference for alignment is the luminance between the outer membrane 26 and the peripheral portion of the blood vessel. This is because the difference is large and easy to check on the screen, and it is difficult to be affected by the thickening of the intima 24 and the medial layer 25.

  Next, when the measurer operates the mouse or the like of the input unit 20 and presses the “OK” button 37, the ultrasonic probe 11 is brought into contact with the subject's neck to start transmission / reception of ultrasonic waves. As shown in FIG. 4, the current rendered image 41 is displayed as a moving image on the monitor, and the trace line 35 and the dot 36 created as described above are superimposed and displayed on the rendered moving image 41. The trace line 35 and the dot 36 are represented by a broken line, a high-intensity line, a colored line, or the like so as to be easily distinguished from the current rendered moving image 41.

  The measurer first moves the probe 11 so that the branch of the carotid artery in the rendered moving image 41 coincides with the dot 36, and then roughly aligns the trace line 35 and the outer edge 34 of the blood vessel of the rendered image. The position and angle of the probe 11 are finely adjusted so that the positions of the two coincide with each other. When the measurer determines that the two match, the drawn moving image 41 is frozen by pressing a “freeze” button 42. It is confirmed again that the position of the trace line 35 and the outer edge 34 of the blood vessel overlap, and if it is determined that they do not coincide with each other, the moving image is displayed again and the freeze is performed again.

When the measurer determines that the trace line 35 and the position of the outer edge 34 of the blood vessel sufficiently match, the “template call” button 43 is pressed. As a result, an image for IMT measurement is determined and a template is superimposed and displayed on the image. The position and size of the template are stored in the storage unit together with the measurement image at the first visit, and the template can specify the same area where the IMT measurement was performed at the first visit. .
Thereafter, when the measurer performs a predetermined operation, the IMT value is measured based on the image data in the template as in the first visit.

  The trace lines 35 and dots 36 created as described above are preferably stored in association with the measurement image 21 at the first visit so that they can be recalled and used at the next measurement. The trace line may be created at the time of the second and subsequent measurements as described above, but the trace line and the like may be created and stored at the first visit.

  The measurement range designation means and the data analysis means in the ultrasonic diagnostic apparatus of the present invention can be realized by conventional IMT software. The position information creation means, the position information display means, and the measurement range designation frame display means are the conventional IMT. Since it can be realized by modifying the measurement software, it is not necessary to add new parts, and the cost is not significantly increased.

  In the above embodiment, the case where the present invention is used for IMT measurement by carotid artery echo is shown. However, the configuration of the present invention can be applied to observation and measurement of other parts such as the chest and abdomen. it can. In this case, the outline of the organ and the like are displayed in a trace to perform positioning, and a template is saved and called as necessary, and predetermined measurement is performed by dedicated measurement software or the like.

The block diagram which shows the structure of the principal part of the ultrasonic diagnosing device which concerns on the Example of this invention. The figure which shows the screen display at the time of designating the measurement range in an ultrasonic image in the ultrasonic diagnosing device of the Example. The figure which shows the screen display at the time of trace line creation in the ultrasonic diagnosing device of the Example. The figure which shows the screen display at the time of the alignment at the time of the ultrasonic imaging in the ultrasonic diagnosing device of the Example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 11 ... Probe 12 ... Ultrasonic transmission / reception part 13 ... Ultrasonic signal processing part 14 ... Display processing part 15 ... Monitor 16 ... IMT value measurement part 17 ... Memory | storage part 18 ... Position information creation part 19 ... Control part 20 ... Input part 21 ... Image for measurement 22 ... Template 23 ... Blood vessel wall 24 ... Inner membrane 25 ... Intima 26 ... Outer membrane 31 ... Thumbnail image 34 ... Outer edge 35 of blood vessel ... Trace line 36 ... Dot 41 ... Drawing animation

Claims (2)

In an ultrasonic diagnostic apparatus for transmitting an ultrasonic wave to an observation target in a body of a subject and creating an ultrasonic image based on the ultrasonic wave reflected by the observation target,
a) a measurement range designating means for designating an arbitrary region in the ultrasonic image as a measurement object by a measurement range designating frame;
b) data analysis means for performing a predetermined measurement based on the luminance value of the image data in the area specified by the measurement range specifying means;
c) storage means for associating and storing information on the position and size of the measurement range designation frame and the ultrasonic image;
d) position information generating means for detecting the characteristic position of the observation target from the ultrasonic images taken in the past and generating position information;
e) position information display means for superimposing and displaying the position information on the current rendered image;
f) Measurement range designation stored in association with the ultrasound image used to create the position information when the user inputs a measurement range designation frame call instruction after the position information is displayed by the position information display means. Measurement range designation frame display means for reading out information on the position and size of the frame from the storage means, and displaying a measurement range designation frame of the same size at the same position on the current rendered image;
An ultrasonic diagnostic apparatus comprising: The ultrasonic diagnostic apparatus according to claim 1 , wherein the data analysis unit detects an intima of a blood vessel and calculates an intima-media complex thickness.

Images