JP4473800B2 - Therapeutic device selection support system and therapeutic device selection method - Google Patents

Description

  The present invention relates to a therapeutic device selection support system and a therapeutic device selection method for supporting selection of a therapeutic device used for endovascular treatment, and in particular, selects a therapeutic device based on information on a diseased part in image data. The present invention relates to a therapeutic device selection support system and a therapeutic device selection method.

  In recent years, minimally invasive treatment called MIT (Minimally Invasive Treatment) has attracted attention. A typical example of MIT for patients with ischemic brain disease or heart disease is so-called interventional treatment using a catheter or the like under image observation.

  A catheter with a balloon that expands the stenotic region in the radial direction as a device for endovascular treatment used to treat cerebrovascular and cardiovascular and peripheral blood vessels where stenosis has occurred due to cholesterol deposition on the inner wall. DCA (directional coronary plaque excision), which removes the deposit (plaque) of the stenosis site by moving or rotating a microcutter attached to the distal end of the catheter, and a microcutter attached to the distal end of the catheter. There is a rotablator.

  The shape of the endovascular treatment device (hereinafter referred to as the treatment device) used for the above-mentioned endovascular treatment is the length of the diseased part (stenosis range in the direction of blood vessel travel), the curvature of the blood vessel, the diameter of the blood vessel It is necessary to make a selection based on information such as (blood vessel diameter) (hereinafter collectively referred to as disease site information). For example, if the diameter of the balloon or stent after expansion is smaller than the diameter of the blood vessel, the therapeutic effect is small, and if it is too large, there is a risk of damaging the blood vessel wall. That is, when performing endovascular treatment, a doctor who performs treatment needs to know in advance the length of a diseased part, the curvature and diameter of a blood vessel, etc., and designate an optimal treatment device based on such information.

  For this reason, prior to endovascular treatment, for example, a doctor grasps the above-mentioned disease site information in image data collected from a patient who has been administered a contrast agent, and has a shape optimal for this disease site information. I asked the nearest medical staff to order the device. The medical staff who has received this request selects a designated therapeutic device from various therapeutic devices provided in advance in the hospital and provides it to the doctor.

In the past, two-dimensional image data obtained by a medical image diagnostic apparatus such as an X-ray diagnostic apparatus, an X-ray CT apparatus, an MRI apparatus, or an ultrasonic diagnostic apparatus has been used for grasping disease site information in the patient. However, in recent years, medical image diagnostic apparatuses capable of collecting three-dimensional information have been put into practical use in clinical settings, and the above-mentioned disease site information can be obtained with higher accuracy (see, for example, Patent Document 1). .)
JP 2002-263093 A

  When selecting a treatment device having the optimal shape for the treatment of the diseased part, if the treatment device designated by the doctor is not provided in the hospital, the medical staff will inform the doctor and inform the other treatment It was necessary to receive device designation. And the above-mentioned action by the doctor and the medical staff has been repeated until the treatment device redesignated by the doctor matches the treatment device provided in the hospital. For this reason, it takes a lot of time until the treatment device is finally obtained, and there is a problem that the treatment efficiency is remarkably lowered and the burden on the doctor, the medical staff, and the patient is increased. It was.

  In addition, since the doctor designates the treatment device as described above, it is necessary to perform the treatment based on a plurality of parameters (hereinafter referred to as shape parameters) such as the length and curvature of the diseased part and the blood vessel diameter. When the doctor himself / herself designates the optimal therapeutic device based on the observed image data, not only much time is spent, but it is often difficult to accurately designate the optimal therapeutic device.

The present invention has been made in view of such problems, and an object thereof is to shorten the time required for selecting a treatment device used for endovascular treatment and to improve treatment efficiency .

In order to solve the above-described problem, a therapeutic device selection support system according to a first aspect of the present invention is based on signal detection means for detecting an image signal necessary for generating image data from a subject, and the image signal. Image data generating means for generating image data, device shape setting means for setting a value related to a shape parameter of a treatment device for the diseased part based on information on the diseased part of the subject in the image data, A device database section in which information on treatment devices is stored in advance, and information on the various treatment devices stored in the device database section in accordance with the priorities of the shape parameters of the treatment devices set in advance. a device information search means you search on the basis of the value for the shape parameters of the use device, search more A display means for displaying the results is provided.

According to a sixth aspect of the present invention, there is provided the therapeutic device selection support system according to the present invention , wherein the value of the shape parameter of the therapeutic device for the diseased part based on the information on the diseased part in the image data generated by the medical image diagnostic apparatus. The device shape setting means for setting the device, the device database portion in which information on various treatment devices is stored in advance, and the device database portion is stored in accordance with the priorities of the shape parameters of the treatment devices set in advance a device information search means you search on the basis of information of the various therapeutic devices such values to the shape parameter of the therapeutic device is characterized by comprising display means for displaying the search results.

On the other hand, in the therapeutic device selection method of the present invention according to claim 11 , the signal detecting unit detects an image signal necessary for generating image data from the subject, and the image data generating unit outputs the image signal to the image signal. A step of generating image data based on the information, and a step in which the device shape setting means sets a value relating to a shape parameter of the treatment device for the diseased part based on information on the diseased part of the subject in the image data. The device information search means uses information on various treatment devices stored in advance in the device database unit in accordance with a preset priority of the shape parameter of the treatment device based on a value relating to the shape parameter of the treatment device. a step you search Te, a display unit, and characterized by the step of displaying the search results is doing.

According to a twelfth aspect of the present invention, there is provided the therapeutic device selection method according to the present invention, wherein the device shape setting unit is configured so that the therapeutic device for the diseased part is based on the diseased part information in the image data generated by the medical image diagnostic apparatus. A step of setting a value relating to a shape parameter; and a device information search unit that stores information on various treatment devices stored in advance in a device database unit in accordance with a preset priority of the shape parameter of the treatment device. A search is performed based on a value relating to a shape parameter of the medical device, information on a therapeutic device suitable for the diseased part is selected, and a display means includes a step of displaying the search result .

According to the present invention, the time required for selection of therapeutic devices for use in the endovascular treatment is shortened treatment efficiency is improved.

  Embodiments of the present invention will be described below with reference to the drawings.

  In an embodiment of the present invention described below, X-ray irradiation is performed from a plurality of directions on a heart disease patient (hereinafter referred to as a subject) to which a contrast medium has been administered to generate three-dimensional image data. Based on the diseased part information of the subject in the dimensional image data, the optimal shape of the therapeutic device used for the treatment of the diseased part is set. Next, a treatment device suitable for treatment of the diseased site is automatically selected based on the information on the optimum shape from a device database in which information on treatment devices that can be obtained immediately is stored in advance.

  In the following description, the case of measuring a treatment target site in a blood vessel based on image data obtained using an X-ray diagnostic apparatus will be described. However, an X-ray CT apparatus, an MRI apparatus, an ultrasonic diagnostic apparatus, etc. Image data obtained by another medical image diagnostic apparatus may be used. Further, the above-described image data is not limited to the three-dimensional image data described later, and may be two-dimensional image data. Also, volume rendering image data generated based on volume data or MPR (Multiplanar Reconstruction). ) Image data, MIP (Maximum Intensity Projection) image data, etc.

(Configuration of support system)
The configuration of the therapeutic device selection support system in the embodiment of the present invention will be described with reference to FIGS. However, FIG. 1 is a block diagram showing the overall configuration of the therapeutic device selection support system, and FIGS. 2 and 4 are specific examples of the signal detection unit and the image data generation unit that constitute the therapeutic device selection support system. It is a block diagram which shows a structure.

  The therapeutic device selection support system 100 of the present embodiment shown in FIG. 1 includes a signal detection unit 1 that detects an image signal necessary for generating image data for a subject, and the detected image signal by a predetermined method. An image data generation unit 2 for processing and generating image data, an image data display unit 3 for displaying the obtained image data, and treatment of a diseased part based on the image data and diseased part information measured in the image data A device shape setting unit 4 for setting an optimal shape of a treatment device used in the hospital, a device database unit 5 in which information on a treatment device that can be used immediately in the hospital is stored, and a device database unit 5 A device information search unit 6 for searching for information on a therapeutic device having a shape closest to the optimum shape from information on the therapeutic device. Eteiru.

  Further, the therapeutic device selection support system 100 includes a device information display unit 7 for displaying information on the therapeutic device searched by the device information search unit 6, setting of image data generation conditions, setting of a disease range in image data, and the like. An input unit 8 that performs control, a system control unit 9 that comprehensively controls each of the above-described units, and a biological signal measurement unit 10 that measures an ECG signal of the subject for the purpose of adding time-phase information to image data. ing.

  When the X-ray diagnostic apparatus is used, the signal detection unit 1 performs an X-ray generation unit 11 that irradiates the subject 150 with X-rays as shown in FIG. 2, and X-ray irradiation in the X-ray generation unit 11. A high voltage generation unit 14 that supplies a necessary high voltage, an X-ray detection unit 12 that detects projection data of X-rays transmitted through the subject 150, and a C that holds the X-ray generation unit 11 and the X-ray detection unit 12 The imaging position with respect to the subject 150 is set by the rotation of the arm-shaped holding unit 15, the top plate 17 on which the subject 150 is placed, the X-ray generation unit 11 and the X-ray detection unit 12, and the movement of the top plate 17. A moving mechanism unit 13 is provided.

  The X-ray generator 11 includes an X-ray tube 111 that irradiates the subject 150 with X-rays, and an X-ray diaphragm that forms an X-ray weight (cone beam) with respect to the X-rays irradiated from the X-ray tube 111. 112 is provided. The X-ray tube 111 is a vacuum tube that generates X-rays, and accelerates electrons emitted from a cathode (filament) by a high voltage to collide with a tungsten anode to generate X-rays. The X-ray diaphragm 112 is located between the X-ray tube 111 and the subject 150 and has a function of narrowing the X-ray beam irradiated from the X-ray tube 111 to an irradiation range of a predetermined size in the X-ray detection unit 12. Have.

  Further, the X-ray detection unit 12 has an X-ray I.D. I. And a method using a so-called X-ray flat panel detector in which X-ray detectors are two-dimensionally arranged. Here, X-ray I.D. I. However, the present invention is not limited to this method, and other methods such as an X-ray flat panel detector may be used.

  That is, the X-ray detection unit 12 performs X-ray I.D. I. 121, an X-ray television camera 122, and an A / D converter 123. X-ray I.D. I. 121 converts X-rays transmitted through the subject 150 into visible light, and further performs luminance multiplication in the process of light-electron-light conversion to form projection data with high sensitivity. On the other hand, the X-ray television camera 122 converts the above-mentioned optical projection data into an electrical signal using a CCD imaging device, and the A / D converter 123 is a time series output from the X-ray television camera 122. An electric signal (video signal) is converted into a digital signal.

  On the other hand, the moving mechanism unit 13 includes a top plate moving mechanism 131 for moving the top plate 17 in the body axis direction of the subject 150 (Z direction in FIG. 2), the X-ray generation unit 11, and the X-ray detection unit 12. A holding unit moving mechanism 132 for rotating the attached holding unit 15 around the subject 150, and a mechanism control unit 133 for controlling movement / rotation of the top plate moving mechanism 131 and the holding unit moving mechanism 132 are provided. ing.

  Then, the mechanism control unit 133 holds a control signal for rotating the holding unit 15 around the subject 150 based on the instruction signal supplied from the input unit 8 via the system control unit 9 of FIG. The X-ray irradiation position and the X-ray irradiation direction are set by supplying to the moving mechanism 132. Similarly, the mechanism control unit 133 supplies a control signal to the top board moving mechanism 131 based on an instruction signal from the system control unit 9, and performs initial setting and update of an imaging region for the subject 150.

  In the present embodiment, the X-ray generation unit 11 and the X-ray detection unit 12 are rotated around the subject 150 by the holding unit moving mechanism 132, so that two different imaging directions (first imaging direction and second imaging direction) are obtained. ) To generate time-series two-dimensional image data. Next, using the two-dimensional image data of the same time phase obtained in the first photographing direction and the second photographing direction, three-dimensional image data for the purpose of setting the range of the diseased part and the optimum shape of the treatment device is generated. To do.

  FIG. 3A shows the X-ray generation unit 11 and the X-ray detection unit 12 that are rotated around the subject 150 together with the holding unit 15 by the holding unit moving mechanism 132. For example, the floor stand 151 is illustrated in FIG. The X-ray generation unit 11 and the X-ray detection unit 12 are rotated in the R1 direction about an axis substantially parallel to the body axis direction of the subject 150 by the holding unit moving mechanism 132 that is rotatably attached to.

  FIG. 3B shows the first imaging direction and the second imaging direction set by rotating the X-ray generation unit 11 and the X-ray detection unit 12 around the subject 150. For example, time-series two-dimensional image data is generated for a predetermined period based on the projection data obtained in the first set imaging direction, and then the X-ray generator 11 and the X-ray detector 12 is rotated in the R1 direction to generate time-series two-dimensional image data in the second imaging direction for a predetermined period.

  Returning to FIG. 2, the high voltage generator 14 includes a high voltage generator 141 that generates a high voltage to be applied between the anode and the cathode in order to accelerate the thermal electrons generated from the cathode of the X-ray tube 111. A high voltage control circuit 142 that controls X-ray irradiation conditions such as tube current, tube voltage, and irradiation time in the high voltage generator 141 in accordance with an instruction signal from the system control unit 9 is provided.

  The biological signal measuring unit 10 in FIG. 1 is for collecting heart rate information of the subject 150 and has an ECG unit (not shown). Then, an electrocardiogram waveform (ECG signal) detected from an ECG electrode attached to the chest of the subject 150 is once converted into a digital signal to generate time phase information and supplied to the image data generation unit 2. Instead of the ECG unit, for example, the biological signal measurement unit 10 including a PCG unit that can measure a heart sound waveform may be used.

  Next, a specific example of the image data generation unit 2 is shown in FIG. 4 includes a two-dimensional image data generation unit 21, a contour extraction unit 22, a three-dimensional image data generation unit 23, and an image data storage unit 24.

  The two-dimensional image data generation unit 21 receives the heartbeat supplied from the biological signal measurement unit 10 to the projection data in the first imaging direction and the second imaging direction supplied from the A / D converter 123 of the X-ray detection unit 12. Information is added and sequentially stored, and time-series two-dimensional image data for each shooting direction is generated. The contour extraction unit 22 performs signal processing such as binarization processing on the two-dimensional image data obtained in the first imaging direction and the second imaging direction, and extracts blood vessel contour information.

  On the other hand, the three-dimensional image data generation unit 23 reads out two-dimensional image data in the same time phase based on the time phase information that is supplementary information of the above-described two-dimensional image data, and uses the contour information of these two-dimensional image data. To generate three-dimensional image data. The obtained three-dimensional image data is stored in the image data storage unit 24.

  FIG. 5 is a diagram for explaining a method of generating three-dimensional image data. FIG. 5A shows two-dimensional image data of a predetermined time phase obtained in the first photographing direction and the second photographing direction. The contour information of the inner wall of the blood vessel in (hereinafter referred to as first image data and second image data). FIG. 5B schematically shows three-dimensional image data generated based on the contour information.

  The above-described three-dimensional image data generation unit 23 first sets the central axis Ca in the blood vessel running direction for the blood vessel contour Va in the first image data obtained by the contour extraction unit 22, and then this central axis Ca. A perpendicular to the central axis Ca is set at the central points Ca1, Ca2, Ca3,. Then, the blood vessel diameters a1, a2, a3,... Are measured based on the intersection coordinates of these perpendicular lines and the blood vessel contour Va. Similarly, blood vessel diameters b1, b2, b3... Are measured with respect to the blood vessel contour Vb in the second image data.

  Next, elliptical approximation is performed using the blood vessel diameter a1 and the blood vessel diameter b1, and blood vessel cross-sectional data D1 at the center point Ca1 is generated. Similarly, blood vessel cross-sectional data D2, D3,... At the center points Ca2, Ca3,... Are obtained by elliptic approximation using the blood vessel diameters a2, a3,. Generate. These blood vessel cross-sectional data are arranged in the blood vessel traveling direction based on the position coordinates of the center points Ca1, Ca2, Ca3,..., And further subjected to signal processing such as interpolation processing to obtain three-dimensional blood vessel image data Dx. Is generated.

  Returning to FIG. 1, the image data display unit 3 includes the first image data and the second image data generated by the image data generation unit 2, and blood vessel contour information generated based on these two-dimensional image data. And 3D image data is displayed. Furthermore, the optimal shape of the therapeutic device set by the device shape setting unit 4 to be described later based on the range of the diseased part set by the input unit 8 and the blood vessel image Dx for the blood vessel image Dx of the displayed three-dimensional image data. Display information.

  In addition, the device shape setting unit 4 is based on the diseased part information in the blood vessel image Dx of the three-dimensional image data displayed on the image data display unit 3, and the optimal shape (length, thickness) of the treatment device used for the treatment of this diseased part. Set the curvature, etc.).

  FIG. 6 shows a method for setting the optimal shape of the therapeutic device based on the three-dimensional image data, and the operator can select a disease for the blood vessel image Dx of the three-dimensional image data displayed on the image data display unit 3. Set the region range. In this case, the operator uses the input device of the input unit 8 to set the marker M1 and the marker M2 that indicate the upper and lower ends of the diseased part (stenosis part) in the blood vessel image Dx.

  Next, the device shape setting unit 4 that has received the information of the markers M1 and M2 via the system control unit 9 calculates the center Cx1 of the blood vessel cross section at the upper end and the center Cx2 of the blood vessel cross section at the lower end. Then, the central axis Cd of the blood vessel image Dx connecting these centers Cx1 and Cx2 is set, and the length L1 between Cx1 and Cx2 on the central axis Cd is measured as the length of the diseased part. Then, a length L2 obtained by adding a predetermined margin ΔL to the length L1 is set as the optimal length of the treatment device. The margin ΔL is set to about 1 mm, for example, with respect to the length L1 of the normal disease site.

  Furthermore, the device shape setting unit 4 sets the optimum diameter of the therapeutic device based on the normal blood vessel diameter in the vicinity of the diseased part (for example, the end portions Cx11 and Cx22 of the optimum length L2 set in FIG. 6), The curvature of the blood vessel central axis Cd at the site is set. When the therapeutic device is a balloon or a stent, the above-mentioned optimum diameter means the dimension when expanded.

  Next, the device database unit 5 stores the latest information on treatment devices that are already received in the hospital and can be used at all times. FIG. 7 schematically shows the latest information of the stent stored in the device database 5 as the above-mentioned therapeutic device, and the length and diameter of the stent are registered together with the product name. For example, the length / diameter is 9.0 mm / 2.5 mm, 12.0 mm / 2.5 mm, 15.0 mm / 2.5 mm, 18.0 mm / 2.5 mm, and 24.0 mm / 2.5 mm. The stent is registered under the trade name “AAA”.

  As shown in FIG. 7, the stent length is often supplied at intervals of 3 mm and the diameter at intervals of 0.5 mm. For this reason, it is desirable to select a stent having a size closest to the above-mentioned optimum length or optimum diameter from among these stents. In the device database unit 5, a product name corresponding to each stent having a predetermined length / diameter may be registered instead of the product name, and a product number or the like may be registered instead of the product name. Identification information may be registered. In addition to the length / diameter of the stent, information such as hardness, manufacturer name, and price may be registered corresponding to the product name and product identification information.

  Next, the device information search unit 6 is based on the information on the optimal shape of the therapeutic device set by the device shape setting unit 4, and from the latest information on the therapeutic device stored in the device database unit 5, A product name or product identification information of a treatment device having a shape closest to the optimum shape is searched.

  However, when the search for the therapeutic device is performed based on a plurality of shape parameters such as length, diameter, curvature and the like, it is necessary to set a priority for each shape parameter in advance. For example, when “length” and “diameter” are the shape parameters when searching for a stent, the “length” with less redundancy than the “diameter”, which can be slightly adjusted by balloon pressure, is used. It is desirable to set a high priority.

  FIG. 8 schematically shows search priorities for stents when the shape parameters are “length” and “diameter”. For example, the optimal shape (length / diameter) of the therapeutic device set in the device shape setting unit 4 is 15.2 mm / 2.6 mm, and the therapeutic devices G1 to G5 stored in the device database unit 5 Shape information (length / diameter) is 15.0 mm / 2.0 mm, 15.0 mm / 3.0 mm, 18.0 mm / 2.0 mm, 18.0 mm / 2.5 mm, 18.0 mm / 3. In the case of 0 mm, first, devices G1 and G2 having a length of 15 mm that is closest to the optimal length of the therapeutic device are searched for, and then among these, the diameter that is closest to the optimal diameter of the therapeutic device is 2.6 mm. The therapeutic device G2 having 3.0 mm is finally selected. Information on the selected therapeutic device is supplied to the device information display unit 7 via the system control unit 9 and displayed.

  FIG. 9 shows a display example of information on a treatment device in the device information display unit 7, and as shown in FIG. 9A, the product name or product identification of the treatment device selected by the device information search unit 6 Although the information may be displayed as it is, an available therapeutic device having an optimal shape (☆) of the therapeutic device and dimensions close to the optimal shape as shown in FIGS. 9 (b) and 9 (c) The shape (○) may be displayed by a one-dimensional or two-dimensional graph. Further, as shown in FIG. 9D, information on the therapeutic device selected by the device information search unit 6 in the list of available therapeutic devices may be highlighted using a color or an arrow. In addition, when the product name or shape of the selected treatment device is displayed, other information about the treatment device (eg, manufacturer name, optimal pressure on the balloon, price, stent restenosis rate, non-applicability) (Cases, results of this hospital, number of stocks, attached drugs, etc.) may be displayed simultaneously.

  On the other hand, the input unit 8 is an interactive interface including an input device such as a keyboard, a trackball, a joystick, and a mouse, a display panel, or various switches. Then, in the input unit 8, input of subject information and various commands, setting of image data generation conditions, setting of priority of shape parameters in searching for a treatment device, setting of range of diseased part in displayed three-dimensional image data, etc. To do.

  The system control unit 9 includes a CPU and a storage circuit (not shown), and the above-described various information input or set by the operator from the input unit 8 is stored in the storage circuit. The CPU controls each unit of the signal detection unit 1, the image data generation unit 2, the device shape setting unit 4, the device information search unit 6, and the device information display unit 7 based on these pieces of information, and controls the entire system. To supervise.

(Selection procedure for therapeutic device)
Next, a procedure for selecting a treatment device in the treatment device selection support system 100 according to the present embodiment will be described with reference to the flowchart of FIG.

  The operator inputs the subject information of the subject 150 in the input unit 8, and then sets the image data generation conditions, sets the priority of the shape parameter in the search for the treatment device, and the like. Is stored in the storage circuit of the system control unit 9 (step S1 in FIG. 10). In the following, a case where a stent is assumed as a therapeutic device will be described. However, the present invention is not limited to this, and other therapeutic devices such as a balloon, DCA, and rotablator may be used.

  When the above initial setting is completed, the operator places the subject 150 on the top board 17 and attaches the ECG electrode of the biological signal measuring unit 10 to the chest. Then, the biological signal measurement unit 10 converts the ECG signal of the subject 150 obtained at this time into a digital signal and then supplies the digital signal to the image data generation unit 2 (step S2 in FIG. 10).

  Next, the operator inserts a contrast medium injecting catheter through the blood vessel of the subject 150, and when the tip of the catheter reaches the origin of the coronary artery, the operator operates an injector (not shown) for a predetermined amount. The contrast medium is administered into the coronary artery (step S3 in FIG. 10).

  Then, when the administration of the contrast medium into the coronary artery having the diseased part is completed, the operator inputs an X-ray imaging start command at the input unit 8, and based on this imaging start command, the monitoring image data Generation and display are started.

  The operator inputs an instruction signal for moving the X-ray generation unit 11 and the X-ray detection unit 12 attached to the holding unit 15 to predetermined positions while observing the monitoring image data displayed on the image data display unit 3. The movement mechanism control unit 133 of the movement mechanism unit 13 that is input at the unit 8 and receives this instruction signal via the system control unit 9 supplies a control signal to the holding unit movement mechanism 132 and the X-ray generation unit 11 and the X-ray generation unit 11. The line detection unit 12 is rotated to a predetermined position to set the first imaging direction (step S4 in FIG. 10).

  During X-ray imaging in the first imaging direction, the high voltage control circuit 142 of the high voltage generation unit 14 receives the drive signal supplied from the system control unit 9 and is included in the initially set image data generation conditions. The high voltage generator 141 is controlled based on the X-ray irradiation conditions being applied, and a high voltage is applied to the X-ray tube 111 of the X-ray generator 11. Next, the X-ray tube 111 to which a high voltage is applied irradiates the subject 150 with X-rays via the X-ray restrictor 112, and the X-rays transmitted through the subject 150 are X-rays provided behind the X-ray tube 111. X-ray I.D. I. 121 is projected.

  On the other hand, X-ray I.D. I. 121 detects X-rays transmitted through the subject 150 and converts them into optical images, and the X-ray television camera 122 converts the optical images into electrical signals (video signals). Next, the A / D converter 123 converts the video signal output in time series from the X-ray television camera 122 into a digital signal to generate projection data, and the two-dimensional image data generation unit of the image data generation unit 2 21.

  On the other hand, the two-dimensional image data generation unit 21 of the image data generation unit 2 including a storage circuit (not shown) supplies the projection data supplied from the A / D converter 123 of the X-ray detection unit 12 from the biological signal measurement unit 10. Two-dimensional image data (first image data) is generated by adding the time phase information, and stored in the storage circuit. Similarly, the X-ray generation unit 11 repeatedly performs X-ray irradiation in the first imaging direction of the subject 150 at a predetermined interval, and the two-dimensional image data generation unit 21 is generated by the X-ray detection unit 12 at this time. The time phase information supplied from the biological signal measuring unit 10 is added to the projection data thus generated to generate first time-series image data, which is stored in the storage circuit (step S5 in FIG. 10).

  When the generation and storage of the first image data in the predetermined period is completed, the operator uses the input unit 8 to rotate the X-ray generation unit 11 and the X-ray detection unit 12 in the R1 direction of FIG. Input an instruction signal. The movement mechanism control unit 133 of the movement mechanism unit 13 that has received the instruction signal via the system control unit 9 supplies a control signal to the holding unit movement mechanism 132 to supply the X-ray generation unit 11 and the X-ray detection unit 12. Is rotated to a predetermined position to set the second shooting direction (step S4 in FIG. 10).

  Next, the X-ray generation unit 11 of the signal detection unit 1 repeats X-ray irradiation with respect to the second imaging direction of the subject 150 a plurality of times at predetermined intervals by the same procedure as in the first imaging direction. Then, the two-dimensional image data generation unit 21 of the image data generation unit 2 adds the time phase information supplied from the biological signal measurement unit 10 to the projection data generated by the X-ray detection unit 12 at this time, so that it is time-series. Second image data is generated, and the obtained second image data is stored in its own storage circuit (step S5 in FIG. 10).

  When the generation and storage of the first image data in the first shooting direction and the second image data in the second shooting direction are completed, the contour extraction unit 22 of the image data generation unit 2 adds these image data to these image data. On the other hand, binarization processing is performed to extract blood vessel contour information. Then, the three-dimensional image data generation unit 23 converts the first image data and the second image data in a predetermined time phase based on the time phase information added to the first image data and the second image data described above. The three-dimensional image data is generated based on the outline information of these image data and stored in the image data storage unit 24 (step S6 in FIG. 10).

  Further, the image data display unit 3 displays the first image data, the second image data, and the three-dimensional image data in the predetermined time phase generated by the image data generation unit 2 described above. In this case, the image data display unit 3 may display these image data as still images, but can also display moving images, and the display method is not particularly limited.

  Next, the operator designates the range of the diseased part (stenosis part) for the blood vessel image of the three-dimensional image data displayed on the image data display unit 3 (step S7 in FIG. 10), and the device shape setting unit 4 Sets the optimal shape of the therapeutic device based on the measurement result of the diseased part in the three-dimensional image data in the designated range (step S8 in FIG. 10).

  On the other hand, the device information search unit 6 searches the latest information on the available therapeutic devices stored in the device database unit 5 based on the information on the optimal shape of the therapeutic device set by the device shape setting unit 4. Then, the product name or product identification information of the treatment device having the shape closest to the optimum shape is selected. Then, the information on the selected treatment device is supplied to the device information display unit 7 via the system control unit 9 and displayed (step S9 in FIG. 10). When there are a plurality of shape parameters used for selecting the treatment device, the device information search unit 6 determines the treatment device based on the priority of the shape parameters set in advance in step S1 of FIG. Select the information.

  Then, the operator who has observed the information on the above-described treatment device displayed on the device information display unit 7 transmits the information on the treatment device to the nearest medical staff and is available in the hospital. A device for medical use is obtained, and treatment for a diseased site in a blood vessel is performed using this therapeutic device (step S10 in FIG. 10).

(Modification)
Next, a modification of the present embodiment will be described with reference to FIG. FIG. 11 is a block diagram showing the overall configuration of the therapeutic device selection support system in the present modification, and the features of this modification with respect to the embodiment described above are provided in the therapeutic device selection support system 100 in FIG. That is, the signal detection unit 1, the image data generation unit 2, and the biological signal measurement unit 10 are provided in a separately installed medical image diagnostic apparatus (X-ray diagnostic apparatus). In FIG. 11, units having functions similar to those of the units of the therapeutic device selection support system 100 in FIG. 1 are assigned the same reference numerals, and detailed descriptions thereof are omitted.

  That is, the treatment device selection support system 110 of the present modification shown in FIG. 11 includes an image data storage unit 20 that temporarily stores image data generated by a medical image diagnostic apparatus (not shown) for a subject, and this image data. A device shape setting unit 4 that measures a diseased part using the information and sets an optimum shape of the treatment device based on the measured diseased part information, and the diseased part information and the optimum shape of the treatment device together with the image data An image data display unit 3 for displaying information and the like; a device database unit 5 in which information on therapeutic devices that can be used immediately in the hospital is stored; and information on therapeutic devices stored in the device database unit 5 A device information search unit 6 is provided for searching for information on a therapeutic device having a shape closest to the optimum shape.

  Furthermore, the treatment device selection support system 110 includes a device information display unit 7 for displaying information on the treatment device searched by the device information search unit 6, an input unit 8 for setting a disease range in the image data, and the like. A system control unit 9 that controls the above-described units in an integrated manner is provided.

  On the other hand, the procedure for selecting a therapeutic device using the therapeutic device selection support system 110 described above is the same as the flowchart shown in FIG.

  According to the present embodiment and the modifications described above, when selecting a treatment device to be used for endovascular treatment, a treatment device having a suitable shape and easily available can be obtained from the image data of the subject. Since it is possible to automatically select based on diseased site information, the time required for selection is shortened and the treatment efficiency is greatly improved, as well as the operator (doctor), medical staff, and subject (patient). The burden of is reduced.

  In addition, since the selection of the treatment device is systematically performed based on the preset priority of the shape parameter, the selection of the treatment device having a plurality of shape parameters depends on the experience level of the operator. Can always be performed accurately.

  Furthermore, according to the above-described embodiment, since the optimal shape of the treatment device is set based on the information on the diseased part in the three-dimensional image data, the setting is more accurate than when using the two-dimensional image data. It becomes possible. In addition, since the generation of the 3D image data is generated based on the 2D image data obtained in two different shooting directions, it is enormous as in the case of using 3D image data based on strict volume data. Generation of complicated projection data and complicated reconstruction processing are not required, and blood vessel three-dimensional information can be obtained relatively easily.

  As mentioned above, although the Example of this invention and its modification were described, this invention is not limited to the above-mentioned Example and its modification, It can change and implement. For example, as described above, the optimal shape of the treatment device is set based on the information on the diseased part in the image data obtained by the X-ray diagnostic apparatus, but the present invention is not limited to this. The optimal shape of the therapeutic device may be set based on information on a diseased part in image data obtained by another medical image diagnostic apparatus such as a CT apparatus, an MRI apparatus, or an ultrasonic diagnostic apparatus.

  In addition, the optimal shape of the therapeutic device is set using the three-dimensional image data obtained by the X-ray diagnostic apparatus, but the MIP image data based on the two-dimensional image data or the volume data obtained by the above-described medical image diagnostic apparatus. The optimal shape of the treatment device may be set using volume rendering image data or the like. When using two-dimensional image data, the generation time of the image data is further shortened as compared with the above-described embodiment, while when using image data based on volume data, the optimal shape of the treatment device is more accurate. It becomes possible to set to.

  FIG. 12 shows a method for detecting a diseased part in which QCA (quantitative coronary artery analysis) is applied to two-dimensional image data obtained by an X-ray diagnostic apparatus. FIG. 12 (a) shows a predetermined imaging direction. 7 is X-ray fluoroscopic image data having a disease site (stenosis site) Ro obtained in FIG. On the other hand, FIG. 12B shows changes in the blood vessel diameter in a direction perpendicular to the central axis Cy of the blood vessel image in the X-ray fluoroscopic image data, and P1-P2 in which the blood vessel diameter is remarkably narrowed. Can be detected as the disease site Ro.

  Furthermore, although the case where a stent is assumed as a therapeutic device has been described, the present invention is not limited to this, and other therapeutic devices such as a balloon, a DCA, and a rotablator may be used. An inspection device such as an intravascular ultrasound (IVUS) used for an intravascular inspection at the time of performing is also included in the therapeutic device in a broad sense. Further, the diseased site where the therapeutic device is used is not limited to the cardiovascular, but may be other blood vessels such as a cerebral blood vessel, a peripheral blood vessel, and an aorta.

Further, in the embodiment and its modifications described above, provided the device information display unit 7 for displaying information of the therapeutic device image data display section 3 and the device information retrieval unit 6 for displaying the images data is independently selected However, the above information may be displayed on the image data display unit 3 or may be displayed on a display panel provided in the input unit 8, and the audio further including information on the selected treatment device. You may alert | report to an operator with the audio | voice signal by an output part.

  On the other hand, in the above-described embodiment, the case where the generation of the image data for the subject and the selection of a suitable treatment device are performed almost simultaneously has been described. However, the two-dimensional image data generated in advance and stored in the image data storage unit (not shown) Alternatively, the therapeutic device may be selected based on disease site information in the three-dimensional image data.

  Further, the range setting of the diseased part is performed using the 3D image data generated by the 3D image data generation unit 23, but the first image data and the second image data generated by the 2D image data generation unit 21 are used. You may carry out using at least any one of these.

The block diagram which shows the whole structure of the treatment device selection assistance system in the Example of this invention. The block diagram which shows the structure of the signal detection part in the Example. The figure for demonstrating the rotation direction and imaging | photography direction of the X-ray generation part and X-ray detection part in the Example. The block diagram which shows the structure of the image data generation part in the Example. The figure which shows the production | generation method of the three-dimensional image data in the Example. The figure which shows the optimal shape setting method of the therapeutic device based on the three-dimensional image data of the Example. The figure which shows typically the information of the device for a treatment stored in the device database part of the Example. The figure which shows typically the search priority of the shape parameter in the Example. The figure which shows the example of a display of the device information for treatment in the device information display part of the Example. The flowchart which shows the selection procedure of the treatment device in the Example. The block diagram which shows the whole structure of the treatment device selection assistance system in the modification of the Example. The figure which shows the other disease site | part detection method in a present Example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Signal detection part 2 ... Image data generation part 3 ... Image data display part 4 ... Device shape setting part 5 ... Device database part 6 ... Device information search part 7 ... Device information display part 8 ... Input part 9 ... System control part 10 ... Biological signal measurement unit 11 ... X-ray generation unit 12 ... X-ray detection unit 13 ... Movement mechanism unit 14 ... High voltage generation unit 15 ... Holding unit 17 ... Top plate 20 ... Image data storage unit 21 ... Two-dimensional image data generation unit 22 ... Contour extraction unit 23 ... 3D image data generation unit 24 ... Image data storage unit 111 ... X-ray tube 112 ... X-ray restrictor 121 ... X-ray I.D. I.
122 ... X-ray TV camera 123 ... A / D converter 131 ... Top plate moving mechanism 132 ... Holding unit moving mechanism 133 ... Mechanism control unit 141 ... High voltage generator 142 ... High voltage control circuit 151 ... Floor stand 100, 110 ... therapeutic device selection support system

Claims (12)

Signal detection means for detecting an image signal necessary for generating image data from the subject;
Image data generating means for generating image data based on the image signal;
A device shape setting means for setting a value relating to a shape parameter of a treatment device for the diseased part based on information on the diseased part of the subject in the image data;
A device database section in which information on various treatment devices is stored in advance;
Devices that search based preset information of the various therapeutic devices that are stored in the device database unit according to the priority of the shape parameter of the therapeutic device on such values to the shape parameter of the therapeutic device Information retrieval means;
A therapeutic device selection support system comprising display means for displaying a search result .   The therapeutic device selection support system according to claim 1, wherein the priority of the shape parameter of the treatment device is set in accordance with the degree of redundancy related to the adjustment of the shape parameter.   2. The therapeutic device selection support system according to claim 1, wherein the signal detection means is provided in any of an X-ray diagnostic apparatus, an MRI apparatus, an X-ray CT apparatus, or an ultrasonic diagnostic apparatus.   2. The therapeutic device selection support system according to claim 1, wherein the image data generation unit generates three-dimensional image data for the subject based on the image signal detected by the signal detection unit.   The image data generation means includes two-dimensional image data generation means for generating a plurality of two-dimensional image data on the basis of the image signals obtained from a plurality of imaging directions of the subject by the signal detection means; 2. The therapeutic device selection support system according to claim 1, further comprising three-dimensional image data generating means for generating three-dimensional image data based on the two-dimensional image data. Based on the disease site information in the image data generated by the medical image diagnostic apparatus,
Device shape setting means for setting a value for the shape parameter of the treatment device for the diseased site;
A device database section in which information on various treatment devices is stored in advance;
Devices that search based preset information of the various therapeutic devices that are stored in the device database unit according to the priority of the shape parameter of the therapeutic device on such values to the shape parameter of the therapeutic device Information retrieval means;
A therapeutic device selection support system comprising display means for displaying a search result . Priority setting means, wherein the device information search means stores information on the various treatment devices stored in the device database unit according to the priority of the shape parameter set by the priority setting means. therapeutic device selection system according to claim 1 or claim 6, characterized in search to isosamples based on a value according to the shape parameters. The device information retrieval unit is configured to store the various treatment devices stored in the device database unit based on at least one of the length, thickness, and curvature of the treatment device set by the device shape setting unit. 7. The therapeutic device selection support system according to claim 1 or 6 , wherein information is retrieved and information on a therapeutic device suitable for the diseased site is selected. The therapeutic device selection support system according to claim 1 or 6 , wherein the device database unit stores information on various therapeutic devices that are received at a medical facility and can be used immediately.   The display means displays the value of the shape parameter of the treatment device and the shape parameter of an available treatment device having a size close to the value of the shape parameter in a one-dimensional or two-dimensional graph. The therapeutic device selection support system according to claim 1 or 6, wherein the therapeutic device selection support system is characterized. A signal detecting unit detecting an image signal necessary for generating image data from the subject; and
Image data generating means generating image data based on the image signal;
A device shape setting means, based on information on the diseased part of the subject in the image data, setting a value related to the shape parameter of the treatment device for the diseased part;
The device information search means is configured to obtain information on various treatment devices stored in advance in the device database unit in accordance with the preset priority of the shape parameter of the treatment device based on a value relating to the shape parameter of the treatment device. and step you search,
A therapeutic device selection method, wherein the display means includes a step of displaying a search result . A device shape setting means, based on the information on the diseased part in the image data generated by the medical image diagnostic apparatus, a value for the shape parameter of the treatment device for the diseased part;
The device information search means is configured to obtain information on various treatment devices stored in advance in the device database unit in accordance with the preset priority of the shape parameter of the treatment device based on a value relating to the shape parameter of the treatment device. Searching and selecting information on a therapeutic device suitable for the disease site;
A therapeutic device selection method, wherein the display means includes a step of displaying a search result .

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