JP4716716B2 - Ultrasonic diagnostic equipment - Google Patents

Description

  The present invention relates to an ultrasonic diagnostic apparatus that transmits an ultrasonic wave to a living body and receives a reflected wave from a living tissue to obtain an ultrasonic image.

  An endoscope is a device that can be inserted into a subject and visually observe the surface inside a luminal organ with an imaging device such as a CCD provided at the distal end of the endoscope device. Such an endoscope may be difficult to insert into a luminal organ by itself, and in such a case, an auxiliary device for enabling easy insertion may be required. is there.

  As a specific example, when the luminal organ to be observed is a respiratory organ such as a bronchus, there are many bronchial branches, and the operator may be wondering which branch to insert. In such a situation, it is generally known that a three-dimensional image of a bronchus is created from a tomographic image of the bronchus obtained in advance by X-ray CT or the like and the created three-dimensional image is referred to (this technique is known). For example, it is disclosed by Unexamined-Japanese-Patent No. 2000-135215.). If the route to the target part is obtained in advance on the three-dimensional image created in this way, and the endoscope is inserted using the three-dimensional image as a guide, the target part can be definitely inserted.

  As another specific example, when the luminal organ to be observed is the large intestine, it is very difficult to insert the endoscope deeply because the large intestine is bent in the body. In such a situation, the endoscope is often inserted while confirming the insertion shape under fluoroscopy.

  Both of the two specific examples described above use X-rays. However, X-ray irradiation is not only required to be performed in a room surrounded by thick lead or the like. There is an inconvenience of being bombed.

  In order to eliminate these points, a number of position sensors are provided along the insertion portion using a flexible member, and an endoscope insertion shape is displayed based on position information obtained from each position sensor. Endoscopic devices are becoming popular. An example of such a technique is disclosed in Japanese Patent Application Laid-Open No. 8-107875. Among these types of endoscopic devices, in addition to a large number of position sensors, an ultrasonic transducer is further provided at the tip, and an ultrasonic tomographic image is obtained by scanning the body cavity with this ultrasonic transducer. An apparatus has been proposed, and examples thereof include those disclosed in Japanese Patent Application Laid-Open No. 2003-305044 and US Pat. No. 6,757,791B2.

  In this type of device, the insertion shape of the endoscope into the body cavity is displayed as an auxiliary image together with the ultrasonic tomographic image, so that the positional relationship between the ultrasonic tomographic image and the body cavity shape is known. There is an advantage that the observation site is easy to understand. However, if both the ultrasonic transducer and a large number of position sensors are permanently installed in the endoscope, the endoscope diameter may increase and the pain of the subject may increase. In other words, the endoscope must be provided with a large number of components such as an insertion portion for inserting biopsy forceps, an optical fiber, a shaft and a signal cable for rotationally driving an ultrasonic transducer, and a signal cable for a number of position sensors. Because it must.

Therefore, an ultrasonic diagnostic apparatus disclosed in, for example, Japanese Patent Application Laid-Open No. 10-248852 among endoscope apparatuses provided with such an ultrasonic transducer and a position sensor has a magnetic sensor as a position sensor. The position detection catheter is provided, and the position detection catheter is inserted through the insertion portion of the ultrasonic endoscope only when necessary. As a result, while satisfying a plurality of functions such as treatment with forceps, insertion shape display, ultrasonic tomogram display, etc., the insertion section and the position detection catheter share their occupied cross-sectional areas and the diameter of the endoscope. Is preventing thickening.
JP 2000-135215 A JP-A-8-107875 JP 2003-305044 A US6755791B2 JP-A-10-248852

  However, in the ultrasonic diagnostic apparatus disclosed in Japanese Patent Application Laid-Open No. 10-248852, it is necessary to design the position detection catheter provided with the magnetic sensor so as to be inserted through the forceps channel of the ultrasonic endoscope. The magnetic sensor in this case uses a coil formed by winding a metal wire, but it is necessary to make the metal wire thinner in accordance with the diameter of the insertion portion of the endoscope. For this reason, sufficient strength cannot be maintained, and it may be easily cut, and care is required for insertion rather than a general endoscope apparatus so as not to break the magnetic sensor.

  In addition, in colonoscopy, it is necessary to display the shape of all cases at the time of insertion, but on the other hand, few cases require an ultrasonic tomogram. However, the ultrasonic diagnostic apparatus disclosed in Japanese Patent Laid-Open No. 10-248852 cannot be said to reflect the actual situation of the breakdown of the number of cases. That is, the ultrasonic transducer is always provided at the distal end portion of the endoscope, and the position detection catheter is inserted later. If an ultrasonic transducer is provided at the distal end of the endoscope, it is necessary to change the imaging device such as a CCD and the optical system in the endoscope from a direct view type to a perspective type. Therefore, the insertion of the endoscope is made difficult. The direct view type and the perspective type indicate the direction of the field of view that can be observed by the endoscope, and the concept is shown in FIG. FIG. 16 is a diagram for explaining a perspective type and a direct-view type of an endoscope. FIG. 16A shows a perspective endoscope, and a CCD 92 is disposed at the distal end portion of the insertion portion 91 of the endoscope so that the visual field direction is inclined with respect to the insertion axis. On the other hand, FIG. 16B shows a direct-view type endoscope, and a CCD 92 is arranged at the distal end portion of the insertion portion 91 of the endoscope so that the visual field direction is a direction along the insertion axis. .

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an ultrasonic diagnostic apparatus capable of accurately confirming the position of an ultrasonic tomographic image and performing an efficient diagnosis.

In order to achieve the above object, an ultrasonic diagnostic apparatus according to a first aspect of the present invention includes an ultrasonic wave generated by an ultrasonic transducer provided at a distal end portion of an ultrasonic probe inserted into a body cavity of a subject. An ultrasonic diagnostic apparatus configured to construct an ultrasonic tomographic image on the basis of an ultrasonic echo signal obtained by reflecting the light, and a position detection means for detecting the position and orientation of the tip A holding unit that holds anatomical image information, a display unit that displays the image information held by the holding unit, and a feature that designates a feature point on the displayed image information A point specifying unit, a reference point position acquiring unit for acquiring a position of a reference point in the subject, a feature point specified by the feature point specifying unit on the image information, and the reference point position acquiring unit The reference point from which Comprising the the orientation and the position of the tip置検detection means has detected, and the guide image creation means for creating a guide image from a said reference point position acquisition means, at least one position of the reference point , And obtained from a position detecting element inserted into the body cavity of the subject and in proximity to the reference point .

The ultrasonic diagnostic apparatus according to the second invention is the ultrasonic diagnostic apparatus according to the first invention, wherein the guide image creating means is a solid composed of the feature points and a solid composed of the reference points. Are converted into a similar shape, and a conversion formula that takes a correspondence between the coordinate system generated by the feature points and the coordinate system generated by the reference points is determined.

Furthermore, an ultrasonic diagnostic apparatus according to a third invention is the ultrasonic diagnostic apparatus according to the second invention, wherein the solid is a triangular pyramid.

An ultrasonic diagnostic apparatus according to a fourth invention is the ultrasonic diagnostic apparatus according to the first invention, wherein the image information held by the holding means is information identified by luminance or color, and the guide image The guide images created by the creating means are color-coded.

An ultrasonic diagnostic apparatus according to a fifth aspect of the invention is the ultrasonic diagnostic apparatus according to the first aspect of the invention, wherein the position acquisition means can be attached to the subject and the position can be acquired. Position correction means for performing position correction on the position according to the change in the posture of the subject is further provided.
An ultrasonic diagnostic apparatus according to a sixth invention is the ultrasonic diagnostic apparatus according to the first invention, wherein the reference point position acquisition means acquires at least one position of the reference point from the body surface of the subject. To do.
An ultrasonic diagnostic apparatus according to a seventh invention is the ultrasonic diagnostic apparatus according to the fifth invention, wherein the reference point position acquisition means acquires the position of a reference point on the body surface of the subject. Body surface position acquisition means is further provided.
An ultrasonic diagnostic apparatus according to an eighth invention is the ultrasonic diagnostic apparatus according to the first invention, wherein the image information held by the holding means is three-dimensional anatomical image information, and the guide image creating means The guide image created by is a cross-section on the image information corresponding to the position and orientation of the ultrasonic tomographic image obtained based on the detection result of the position detecting means.

According to the ultrasonic diagnostic apparatus of the present invention, it is possible to accurately check the position of the ultrasonic tomographic image, it is possible intends row efficient diagnosis.

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

  1 and 2 show Embodiment 1 of the present invention. FIG. 1 is a block diagram showing the configuration of an endoscope apparatus that also serves as an ultrasonic diagnostic apparatus, and FIG. 2 shows an insertion shape image on a monitor screen. It is a figure which shows a mode that it displays simultaneously and a two-dimensional ultrasonic tomogram.

  The endoscope apparatus according to the present embodiment also serves as an ultrasonic diagnostic apparatus. The endoscope apparatus scans an ultrasonic transducer in a body cavity to obtain a two-dimensional ultrasonic tomographic image, and the position of the ultrasonic transducer. And a function of detecting the insertion shape of the endoscope insertion portion. In addition, illustration and description are abbreviate | omitted about the part which is not related to this invention among the general structures provided in the endoscope apparatus.

  This endoscope apparatus is an endoscope 1, a small-diameter ultrasonic probe 2, a drive unit 3, an ultrasonic observation apparatus 4, a position calculation apparatus 5 as position detection means, and a position detection means. The receiving antenna 6 is a position detection element, a first monitor 7, a second monitor 8, an image processing device 9, a keyboard 11, and a mouse 12.

  The endoscope 1 includes an elongated insertion portion 15 having flexibility and configured to be inserted into a body cavity of a subject. An insertion portion 16 as a forceps channel through which forceps and other treatment tools can be inserted is provided in the insertion portion 15. Further, in the insertion portion 15, a plurality of transmission coils C1,..., Cn (here, “n” is one or more) as position detection means and first position detection elements in order from the distal end side to the proximal side. Is incorporated along the longitudinal direction of the insertion portion 15. In addition, a direct-viewing type imaging device (not shown) composed of a CCD or the like is built in the distal end portion of the insertion portion 15. The direct-view endoscope 1 has an advantage that it can be easily inserted by an operator because the direction of the insertion axis can be observed by the imaging device.

  The position calculation device 5 is connected to the endoscope 1 and generates a magnetic field by exciting a plurality of transmission coils C1,..., Cn disposed in the insertion portion 15. Further, a reception antenna 6 is connected to the position calculation device 5. This receiving antenna 6 is for detecting the magnetic field generated by the transmitting coils C1,..., Cn. The signal detected by the receiving antenna 6 is input to the position calculation device 5, and the position calculation device 5 calculates the positions of the transmission coils C 1,.

  The small-diameter ultrasonic probe 2 is configured to have a small diameter so as to be used by being inserted into the insertion portion 16 of the insertion portion 15. The thin ultrasonic probe 2 is detachably fixed using a fixing jig (not shown) after being inserted into the insertion portion 16 to a predetermined position. An ultrasonic transducer 17 for transmitting and receiving ultrasonic waves is provided at the distal end portion of the small-diameter ultrasonic probe 2. The proximal end side of the small-diameter ultrasonic probe 2 is connected to the drive unit 3. The drive unit 3 includes a motor 18, and the motor 18 and the ultrasonic transducer 17 of the small-diameter ultrasonic probe 2 are connected via a flexible shaft (not shown). This flexible shaft is for transmitting the rotational force of the motor 18 to the ultrasonic transducer 17 through the inside of the small-diameter ultrasonic probe 2. An echo signal related to the received echo from the ultrasonic transducer 17 is guided to the drive unit 3 via a signal line disposed in the small-diameter ultrasonic probe 2 and further connected to the drive unit 3. The signal is input to the observation device 4. The ultrasonic observation apparatus 4 processes an input echo signal to create an ultrasonic tomographic image.

  The image processing device 9 includes a large-capacity image memory 19 that can store a large number of images. The ultrasonic tomographic image generated by the ultrasonic observation device 4 and the transmission coil C1 calculated by the position calculation device 5 are provided. ,..., Cn are used to perform image processing as described later.

  The image processing apparatus 9 is further connected with a first monitor 7 and a second monitor 8 as display means, and with a keyboard 11 and a mouse 12 as operation means.

  Next, the operation of such an endoscope apparatus will be described.

  When an ultrasonic scanning instruction is input by the operator via the keyboard 11 or the mouse 12, the ultrasonic transducer 17 built in the distal end portion of the small-diameter ultrasonic probe 2 is rotated by the driving force of the motor 18. While repeating the transmission and reception of ultrasound within the body cavity. This ultrasonic scanning is performed as radial scanning in a plane perpendicular to the insertion direction of the small-diameter ultrasonic probe 2, that is, so-called radial scanning. And the ultrasonic transducer | vibrator 17 converts the echo received by radial scanning into an electric signal, and transmits to the ultrasonic observation apparatus 4 as an echo signal.

  The ultrasonic observation apparatus 4 performs processing such as envelope detection, logarithmic amplification, A / D conversion, and conversion from a polar coordinate system to an orthogonal coordinate system on the echo signal received from the ultrasonic transducer 17 once. One piece of two-dimensional ultrasonic tomographic image data (hereinafter referred to as two-dimensional ultrasonic tomographic image data) is created for radial scanning. The ultrasonic observation device 4 outputs the created two-dimensional ultrasonic tomographic image data to the image processing device 9. Details regarding the creation of the two-dimensional ultrasonic tomographic image data are publicly known, and the description thereof is omitted here.

  The position calculation device 5 supplies magnetic field generation currents having different frequencies to each of the plurality of transmission coils C1,..., Cn.

  The plurality of transmission coils C1,..., Cn supplied with the magnetic field generating current generate magnetic fields having different frequencies toward the surrounding space. Here, different frequencies are used so that the positions of the transmission coils C1,..., Cn can be identified by separating the frequencies later.

  Magnetic fields of different frequencies generated from the transmission coils C1,..., Cn are detected by the reception antenna 6. And the receiving antenna 6 converts the detected magnetic field into an electric current, and outputs it to the position calculation apparatus 5 as an electrical signal.

  The position calculating device 5 performs A / D conversion on the electrical signal from the receiving antenna 6, identifies the frequency, and obtains a position vector ri = (xi, yi, zi) representing the position of each transmitting coil C1,..., Cn. (Where i takes a value from 1 to n). The origin for calculating the position vector ri is set to a specific position in the receiving antenna 6. Then, the position calculation device 5 outputs the calculated position vector ri to the image processing device 9 as insertion position information.

  The image processing device 9 calculates the insertion shape of the insertion portion 15 into the body cavity of the subject based on the positions of the transmission coils C1,. Here, the distal end position of the insertion portion 15 is the position of the transmission coil C1 disposed closest to the distal end as shown in FIG. Here, since the position vector of the transmission coil C1 is r1 = (x1, y1, z1), that is, the position vector r1 represents the tip position of the insertion portion 15. The details of the calculation method of the insertion shape are disclosed in JP-A-8-107875, JP-A-2003-305044, etc. described in the above "Background Art", and thus detailed description thereof is omitted. .

  The image processing device 9 outputs image data indicating the calculated insertion shape to the first monitor 7 for display, and simultaneously outputs image data related to the two-dimensional ultrasonic tomographic image data to the second monitor 8. To display. Here, the insertion shape image and the two-dimensional ultrasonic tomographic image are displayed on separate monitors, but the present invention is not limited to this, and the insertion shape image and the two-dimensional ultrasonic tomographic image are inserted on the same monitor screen 21 as shown in FIG. The shape image 22 and the two-dimensional ultrasonic tomographic image 23 may be displayed simultaneously.

  In this embodiment, a plurality of transmission coils C1,..., Cn are provided in the insertion portion 15 to generate a magnetic field, and this magnetic field is detected by the receiving antenna 6. However, transmission and reception are reversed. It doesn't matter. That is, a receiving coil corresponding to the receiving antenna 6 may be provided in the insertion portion 15 and a transmitting coil may be provided at the position of the receiving antenna 6 of the present embodiment.

  Furthermore, in the present embodiment, position detection is performed by a magnetic field (a coil is used as position detection means), but the present invention is not limited to this, and position detection may be performed by other means. For example, the position detection unit may be configured by connecting an acceleration sensor or the like with a signal line.

  In this embodiment, the small-diameter ultrasonic probe 2 is configured as a mechanical scanning type using a motor 18, but instead of this, an electronic scanning type that electrically switches many ultrasonic transducers 17 is used. You may comprise as a thing. Further, the scanning direction is not limited to radial scanning, but may be convex scanning. That is, the present invention is not based on an ultrasonic scanning method.

  According to the first embodiment, since a plurality of transmission coils C1,..., Cn are provided in the insertion portion 15 of the endoscope 1, the degree of freedom in designing around the transmission coils C1,. Therefore, as compared with the conventional example in which the transmission coil is provided in the position detection catheter, the mechanical stress applied to the transmission coil can be reduced. Furthermore, since it is not necessary to make the signal lines of the transmission coils C1,..., Cn extremely thin, it is possible to make the coil signal lines difficult to cut. Thus, the operator can concentrate on the inspection without worrying about the durability of the apparatus.

  In addition, since the small-diameter ultrasonic probe 2 is configured to be inserted through the insertion portion 16 of the endoscope 1, for example, while observing an insertion shape image, the distal end of the insertion portion 15 reaches a desired part of the large intestine. When the region of interest is observed as an optical image by the optical system of the endoscope 1 and a precise inspection by ultrasonic waves is required, the small-diameter ultrasonic probe 2 is inserted into the insertion portion 16 to superimpose a desired region. An acoustic tomographic image can be observed. Further, even when a biopsy using a biopsy forceps is necessary after observing an ultrasonic tomogram, the small-diameter ultrasonic probe 2 is removed from the insertion portion 16 and the biopsy forceps is inserted into the insertion portion 16. By inserting, the inspection with the biopsy forceps can be performed.

  Since the optical system of the endoscope 1 is a direct view type, there is an advantage that observation is easy at the time of insertion.

  In addition, since the insertion shape image and the two-dimensional ultrasonic tomographic image are displayed at the same time, it is possible to easily grasp at which position in the body cavity the two-dimensional ultrasonic tomographic image is observed.

  Thus, according to the endoscope apparatus as the ultrasonic diagnostic apparatus in the present embodiment, since the insertion shape is displayed, the endoscope 1 can be easily inserted, and an ultrasonic tomographic image is displayed as necessary. Therefore, a series of examination procedures can be performed without replacing the endoscope from the subject (that is, an efficient diagnosis can be performed).

  FIGS. 3 to 8 show a second embodiment of the present invention, FIG. 3 is a block diagram showing the configuration of an endoscope apparatus that also serves as an ultrasonic diagnostic apparatus, and FIG. 4 is an insertion portion of the endoscope. FIG. 5 is a diagram showing the arrangement of transmission coils from the insertion axis direction side, FIG. 5 is a diagram showing the arrangement of two-dimensional ultrasonic tomographic image data groups in a three-dimensional space, and FIG. 6 is two-dimensional ultrasonic tomographic image data composed of pixels. FIG. 7 is a diagram for explaining an expression for calculating coordinates at an arbitrary position on the two-dimensional ultrasonic tomographic image data, and FIG. 8 is a diagram for explaining a plurality of two-dimensional ultrasonic tomographic images. It is a figure which shows a mode that 3D ultrasonic image data is constructed | assembled from data.

  In the second embodiment, the same parts as those of the first embodiment are denoted by the same reference numerals and the description thereof is omitted, and only different points will be mainly described.

  In addition to the function of displaying the insertion shape of the endoscope 1 and the two-dimensional ultrasonic tomographic image described in the first embodiment, the endoscope apparatus that also serves as the ultrasonic diagnostic apparatus in the second embodiment is further provided. It has a function of creating and displaying a three-dimensional ultrasonic image. Also in the present embodiment, illustration and description of portions of the general configuration provided in the endoscope apparatus that are not related to the present invention are omitted.

  The endoscope 1 of this embodiment is obtained by adding a transmission coil C1 'to the endoscope 1 shown in FIG. That is, as shown in FIG. 3 and FIG. 4, in the vicinity of the transmission coil C1 arranged at the most distal end among the transmission coils C1,..., Cn arranged in order from the distal end side to the proximal side of the insertion portion 15. In addition, a transmission coil C1 ′ is disposed. For example, the transmission coils C1,..., Cn are arranged so that the direction of the insertion axis coincides with the direction of the winding axis, whereas the transmission coil C1 ′ is wound in a direction orthogonal to the direction of the insertion axis. It is arranged so as to be in the direction of the linear axis. Further, the transmission coil C1 'is disposed so as to be aligned with the 12 o'clock direction of a two-dimensional ultrasonic tomographic image obtained by radial scanning. As a specific arrangement example of the transmission coil C1 ′, as shown in FIG. 4, the transmission coil C1 and the insertion portion 16 are arranged at positions facing each other in the longitudinal direction of the insertion portion 15, and the transmission coil C1. 'Is disposed between the transmission coil C1 and the insertion portion 16 along the warp direction connecting them. The transmission coil C1 and the transmission coil C1 'function as a pair of transmission coils as described later. The transmission coil C1 is disposed so as to be positioned in the vicinity of the ultrasonic transducer 17 when the small-diameter ultrasonic probe 2 is inserted into the insertion portion 16 to a predetermined position. Accordingly, the position of the transmission coil C1 is considered to be the position of the ultrasonic transducer 17, that is, the center position of the ultrasonic scanning, and is configured to be substantially safe.

  Further, the image processing apparatus 9 is a reconstruction unit having a function of reconstructing three-dimensional ultrasonic image data in addition to the function described in the first embodiment.

  Next, the operation of such an endoscope apparatus will be described.

  As in the first embodiment, when an ultrasonic scanning instruction is input by the operator via the keyboard 11 or the mouse 12, the ultrasonic transducer 17 built in the distal end portion of the small-diameter ultrasonic probe 2 is driven. Driven by the unit 3, radial scanning is performed to transmit and receive ultrasonic waves.

  The ultrasonic observation apparatus 4 performs processing such as envelope detection, logarithmic amplification, A / D conversion, and conversion from a polar coordinate system to an orthogonal coordinate system on the echo signal obtained by this radial scanning, and performs one radial scanning. One piece of two-dimensional ultrasonic tomographic image data is created and output to the image processing apparatus 9.

  The position calculation device 5 supplies magnetic field generation currents having different frequencies to each of the plurality of transmission coils C1, C1 ', C2, ..., Cn.

  Accordingly, the plurality of transmission coils C1, C1 ', C2, ..., Cn generate magnetic fields having different frequencies toward the surrounding space.

  Magnetic fields of different frequencies generated from the transmission coils C1, C1 ', C2, ..., Cn are detected by the reception antenna 6. And the receiving antenna 6 converts the detected magnetic field into an electric current, and outputs it to the position calculation apparatus 5 as an electrical signal.

  The position calculating device 5 performs A / D conversion on the electrical signal from the receiving antenna 6, identifies the frequency, and obtains a position vector ri = (xi, yi, zi) representing the position of each transmitting coil C1,..., Cn. (Where i takes a value from 1 to n). The origin O (see FIGS. 6 and 7) when calculating the position vector ri is set to a specific position in the receiving antenna 6 as in the first embodiment. Further, since the transmission coil C1 'is disposed in the vicinity of the transmission coil C1, which is the other of the pair of transmission coils, it is assumed that the transmission coil C1' is at the same position as the transmission coil C1. Then, the position calculation device 5 outputs the calculated position vector ri to the image processing device 9 as insertion position information.

  Further, the position calculation device 5 not only calculates the position vector r1 for the pair of transmission coils C1 and C1 ', but also calculates two direction vectors V and V12 indicating their orientations. Here, the direction vector V is a vector indicating the direction of the winding axis of the transmission coil C1, and the direction vector V12 is a vector indicating the direction of the winding axis of the transmission coil C1 '(see FIGS. 6 and 7). Note that the position vector r1 = (x1, y1, z1) of the transmission coil C1 can be considered to be a vector that substantially indicates the position of the center R of the two-dimensional ultrasonic tomographic image data 25 as described above. Absent.

  Then, the position calculating device 5 outputs the calculated direction vectors V and V12 to the image processing device 9 as direction information related to the two-dimensional ultrasonic tomographic image. The position information relating to the two-dimensional ultrasonic tomographic image uses the position vector r1 described above.

  The aforementioned direction vector V is calculated based on a signal obtained by detecting the magnetic field of the transmission coil C1 provided so that the direction of the winding axis coincides with the insertion axis direction of the endoscope 1. When radial scanning is performed, the two-dimensional ultrasonic tomographic image data 25 is perpendicular to the insertion axis of the endoscope 1, so the direction vector V corresponds to the normal vector of the two-dimensional ultrasonic tomographic image data 25. To do.

  The direction vector V12 is calculated based on the signal obtained by detecting the magnetic field of the transmission coil C1 ′ provided so that the direction of the winding axis coincides with the 12 o'clock direction of the two-dimensional ultrasonic tomographic image data 25. Is done. Therefore, this direction vector V12 corresponds to the 12 o'clock direction vector of the two-dimensional ultrasonic tomographic image data 25 and is orthogonal to the direction vector V.

  The position calculating device 5 calculates the direction vectors V and V12 by normalizing them in advance to unit lengths.

  By the way, as shown in FIG. 3, when the small-diameter ultrasonic probe 2 is inserted into the insertion portion 16 to a predetermined position and fixed when the ultrasonic transducer 17 protrudes from the distal end of the endoscope 1, the ultrasonic transducer 17. Is always near the distal end of the endoscope 1 and can be regarded as maintaining a certain distance from the distal end of the endoscope 1. Therefore, as described above, the position vector r1 of the transmission coil C1 indicating the distal end position of the endoscope 1 is considered to be the rotation center position of the ultrasonic transducer 17, and may be used in actual use. That is, the position vector r 1 of the most distal transmission coil C 1 corresponds to the coordinates of the center of the two-dimensional ultrasonic tomographic image data 25.

  Next, the operator moves the insertion portion 15 of the endoscope 1 integrally with the small-diameter ultrasonic probe 2 in the body cavity of the subject while performing radial scanning with the ultrasonic transducer 17, thereby A plurality of two-dimensional ultrasonic tomographic image data 25 along the advancing / retreating path of the mirror 1 is obtained. At the same time, information on the insertion position of the insertion portion 15 and position information and orientation information of the ultrasonic transducer 17 are obtained. These data are sequentially transmitted to the image processing device 9.

  The image processing device 9 calculates the insertion shape (position and orientation) of the insertion portion 15 into the body cavity of the subject based on the positions of the transmission coils C1,.

  Then, the image processing device 9 outputs and displays image data indicating the calculated insertion shape on the first monitor 7 and simultaneously displays image data related to the two-dimensional ultrasonic tomographic image data 25 on the second monitor 8. Output to and display. As described above, the insertion shape image and the two-dimensional ultrasonic tomographic image may be displayed on the same monitor screen.

  On the other hand, the image processing device 9 receives the digitized two-dimensional ultrasonic tomographic image data 25 received from the ultrasonic observation device 4 and the direction vectors V and V12 and the two-dimensional ultrasonic tomographic image data received from the position calculating device 5. The position vector r 1 at the center position of 25 is stored in the image memory 19. Thereby, the data group of the two-dimensional ultrasonic tomographic image data 25 stored in the image memory 19 is arranged in a three-dimensional space as a data group having a position and a direction, for example, as shown in FIG. It becomes possible.

  The two-dimensional ultrasonic tomographic image data 25 is generated by the ultrasonic observation apparatus 4 as data in which pixels 25a (see FIG. 6) having a luminance value corresponding to the intensity of the echo signal are two-dimensionally arranged. Since the two-dimensional ultrasonic tomographic image data 25 has a position and a direction, each pixel 25a also has a position in the three-dimensional space and its luminance. In this way, by continuing the radial scanning, the two-dimensional ultrasonic tomographic image data 25 is sequentially obtained, and each pixel 25a constituting the two-dimensional ultrasonic tomographic image data 25 is arranged in the three-dimensional space. By doing so, a pixel group having a position in the three-dimensional space and its luminance is configured.

  Here, a method for obtaining the position of each pixel 25a in the three-dimensional space will be described with reference to FIGS.

First, an arbitrary point on the two-dimensional ultrasonic tomographic image data 25 is P, and the center of the two-dimensional ultrasonic tomographic image data 25, that is, the rotation center of the ultrasonic transducer 17 is R. Further, the distance from the rotation center R to the point P in the 3 o'clock direction is a, and the distance in the 12 o'clock direction is b. Then, the position vector p of the point P in the three-dimensional space can be calculated by the following formula 1 using the normalized direction vectors V and V12, as is apparent from FIGS. it can.
[Equation 1]
p = r1 + a (V12 × V) + bV12
However, V12 × V is the outer product of V12 and V, and is a direction vector indicating the 3 o'clock direction.

  Therefore, each two-dimensional ultrasonic tomographic image data 25 can be said to be a set of voxels having a position P in a three-dimensional space that satisfies Equation 1. A voxel is data in each three-dimensional space constituting three-dimensional ultrasound image data. Each two-dimensional ultrasonic image is along the path of advancement / retraction of the small-diameter ultrasonic probe 2 when the operator moves the endoscope 1 together with the small-diameter ultrasonic probe 2 in the body cavity of the subject.

  Based on the position vector r and the direction vectors V and V12 of each of a plurality of continuous two-dimensional ultrasonic tomographic image data 25, the image processing device 9 performs all the pixels of each of the two-dimensional ultrasonic tomographic image data 25. The position information of 25a is calculated.

  Next, the image processing device 9 constructs the three-dimensional ultrasonic image data 26 as shown in FIG. 8 from the positions of all the pixels 25a of the two-dimensional ultrasonic tomographic image data 25 and the luminance thereof. It can be said that the three-dimensional ultrasonic image data 26 is a set of data (voxels) having the position and brightness in a three-dimensional space.

  Further, the image processing apparatus 9 interpolates the position and luminance of the voxel in the gap between the adjacent two-dimensional ultrasonic tomographic image data 25 based on the position and luminance of the pixel 25a in the vicinity thereof. Insert. Further, the image processing device 9 averages the luminances of the portions where the two-dimensional ultrasonic tomographic image data 25 intersect and overlap to obtain the luminance of the voxel. By performing such processing, the image processing apparatus 9 constructs three-dimensional ultrasonic image data 26 from a plurality of two-dimensional ultrasonic tomographic image data 25 as shown in FIG.

  As described above, the three-dimensional ultrasonic image data 26 is a set of voxels having luminance, and the image processing apparatus 9 converts the three-dimensional ultrasonic image into the first monitor 7 based on the three-dimensional ultrasonic image data 26. Alternatively, it is displayed on the second monitor 8. At this time, at least two of the insertion shape image, the two-dimensional ultrasonic tomographic image, and the three-dimensional ultrasonic image may be displayed simultaneously.

  It is assumed that the three-dimensional ultrasonic image described in the examples described later is configured in the same manner as the three-dimensional ultrasonic image data 26 described here.

  In the present embodiment, the transmission coil C1 ′ is arranged so that the direction of the winding axis is perpendicular to the insertion axis direction. However, the direction of the transmission coil C1 ′ is not limited to this. Instead, the direction vector V12 may be arranged at an arbitrary angle that can be calculated.

  According to the second embodiment, it is possible to obtain substantially the same effect as the first embodiment described above.

  Furthermore, according to the second embodiment, since the means for detecting the position of the ultrasonic transducer 17 and the direction of the two-dimensional ultrasonic tomographic image data 25 is provided, the advancing / retreating path at the distal end of the insertion portion 15 is accurately traced. The obtained three-dimensional ultrasonic image data 26 can be obtained. Therefore, the operator can observe the bending state of the endoscope 1 as the insertion portion 15 advances and retreats, and further inserts the small-diameter ultrasonic probe 2 as necessary, thereby ultrasonicating a desired part. A tomographic image can be observed, and an accurate three-dimensional ultrasonic image that faithfully reflects the bending of the body cavity can be observed.

  In addition, the operator displays the insertion shape image of the endoscope 1, the two-dimensional ultrasonic tomographic image, and the three-dimensional ultrasonic image at the same time so that the endoscope 1 accurately approaches the target organ during scanning, By observing the three-dimensional ultrasonic image, it can be easily determined whether or not the two-dimensional ultrasonic tomographic image accurately captures the region of interest.

  FIGS. 9 to 13 show a third embodiment of the present invention, FIG. 9 is a block diagram showing the configuration of an endoscope apparatus that also serves as an ultrasonic diagnostic apparatus, and FIG. 10 is a guide image by the endoscope apparatus. FIG. 11 is a diagram showing a state in which an image information plane is selected in three-dimensional anatomical image information, and FIG. 12 is a state in which a feature point is designated on the selected image information plane. FIG. 13 is a diagram showing a state in which a guide image and a two-dimensional ultrasonic tomographic image are displayed side by side on the screen at the same time.

  In the third embodiment, the same parts as those in the first and second embodiments are denoted by the same reference numerals, description thereof is omitted, and only different points will be mainly described.

  In the endoscope apparatus of the third embodiment, a plate 13 and a marker coil 14 are further added to the configuration shown in FIG. 3 of the second embodiment. The plate 13 is a substantially elliptical disk-like device incorporating a coil for generating a magnetic field, and is configured so that it can be attached to the body of the subject using a belt. The marker coil 14 is a stick-like device that incorporates a coil that generates a magnetic field on the tip side. The plate 13 and the marker coil 14 are connected to the position calculation device 5 as shown in FIG.

  The image processing apparatus 9 has a function of creating a guide image for navigating the position and direction of the two-dimensional ultrasonic tomographic image in the body cavity in addition to the functions described in the second embodiment. In addition, a reconstruction unit and a guide image generation unit are provided.

  Next, a part of the operation of the endoscope apparatus according to the present embodiment that is different from the operation of the endoscope according to the above-described embodiment, that is, an operation that generates a guide image will be described.

  With reference to FIG. 10, the process which produces | generates a guide image with an endoscope apparatus is demonstrated. Note that the processing described with reference to FIG. 10 includes a part of the operation by the operator.

  In the image memory 19 of the image processing device 9, anatomical image information of a part in the living body is recorded as three-dimensional image data, and this three-dimensional image data includes feature points in the body surface or body cavity. The position can be set. Here, as anatomical image information, for example, image data obtained by slicing a frozen human body at intervals of several millimeters (this is schematic diagram data of a human body) is used. Anatomical image information is a set of voxels in a three-dimensional area composed of biological information identified by monochrome brightness or color, and the image information can be extracted in units of voxels. Yes.

  When creating a guide image, three-dimensional anatomical image information is displayed on the first monitor 7 or the second monitor 8 before the examination is performed, and the operator can display the schematic diagram data of the human body. Four feature points are selected on the anatomical image information. The feature points are selected on the body surface or the body cavity surface. More practically, for example, two feature points are selected on the body surface and two on the body cavity surface. As a more specific example, here, the xiphoid process, the pelvic right end, the pylorus, and the duodenal papilla are selected as feature points.

  A specific method for selecting the feature points will be described with reference to FIGS.

  As shown in FIG. 11, the operator uses the mouse 12 on, for example, three-dimensional anatomical image information 27 having a rectangular parallelepiped shape (the image information 27 is a set of voxels 29). By moving the pointer 31 along the side of the image and clicking the button of the mouse 12, the anatomical image information plane 28 capable of accurately specifying the position of the feature point is selected, and the first monitor is selected. 7 or the second monitor 8.

  Then, as shown in FIG. 12, the image information plane 28 including the cross section of the human body is displayed as a plane. A pointer 31 is also displayed on the image information plane 28.

  Then, the operator moves the pointer 31 to the position of the feature point P using the mouse 12 on the displayed anatomical image information plane 28, and clicks the button of the mouse 12, thereby selecting the feature point. specify. Such an operation is repeated until the four feature points have been designated.

  Each time the position of each feature point is specified, the image processing apparatus 9 registers the position information of each feature point from the origin O ′ of the anatomical image information 27. As a result, a coordinate system is generated with the feature points designated on the anatomical image information 27 (step S1).

  Next, the position data of the four feature points selected previously in the actual living body that is the subject is registered. This includes the coordinates of the four feature points designated on the anatomical image information 27, the position data of the four feature points in the actual living body (hereinafter referred to as a reference point in order to avoid confusion), and It is for making it correspond. Specifically, the operator acquires the position of the xiphoid process as the reference point by attaching the plate 13 to the xiphoid process on the body surface of the subject. The operator obtains the position of the right pelvis as a reference point by applying the marker coil 14 to the right pelvis. Further, the operator inserts the endoscope 1 into the body cavity of the subject and brings the distal end of the insertion portion 15 close to the pylorus in the body cavity, so that the position of the pylorus as the reference point is set in the transmission coil C1. Get as position. Then, the operator moves the insertion position to bring the distal end of the insertion portion 15 close to the duodenal papilla, thereby acquiring the position of the duodenal papilla as a reference point as the position of the transmission coil C1. Thus, a coordinate system is generated with the actual reference point of the subject (step S2).

  Next, the image processing apparatus 9 determines whether the coordinate system generated by the subject's actual reference point and the coordinate system generated by the feature point specified on the anatomical image information 27 correspond to each other. The conversion formula is determined on the assumption that the triangular pyramid composed of the four reference points of the subject and the triangular pyramid composed of the four feature points on the anatomical image information 27 are similar. . Here, the reason why both the triangular pyramids are similar is that the arrangement of the organ including the region of interest on the anatomical image information 27 is the same as the arrangement of the actual organ of the subject. (Step S3).

  Steps S1 to S3 described above are preparation steps for creating a guide image.

  Next, when the ultrasonic scanning is started, the image processing device 9 determines whether or not the ultrasonic scanning is being performed (step S4).

  Here, when it is determined that ultrasonic scanning is being performed, position correction is performed on the position of the four reference points of the subject according to the change in the posture of the subject. Then, the feature point of the anatomical image information 27 is obtained by converting the center position of the two-dimensional ultrasonic tomographic image data 25 obtained from the corrected reference point of the subject using the conversion formula between the coordinate systems determined in step S3. Corresponding points of the center position of the two-dimensional ultrasonic tomographic image data 25 are obtained in correspondence with the coordinate system generated in (1). That is, using the conversion formula between the coordinates, the position information obtained by the position calculation device 5 corresponds to the position of the ultrasonic transducer 17 in the body cavity of the subject (the center position of the two-dimensional ultrasonic tomographic image data 25). A position on the anatomical image information 27 to be identified is specified (step S5).

  Next, the image processing apparatus 9 calculates the two-dimensional ultrasonic tomography including the corresponding point of the center position of the two-dimensional ultrasonic tomographic image on the anatomical image information 27 from the position information indicating the orientation of the ultrasonic transducer 17. A cross section having the same orientation as the image is generated (step S6).

  Then, using the cross section on the anatomical image information 27 having the same position and orientation as the two-dimensional ultrasonic tomographic image as a guide image, together with the two-dimensional ultrasonic tomographic image, as shown in FIG. 2 Display on the monitor 8 (step S7). The guide image 32 shown in FIG. 13 represents the pancreaticobiliary junction, and the pancreatic duct (PD: Pancreas Duct), the common bile duct (CBD: Common Bile Duct), the portal vein (PV: Portal Vein), etc. are color-coded. It is an image on which the annotation is superimposed.

  If the process of this step S7 is performed, it will return to said step S4 and will perform the process as mentioned above. Therefore, each time an ultrasonic scan is performed, the processing from step S4 to step S7 is repeated, and the guide image 32 is displayed in real time.

  According to the third embodiment, the same effects as those of the first and second embodiments can be obtained.

  Further, according to the third embodiment, since the guide image can be observed in real time in addition to the insertion shape image, the distal end of the insertion portion 15 is moved while accurately confirming the position of the two-dimensional ultrasonic tomographic image. It is possible to accurately and easily lead to the region of interest.

  When the region of interest is observed as an optical image by the optical system of the endoscope 1 after the distal end of the insertion portion 15 reaches a desired site, it is necessary to perform a fine inspection with ultrasonic waves. The ultrasonic probe 2 can be inserted through the insertion portion 16 and the guide image of the desired part and the ultrasonic tomographic image can be compared and observed.

  FIGS. 14 and 15 show Example 4 of the present invention and its modification, and FIG. 14 shows an example of an endoscope, a small-diameter ultrasonic probe, and an insertion shape detection probe. FIG. 5 is a diagram showing another example of an endoscope, a thin-diameter ultrasonic probe, and an insertion shape detection probe. In the fourth embodiment, parts similar to those of the first to third embodiments are denoted by the same reference numerals, description thereof is omitted, and only different points will be mainly described.

  Unlike the endoscope 1 of the first to third embodiments described above, the endoscope 1 of the present embodiment does not include the transmission coils C1, ..., Cn. In addition to the insertion portion 16, the endoscope 1 is provided with another tubular insertion portion 16B.

  The thin ultrasonic probe 2 described above is inserted into one insertion portion 16, and a position for detecting the insertion shape of the endoscope 1 is inserted into the other insertion portion 16B. An insertion shape detection probe 41 as a detection probe is inserted.

  The plurality of transmission coils C1,..., Cn are disposed in the insertion shape detection probe 41. That is, in the insertion shape detection probe 41, transmission coils C1,..., Cn are arranged in a line in order from the distal end side to the proximal end side. These transmission coils C1,..., Cn are each electrically connected to the position calculation device 5.

  About another structure, it is the same as that of Example 1 mentioned above.

  Next, portions of the operation of the endoscope apparatus of the present embodiment that are different from the operation of the endoscope apparatus of the first embodiment described above are inserted when the shape of the endoscope 1 is to be detected. The shape detection probe 41 is inserted into the insertion portion 16B and fixed to the insertion portion 15 using a fixing jig (not shown). Thereby, the insertion shape of the endoscope 1 can be detected.

  In addition to this, if the small-diameter ultrasonic probe 2 is inserted through the insertion section 16, the insertion shape image of the endoscope 1 and the two-dimensional ultrasonic tomographic image can be displayed. It is the same.

  In the above description, the insertion shape detection probe 41 is inserted into the insertion portion 16B, and the small-diameter ultrasonic probe 2 is inserted into the insertion portion 16. However, the insertion portion 16 and the insertion portion 16B have the same diameter. In this case, any probe may be inserted into any insertion part.

  According to the fourth embodiment, it is possible to achieve substantially the same effect as the first embodiment described above.

  Furthermore, according to the present embodiment, the insertion shape detection probe 41 and the small-diameter ultrasonic probe 2 can be removed from the insertion portion 16 and replaced with a biopsy forceps according to the usage status and purpose of the endoscope 1. it can. Observation with an optical image, observation of an ultrasonic tomographic image while observing the insertion shape, and biopsy through a biopsy forceps through the insertion portion 16 can be performed.

  As described above, since the endoscope is provided with a plurality of insertion portions, it is possible to perform various treatments using the other insertion portion while performing ultrasonic diagnosis using one insertion portion. Has a remarkable effect. In particular, in the large intestine examination, there is an advantage that water can be injected into the body cavity from one insertion portion 16 and observation of an ultrasonic tomographic image can be continued. Also, in the respiratory system examination, there is an advantage that an ultrasonic tomographic image can be observed while removing a wrinkle with one insertion part.

  Next, a modification of the fourth embodiment will be described with reference to FIG.

  In this modification, a plurality of transmission coils C1,..., Cn are arranged in the insertion shape detection probe 41, and a transmission coil C1 'is further arranged. The transmission coil C1 'is disposed in the insertion shape detection probe 41 so as to have the same positional relationship as the transmission coil C1 shown in FIG. About another structure, it is the same as that of Example 2 mentioned above.

  Of the action of the endoscope apparatus according to this modification, a part different from the action of the endoscope apparatus according to the second embodiment described above is used for detecting the insertion shape when detecting the shape of the endoscope 1. The probe 41 is inserted into the insertion portion 16B and fixed to the insertion portion 15 using a fixing jig (not shown).

  Thereby, the position and orientation information of the ultrasonic transducer 17 can be obtained. In addition to the insertion shape image of the endoscope 1 and the two-dimensional ultrasonic tomographic image, a three-dimensional ultrasonic image can be displayed.

  According to such a modification, it is possible to achieve substantially the same effect as in the second embodiment described above. In addition to this, the same effects as those of the fourth embodiment described above can be obtained.

  In addition, by further providing the plate 13 and the marker coil 14, the same effects as those of the third embodiment described above can be obtained.

  In addition, this invention is not limited to the Example mentioned above, Of course, a various deformation | transformation and application are possible within the range which does not deviate from the main point of invention.

  The present invention can be suitably used for an ultrasonic diagnostic apparatus that transmits an ultrasonic wave to a living body and receives a reflected wave from a living tissue to obtain an ultrasonic image.

1 is a block diagram illustrating a configuration of an endoscope apparatus that also serves as an ultrasonic diagnostic apparatus according to Embodiment 1 of the present invention. In the said Example 1, the figure which shows a mode that an insertion shape image and a two-dimensional ultrasonic tomogram are simultaneously displayed on the screen of a monitor. The block diagram which shows the structure of the endoscope apparatus which served as the ultrasonic diagnosing device in Example 2 of this invention. The figure which shows arrangement | positioning of the transmission coil in the insertion part of the endoscope of the said Example 2 from the insertion-axis direction side. In the said Example 2, the figure which shows arrangement | positioning of the two-dimensional ultrasonic tomogram data group in three-dimensional space. In the said Example 2, the figure for demonstrating the coordinate of the two-dimensional ultrasonic tomographic image data comprised by a pixel. The figure for demonstrating the type | formula which calculates the coordinate of the arbitrary positions on the two-dimensional ultrasonic tomographic image data in the said Example 2. FIG. In the said Example 2, the figure which shows a mode that three-dimensional ultrasonic image data is constructed | assembled from two or more sheets of two-dimensional ultrasonic tomogram data. The block diagram which shows the structure of the endoscope apparatus which served as the ultrasonic diagnosing device in Example 3 of this invention. 9 is a flowchart showing processing for generating a guide image by the endoscope apparatus in the third embodiment. The figure which shows a mode that the image information plane is selected in the said Example 3 in three-dimensional anatomical image information. In the said Example 3, the figure which shows a mode that a feature point is designated on the selected image information plane. In the said Example 3, the figure which shows a mode that a guide image and a two-dimensional ultrasonic tomographic image are displayed side by side on the screen simultaneously. The figure which shows an example of the endoscope in Example 4 of this invention, a small diameter ultrasonic probe, and the probe for insertion shape detection. The figure which shows the example of the endoscope in the modification of the said Example 4, a thin diameter ultrasonic probe, and the probe for insertion shape detection. The figure for demonstrating the perspective type and direct view type of an endoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Small diameter ultrasonic probe 3 ... Drive part 4 ... Ultrasonic observation apparatus 5 ... Position calculation apparatus (position detection means)
6. Receiving antenna (position detecting means, second position detecting element)
7 ... 1st monitor 8 ... 2nd monitor 9 ... Image processing apparatus (reconstruction means, guide image generation means)
DESCRIPTION OF SYMBOLS 11 ... Keyboard 12 ... Mouse 13 ... Plate 14 ... Marker coil 15 ... Insertion part 16, 16B ... Insertion part 17 ... Ultrasonic transducer 18 ... Motor 19 ... Image memory 21 ... Screen 22 ... Insertion shape image 23 ... Two-dimensional ultrasound Tomographic image 25 ... Two-dimensional ultrasonic tomographic image data 25a ... Pixel 26 ... Three-dimensional ultrasonic image data 27 ... Three-dimensional anatomical image information 28 ... Anatomical image information plane 29 ... Voxel 31 ... Pointer 32 ... Guide image 41... Insert shape detection probe (position detection probe)
C1, C1 ′, C2,..., Cn... Transmission coil (position detecting means, first position detecting element)
Agent Patent Attorney Susumu Ito

Claims (8)

An ultrasonic tomographic image is constructed based on the ultrasonic echo signal obtained by reflecting the ultrasonic wave generated by the ultrasonic transducer provided at the tip of the ultrasonic probe inserted into the body cavity of the subject. An ultrasound diagnostic apparatus configured to:
Position detecting means for detecting the position and orientation of the tip,
Holding means for holding anatomical image information;
Display means for displaying the image information held by the holding means;
Feature point designating means for designating feature points on the displayed image information;
Reference point position acquisition means for acquiring a position of a reference point in the subject;
The feature point designated by the feature point designation unit on the image information, the reference point obtained by the reference point position obtaining unit, the position and the orientation of the tip detected by the position detection unit, , Guide image creation means for creating a guide image from,
Equipped with,
The ultrasonic diagnostics characterized in that the reference point position acquisition means acquires at least one position of the reference point from a position detection element inserted into the body cavity of the subject and close to the reference point. apparatus.   The guide image creation means uses a coordinate system generated by the feature points and the reference point by utilizing that the solid formed by the feature points and the solid formed by the reference points are similar. The ultrasonic diagnostic apparatus according to claim 1, wherein a conversion formula that takes a correspondence with a generated coordinate system is determined.   The ultrasonic diagnostic apparatus according to claim 2, wherein the solid is a triangular pyramid. The image information held by the holding means is information identified by luminance or color,
The ultrasonic diagnostic apparatus according to claim 1, wherein the guide image created by the guide image creating unit is color-coded. A subject position acquisition means attachable to the subject and capable of acquiring a position;
Position correcting means for correcting the position of the reference point according to the change in the posture of the subject;
The ultrasonic diagnostic apparatus according to claim 1, further comprising:   The ultrasonic diagnostic apparatus according to claim 1, wherein the reference point position acquisition unit acquires at least one position of the reference point from the body surface of the subject. The reference point position acquisition means, super according to claim 5, characterized in that it further comprises a body position obtaining means for obtaining a position of a reference point in said body surface of said subject Ultrasonic diagnostic equipment. The image information held by the holding means is three-dimensional anatomical image information,
The guide image created by the guide image creating means is a cross section on the image information corresponding to the position and orientation of the ultrasonic tomographic image obtained based on the detection result of the position detecting means. The ultrasonic diagnostic apparatus according to claim 1.

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