JP4797173B2 - X-ray diagnosis support apparatus, program, and recording medium - Google Patents

Description

  The present invention relates to an X-ray diagnosis support technique for performing computer analysis using a CT (Computed Tomography) image and an X-ray moving image to obtain information for dynamic image diagnosis.

  Conventionally, the prevalence of respiratory diseases has been increasing worldwide, and in particular, the prevalence of chronic obstructive pulmonary disease (COPD) is high. This chronic obstructive pulmonary disease is a disease such as pulmonary emphysema and chronic bronchitis mainly caused by air pollution and smoking, and occurs frequently in the elderly. For this reason, with an increase in the prevalence of respiratory diseases, a method for simply and repeatedly performing quantitative functional evaluation on chest diseases is required.

  In general, functional evaluation of respiratory diseases is performed by a pulmonary function test. This pulmonary function test determines whether ventilation, gas and blood flow distribution, diffusion, etc. are performed normally in order to evaluate the basic function of taking oxygen into the body and discharging carbon dioxide outside the body. Qualitative and quantitative inspection. However, in the pulmonary function test, there is a problem that the left and right lungs cannot be examined locally or separately, and accurate examination cannot be performed unless maximum effort breathing is performed. The examinee also had a burden that a great deal of physical strength was required for the examination.

  In order to solve such a problem of pulmonary function testing and reduce the burden on the examinee, an X-ray diagnostic apparatus for locally quantitatively evaluating pulmonary function has been developed (for example, see Patent Document 1). . In this X-ray diagnostic apparatus, a still image obtained by X-ray imaging of the chest is stored in a storage unit, and an arbitrary part of the chest in this still image, a density value calculation method, and a result display method are set. Then, an analysis process related to the density is performed based on the pixel value (density value) of the set part, and the analysis process result is displayed on the screen. In addition, the X-ray diagnostic apparatus stores a still image of a time-series frame obtained by X-ray imaging of the chest in a storage unit, an arbitrary part of the chest in this still image, a method for calculating a density value, and an analysis target When the frame and the result display method are set, the analysis processing regarding the density between frames is performed in time series based on the pixel value of the set portion, and the analysis processing result is displayed on the screen. Since the information necessary for interpretation and diagnosis is displayed by such still image analysis processing and moving image analysis processing, it is possible to realize diagnosis that does not rely on human eyes, The possibility that the diagnostic results vary by the interpretation doctor is reduced. Various processing techniques relating to images obtained by X-ray diagnosis are disclosed (see, for example, Patent Documents 2 to 4).

  Conventionally, an X-ray CT apparatus that obtains a tomographic image (CT image) of a subject by X-ray irradiation has been used. This X-ray CT apparatus irradiates a subject with X-rays, detects differences in X-ray absorption rates of human tissues such as organs, blood, and gray matter with a detector, and reconfigures them by computer processing. Thus, an image of the tomographic plane (slice plane) of the examination site is obtained. Based on the CT image thus obtained, a doctor can diagnose a patient's medical condition or the like with high accuracy.

  Conventionally, an apparatus for screening examination of a subject's chest has been developed. For example, an FPD (Flat Panel Detector) is a device that obtains an image by converting X-rays into an electrical signal, and is an imaging device that uses a flat panel detector that directly digitizes the image. By using this FPD, image confirmation, density adjustment and geometric adjustment can be performed to obtain a stable moving image. For example, a moving image of a series of breathing movements from inspiration to expiration is obtained, the distance from the lung apex to the diaphragm is measured, the moving image is analyzed, and the results are used as information necessary for interpretation and diagnosis. Can be displayed. However, in order to interpret moving images obtained using FPD, knowledge of respiratory physiology is required.

[Patent Document 1] Japanese Patent Laid-Open No. 7-194583 [Patent Document 2] Japanese Patent Laid-Open No. 5-7579 [Patent Document 3] Japanese Patent Laid-Open No. 4-134568 [Patent Document 4] Japanese Patent Laid-Open No. 64-17631

  Under such circumstances, the CT image or moving image morphological information obtained by the X-ray CT apparatus is associated with the dynamic information obtained by analyzing the moving image. It is desired that new information is superimposed on the dynamic information, and the superimposed information is used for interpretation and diagnosis.

  Therefore, the present invention has been made in view of such a situation, and the purpose thereof is to perform local quantitative evaluation on the function of the subject lung or the like, and can be used effectively for interpretation and diagnosis. An object is to provide an X-ray diagnosis support apparatus, a program, and a storage medium that can obtain an evaluation result.

  An X-ray diagnosis support apparatus according to the present invention includes a moving image storage unit that stores an X-ray moving image of a series of operations of a diagnostic region, a still image storage unit that stores an X-ray still image of the diagnostic region, A moving image is read from the moving image storage unit, a moving image processing unit that generates dynamic information indicating a function related to the diagnosis part based on the moving image, a still image is read from the still image storage unit, and the moving image is read from the still image At least one of a still image processing unit that generates a new image relating to a diagnostic region, dynamic information generated by the moving image processing unit, and a new image generated by the moving image and the still image processing unit And an integration unit that integrates the form information and displays the integrated information on a screen.

  Here, the morphological information includes, for example, the thickness and distribution of blood vessels and bronchi, the size and position of the heart, the position and shape of the diaphragm, bone infiltration and fracture, the nature of the lungs, abnormal substances (cancer, water, foreign matter, mold, etc. , Information on still images or moving images capable of recognizing the presence of air masses. The dynamic information is biological function information obtained by analyzing and processing moving images, for example, diffusion or contraction of blood vessels or bronchi, heart pulsation, diaphragm movement or movable region, lung ventilation, abnormalities, etc. Information about the mobility of things. This dynamic information includes respiratory dynamic information and heartbeat dynamic information.

  Further, the X-ray diagnosis support apparatus according to the present invention captures an X-ray moving image stored in the moving image storage unit from the rear surface of the chest, and shows a series of breathing operations from inspiration to expiration. The X-ray still image stored in the still image storage unit is a CT image showing a slice plane of the chest, and the moving image processing unit measures the position of the diaphragm for each frame of the chest X-ray moving image, A frame of maximum inspiration and a frame of maximum exhalation are specified from the position of the diaphragm, and a pixel difference value between the frame of maximum inspiration and the frame of maximum exhalation is calculated for each predetermined chest area, and ventilation is performed. Information, and the ventilation information is generated as dynamic information, and the still image processing unit newly generates at least one of a laysum image, a coronal image, and a sagittal image viewed from the back of the chest based on the CT image. And generating an image.

  Further, the X-ray diagnosis support apparatus according to the present invention captures an X-ray moving image stored in the moving image storage unit from the rear surface of the chest, and shows a series of breathing operations from inspiration to expiration. The X-ray still image stored in the still image storage unit is a CT image showing a slice plane of the chest, and the moving image processing unit measures the position of the diaphragm for each frame of the chest X-ray moving image, For each frame of the chest X-ray moving image that is set in advance, for each frame of the chest X-ray moving image, the pixel difference value between the frames before and after the time series is calculated as ventilation information, and the ventilation information is generated as dynamic information, A still image processing unit generates a new image including at least the above-described ray-thum image among a ray-thum image, a coronal image, and a sagittal image viewed from the back of the chest based on the CT image, and the generated ray-sum The position of the diaphragm is measured for the image, and the integration unit compares the position of the diaphragm measured by the still image processing unit with the position of the diaphragm measured for each frame by the moving image processing unit. Moving image information generated by the moving image processing unit, the moving image, the specified moving image frame, the laysum image generated by the still image processing unit, the coronal image, and the sagittal image Is integrated with at least one of the form information, and the integrated information is displayed on a screen.

  In the X-ray diagnosis support apparatus according to the present invention, the integration unit shifts and rotates the identified moving image frame and the laysum image generated by the still image processing unit, and the pixel difference value at each position. Calculating the shift and rotation position with the smallest sum of absolute values of the pixel difference values, determining the position as a matching position, and integrating the dynamic information and the form information by the matching position. It is characterized by displaying.

  An X-ray diagnosis support program according to the present invention includes a moving image storage unit that stores an X-ray moving image of a series of operations of a diagnostic region, and a still image storage unit that stores an X-ray still image of the diagnostic region. A program executed by an X-ray diagnosis support apparatus that supports diagnosis using the X-ray moving image and the still image, the computer configuring the X-ray diagnosis support apparatus from the moving image storage unit A process of reading an image, generating dynamic information indicating a function related to the diagnostic region based on the moving image, reading a still image from the still image storage unit, and generating a new image related to the diagnostic region from the still image And a process of integrating the generated dynamic information and at least one form information of the moving image and the new image and displaying the integrated information on a screen. To.

  According to the present invention, a local quantitative evaluation of the function of a subject lung or the like is performed, and for example, obtained by analyzing morphological information, which is a CT image obtained by an X-ray CT apparatus, and a moving image. Therefore, new information obtained by integrating morphological information and dynamic information regarding the chest can be effectively used for interpretation and diagnosis.

It is the schematic which shows the structure of the whole system containing the X-ray-diagnosis assistance apparatus by embodiment of this invention. It is a block diagram which shows the function structure of a X-ray-diagnosis assistance apparatus. It is a flowchart figure which shows operation | movement of a X-ray-diagnosis assistance apparatus. It is a figure which shows an example of the screen displayed on the display. It is a graph which shows the distance from a pulmonary apex to a diaphragm in a series of breathing operations from inspiration to expiration. It is a figure which shows the example of a display of the coronal image which overlap | superposed ventilation information. It is a figure which shows the example of a display of ventilation information.

Explanation of symbols

1 X-ray diagnosis support device 2 X-ray moving image device 3 X-ray CT device 11 CPU
12 RAM
13 ROM
14 HD
15,16 I / F
17 Display 18 Mouse 19 Keyboard 21 Moving Image Storage Unit 22 CT Image Storage Unit 23 Moving Image Processing Unit 24 CT Image Processing Unit 25 Integration Unit

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
〔Constitution〕
FIG. 1 is a schematic diagram showing a configuration of an entire system including an X-ray diagnosis support apparatus according to an embodiment of the present invention. This system includes an X-ray diagnosis support apparatus 1, an X-ray moving image apparatus 2, and an X-ray CT apparatus 3, and the internal configuration of the X-ray diagnosis support apparatus 1 represents hardware resources. The X-ray diagnosis support apparatus 1 includes a CPU 11 that executes each process according to a program, a RAM 12 that temporarily stores programs and data, a ROM 13 that stores system programs and system data such as an OS, and each process. Programs and data, HD 14 for storing moving images and CT images, I / F 15 for relaying information input / output between the X-ray moving image apparatus 2 and the X-ray CT apparatus 3, moving images and CT images, etc. A display 17 displayed on the screen, a mouse 18 for inputting an operator's operation, a keyboard 19, and an I / F 16 for relaying the display 17 and the like are provided. The CPU 11 inputs a moving image and a CT image from the X-ray moving image apparatus 2 and the X-ray CT apparatus 3 via the I / F 15 and stores them in the HD 14. In addition, the CPU 11 reads a program and data for executing each process from the HD 14 and stores them in the RAM 12. According to the program, the CPU 11 operates the mouse 18 and the keyboard 19 through the I / F 16 to move the moving image and the data from the HD 14. The CT image is read out, each process is executed, and the execution result is displayed on the display unit 17 via the I / F 16.

  FIG. 2 is a block diagram showing a functional configuration of the X-ray diagnosis support apparatus 1 shown in FIG. The X-ray diagnosis support apparatus 1 includes a moving image storage unit 21, a CT image storage unit 22, a moving image processing unit 23, a CT image processing unit 24, and an integration unit 25. The moving image storage unit 21 stores a chest X-ray moving image captured by the X-ray moving image apparatus 2 such as the FPD described above. The chest X-ray moving image is a moving image in a series of breathing motions from inspiration to expiration, and is stored for each examinee. The CT image storage unit 22 stores CT images of the chest imaged by the X-ray CT apparatus 3. The CT image is a still image obtained by slicing each part of the chest horizontally, and is stored for each examinee. Here, the moving image storage unit 21 and the CT image storage unit 22 correspond to the HD 14 in FIG.

  The moving image processing unit 23 reads out a moving image from the moving image storage unit 21 by an operator's operation, measures the position of the diaphragm to obtain a moving amount, and specifies a frame of the moving image at the time of maximum inspiration and maximum expiration. Then, relative ventilation information (ventilation volume) is obtained for each divided chest area using a pixel difference value that is a difference between pixel values of these frames and a pixel difference value between frames. Further, the moving image read from the moving image storage unit 21 and the measured position information of the diaphragm are displayed on the screen by the operation of the operator.

  The CT image processing unit 24 reads out the CT image from the CT image storage unit 22 by the operator's operation, performs linear interpolation between the read CT images, creates isotropic CT data, and from there for display MPR (Multi Planer Reconstruction) images (coronal images (tomographic images of the chest viewed from the front), sagittal images (tomographic images of the chest viewed from the side), and DRR (Digital Reconstruction Radiographs: Latham ( Ray Sum) image) is measured, and the position of the diaphragm is measured from the ray sum image, and the CT image read from the CT image storage unit 22 and the created coronal image and sagittal image are displayed on the screen by the operation of the operator. indicate.

  The integration unit 25 identifies a moving image frame having a respiratory level that matches the CT image, and then positions the moving image frame having a respiratory level that matches the CT image and a laysum image created from the CT image. Align. Further, the integration unit 25 inputs from the moving image processing unit 23 chest division information indicating area information obtained by dividing the chest and relative ventilation information for each chest area, and converts the ventilation information for each area into a coronal image and a moving image. Superimpose on the image. Further, the integration unit 25 displays a coronal image and a moving image in which ventilation information is superimposed by an operator's operation.

[Operation]
Next, the operation of the X-ray diagnosis support apparatus 1 shown in FIGS. 1 and 2 will be described. FIG. 3 is a flowchart showing the operation of the X-ray diagnosis support apparatus 1. As shown in FIG. 3, the X-ray diagnosis support apparatus 1 reads a chest X-ray moving image and a CT image, performs preprocessing, alignment between the moving image and the CT image, dynamic analysis of the moving image, and superposition. A series of processing is performed. This will be specifically described below. The moving image storage unit 21 stores chest X-ray moving images for 30 frames in time series with an image size (resolution) of 1344 × 1344 pixels, 0.32 mm / pixel, and gradation of 12 bits / 4096. It shall be. It is assumed that the CT image storage unit 22 stores 66 CT images having a slice thickness of 5 mm at an image size of 512 × 512 pixels, a gradation of 0.64 mm / pixel, and 16 bits / 65536.

  The moving image processing unit 23 reads the 30 frames worth of moving images from the moving image storage unit 21 (step 301). Then, in order to match the image size of the CT image, the image size of 1344 × 1344 pixels is adjusted to the image size of 512 × 512 pixels, and a moving image of the size corresponding to 30 frames is created (step 302).

  The CT image processing unit 24 reads the 66 CT images from the CT image storage unit 22 (step 303). Then, voxelization of image data is performed by linear interpolation on two CT images having a slice thickness of 5 mm (step 304). Specifically, using the two CT images, a 1-slice CT image is interpolated into a 7.8125-slice CT image. That is, a CT image of 512 pixels × 512 pixels × 512 slices (sheets) is generated by interpolating the read CT images of 512 pixels × 512 pixels × 66 slices (sheets). In this case, the total size is 327.68 mm × 327.68 mm × 327.68 mm. Then, the CT image processing unit 24 creates a coronal image and a sagittal image for MPR display by using the interpolated CT image, and also creates a DRR (latham image) (step 305). In this case, the coronal image, the sagittal image, and the laysum image have an image size of 512 × 512 pixels and an image of 0.64 mm / pixel, respectively.

  The moving image processing unit 23 recognizes a lung field region for all frames of moving images created in step 302 (step 306). Further, the CT image processing unit 24 recognizes the lung field region by threshold processing (step 306). Specifically, the CT image processing unit 24 sets the CT value of air as a threshold value, compares the CT value of each pixel with the threshold value, extracts pixels whose CT value is equal to or less than the threshold value, and extracts the extracted pixels. Recognize the region as a lung field region.

  The moving image processing unit 23 detects the positions of the lung apex and the diaphragm in the moving image of all frames created in step 302, and calculates the distance from the lung apex to the diaphragm (step 307). In addition, the CT image processing unit 24 detects the positions of the lung apex and the diaphragm for the latham image created in step 305, and calculates the distance from the apex to the diaphragm (step 307). Specifically, the moving image processing unit 23 detects a boundary where the value of the moving image of the first frame and the CT image processing unit 24 greatly change the value of the latsum image based on the pixel value, and the upper part of the lung field region. The coordinates (position) of the pulmonary apex are determined, and the coordinates of the diaphragm are determined below the lung field region. The moving image processing unit 23 sets the periphery of the lung apex coordinates determined from the moving image of the first frame as a region of interest (ROI), and similarly sets the periphery of the coordinates of the diaphragm as a region of interest. The moving image after the second frame is tracked with respect to the region of interest, the boundary where the pixel value changes greatly is detected, and the coordinates of the lung apex and the diaphragm are determined.

  The integration unit 25 inputs the distance from the lung apex to the diaphragm calculated in step 307 from the moving image processing unit 23 and the CT image processing unit 24, and compares the distance in the laysum image with the distance in each frame of the moving image. Then, frames having the same distance are specified (step 308). That is, a frame in which the respiratory level of the CT image matches the respiratory level of the moving image is specified from a plurality of frames.

The integration unit 25 inputs the laysum image from the CT image processing unit 24, and performs alignment between the frame of the identified moving image and the laysum image (step 309). Specifically, while shifting and rotating the input specific frame and the laysum image little by little, the difference between the pixel values of both images in each pixel is calculated, and the shift and rotation with the smallest sum of absolute values of the difference values are calculated. Find the position. This position is determined as a position where both images are matched. That is, the integration unit 25 obtains R in the following mathematical formula by shifting and rotating both images little by little, and determines the shift and rotation position where R is the minimum as the matching position.

Here, R is the sum of absolute values of pixel difference values, F (x, y) is a specific frame of a moving image, G (x, y) is a ray-sum image, Rotation is a rotation function (input is image and rotation angle, output) Is a horizontal coordinate (0 <x <M), y is a vertical coordinate (0 <y <N), M is a horizontal image size (unit is pixel), and N is Vertical image size (unit is pixel), dx is horizontal shift amount (0 <dx <10, unit is pixel), dy is vertical shift amount (0 <dy <10, unit is pixel), dr Is a rotation amount (0 <dr <5, unit is deg).

  Note that the integration unit 25 reduces the image size of 512 × 512 pixels of the input frame and the laysum image to an image size of 128 × 128 pixels, respectively, and uses this reduced frame and the laysum image to determine the matching position. It may be determined. Thereby, the time for determining a matching position can be shortened.

  The moving image processing unit 23 divides the frame of the moving image identified in step 308 by a predetermined number for each area horizontal in the x-axis direction with respect to the left lung field and the right lung field (step 310). Here, from the viewpoint of ecological follow-up accuracy in lung function, it is preferable to divide the left and right lung field regions into 8 parts.

  The moving image processing unit 23 calculates an average of pixel values for each area divided in step 310, and calculates a difference in pixel values between frames of moving images adjacent in time series. Also, the difference between the pixel value at the time of maximum inspiration and the pixel value at the time of maximum expiration is calculated (step 311). Specifically, the moving image processing unit 23, in a time-series moving image frame, the pixel difference value (average difference value of pixel values) between the first frame and the second frame, the second frame, A pixel difference value from the third frame,... Is calculated for each area. Further, the moving image processing unit 23 specifies the frame having the maximum distance from the distances from the lung apex to the diaphragm of all the moving image frames calculated in step 307, and selects the frame having the minimum distance. Identify. Here, the frame with the maximum distance indicates the form at the time of maximum inspiration, and the frame with the minimum distance indicates the form at the time of maximum expiration. Then, the moving image processing unit 23 calculates, for each area, a pixel difference value that is a difference between the pixel value of the frame at the time of the maximum inspiration and the pixel value of the frame at the time of the maximum expiration. Here, the pixel difference value calculated by the moving image processing unit 23 is ventilation information.

  The integration unit 25 inputs the chest division information, the inter-frame pixel difference value for each area, and the maximum inspiration / expiration pixel difference value from the moving image processing unit 23, and the gray color corresponding to the inter-frame pixel difference value for each area. Are superimposed and displayed on the moving image, and the shade color corresponding to the maximum inspiration / expiration pixel difference value for each area is superimposed and displayed on the coronal image and the moving image (step 312). Details of the screen display will be described later.

〔Screen display〕
FIG. 4 is a diagram showing an example of a screen displayed on the display unit 17 shown in FIG. This screen is displayed when the operator operates the mouse 18 or the keyboard 19. In FIG. 4, a CT image is in a region 401 at the upper left of the screen, a moving image is in a region 402 at the center of the screen, a coronal image is in a region 403 at the lower left of the screen, a sagittal image is in a region 404 to the right of the screen. The area 405 displays the same moving image as the area 402, the area 406 on the right side of the moving image displays a graph indicating the distance from the lung apex to the diaphragm, and the operation areas 407 to 409 by the operator are displayed on the right side of the screen. Hereinafter, the operation from the operation of the operator to the screen display will be described.

  First, when the operator selects a folder or file in the area 407 and presses the “Open images” button in the area 409, a moving image is read from the HD 14 (moving image storage unit 21) and displayed in the areas 402 and 405. . This moving image is a series of breathing motion images from inspiration to expiration. Similarly, when the operator selects the same examinee's holder or file in the area 407 and presses the “Open CT” button in the area 409, the CT image is read out from the HD 14 (CT image storage unit 22) and stored in the area 401. Is displayed. In the area 408, the image size in the x-axis direction, the image size in the y-axis direction, the pixel size, the slice thickness, and the number of gradation bits are set and displayed.

  When the operator presses the “Lung area” button in the area 409, lung field recognition of the moving image is performed, and the movement amount is obtained by measuring the position of the diaphragm in the moving image, and the lung apex portion in each frame of the moving image A graph of the distance from the diaphragm to the diaphragm is displayed in area 406. In this case, when the operator operates the scroll bar at the bottom of the area 406 to the left and right, a frame of a moving image corresponding to the position of the scroll bar is displayed in the areas 402 and 405. That is, when the operator moves the scroll bar from the left end to the right end, moving images of a series of breathing motions from inspiration to expiration are displayed in areas 402 and 405.

  FIG. 5 is an enlarged graph of the region 406 shown in FIG. 4 and shows the distance from the lung apex to the diaphragm in a series of breathing operations from inspiration to expiration. The characteristic of the circle (circle) is the distance in the right lung, and the cross (cross) is the distance in the left lung.

  Returning to FIG. 4, when the operator presses the “Isotropic data” button in the area 409, the CT image is voxelized, and a coronal image, a sagittal image, and a latham image are created. Are displayed in the area 404 respectively. At this stage, ventilation information is not superimposed on the areas 403 and 405. In addition, the latham image is not displayed on the screen. In this case, when the operator operates the scroll bar at the bottom of the area 401 to the left or right, a sagittal image corresponding to the position of the scroll bar is displayed in the area 404. When the operator operates the scroll bar on the right side of the area 401 up and down, a coronal image corresponding to the position of the scroll bar is displayed in the area 403. When the operator operates the scroll bar on the right side of the region 404 up and down, CT images (axial images) corresponding to the positions of the scroll bars in the regions 403 and 404 are displayed in the region 401. In addition, the distance from the lung apex to the diaphragm in the Latham image is measured.

  When the operator presses the “Registration” button in the region 409, the respiratory levels match using the distance from the apex to the diaphragm in each frame of the moving image and the distance from the apex to the diaphragm in the layham image. A frame of the moving image is specified, and the frame is displayed in the areas 402 and 405. Then, alignment is performed between the images. The position of the scroll bar in the area 406 is a position corresponding to the specific frame. At this stage, ventilation information is not superimposed on the areas 403 and 405.

  When the operator presses the “Ventilation” button in the region 409, the pixel difference value at the time of maximum inspiration / expiration for each chest area is displayed as ventilation information superimposed on a specific frame of the coronal image in the region 403 and the moving image in the region 405. Is done. Further, the inter-frame pixel difference value for each chest area is displayed as ventilation information superimposed on the moving image in the region 405. In this case, when the operator operates the scroll bar at the bottom of the area 406 left and right, a moving image corresponding to the position of the scroll bar is displayed in the area 405 and ventilation information of the inter-frame pixel difference value is displayed in an overlapping manner. The The inspiration and expiration state can be grasped from the moving image in this area 405.

  FIG. 6 is an enlarged view of the region 403 shown in FIG. 4, and the pixel difference value at the time of maximum inspiration / expiration is displayed superimposed on the coronal image as ventilation information. As shown in FIG. 6, the ventilation information is displayed for each area obtained by dividing the left and right chests into eight equal parts, and the pixel difference value is shown in shades according to the size. The larger the pixel difference value, the more the color of the area It is dark. FIG. 7 is an enlarged view of the area 405 shown in FIG. 4, and the pixel difference value at the time of the maximum inspiration / expiration is displayed as ventilation information superimposed on a specific frame of the moving image. As in FIG. 6, ventilation information is displayed for each area obtained by dividing the left and right breasts into eight equal parts, and the pixel difference value is shown in shades according to the size. The larger the pixel difference value, the darker the area color. It has become. The central mountain-shaped curve indicates the pixel difference value of each area with the central vertical line being 0, the left curve is the left chest difference value, and the right curve is the right chest difference value. It is. The closer to the lower part of the chest, the larger the pixel difference value, so the area becomes darker and the curve is wider.

  4 and 6, when the operator presses a button at the bottom of the region 403, the display of the original coronal image or the pixel difference value at the time of coronal image and maximum inspiration / expiration ( The overlay display of ventilation information) can be selected. 4 and 7, when a button at the bottom of the area 405 is pressed, in the area 405, the display of the moving image, the specific frame of the moving image, and the pixel difference value during the maximum inspiration / expiration (ventilation) Information) or superimposed display of moving image and inter-frame pixel difference value can be selected.

  Here, although not shown in the figure, in the area 405, when the inter-frame pixel difference value for each chest area is displayed as ventilation information superimposed on the moving image, when the pixel difference value is positive, the expiration phase When the pixel difference value and the pixel difference value are negative, the color is divided into the colors of the intake phase, and is further shown by the shading of the color according to the size of the pixel difference value.

  Further, in the area 409, setting and display of the screen contrast and the like, setting of a data storage method such as a bitmap, storage of data, and the like are performed by an operator's operation.

  As described above, according to the X-ray diagnosis support apparatus 1 according to the embodiment of the present invention, the integration unit 25 obtains the chest shape information and the respiratory dynamics information that is ventilation information for each divided chest area. Overlaid on the screen. As a result, local quantitative evaluation can be realized, and an evaluation result that can be effectively used for interpretation and diagnosis can be obtained.

  The present invention has been described with reference to the embodiment. However, the present invention is not limited to the above embodiment, and various modifications can be made without departing from the spirit and intention of the present invention. For example, in the above embodiment, the pixel difference value in the chest is superimposed on the form information as ventilation information. However, the part is not limited to the chest but may be a heart or the like, and is limited to the ventilation information. Instead, it may be other dynamic information, for example, information related to blood vessel diffusion and contraction.

  The conditions such as the image size, the number of gradations, and the number of frames of the chest X-ray moving image, and the conditions such as the image size, the number of gradations, and the slice thickness of the CT image are limited to the conditions described in the above embodiment. It is not something. The image size adjusted by the moving image processing unit 23 and the number of slices voxelized by the CT image processing unit 24 are not limited to the image size and the number of slices shown in the above embodiment. In FIGS. 4, 6, and 7, the ventilation information is displayed for each area obtained by dividing the left and right breasts into eight equal parts. However, the ventilation information is not limited to eight equal areas.

As shown in FIG. 1, the X-ray diagnosis support apparatus 1 includes a volatile storage medium such as a CPU 11 and a RAM 12, a non-volatile storage medium such as a ROM 13, an input device such as a mouse 18, a keyboard 19, and a pointing device. And a display 17 for displaying images and data, and a computer having an interface I / F 15 for communicating with an external device. Each function of the moving image processing unit 23, the CT image processing unit 24, and the integration unit 25 provided in the X-ray diagnosis support apparatus 1 is realized by causing the CPU 11 to execute a program describing these functions. These programs can also be stored and distributed in a storage medium such as a magnetic disk (floppy disk, hard disk HD14, etc.), an optical disk (CD-ROM, DVD, etc.), or a semiconductor memory.

Claims (6)

A moving image storage unit in which an X-ray moving image of a series of operations of the diagnostic region is stored;
A still image storage unit storing an X-ray still image of the diagnostic region;
A moving image processing unit that reads out a moving image from the moving image storage unit and generates dynamic information indicating a function related to the diagnostic region based on the moving image;
A still image processing unit that reads out a still image from the still image storage unit and generates a new image related to the diagnostic region from the still image;
The dynamic information generated by the moving image processing unit and at least one form information of the moving image and the new image generated by the still image processing unit are integrated, and the integrated information is displayed on the screen. An X-ray diagnosis support apparatus, comprising: The X-ray diagnosis support apparatus according to claim 1,
The X-ray moving image stored in the moving image storage unit is taken from the back of the chest, and is a chest X-ray moving image showing a series of breathing movements from inspiration to expiration,
The X-ray still image stored in the still image storage unit is a CT image showing a slice plane of the chest,
The moving image processing unit measures the position of the diaphragm for each frame of the chest X-ray moving image, specifies the frame of maximum inspiration and the frame of maximum exhalation from the position of the diaphragm, and sets each predetermined chest area , Calculating a pixel difference value between the maximum inspiration frame and the maximum expiration frame to obtain ventilation information, and generating the ventilation information as dynamic information,
The still image processing unit generates, as a new image, at least one of a ray-sum image, a coronal image, and a sagittal image viewed from the rear of the chest based on a CT image. . The X-ray diagnosis support apparatus according to claim 1,
The X-ray moving image stored in the moving image storage unit is taken from the back of the chest, and is a chest X-ray moving image showing a series of breathing movements from inspiration to expiration,
The X-ray still image stored in the still image storage unit is a CT image showing a slice plane of the chest,
The moving image processing unit measures the position of the diaphragm for each frame of the chest X-ray moving image, and for each predetermined chest area, between each frame of the chest X-ray moving image before and after the time series The pixel difference value is calculated as ventilation information, the ventilation information is generated as dynamic information,
The still image processing unit generates a new image including at least the Latham image among a Latham image, a coronal image, and a sagittal image viewed from the back of the chest based on the CT image, and the diaphragm is generated with respect to the generated Latham image. Measure the position of
The integration unit compares the position of the diaphragm measured by the still image processing unit with the position of the diaphragm measured for each frame by the moving image processing unit, specifies a moving image frame in which both positions match, Dynamic information generated by the moving image processing unit, and at least one form information of the moving image, the frame of the identified moving image, a laysum image generated by the still image processing unit, a coronal image, and a sagittal image Are integrated, and the integrated information is displayed on a screen. The X-ray diagnosis support apparatus according to claim 3,
The integration unit calculates a pixel difference value at each position while shifting and rotating the frame of the identified moving image and the laysum image generated by the still image processing unit, and calculates an absolute value of the pixel difference value. X-ray diagnosis support characterized in that a shift and rotation position having the smallest sum is obtained, the position is determined as a matching position, and the dynamic information and form information are integrated and displayed on the screen by the matching position. apparatus. A moving image storage unit storing an X-ray moving image of a series of operations of a diagnostic region; and a still image storage unit storing an X-ray still image of the diagnostic region, the X-ray moving image and the still image being stored A program executed by an X-ray diagnosis support apparatus that supports diagnosis by using a computer constituting the X-ray diagnosis support apparatus,
A process of reading out a moving image from the moving image storage unit and generating dynamic information indicating a function related to the diagnostic region based on the moving image;
A process of reading a still image from the still image storage unit and generating a new image related to the diagnostic region from the still image;
An X-ray diagnosis support program for executing a process of integrating the generated dynamic information and at least one form information of a moving image and a new image and displaying the integrated information on a screen.   A recording medium on which the X-ray diagnosis support program according to claim 5 is recorded.