JP4878828B2 - X-ray fluoroscopic equipment - Google Patents

Description

  The present invention relates to an X-ray fluoroscopic imaging apparatus, and in particular, an X-ray that makes it easy to compare a current fluoroscopic image that changes corresponding to an X-ray irradiation range limited by an X-ray movable aperture device and a past reference image. The present invention relates to a fluoroscopic apparatus.

  In recent years, digitalization of X-ray image diagnostic apparatuses has progressed. The reason for this is that X-ray detectors are semiconductor digital X-ray detectors that can convert X-rays directly into digital electrical signals from image intensifiers where X-ray images are detected as X-ray film or analog optical images. This is because it is being replaced by a flat panel detector (hereinafter referred to as FPD).

  Since this FPD is positioned as an alternative to X-ray film, a wide field of view is adopted so that a wide range of parts such as the abdomen, chest, thigh of the subject can be obtained at one time, It is used not only for the wide field of view but also for fluoroscopic imaging of the narrow field of view, and these regions are shared to obtain an X-ray image.

When such a wide-field FPD is used and the desired range (region of interest) such as the heart is narrow, the X-ray irradiation field is limited to the range of the region of interest with an X-ray movable aperture device. By performing imaging, it can also be used for diagnostic and therapeutic methods using a catheter called interventional radiology (hereinafter referred to as IVR).
This IVR, for example, inserts a catheter from the femoral vein, etc., advances the catheter to the target blood vessel under fluoroscopy, injects a contrast medium at the target site, images the blood vessel, or examines it, or This is a treatment method using a balloon catheter or atherectomy catheter to open the stenosis.

  In the IVR procedure, it is necessary to know the position and structure of the blood vessel in order to insert a guide wire or catheter into the blood vessel to be treated. Therefore, X-ray imaging is performed by injecting contrast medium into the blood vessel. The blood vessel image obtained in this way is displayed on an image display device different from the X-ray fluoroscopic image display device, and the operator confirms the position and structure of the blood vessel while displaying the X image displayed on the X-ray fluoroscopic image display device. While observing a fluoroscopic image, a guide wire or a catheter is inserted to a target site for diagnosis and treatment.

In order to advance such examination or treatment efficiently, there is a request to compare the current image with the past image, and Patent Document 1 discloses a technique for comparing and displaying the current image and the past image. Yes.
In Patent Document 1, when a captured image is displayed on the day, if there is a past image of the patient, the past image is automatically displayed together.
JP 2000-166878 A

  An image for referring to the position and structure of the blood vessel displayed on an image display device different from the X-ray fluoroscopic image display device does not limit the X-ray irradiation field to the region of interest by the X-ray movable diaphragm device. Since the adjustment of the image quality is not optimized for the target part because the entire field of view is taken, the position and structure of the blood vessel are very difficult to understand.

  Further, in the above-described IVR under X-ray fluoroscopy, it is desired to compare a current fluoroscopic image in which only a region of interest (X-ray irradiation region) is displayed with a past image of the same region of interest as this fluoroscopic image.

However, the technique disclosed in Patent Document 1 is a comparison between the image captured this time and the previous image captured in the same imaging region, and the current perspective image that changes in real time and this perspective image It does not compare images with the same region of interest.
Further, Patent Document 1 does not mention any necessity for comparison of fluoroscopic images.

  Therefore, the object of the present invention is to change the display region of the reference image in the same manner even when the region of the X-ray aperture is changed while viewing the X-ray fluoroscopic image, so that the current fluoroscopic image and the past reference image can be easily changed. An object of the present invention is to provide an X-ray fluoroscopic apparatus capable of comparative interpretation.

The present invention displays a reference image of the same X-ray irradiation area as the current X-ray fluoroscopic image on the display means, and is specifically achieved by the following means.
(1) X-ray generation means for emitting X-rays to a subject, and an X-ray detection device that is arranged opposite to the X-ray generation means and that includes a plurality of two-dimensionally arranged X-ray detection elements that detect transmitted X-rays of the subject A line flat detector, an X-ray irradiation area setting means for setting an X-ray irradiation area on the subject, and an X-ray diaphragm means for focusing X-rays on the X-ray irradiation area set by the X-ray irradiation area setting means; , Image processing means for performing image processing on the image data output from the X-ray flat panel detector, current image display means for displaying the current X-ray image processed by the image processing means, and past references An X-ray fluoroscopic apparatus comprising a reference image display means for displaying an image, the reference image storage means for storing the past reference image with the X-ray irradiation area information attached thereto, and the current image display means A reference image of the same X-ray irradiation area as the fluoroscopic image displayed on the screen is stored from the reference image storage means. -Option to configure a reference image display control means for display control in the reference image display unit.

  In this way, the region of interest is changed in response to the setting signal set by the X-ray irradiation region setting means, the perspective image of the changed region of interest is enlarged by the perspective image enlargement processing means, and this enlarged image is displayed. Since it is displayed on the current image display means and a past reference image at the same position as the current fluoroscopic image being displayed is selected from the reference image storage means and displayed on the reference image display means, in real time It is possible to comparatively interpret a changed enlarged perspective image and a reference image at the same position (region of interest) as the perspective image.

  (2) Further, a fluoroscopic image magnifying means for magnifying a current fluoroscopic image displayed on the current image display means at a predetermined magnification is provided. Further, the image processing apparatus further includes reference image enlargement means for enlarging the reference image displayed on the reference image display means at an enlargement ratio equal to or higher than the enlargement ratio.

  In this way, the region of interest is changed in response to the setting signal set by the X-ray irradiation region setting means, the perspective image of the changed region of interest is enlarged by the perspective image enlargement processing means, and this enlarged image is displayed. While displaying on the current image display means, a past reference image at the same position as the displayed current fluoroscopic image is enlarged by the reference image enlargement means at the same magnification as the current fluoroscopic image and displayed on the current image display means Since the reference image is displayed on the reference image display means so as to be the same as the display area of the displayed image, the reference image is enlarged and the display area is the same as the display area of the current fluoroscopic image. Comparison with a fluoroscopic image that changes in real time becomes easy.

In addition, since the reference image enlargement means can display an enlarged image on an area wider than the enlarged reference image area, the blood vessel configuration outside the display area of the current fluoroscopic image can also be known. The guide wire can be inserted more efficiently.
(3) Further, the reference image enlargement means expands the reference image in a larger area than the enlarged current fluoroscopic image, and superimposes the enlarged fluoroscopic image on the enlarged reference image; and Means for controlling display of an image superimposed by the superimposing means on either or both of the current image display means and the reference image display means.

In this way, when the enlarged reference image and the current fluoroscopic image are superimposed and displayed on the current image display means, the reference image display means is used when it is desired to view the blood vessel configuration outside the display area of the current fluoroscopic image. It is possible to confirm the surrounding blood vessel configuration simultaneously with the current fluoroscopic image without moving the line of sight.
Note that the superimposed image is not displayed only on the current image display means, but also displayed on the reference image display means, or displayed on both the current image display means and the reference image display means. You may do it.

(5) Means for displaying the reference image in an empty area of the current image display means or controlling the display of the current fluoroscopic image in an empty area of the reference image display means.
(6) The reference image displayed in the empty area of the current image display means is enlarged to a range that can be displayed in the empty area by the reference image enlargement means, and means for controlling display of the enlarged image in the empty area Equipped with.
(7) The current fluoroscopic image displayed in the empty area of the reference image display means is enlarged to a range that can be displayed in the empty area by the fluoroscopic image enlarging means, and display control of the enlarged image in the empty area is performed. It has a means to do.
(8) Further, a reference image reduction means for reducing the reference image, and means for controlling display of the image reduced by the reference image reduction means in an empty area of the current image display means.
(9) Further, a perspective image reduction means for reducing the current perspective image, and a control means for displaying the image reduced by the perspective image reduction means in an empty area of the reference image display means.
(10) Display control means for displaying an image obtained by enlarging or reducing the current fluoroscopic image and an image obtained by enlarging or reducing the reference image on both the current image display means and the reference image display means.

By configuring in this way, the reference image and the current fluoroscopic image can be displayed on the same display means, so that it is possible to simultaneously display the current fluoroscopic image without moving the line of sight to a display means other than the display means. The surrounding blood vessel configuration can be confirmed, and the current fluoroscopic image and the reference image are displayed separately on the same display screen, making it easy to distinguish between the images and making it easy to compare blood vessel structures. Become.
In addition, since the same perspective image and reference image are displayed on both the current image display means and the reference image display means, the operator can easily view the current image display means or the reference image display means. Can be compared and read on the display screen.

  (11) The reference image is a captured image or a fluoroscopic image accompanied with X-ray irradiation region information.

  According to the present invention, even when the region of the X-ray movable diaphragm is changed while viewing the X-ray fluoroscopic image, the display region of the reference image is also changed, and the blood vessel structure can be easily confirmed in the angiography examination. It is possible to easily compare and interpret the fluoroscopic image and the past reference image.

Hereinafter, preferred embodiments of an X-ray fluoroscopic apparatus according to the present invention will be described in detail with reference to the accompanying drawings.
Note that components having the same function are denoted by the same reference symbols throughout the drawings for describing the embodiment of the invention, and the repetitive description thereof is omitted.
FIG. 1 is a diagram showing a configuration of an X-ray fluoroscopic apparatus according to the first embodiment of the present invention.

The X-ray fluoroscopic apparatus of FIG. 1 limits the X-ray tube 3 that generates X-rays to be irradiated to the subject 2 placed on the bed 1 and the irradiation range of the X-rays to be irradiated to the subject 2 X-ray movable diaphragm device 4, X-ray compensation filter 5 for controlling the intensity distribution of X-rays throttled by this X-ray movable diaphragm device 4, X-ray tube 3, X-ray movable diaphragm device 4 and X-ray An X-ray flat detector 7 that detects the transmitted X-rays of the subject 2 arranged opposite to the X-ray generator 6 composed of the compensation filter 5 and converts it to digital X-ray image data, and the X-ray generators 6 and X A mechanism control device 9 for controlling the mechanical operation of the fluoroscopic imaging mechanism unit 8 constituted by the line plane detector 7 and the bed 1 and an X for reading and controlling the X-ray image data detected by the X-ray plane detector 7 A line plane detector control device 10, an image processing device 11 for performing image processing on the X-ray digital image data read out by the X-ray plane detector control device 10, and the image processing An image memory 12 that reads and stores an image processed by the device 11, a perspective image enlargement processing device 13 that performs an enlargement process on the perspective image read to the image memory 12, and a current perspective image that has been enlarged Current image display device 14 for displaying the voltage applied between the anode and the cathode of the X-ray tube 3, the current flowing between the anode and the cathode, and the imaging time according to the fluoroscopy or imaging conditions set by the operation device 21 described later X-ray high-voltage device 15 having a function of controlling the X-ray dose, X-ray diaphragm operating device 16 for setting the X-ray irradiation range, and the X-ray irradiation range set by the X-ray diaphragm operating device 16 The X-ray diaphragm control device 17 that inputs and controls the X-ray irradiation range by the X-ray movable diaphragm device 4, the reference image storage device 18 that stores past images to be referenced, and the current image display device 14 A reference image in the same area as the displayed fluoroscopic image is used as the reference image storage device 18. A reference image memory 19 that is selected and stored, a reference image display device 20 that displays an image stored in the reference image memory 19 as a reference image, and an operating device 21 that sets an operation signal necessary for fluoroscopic imaging, The system control device 22 is configured to control the entire X-ray fluoroscopic imaging system by the operation signal set by the operation device 21.
The operating device 21 includes a touch input unit of a touch panel, an external input unit such as a mouse and a keyboard, and the name, fluoroscopic part, fluoroscopic direction, and fluoroscopic X-ray condition of the subject 2 from these input units. And a display unit for inputting various parameters necessary for the image processing and displaying them.
Further, the X-ray generator 6 and the X-ray flat detector 7 are supported by a C-shaped arm supporter or a fluoroscopic imaging table (not shown), and together with the bed 1 constitute a fluoroscopic imaging mechanism unit 8, and this fluoroscopy The imaging mechanism unit 8 is positioned and controlled by the mechanism control device 9 in a region of interest for fluoroscopic imaging of the subject 2.

As is well known, the X-ray movable aperture device 4 is provided with a pair of upper and lower restricting blades mainly made of lead for adjusting the X-ray irradiation field, and the upper and lower restricting blades are arranged in a grid pattern, A pair of restricting blades facing each other is configured to move symmetrically in parallel, and these blades are configured to be able to move independently of each other, and an X-ray irradiation field is arbitrarily set.
The X-ray movable diaphragm device 4 having such a configuration forms X-rays radiated from the focal point of the X-ray tube 3 in a conical shape and adjusts the pyramidal X-ray irradiation field.
Accordingly, the X-ray irradiation range (X-ray irradiation field) is adjusted by controlling the position of the limiting blade of the X-ray movable diaphragm device 4 by the control signal generated by the X-ray diaphragm controller 17.

The X-ray irradiation field inputs an irradiation field setting signal set by an operator in the X-ray diaphragm operation unit 16 to the X-ray diaphragm control device 17, and the X-ray diaphragm control device 17 inputs the X-ray movable diaphragm. An X-ray diaphragm blade position control signal is generated by the X-ray diaphragm controller 17 so that the position of the limiting blade of the apparatus 4 is set to the set irradiation field setting position, and the X-ray movable diaphragm device 4 is generated based on the generated control signal. The X-ray field is set by controlling the position of the limiting blade.
The X-ray aperture range signal generated by the X-ray aperture control device 17 is also input to the image processing device 11 and used as effective visual field area information of a fluoroscopic image displayed on the current image display device 14 described later. .

The X-ray flat panel detector 7 is a semiconductor digital X-ray detector that obtains a digital image in real time in order to see through and photograph the X-ray image directly as a digital image.
This X-ray flat panel detector 7 has an indirect conversion method and a direct conversion method depending on the X-ray conversion method, and the present invention can be applied to any conversion method, but here the indirect conversion method is used. And
This indirect conversion type X-ray flat detector 7 is a scintillator that converts X-rays transmitted through the subject 2 into light, and a photodiode (for example, an amorphous silicon type) that converts light output from the scintillator into electric charge. X-ray image data is obtained by reading out the charge of the photodiode via a switching element (e.g., TFT (Thin Film Transistor)), and the electric charge corresponding to the X-ray dose transmitted through the subject 2 A large number of detectors to be converted into signals are arranged in a planar matrix, and the X-ray dose becomes an electrical image signal converted into an electrical signal by each of the detectors.

  Assuming that the X-ray irradiation field set by the X-ray movable diaphragm device 4 is the effective field of view of the X-ray flat detector 7, this effective field of view is the position control of the X-ray diaphragm blades generated by the X-ray diaphragm controller 17. Since it corresponds to a signal, this signal is taken into the image processing device 11, and the fluoroscopic image is associated with the positions of the X-ray detection elements (pixels) arranged side by side in the plane matrix of the X-ray plane detector 7. The effective visual field information is attached to the fluoroscopic image.

  By configuring and controlling in this manner, only the region of interest that is a part of the X-ray flat detector 7 with a large field of view is irradiated with fluoroscopic X-rays, and an image of the region of interest can be acquired.

The image processing device 11 takes in digital image data that is converted to a digital image signal by the X-ray flat detector control device 10 and controlled to be read out, and performs various corrections such as offset correction and gain correction of the X-ray flat detector 7. Correction processing is performed, and further, various types of image processing such as dynamic range compression processing and filter processing are performed on the corrected image data to generate X-ray fluoroscopic image data.
Then, the image area of interest is calculated from the current X-ray aperture position information (effective visual field information), and one frame of X-ray fluoroscopic image data corresponding to this image area is read out to the image memory 12, and this image Data is temporarily stored, and the stored image data is read by the perspective image enlargement processing device 13 and enlarged at a predetermined enlargement ratio.

  Since the enlargement ratio changes depending on the distance SID (Source-Image Distance) between the current X-ray tube 3 and the X-ray flat detector 7, the perspective image enlargement processing device 13 controls the current SID. The image is received from the device 9 via the system control device 22 and the image processing device 11, and is enlarged to a size suitable for the image display area of the current image display device 14 at an enlargement rate in consideration of the SID. The fluoroscopic image is displayed on the current image display device 14.

Examples of images displayed on the current image display device 14 are shown in FIGS.
When a fluoroscopic image of the entire region of the X-ray flat panel detector 7 when the aperture is inserted is displayed as shown in FIG. Specifically, the region where the X-ray movable diaphragm plates 17, 18, 19, and 20 are inserted has low brightness because X-rays do not pass through.
In this case, the region of interest on the image memory 12 is a range surrounded by (200, 256), (200, 600), (400, 256), and (400, 600) shown in FIG.
When only this region of interest is read out to the image memory 12 and this read-out image is enlarged by the perspective image enlargement processing device 13 so as to fit within the display region of the current image display device 14, it is as shown in FIG.
In this way, only the region of interest can be cut out on the current image display device 14 and displayed in an enlarged manner.

  In the reference image storage device 18, images taken in the past are stored with X-ray aperture region information (effective visual field information) by the X-ray movable aperture device 4 and stored on the current image device 14. The X-ray aperture position information of the current fluoroscopic image is transmitted to the reference image memory 19, and the past reference image at the same position as the X-ray aperture position of the current fluoroscopic image displayed on the current image device 14 is referred to the reference image memory 19. And temporarily stores the stored image on the reference image display device 20 as a reference image.

Hereinafter, the reference image will be described as a captured image taken in the past unless otherwise specified.
FIG. 4 is a flowchart in the first embodiment in which the current fluoroscopic image and a past captured image in the same area as the fluoroscopic image are displayed on the respective display devices.
In the flowchart of FIG. 4, first, the region of interest is set by operating the X-ray aperture operation device 16, X-ray fluoroscopic image data of the set region of interest is read into the image memory 12, and the fluoroscopic image enlargement processing device 13 A perspective image of a predetermined magnification is enlarged and displayed on the current image display device 14, and a past captured image in the same area as this display image is displayed on the reference image display device 20, and the region of interest is changed from this state. It shall be done.

(1) It is determined whether or not the X-ray aperture blade insertion position (X-ray aperture range) of the X-ray movable aperture device 4 has been changed (S41). Are displayed on the reference image display device 20.
(2) When the insertion position (X-ray diaphragm range) of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 is changed, the perspective image corresponding to the changed position is enlarged by the perspective image enlargement processing device 13. Display the current image display device 14 and transmit the changed X-ray aperture blade insertion position signal to the reference image memory 19 (S42), and reference image storage device for past captured images at the same position as the current fluoroscopic image 18 is selected (S43), and the selected past photographed image is stored in the reference image memory 19 (S44).
(3) The past captured image stored in the reference image memory 19 is displayed on the reference image display device 20 (S45).

In this way, the region of interest is changed in response to the operation signal of the X-ray aperture operation device 16, the perspective image of the changed region of interest is enlarged by the perspective image enlargement processing device 13, and this enlarged image is converted into the current image. Since the past photographed image at the same position as the currently displayed fluoroscopic image displayed on the display device 14 is selected from the reference image storage device 18 and displayed on the reference image display device 19, it changes in real time. The enlarged fluoroscopic image and the captured image at the same position (region of interest) as the fluoroscopic image can be comparatively interpreted.
Thus, for example, while confirming the position and structure of the blood vessel, while observing the images displayed on the current image display device 14 and the reference image display device 20, a guide wire or catheter is inserted to the target site for diagnosis and treatment. The operation to be performed can be made efficient.

FIG. 5 is a diagram showing a configuration of an X-ray fluoroscopic apparatus according to the second embodiment of the present invention.
In the second embodiment of FIG. 5, in the X-ray fluoroscopic imaging apparatus in the first embodiment of FIG. 1, a past captured image at the same position as the current fluoroscopic image stored in the reference image memory 19 is referred to. A reference image enlargement processing device 23 for adding an image suitable for the display area of the image display device 19 is added.

FIG. 6 is a flowchart in the second embodiment in which an image obtained by enlarging a current fluoroscopic image and an image obtained by enlarging a past captured image in the same area as the image are displayed on the respective display devices.
In the flowchart of FIG. 6, first, the region of interest is set by operating the X-ray diaphragm operator 16, and the X-ray fluoroscopic image data of the set region of interest is read into the image memory 12, and the fluoroscopic image magnification processing device 13 A perspective image with a predetermined magnification is enlarged and displayed on the current image display device 14, and a past captured image in the same area as the display image is magnified at the same magnification as the perspective image by the reference image magnification processing device 23. It is displayed on the reference image display device 20, and the region of interest is changed from this state.

(1) It is determined whether the insertion position (X-ray aperture range) of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 has been changed (S61). Are displayed on the reference image display device 19.
(2) When the insertion position (X-ray diaphragm range) of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 is changed, the perspective image corresponding to the changed position is enlarged by the perspective image enlargement processing device 13. Display the current image display device 14 and transmit the changed X-ray aperture blade insertion position signal to the reference image memory 19 (S62), and store the past captured image at the same position as the current fluoroscopic image as a reference image storage. The selection is made from the device 18 (S63), and the selected past photographed image is stored in the reference image memory 19 (S64).
(3) The past photographed image stored in the reference image memory 19 is enlarged by the reference image enlargement processing device 23 at substantially the same enlargement rate as that of the fluoroscopic image transmitted from the image processing device 11, and this enlarged past The captured image is displayed on the reference image display device 20 (S65).
As a result, the reference image display device 20 displays an enlarged reference image in the same region as the display region of the current fluoroscopic image displayed on the current image display device.

  FIG. 7 is an example of an image enlarged and displayed as described above. (A) is an enlarged image of the current fluoroscopic image displayed on the current image display device 14, and (b) is the current image displayed on the reference image display device 20. It is the image which expanded the past picked-up image of the same position as this fluoroscopic image.

When the insertion position or SID of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 is changed, the reading position from the X-ray flat panel detector 7 and the enlargement ratio are also changed to change the reference image display area. It is substantially the same as the display area of the current image.
If the SID at the time of reference image shooting and the height of the bed 1 are different from the current fluoroscopic position, the image sizes stored in the image memory 12 and the reference image memory 19 are different.
In this case, the enlargement ratio transmitted to the reference image enlargement processing device 23 is corrected by the image processing device 11 so that the reference image has the same image size as the current fluoroscopic image.
In addition, when the position of the bed 1 is changed, the reading position from the X-ray flat detector 7 is also changed.
The SID at the time of taking the reference image, the height of the bed 1 (distance from the X-ray tube 3 to the table 1), and the position information of the table are transmitted from the mechanism control device 9 to the system control device 22, and the reference image storage device 18 Therefore, the display area of the reference image and the display area of the current image can be made the same by processing using these pieces of information.

  In this way, the region of interest is changed in response to the operation signal of the X-ray aperture operation device 16, the perspective image of the changed region of interest is enlarged by the perspective image enlargement processing device 13, and this enlarged image is converted into the current image. The past captured image displayed at the same position as the current fluoroscopic image displayed on the display device 14 is enlarged by the reference image enlargement processing device 21 at the same magnification as the current fluoroscopic image, and is displayed on the current image display device 14. Since it is displayed on the reference image display device 19 so as to be the same as the display area of the displayed image, the image to be referenced is enlarged and displayed as compared with the first embodiment, and the display area is also the current fluoroscopic image. Therefore, it becomes easy to compare with a fluoroscopic image at a position that changes in real time.

Next, a third embodiment of the present invention will be described.
As in the second embodiment, the display area of the reference image that is the past captured image displayed on the reference image display device 20 is the display area of the perspective image of the region of interest displayed on the current image display device 14. If they are displayed exactly the same, there is a concern that the blood vessel structure other than the display area is connected to the blood vessel structure, and it is inconvenient when it is desired to know the position configuration of the blood vessel.

In view of this, it is possible to display a blood vessel structure over a wide range by reading out the reading area of the reference image memory 19 in the second embodiment above by several percent over the current image reading area and displaying it on the reference image display device. it can.
A flowchart according to the third embodiment of the present invention is shown in FIG.

(1) It is determined whether the insertion position (X-ray aperture range) of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 has changed (S81). The image is displayed on the reference image display device 19.
(2) When the X-ray aperture blade insertion position (X-ray aperture range) of the X-ray movable aperture device 4 is changed, position information obtained by expanding the read position of the image memory 12 by several percent is referred to the reference image memory 19. (S82).
(3) The enlargement ratio of the perspective image enlargement processing device 13 is transmitted to the reference image enlargement processing device 23 (S83).
(4) The past reference captured image in a wider area than the current fluoroscopic image is displayed on the reference image display device 20 (S84).
As a result, the reference image display device 20 displays a reference image in a larger area than the display region of the current fluoroscopic image displayed on the current image display device.

  FIG. 9 is an example of an image in which the reference image area is expanded from the current fluoroscopic image area as described above. (A) is an enlarged image of the current fluoroscopic image displayed on the current image display device 14, and (b) is a reference image. Although it is the same position as the current fluoroscopic image displayed on the display device 20, it is an image obtained by enlarging a past captured image in an area wider than the fluoroscopic image area.

  Thus, it is wider than the display area of the reference image of the second embodiment (broken line rectangular portion in FIG. 9), so that the blood vessel configuration outside the current fluoroscopic image display area can also be known, and the catheter And the guide wire can be easily inserted.

FIG. 10 is a diagram showing a configuration of an X-ray fluoroscopic apparatus according to the fourth embodiment of the present invention.
In the second embodiment of FIG. 5, the reference image is displayed on the reference image display device 20 different from the current image display device 14, but in the fourth embodiment shown in FIG. 10, the current image is displayed. 11 is characterized in that a reference image with an enlarged display area is superimposed on the current image and displayed on the current image display device 14, and image combining means 24 is provided for this purpose, and a flowchart is shown in FIG.

(1) It is determined whether the X-ray diaphragm blade insertion position (X-ray diaphragm range) of the X-ray movable diaphragm device 4 has been changed (S111). An image and a past reference captured image in a wider range than the fluoroscopic image are combined, and the combined image is displayed on the current image display device 14.
(2) When the X-ray diaphragm blade insertion position (X-ray diaphragm range) of the X-ray movable diaphragm device 4 is changed, the position information obtained by extending the read position of the image memory 12 by several percent is referred to the reference image memory 19. Transmit (S112).
(3) The enlargement ratio of the perspective image enlargement processing device 13 is transmitted to the reference image enlargement processing device 23 (S113).
(4) Using the position information obtained by extending the read position of the transmitted image memory 12 by several percent and the magnification rate of the perspective image enlargement processing device 13, past reference captured images in a wider area than the current perspective image The enlarged past reference photographed image and the current fluoroscopic image in which the X-ray diaphragm blade insertion position (X-ray diaphragm range) of the X-ray movable diaphragm device 4 is changed are synthesized by the image synthesis device 24. The composite image is displayed on the current image display device 14 (S114).

  FIG. 12 shows an example of an image synthesized as described above, where L is the current fluoroscopic image, and R is a past reference photographed image.

  According to the fourth embodiment, when it is desired to view the blood vessel configuration outside the current fluoroscopic image display area, the surrounding blood vessels are simultaneously with the current fluoroscopic image without moving the line of sight to the reference image display device 20. The configuration can be confirmed.

  The fourth embodiment is an example in which the synthesized image is displayed on the current image display device 14, but the synthesized image is displayed on the reference image display device 20 without being displayed on the current image display device 14. Alternatively, it may be displayed on both the current image display device 14 and the reference image display device 20, and the composite image display device is not limited.

FIG. 13 is a diagram showing a configuration of an X-ray fluoroscopic apparatus according to the fifth embodiment of the present invention.
In X-ray fluoroscopy, when the X-ray movable diaphragm 4 is inserted into the region of interest, the catheter may be inserted while viewing the normal fluoroscopic image (the image in FIG. 2) without cutting out or expanding the region of interest. .
In this case, the region of interest is narrow, and the fluoroscopic image may be displayed within 50% of the display region of the current image display device 14.
In the fifth embodiment shown in FIG. 13, in order to display a reference image taken in the past at the time of such fluoroscopy in the margin of the current image display device 14, the image processing device 11 of FIG. 10 is provided, and the other points are the same as in FIG.

FIG. 14 shows a flowchart of the fifth embodiment.
(1) It is determined whether the insertion position (X-ray diaphragm range) of the X-ray diaphragm blades of the X-ray movable diaphragm device 4 has been changed (S141) .If not, the current fluoroscopic image is the same as the fluoroscopic image. Both of the images are arranged side by side by a later-described image synthesizer 24 ′, and the images are displayed on the current image display device 14.
(2) When the X-ray aperture blade insertion position (X-ray aperture range) of the X-ray movable aperture device 4 is changed, the read position information of the image memory 12 is transmitted to the reference image memory 19 (S142).
(3) The enlargement ratio of the perspective image enlargement processing device 13 is transmitted to the reference image enlargement processing device 23 (S143).
(4) It is determined whether the image displayed on the current image display device 14 is within 50% of the display area of the current image display device 14 (S144).
(5) If the display area of the current image display device 14 is within 50%, the margin display area of the current image display device 14 is calculated (S145).
(6) A process of displaying a past reference photographed image having the same area and the same magnification as that of the current perspective image in the margin display area of the calculated current image display device 14 by the image composition device 24 ′. The current fluoroscopic image and the past reference captured image are displayed on the current image display device 14 (S146).

FIG. 15 is an example in which the current fluoroscopic image and the past reference photographed image are displayed side by side. However, even when the margin display area of the current image display device is 50% or more, there is more margin. Although a reference image reduction device for reducing the reference image is provided, the reference image is reduced and displayed in the margin area, and the current perspective image is enlarged and displayed, as shown in FIG. This is effective for making the current perspective image easier to see.
In this case, since the reference image is reduced, if it is desired to look at the reference image in detail, a perspective image reduction device that reduces the current perspective image is provided, although not shown, and the enlarged perspective image is reduced. By inputting a switching signal for switching to the fluoroscopic image from the operation device 21, the reduced reference image is displayed in the current image display area, and the enlarged reference photographed image is displayed in the blank area of the current image display device. May be.
In addition, the configuration example of displaying the enlarged or reduced current fluoroscopic image and the reduced or enlarged reference photographed image on the current image display device 14 has been described, but the present invention is not limited thereto, and is referred to. The image may be displayed on the image display device 20, or may be displayed on both the current image display device 14 and the reference image display device 20.

  Also in this embodiment, since the reference image can be displayed on the same display device as the current image, the surrounding blood vessel configuration is confirmed simultaneously with the current fluoroscopic image without moving the line of sight to the reference image display device 20. Furthermore, since the current fluoroscopic image and the reference image are separately displayed on the same display screen, the images can be easily distinguished from each other, and the blood vessel structure can be easily compared.

  In the above first to fifth embodiments, the description has been given using the past captured image as the reference image. However, if the X-ray irradiation area information is attached, the past fluoroscopic image is used. There is no problem.

1 is a diagram showing a configuration of an X-ray fluoroscopic apparatus according to a first embodiment of the present invention. An image example displaying a fluoroscopic image of the entire region of the X-ray flat panel detector. An example of an image obtained by enlarging a fluoroscopic image to fit in a display area of an image display device. 1 is a flowchart of a first embodiment according to the present invention. The figure which shows the structure of the X-ray fluoroscopy apparatus in 2nd Embodiment by this invention. 6 is a flowchart of a second embodiment according to the present invention. The example of an image enlarged and displayed by 2nd Embodiment. 10 is a flowchart of a third embodiment according to the present invention. An image example in which a reference image area is displayed wider than a perspective image area. The figure which shows the structure of the X-ray fluoroscope in 4th Embodiment by this invention. 10 is a flowchart of a fourth embodiment according to the present invention. An image example in which an enlarged perspective image and a reference image are superimposed. The figure which shows the structure of the X-ray fluoroscopy apparatus in 5th Embodiment by this invention. 10 is a flowchart of a fifth embodiment according to the present invention. An image example in which a current fluoroscopic image and a past reference captured image are displayed side by side on the same screen. An example of an image in which a reduced reference image is displayed side by side with a current perspective image in a margin display area of a current image display device.

Explanation of symbols

  1 subject bed, 2 subject, 3 X-ray tube, 4 X-ray movable diaphragm, 5 X-ray compensation filter, 6 X-ray generator, 7 X-ray flat panel detector, 8 fluoroscopic imaging mechanism, 9 mechanism controller , 10 X-ray flat panel detector control device, 11 image processing device, 12 image memory, 13 perspective image enlargement processing device, 14 current image display device, 15 X-ray high voltage device, 16 X-ray aperture operation device, 17 X-ray movable Aperture control device, 18 reference image storage device, 19 reference image memory, 20 reference image display device, 21 operation unit, 22 system control device, 23 reference image enlargement processing device, 24, 24 'image composition device

Claims (5)

X-ray generation means for emitting X-rays to the subject, an X-ray flat panel detector arranged to face the X-ray generation means for detecting transmitted X-rays of the subject, and an X-ray irradiation area to the subject X-ray irradiation area setting means for setting, X-ray diaphragm means for focusing X-rays on the X-ray irradiation area set by the X-ray irradiation area setting means, and image data output from the X-ray flat panel detector An X-ray fluoroscopic apparatus comprising: image processing means for performing image processing; and image display means for displaying a current X-ray image processed by the image processing means and a past reference image,
Reference image storage means for appending and storing X-ray irradiation area information at the time of acquiring the past reference image to the past reference image, and current display on the image display means based on the X-ray irradiation area information a reference image of the X-ray irradiation area spread a percentage with respect to X-ray images selected from the reference image storage unit, the reference image display control means for displaying a magnified reference image in the past and the selected on the image display unit And an X-ray fluoroscopic apparatus.   The X-ray fluoroscopic apparatus according to claim 1, further comprising: a unit that superimposes the current X-ray image on the past enlarged reference image and displays the image on the image display unit.   The image display means includes two display means: a current image display means for displaying the current X-ray image and a reference image display means for displaying the past enlarged reference image. The X-ray fluoroscopic apparatus according to claim 1.   4. The past enlarged reference image corresponding to the change is displayed on the image display means in accordance with the change of the X-ray irradiation area of the current X-ray image. X-ray fluoroscopic apparatus according to the item.   5. The X-ray irradiation area information is generated based on a positional relationship between the X-ray generation means and an X-ray flat panel detector, and an X-ray irradiation area by the X-ray diaphragm means. The X-ray fluoroscopic imaging apparatus according to any one of the above.

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