JP5016936B2 - Ultrasonic diagnostic equipment - Google Patents

Description

  The present invention relates to an ultrasonic diagnostic apparatus, and more particularly, to an ultrasonic diagnostic apparatus suitable for diagnosing benign or malignant biological tissue by observing an elastic image obtained by imaging elasticity information of the biological tissue.

  In order to diagnose the lesion site by the softness or hardness of the living tissue, the living tissue is compressed with an ultrasonic probe or the like, and based on the displacement of the living tissue caused by the compression, strain or elastic modulus An elasticity image is calculated to generate an elasticity image, and the displayed elasticity image is observed to diagnose benign or malignant tissue.

  By the way, it is accurate that the elastic information is based on a quantitative elastic modulus, but since the elastic modulus is a value obtained by dividing the stress applied to each part of the living tissue by strain, it is added to the contact surface with the subject. It is necessary to measure the pressure with a pressure sensor or the like and estimate the stress acting on the inside of the tissue by calculation. The calculation processing for accurately estimating the stress distribution is a huge amount of processing.

  Therefore, at present, diagnosis is based on a distortion image obtained by imaging the distortion obtained by differentiating the displacement. For example, in the diagnostic field such as prostate cancer, since prostate cancer is harder than normal tissue, the strain generated by compressing the tissue is calculated and a distortion image is displayed. Diagnosis is made by suspecting a hard region) as a malignant site.

  However, strain is not quantitative, but is qualitative elasticity information according to the amount of compression on which the tissue is applied, so it is affected by the difference in compression conditions, and the distortion is caused by inappropriate compression conditions. A small area may be required. In that case, since the area | region with small distortion will be misidentified as a hard area | region, it may lead to a misdiagnosis.

  Therefore, as described in Patent Document 1, an elastic reference body whose relation between the stress-strain characteristics is known is interposed between the probe and the subject, and the subject is compressed by the probe. It has been proposed to estimate the stress acting on the tissue of the subject by applying force. That is, the same compression force as that applied to the subject is applied to the elastic reference body, the displacement of the elastic reference body is measured based on a pair of RF signal frame data having different acquisition times, and the amount of strain is obtained. It has been proposed to calculate the elastic modulus on the assumption that the stress acting on the elastic reference body is obtained based on the stress-strain characteristics and that the stress is equivalent to the stress acting on the skin of the subject.

JP 2005-66041 A

  However, in Patent Document 1, no consideration is given to obtaining stress acting on the living tissue of the subject when the shape of the contact surface of the target tissue to be pressed and the surface of the probe do not match.

  The problem to be solved by the present invention is to realize an ultrasonic diagnostic apparatus that can easily acquire quantitative elasticity information of a living tissue of a subject when the target tissue cannot be uniformly compressed.

  In order to solve the above problems, the present invention provides a probe having a curved surface and a pair of different acquisition times of reflected echo signals measured by applying a compression force to the subject via the probe. Frame data selection means for selecting RF signal frame data, displacement measurement means for obtaining displacement of a living tissue at a plurality of measurement points based on the selected pair of RF signal frame data, and displacement obtained by the displacement measurement means Elasticity calculation means for calculating elasticity information of the living tissue at each measurement point based on the above, elasticity image generation means for generating an elasticity image based on elasticity information obtained by the elasticity calculation means, and elasticity image generation means And an elastic diagnostic apparatus comprising: a display unit configured to display an elastic image generated by the step of calculating a predetermined stress-strain in the field of view of the probe. It obtains the distortion of the reference area based on the displacement of the reference area with sex, and obtains elasticity information at each measurement point of the body tissue other than the reference region based on the strain of the reference region.

  That is, the present invention can determine the stress acting on the reference region based on the known stress-strain characteristics by measuring the strain of the reference region, and this stress is in the same direction as the compression force acting on the reference region. Based on the strain data of each measurement point of the living tissue other than the reference region located in the same compression direction, the elastic modulus that is quantitative elastic information of the measurement point Can be requested. Alternatively, by using the strain data of the reference region as a reference, the strain data of each measurement point of the living tissue other than the reference region is converted into an index value, whereby an elasticity index that is quantitative elasticity information of the measurement point can be obtained. .

  This eliminates the need for calculating the stress acting on the living body by measuring the pressure acting on the subject by the pressure sensor, so that quantitative elasticity information of the living tissue can be easily obtained, and thus the region of interest. It is possible to quantitatively evaluate the tissue hardness information. In other words, even in a region (direction) in which compression is relatively weak in the region of interest, it can be evaluated as an elastic modulus representing elasticity inherent in the region.

  In this case, the reference region can be a region set in one of the living tissues existing in the visual field of the probe. Alternatively, the reference region can be a region set in the elastic reference body provided on the ultrasonic wave transmitting / receiving surface of the probe. By using this elastic reference body, it is possible to use a stress-strain diagram with higher accuracy than when a reference region is set in a tissue such as fat. Therefore, the elastic modulus or elastic index Eindex of an arbitrary region of interest can be obtained. It can measure with high accuracy.

  Furthermore, the present invention can add the following configuration. That is, a balloon can be provided on the ultrasonic wave transmitting / receiving surface of the cylindrical probe, and a fluid can be put in and out of the balloon to be inflated and contracted to apply a compression force to the subject. Alternatively, the cylindrical probe can be configured to be inserted into a balloon, injecting fluid into and out of the balloon, and expanding and contracting to apply a compression force to the subject. In this way, if the balloon is inflated and deflated, and the compression operation is performed, even a cylindrical probe can apply a uniform compression force in all directions of the field of view. Information can be acquired.

  In this case, an elastic reference body constituting the reference region can be mounted on the body cavity wall side of the balloon. In addition, a balloon catheter can be inserted into a body cavity different from the body cavity into which the cylindrical probe is inserted, and fluid can be taken in and out of the balloon catheter to apply a compression force to the subject. In this case, the elastic reference body which comprises a reference | standard area | region can be mounted | worn with the outer surface of a balloon catheter.

  According to the present invention, it is possible to easily acquire quantitative elasticity information of a biological tissue of a subject using a probe having a curved surface.

  Hereinafter, embodiments of the ultrasonic diagnostic apparatus of the present invention will be described.

  FIG. 1 shows a block diagram of an embodiment of the ultrasonic diagnostic apparatus of the present invention. As shown in the figure, an ultrasonic probe 2 used in contact with a subject 1 is an ultrasonic transmission / reception surface in which a plurality of transducers for transmitting and receiving ultrasonic waves to and from the subject 1 are arranged. It is formed. The probe 2 is driven by ultrasonic pulses supplied from the transmission circuit 3. The transmission / reception control circuit 4 controls the transmission timing of ultrasonic pulses for driving the plurality of transducers of the probe 2 to form an ultrasonic transmission beam toward the focal point set in the subject 1. It is like that. The transmission / reception control circuit 4 is configured to electronically scan the transmission beam in the arrangement direction of the transducers of the probe 2.

  On the other hand, the probe 2 receives a reflected echo signal generated from the subject 1 and outputs it to the receiving circuit 5. In accordance with the timing signal input from the transmission / reception control circuit 4, the reception circuit 5 takes in the reflected echo signal and performs reception processing such as amplification. The reflected echo signal received by the receiving circuit 5 is amplified by adding the phases of the reflected echo signals received by a plurality of transducers in the phasing and adding circuit 6 to generate an ultrasonic reception beam. Is done. The RF signal of the received beam generated in the phasing and adding circuit 6 is input to the signal processing unit 7 and subjected to signal processing such as gain correction, log compression, detection, contour enhancement, and filter processing. The RF signal generated in the phasing addition circuit 6 may be complex demodulated I and Q signals.

  The RF signal processed by the signal processing unit 7 is guided to the black and white scan converter 8 where it is converted into a digital signal and also converted into two-dimensional tomographic image data corresponding to the scanning surface of the ultrasonic beam. These signal processing unit 7 and monochrome scan converter 8 constitute a tomographic image (B-mode image) image reconstruction means. The tomographic image data output from the black-and-white scan converter 8 is supplied to the image display 10 via the switching adder 9 so that a B-mode image is displayed.

  On the other hand, the RF signal output from the phasing addition circuit 6 is guided to the RF signal frame data selection unit 11. The RF signal frame data selection unit 11 acquires a plurality of frames of RF signal groups corresponding to the scanning plane (tomographic plane) of the ultrasonic beam as frame data and stores them in a memory or the like. The displacement measurement unit 12 sequentially takes in a plurality of pairs of frame data with different acquisition times stored in the RF signal frame data selection unit 11, and based on the fetched pairs of frame data, displacement vectors of a plurality of measurement points on the tomographic plane. And is output as displacement frame data to the elasticity calculation unit 13 which is a strain calculation means.

  The elasticity calculation unit 13 of the present embodiment is configured to obtain strain frame data or elastic modulus frame data by obtaining the strain of the biological tissue at each measurement point based on the displacement frame data. The strain frame data or elastic modulus frame data generated by the elasticity calculation unit 13 is output to the elasticity data processing unit 14.

  The elasticity data processing unit 14 performs smoothing processing in the coordinate plane, contrast optimization processing, smoothing processing in the time axis direction between frames, etc. on the strain frame data or the elasticity modulus frame data input from the elasticity calculation unit 13. Various image processings are performed and sent to the color scan converter 15.

  The color scan converter 15 takes in the distortion frame data or elastic modulus frame data processed by the elastic data processing unit 14, and assigns a tone code to each pixel of the frame data according to the set one-dimensional or two-dimensional color map. An elastic image of a color distortion image or an elastic modulus image is generated. These elastic data processing unit 14 and color scan converter 15 constitute elastic image generating means.

  The color distortion image or the color elastic modulus image generated by the color scan converter 15 is displayed on the image display 10 via the switching addition unit 9. Further, the switching addition unit 9 inputs the black and white tomographic image output from the black and white scan converter 8 and the color distortion image or the color elastic modulus image output from the color scan converter 15 and switches both images. It has a function of displaying one image, a function of adding and synthesizing one of the two images to be displayed on the image display 10 and a function of displaying both images side by side.

  Furthermore, the ultrasonic diagnostic apparatus of the present embodiment is provided with a reference area setting unit 17 and a device control interface unit 18. The reference region setting unit 17 suppresses the influence due to the difference in the compression condition and obtains the inherent hardness of the living tissue in the region of interest (ROI), so that the reference region 19 is set in the tissue region on the measurement surface of the subject 1. Is input from the device control interface unit 18. Here, as the reference region 19, a tissue region that exists in the visual field of the measurement site, in which stress-strain characteristics are obtained in advance by experimental measurement or the like, and the elastic modulus E 0 is known is set. Further, the reference area setting unit 17 can be configured to automatically detect the reference area 19 that satisfies the condition from the RF signal frame data based on a preset condition.

  The apparatus control interface unit 18 inputs various commands, setting data, and the like to the reference area setting unit 17 and the color scan converter 15. The reference region setting unit 17 sets a region used as a reference for strain calculation of the elastic calculation unit 13 according to the coordinate data of the reference region 19 input and set from the device control interface unit 18, and outputs it to the elastic calculation unit 13. It has become. Furthermore, in the present embodiment, the RF signal frame data selection unit 11 is configured to capture the RF signal frame data, detect the region corresponding to the condition input from the device control interface unit 18 and set the reference region 19. Yes. The reference area setting unit 17 outputs coordinate data of the set reference area to the elasticity calculation unit 13. The reference area setting unit 17 outputs the set coordinate data of the reference area 19 to the color scan converter 15 to display the reference area on the color distortion image or the color elastic modulus image.

  Although not shown, the elasticity calculation unit 13 performs distortion calculation only for the region of interest (ROI) input and set from the device control interface unit 18, and the elasticity data processing unit 14 and the color scan converter 15 Color distortion images or color elastic modulus images can be constructed only for.

  The basic operation of this embodiment configured as described above will be described. First, the probe 2 applies a compressive force to the subject 1 to scan the subject 1 with a transmitted beam and continuously receive reflected echo signals from the scanning surface. Based on the RF signal of the received beam output from the phasing addition circuit 6, a tomographic image is reconstructed by the signal processing unit 7 and the black and white scan converter 8 and is supplied to the image display 10 via the switching adder 9. Is displayed.

  On the other hand, the RF signal frame data selection unit 11 captures an RF signal and repeatedly acquires frame data in synchronization with the frame rate in the process of changing the compression force applied to the subject 1, and stores it in the built-in frame memory. Save in chronological order. Then, a plurality of pairs of frame data are successively selected and output to the displacement measuring unit 12 with a pair of frame data having different acquisition times as a unit. The displacement measuring unit 12 performs one-dimensional or two-dimensional correlation processing on the selected pair of frame data, and measures the displacement vector at each measurement point on the scanning plane to generate displacement frame data. As a method for detecting the displacement vector, for example, a block matching method or a gradient method described in JP-A-5-317313 is known. In the block matching method, an image is divided into blocks of N × N pixels, for example, a block closest to the target block in the current frame is searched from the previous frame, and based on this, the displacement vector of the measurement point is searched. Ask for. Further, the displacement can be calculated by calculating the autocorrelation in the same region of the pair of RF signal frame data.

  The displacement frame data obtained by the displacement measurement unit 12 is input to the elasticity calculation unit 13, calculates the strain at each measurement point, and outputs the strain frame data to the elasticity data processing unit 14. The distortion calculation is calculated by spatially differentiating the displacement as is well known.

  Here, a basic embodiment of the strain calculation in the elasticity calculation unit 13 which is a characteristic part of the present invention will be described. The elasticity calculation unit 13 calculates the distortion at each measurement point based on the displacement frame data input from the displacement measurement unit 12. At this time, the coordinate data of the reference area 19 set by the reference area setting unit 17 is taken in, and the distortion of one or a plurality of measurement points included in the reference area 19 is obtained. At this time, the distortion of one or a plurality of measurement points in the reference region 19 where the compression force acts is obtained in association with the direction of the compression force applied by the probe 2. Next, based on the stress-strain characteristics of the reference region 19 and the elastic modulus E0, the stress acting on the reference region 19 is calculated in association with the direction of the compression force. Then, assuming that the same stress is acting on other tissues existing in the same compression force direction, based on the strain and stress obtained for the measurement points of the other tissues, Calculate the elastic modulus at the measurement point. Thereby, the information on the hardness of the tissue of the region of interest can be quantitatively evaluated. In other words, even in a region (direction) in which compression is relatively weak in the region of interest, it can be evaluated as an elastic modulus representing elasticity inherent in the region.

  Here, for example, as the reference region 19, for example, when acquiring an elastic image around the prostate and diagnosing the presence or absence of a malignant lesion, the obtained elastic image includes a ureter, Tissue regions such as bladder, anterior fibromuscular stroma (AFS), fat, muscle, seminal vesicle tissue are drawn in the same field of view. Of these tissue regions, for example, the fat that is the tissue of the prostate membrane is set as the reference region 19, and if the strain value of other tissues is relatively determined with reference to the fat strain, The elastic modulus can be determined deterministically. In other words, the stress acting on the living tissue due to the compression can be accurately obtained by previously obtaining the stress-strain characteristic of fat by experimental measurement and measuring the fat strain in actual measurement.

  As a result, according to the present embodiment, it is necessary to detect the pressing force applied to the subject from the probe by a pressure sensor or the like and calculate the stress acting on each part of the living tissue based on the detected pressure. Therefore, no additional device such as a pressure sensor is required, and quantitative elasticity information specific to the tissue of the region of interest can be obtained deterministically.

  Hereinafter, based on a concrete Example, the detail of the measuring method of the elasticity information of the characteristic part of this invention is demonstrated.

  With reference to FIGS. 2-5, the example which performed the image diagnosis of the prostate using the ultrasonic diagnostic apparatus of embodiment of FIG. 1 is demonstrated. For the image diagnosis of the prostate, a transrectal probe 101 as shown in FIG. 2 is used, and the prostate is diagnosed by a transrectal approach as shown in FIG.

  As shown in FIG. 2 (A), the transrectal probe 101 is formed in a cylindrical shape and is provided with a convex probe 103 and a linear probe 104 at the distal end portion 102 inserted into the body. The rear end holding portion 105 is held by hand and is inserted. The convex probe 103 is arranged in the circumferential direction along the cylindrical surface as shown in FIG. 2B, and the linear probe 104 is arranged along the cylindrical surface as shown in FIG. It is arranged in the axial direction. The transrectal probe 101 formed in this way is used by being inserted into the rectum 110 as shown in FIG. 3, and the ultrasonic transmission / reception surfaces of the convex probe 103 and the linear probe 104 are used. Is imaged toward the prostate 111. Within the imaging field of view of the transrectal probe 101, there are a bladder 112 and a ureter 113 around the prostate 111, and the like.

  FIG. 4 shows a representative image of the transverse section of the prostate imaged by the transrectal probe 101. FIG. 4A is a B-mode image, and FIG. 4B is an elastic image typified by a strain image. As shown in the figure, the elastic image is displayed as a color image in which a hard region, a soft region, and a noise region can be identified. As shown in the figure, in the cross section of the prostate, in addition to the glandular tissue of the prostate 111, tissues of the ureter 113, bladder 112, anterior fibromuscular stroma (AFS) 114, and skin 115 such as fat and muscle Are simultaneously displayed in the field of view.

  In this embodiment, a method for measuring the elasticity information specific to the tissue of the region of interest by setting fat, which is the tissue of the prostate capsule, as the reference region 19 will be described with reference to the flowchart of FIG.

  First, the reference area 19 is set by inputting a freeze command from the device control interface unit 18 and displaying a still image of a B-mode image and a distorted image currently being captured (S1). Next, the apparatus control interface unit 18 switches to the reference area designation mode (S2). Then, the cursor is moved using an input device such as a mouse or a trackball, and the region of the prostate capsule tissue is designated as the reference region on the B-mode image or the distorted image (S3). As a result, the reference area setting unit 17 outputs the coordinate data of the reference area to the elasticity calculator 13. The elasticity calculation unit 13 calculates strain for the designated reference region, and calculates a stress distribution based on the calculated strain value and the elastic modulus set for the reference region (S4). Next, the elastic modulus of the tissue of interest is calculated according to the obtained stress value (S5). Next, an elastic image is constructed by the elastic data processing unit 14 and the color scan converter 15 according to the calculated elastic modulus value and displayed on the image display 10 (S6).

  Details of the procedure in steps S4 to S6 in FIG. 5 will be described with reference to FIG. The elastic modulus E0 of the film portion set as the reference region is known by experimental measurement or the like (for example, E0 = 10 kPa). In addition, the fan-shaped field of view imaged by the convex probe 103 is represented by a distance r from the fan-shaped center and an angle θ from the radial line at one end of the fan-shaped field.

  Now, as shown in FIGS. 7A to 7C, the stress change Δσ0 in the θ direction is calculated from the elastic modulus E0 of the fat tissue of the skin part and the strain change Δε0 (θ) measured in the fat in the θ direction. (Θ) is obtained by the following equation (1).

Δσ (θ) = E0 × Δε0 (θ) (1)
Then, the frame data of the elastic modulus E is constructed by using the strain distribution Δε (r, θ) and the stress change Δσ0 (θ) as the boundary condition. For example, assuming that the stress change in the θ direction is constant regardless of the depth r, the frame data E (r, θ) of the elastic modulus is constructed based on the following equation (2).

E (r, θ) = Δσ0 (θ) / Δε (r, θ) (2)
In general, when the subject 1 is pressed with the transrectal probe 101 by a technique using an intracorporeal probe such as the transrectal probe 101, all directions (θ) of the fan-shaped region are used. It is often not possible to apply pressure evenly. For this reason, the region (direction) where sufficient compression is not applied has a small distortion, and for example, in a strain image that does not consider the stress distribution, it is mistaken as a relatively hard region.

  In this regard, according to the first embodiment, the stress change Δσ 0 (θ) in the θ direction is calculated from the known elastic modulus E 0 of the fat tissue of the film portion and the strain change Δε 0 (θ) measured by the elasticity calculation unit 13. Is obtained by equation (1). Then, using the obtained stress change Δσ 0 (θ) and the measured strain change Δε 0 (θ), the elastic modulus E (r, θ) of each measurement point (r, θ) is obtained by Equation (2). That is, the stress acting on other unknown tissue is estimated based on the known elastic modulus E0 of the fat tissue, and the elastic modulus E (r, θ) is obtained based on the estimated stress and the actually measured strain. Information on the hardness of the tissue of the region of interest can be quantitatively evaluated. In other words, even in a region (direction) in which compression is relatively weak in the region of interest, it can be evaluated as an elastic modulus representing elasticity inherent in the region.

  In the above description, an example has been described in which the hardness of an unknown tissue is determined by a quantitative elastic modulus dimension (kPa) based on a known elastic modulus E0 of a fat tissue. However, the present invention is not limited to this, and instead of the elastic modulus image, for example, the strain change Δε0 (θ) of a reference region such as adipose tissue and the strain change Δε (r, θ measured for other unknown tissues). ) As an index value, the elastic index Eindex can be obtained by the following equation (3). This elastic index Eindex is an index value of the tissue strain change in the same compression direction (θ) with reference to the strain change Δε0 (θ) of the reference region in the same compression direction (θ).

Eindex (r, θ) = Δε0 (θ) / Δε (r, θ) (3)
By using the elastic index Eindex thus obtained as frame data, a quantitative elastic image can be drawn based on the strain information.

  Furthermore, although the first embodiment has been described based on an example in which the reference region is set to the fatty tissue of the prostate skin part, muscle tissue further outside the fat of the skin part may be used. It is also possible to apply the ureter wall, anterior fibromuscular stroma (AFS), seminal vesicles, etc. as the reference region.

  In the first embodiment, an example has been described in which the reference region is manually set on the still image. However, the present invention automatically detects a characteristic region appearing in the still image and automatically sets the reference region. be able to. There are several methods for automatic setting as follows.

  (1) For example, if a diagnostic site such as the prostate is determined, the adipose tissue of the skin part, the muscle tissue further outside the adipose tissue, the ureter wall, the anterior fibromuscular stroma (AFS), the seminal vesicle, etc. Since it has a characteristic arrangement and shape, it can be identified on the image. Therefore, it is possible to prepare a template having a characteristic arrangement and shape and automatically detect a reference region by applying a known image matching method.

  (2) Even without using a template, for example, the ureter contains fluid inside, and the behavior for compression automatically sets the reference region by utilizing the behavior specific to the fluid. be able to. That is, since the inside of the ureter is not a living tissue, it tends to have displacement vectors having completely different sizes and directions between adjacent measurement points. The inside of the ureter can be identified using the variation in the direction of the displacement vector.

  (3) The anterior fibromuscular stroma (AFS) is a tissue region that is localized from the base portion of the prostate to the middle portion. When this is observed on the prostate cross section imaged by the transrectal probe 101, the prostate It can be recognized as a low-echo area of an inverted triangle that spreads from the center toward the ventral membrane of the prostate in front of the bladder.

  Therefore, for example, if threshold processing corresponding to the luminance in the low echo area is performed using a B-mode image, shape information and position information of AFS can be obtained. Specifically, a low echo area is detected, and, for example, Th (AFS) of “1” or less is set as a value indicating a multiple of the brightness average value Pmean of the B-mode image including the entire prostate gland. Then, the AFS luminance threshold is set by the following equation (4).

(AFS brightness threshold) = Th (AFS) × Pmean (4)
The AFS region is determined by recognizing the shape of the region obtained by the AFS luminance threshold processing. That is, the AFS region can be confirmed by determining whether or not the lateral width tends to increase from the back side (near in the image) to the ventral side (the deep portion in the image).

  Also, it is determined whether or not it is an AFS region based on the extracted position information of the AFS region. That is, the AFS region can be confirmed by determining whether the prostate is located in the center without being biased to the right or left. Furthermore, the AFS region can be confirmed by determining whether or not the bladder exists in the ventral region of the low echo region.

  (4) A prostate region can be extracted on a B-mode image and a reference region can be automatically set. In other words, the prostate capsule part (contour part) is utilized by utilizing the fact that the prostate coat part has higher brightness than the glandular tissue region of the prostate, and that the prostate coat part is continuously connected as an arc-shaped band. ) Area can be detected.

  In the first and second embodiments, the example in which the reference region is automatically detected and set using the ultrasonic B-mode image has been described. Instead, for example, by combining with real-time virtual sonography (RVS) technology, it becomes possible to use 3D images such as CT and MRI, and for example, tissue identification such as AFS and skin fat can be easily performed. It can be carried out.

  In the first and second embodiments, the method has been described in which the reference region is set and the influence of the difference in the compression condition applied to the region of interest is suppressed and the diagnosis of the presence or absence of the malignant region is performed deterministically. In the third embodiment, a technique for measuring the elasticity inherent in tissue by further improving the uniformity of compression will be described.

  As shown in FIGS. 8A and 8B, the ultrasound transmitting / receiving surface of the convex probe 103 of the transrectal probe 101 is covered with a balloon 120 formed of a flexible material such as rubber, The balloon 120 is configured so that liquid can be taken in and out. Then, the balloon 120 is applied to the tissue of the prostate 111, and a liquid is injected into the balloon 120 to inflate it, thereby applying an even pressure to the tissue of the prostate 111 in the forward direction of the fan-shaped field of the convex probe 103. Can be added.

  By combining the present embodiment with the first and second embodiments, even when there is no reference area across all directions of the fan-shaped field of view, the stress obtained based on the reference area is applied to all directions, and quantitative Elastic modulus and elastic index can be determined.

  This embodiment is a modification of the third embodiment. As shown in FIGS. 9A and 9B, the balloon catheter 121 is inserted into the ureter 113, and liquid is taken in and out of the balloon catheter 121 from the syringe 103. Thus, the tissue is inflated and contracted, thereby applying pressure from the ureter 113 to the surrounding prostate 111 tissue.

  According to the fourth embodiment, uniform compression can be performed on the omnidirectional region inside the prostate 111. Therefore, it is possible to measure the elasticity information of the region of interest while suppressing the influence due to the difference in the compression conditions applied to the region of interest, and construct an elastic image with less noise. It can be carried out.

  That is, conventionally, when the probe such as the transrectal probe 101 is moved while being held by hand to compress the prostate, the deep region (ventral side) region or the peripheral portion (PZ) However, according to the present embodiment, it is possible to perform uniform compression on the region of interest.

  Therefore, according to the present embodiment, it is possible to avoid erroneous diagnosis of a region of interest due to improper pressure operation by the probe, and to perform objective diagnosis with high reproducibility. Further, by automating the liquid in and out of the balloon catheter 121, the burden on the examiner is reduced.

  Further, by combining the first and second embodiments with the first embodiment and setting the ureter wall 113a as the reference region, the qualitative strain information to be measured and the known elastic modulus of the ureter wall 113a are obtained. If the stress acting on the ureter wall 113a is obtained based on this, the elastic modulus or the elastic index Eindex of an arbitrary region of interest can be obtained in the same manner as in the equations (2) and (3) described above.

  With reference to FIGS. 10A and 10B, a method of measuring elasticity information according to the fifth embodiment will be described. This embodiment is an example of measuring elasticity information regarding the prostate using the transrectal probe 101, as in the other embodiments. Similar to FIG. 8, the transrectal probe 101 is provided with a balloon 120 that surrounds the ultrasonic transmission / reception surface 103 and applies a compression force. Further, an elastic reference is made to the opposite surface of the balloon 120 to the ultrasonic transmission / reception surface 103. A body 122 is attached. The elastic reference body 122 is an object having a certain elasticity and having previously measured the relationship between strain, stress, and elastic modulus in the same manner as the tissue of the reference region described above. For example, an acoustic coupler commercially available as Sonar Aid (SONAR-AID: manufactured by Geistlich) can be used.

  The balloon 120 is inflated and deflated with such an elastic reference body 122 interposed therebetween, and a compression force is applied to the prostate 111 to continuously acquire RF signal frame data. Based on a pair of RF signal frame data having different acquisition times, displacement frame data of each measurement point including the elastic reference body 122 is obtained, and further, distortion frame data is obtained based on the displacement frame data. Since the elastic reference body 122 has a known elastic modulus, the stress can be obtained based on the relationship between the elastic modulus and the measured strain. Assuming that the same stress as that acting on the elastic reference body 122 (reference stress) is acting on the tissue of the prostate 111, using the measured strain frame data and the reference stress, the elastic modulus at each measurement point Ask for.

  Since the elastic reference body 122 of the present embodiment can use a stress-strain diagram with higher accuracy than the reference region of tissue such as fat set in the first and second embodiments, the elasticity of an arbitrary region of interest can be used. The rate or elasticity index Eindex can be accurately measured.

  In addition, according to the present embodiment, an even compression force can be applied in all directions by inflating and deflating the balloon 120. Therefore, coupled with the use of the elastic reference body 122, the elastic information of the portion of interest can be quantitatively determined. Can be obtained.

  With reference to FIGS. 11A and 11B, a method of measuring elasticity information in Example 6 will be described. This embodiment is an example of measuring elasticity information regarding the prostate, as in the other embodiments. However, the intravascular ultrasound probe 124 is attached to the balloon catheter 121 and used as the ultrasound probe. Is different.

  That is, at the same time as pressing in all directions from the inside of the ureter 113 with the balloon catheter 121, as in the first embodiment, any tissue (for example, the ureter wall) is set as the reference region and the elastic modulus of the region of interest is set. Measure. According to the present embodiment, since the ureter wall is located at a position in contact with the ultrasound transmission / reception surface of the intravascular ultrasound probe 124, the elastic modulus can be measured by setting the ureter wall as the reference region. Can be done with precision.

  Similarly to the fifth embodiment, if an elastic reference body is attached to the outer surface of the balloon catheter 121, the elastic modulus can be measured with higher accuracy.

  When generating an elasticity image based on the elasticity information measured in the first and second embodiments and displaying it on the image display 10, the elasticity image in an inappropriate compression direction is deleted with a mask or the like so as not to be displayed. Therefore, it is preferable to remove unnecessary information.

  That is, according to the first and second embodiments, as shown in FIG. 3, the transrectal probe 101 is pressed against the prostate 111 to apply a compression force. According to this, since the pressing force cannot be applied uniformly to all the vertical directions of the circular arc surface of the convex probe 103, the entire visual field range can be uniformly pressed by a single pressing operation. Therefore, a direction that cannot be fully squeezed occurs.

  Therefore, in this embodiment, by determining whether or not the distortion generated in the prostate skin part (fat, muscle) arranged on the ventral part of the region of interest exceeds a predetermined threshold, it is appropriately compressed in that direction. Determine whether or not.

  That is, the distortion threshold value εthrs for determining the degree of compression is set as the distortion value. The distortion threshold value εthrs is a threshold value for a value obtained by normalizing the distortion at each measurement point by the distortion average value εmean measured at all measurement points in the prostate image.

  (1) Normalize the strain distribution of the prostate. In other words, the strain value εmeas (i, j) measured at each measurement point is divided by the strain average value εmean measured at all measurement points (N) as shown in the following equation (4). Then, normalization distortion εnorm (i, j) is obtained.

εmean = Σεmeas (i, j) / N
εnorm (i, j) = εmeas (i, j) / εmean (4)
Thereby, the distortion threshold value independent of the compression amount before and after the compression can be set.

  (2) For the normalized strain εnorm (i, j) measured in the prostate capsule, it is determined whether the strain threshold εthrs has been exceeded. If so, it is determined that compression in the direction of the measurement point (i, j) was appropriate.

  Here, the description has been made using the distortion distribution. However, if a distortion image is constructed, a threshold value corresponding to the distortion threshold value is set in the luminance information and hue information of the distortion image to determine whether compression is appropriate. be able to.

  As shown in FIG. 12B, the elastic image in the direction of the film portion 126 is covered with the mask 129 and is not displayed on the film portion 126 that does not exceed the strain threshold εthrs in FIG. It has become. This eliminates unnecessary image information and avoids misdiagnosis.

  Even if the elasticity image in the direction of the skin part 128 exceeds the strain threshold εthrs, the elasticity image behind the skin part is masked, and only the elasticity image of the prostate gland tissue part inside the skin is extracted and displayed. It can also be done.

  Here, although not shown, an eighth embodiment of the present invention will be described. This embodiment is different from the other embodiments in that a convex ultrasonic probe that presses from the body surface of the subject is used.

  Specifically, as in FIGS. 7A to 7C, the stress in the θ direction is calculated from the elastic modulus E0 of the fat tissue of the skin part and the strain change Δε0 (θ) measured in the fat in the θ direction. The change Δσ0 (θ) is obtained by the following equation (5).

Δσ (θ) = E0 × Δε0 (θ) (5)
Then, the elastic modulus frame data is constructed using the strain distribution Δε (r, θ) and the stress change Δσ0 (θ) as a boundary condition. For example, assuming that the stress change in the θ direction is constant regardless of the depth r, the frame data E (r, θ) of the elastic modulus is constructed based on the following equation (6).

E (r, θ) = Δσ0 (θ) / Δε (r, θ) (6)
Usually, when the subject 1 is compressed with a convex probe, it is often impossible to apply pressure evenly in all directions (θ) of the fan-shaped region. For this reason, the region (direction) where sufficient compression is not applied has a small distortion, and for example, in a strain image that does not consider the stress distribution, it is mistaken as a relatively hard region.

  In this regard, according to the eighth embodiment, the stress change Δσ0 (θ) in the θ direction is calculated from the known elastic modulus E0 of the fat tissue of the film portion and the strain change Δε0 (θ) measured in the elasticity calculation unit 13. It calculates | requires by Formula (5). Then, using the obtained stress change Δσ0 (θ) and the measured strain change Δε0 (θ), the elastic modulus E (r, θ) of each measurement point (r, θ) is obtained by Equation (6). That is, since the stress acting on another unknown tissue is obtained with reference to the known elastic modulus E0 of the fat tissue, the information on the hardness of the tissue of the region of interest can be quantitatively evaluated. In other words, even in a region (direction) in which the compression force is relatively weak in the region of interest, it can be evaluated as an elastic modulus representing elasticity inherent in the region.

  As described above, the elastic information measuring method of the present invention has been described based on the example of measuring the elastic information related to the prostate. However, the present invention is not limited to the prostate, and the elastic information of other tissues is measured to determine the good region of interest. Needless to say, it can also be applied to the diagnosis of malignancy.

  Needless to say, determining whether the compression operation is inappropriate and not displaying an elastic image of an inappropriate area is the same even if the target tissue changes.

It is a block block diagram of one Embodiment of the ultrasonic diagnosing device of this invention. It is a figure which shows the structure of the transrectal probe of one Embodiment. It is a figure explaining operation which inserts a transrectal probe in a rectum and images a prostate. It is a figure which shows a typical image about the cross section of the prostate imaged with a transrectal probe. It is a flowchart explaining Example 1 which measures the elasticity information intrinsic | native to the structure | tissue of an interested part by using the fat which is the structure | tissue of a prostate membrane part as a reference area. It is a flowchart explaining the detail of the procedure in step S4-S6 of FIG. FIG. 7 is an image example used for explaining the flowchart of FIG. 6. FIG. It is a figure explaining Example 3 which covers the ultrasonic wave transmission / reception surface of a convex probe with a balloon, puts liquid in and out of the balloon, and compresses and measures elasticity information. It is a figure explaining Example 4 which inserts a balloon catheter in a ureter, puts liquid in and out of a balloon catheter, and compresses and measures the elasticity information of the tissue of a prostate. It is a figure explaining Example 5 which attaches an elastic reference body to the opposite surface to the ultrasonic wave transmission / reception surface of a balloon, and measures the elasticity information of the tissue of a prostate. It is a figure explaining Example 6 which mounts the intravascular ultrasonic probe of Example 6 in a balloon catheter, and measures elasticity information. It is a figure explaining the example which masks and does not display the elastic image of the direction corresponding to the membrane | film | coat part which did not exceed the distortion threshold value of Example 7. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Subject 2 Probe 9 Switching addition part 10 Image display 11 RF signal frame data selection part 12 Displacement measurement part 13 Elasticity calculation part 14 Elasticity data processing part 15 Color scan converter 17 Reference area setting part 19 Reference area

Claims (11)

A probe having a curved surface, and frame data selection means for selecting a pair of frame data having different acquisition times of reflected echo signals measured by applying a compression force to the subject via the probe; Based on the selected pair of frame data, displacement measurement means for obtaining displacement of the biological tissue at a plurality of measurement points, and calculating elasticity information of the biological tissue at each measurement point based on the displacement obtained by the displacement measurement means An elasticity calculation means, an elasticity image generation means for generating an elasticity image based on the elasticity information obtained by the elasticity calculation means, and a display means for displaying the elasticity image generated by the elasticity image generation means In ultrasonic diagnostic equipment,
The elasticity calculation means obtains strain at a measurement point in a reference region having a known stress-strain characteristic set in the field of view of the probe, and calculates the strain at the measurement point in the reference region and the stress-strain. The stress acting on the measurement point of the reference region is calculated based on the characteristics, and it is assumed that the same stress is acting on the tissue in another region existing in the same compression force direction as the reference region. and, based on the distortion obtained for the measurement point of the other tissues it is intended to obtain the elasticity information in the measurement point of the other tissues,
The ultrasonic diagnostic apparatus , wherein the reference region is automatically detected and set by an image matching method using a template having a characteristic biological tissue arrangement and shape . A probe having a curved surface, and frame data selection means for selecting a pair of frame data having different acquisition times of reflected echo signals measured by applying a compression force to the subject via the probe; Based on the selected pair of frame data, displacement measurement means for obtaining displacement of the biological tissue at a plurality of measurement points, and calculating elasticity information of the biological tissue at each measurement point based on the displacement obtained by the displacement measurement means An elasticity calculation means, an elasticity image generation means for generating an elasticity image based on the elasticity information obtained by the elasticity calculation means, and a display means for displaying the elasticity image generated by the elasticity image generation means In ultrasonic diagnostic equipment,
The elasticity calculation means obtains strain at a measurement point in a reference region having a known stress-strain characteristic set in the field of view of the probe, and calculates the strain at the measurement point in the reference region and the stress-strain. The stress acting on the measurement point of the reference region is calculated based on the characteristics, and it is assumed that the same stress is acting on the tissue in another region existing in the same compression force direction as the reference region. The elasticity information at the measurement point of the other tissue is obtained based on the strain obtained for the measurement point of the other tissue,
The reference region is set by automatically detecting and obtaining characteristic shape information and position information of a biological tissue by performing threshold processing corresponding to the luminance of a low echo region using a B-mode image. Ultrasonic diagnostic equipment . In claim 1 or 2 ,
The elasticity calculation means obtains, as the elasticity information, stress acting on the reference region based on the strain of the reference region and the stress-strain characteristic of the reference region, and the stress acting on the reference region and the other living body based on the distortion determined for tissue measurement point, an ultrasonic diagnostic apparatus characterized by determining the modulus of the measuring point. In claim 1 or 2 ,
Said elastic computing means, the distortions index valued distortion in measurement point of said other body tissue strain as an index value of the reference area and the elasticity information,
The ultrasound diagnostic apparatus, wherein the elasticity image generation means generates the elasticity image based on the elasticity information . In claim 1 or 2 ,
The probe is inserted into a body cavity of a subject, and a balloon is provided on an ultrasonic wave transmission / reception surface. A fluid is taken in and out of the balloon to expand and contract, thereby applying a compression force to the subject. An ultrasonic diagnostic apparatus configured as described above. In claim 1 or 2 ,
The probe is attached to a balloon and inserted into the body cavity of the subject, and is configured to apply a compressive force to the subject by inflating and deflating a fluid in and out of the balloon. An ultrasonic diagnostic apparatus characterized by comprising: In claim 5 or 6 ,
An ultrasonic diagnostic apparatus, wherein an elastic reference body constituting the reference region is mounted on a body cavity wall side of the balloon. In claim 1 or 2 ,
The ultrasonic diagnostic apparatus, wherein the probe is pressed from the body surface of a subject. A columnar probe that is inserted into the body cavity of the subject, and a frame data selection unit that selects a pair of frame data having different acquisition times of reflected echo signals measured by the columnar probe; Displacement measuring means for obtaining a displacement of a living tissue at a plurality of measurement points based on a pair of frame data, and an elastic calculation for calculating elasticity information of the living tissue at each measurement point based on the displacement obtained by the displacement measuring means Diagnostic means comprising: means; an elasticity image generating means for generating an elasticity image based on the elasticity information obtained by the elasticity calculating means; and a display means for displaying the elasticity image generated by the elasticity image generating means In the device
A balloon catheter is inserted into a body cavity different from the body cavity present in the field of view of the cylindrical probe, fluid is taken in and out of the balloon catheter, and a compression force is applied to the subject;
The elasticity calculation means obtains the distortion of the measurement point in the reference region having a known stress-strain characteristic set in the field of view of the cylindrical probe, and obtains the distortion of the measurement point and the stress in the obtained reference region. -When the stress acting on the measurement point of the reference region is calculated based on the strain characteristics, and the same stress is acting on the tissue in another region existing in the same compression force direction as the reference region regarded, it is intended to obtain the elasticity information in the measurement point of the other tissues on the basis of the distortion obtained for the measurement point of the other tissues,
The ultrasonic diagnostic apparatus , wherein the reference region is automatically detected and set by an image matching method using a template having a characteristic biological tissue arrangement and shape . A columnar probe that is inserted into the body cavity of the subject, and a frame data selection unit that selects a pair of frame data having different acquisition times of reflected echo signals measured by the columnar probe; Displacement measuring means for obtaining a displacement of a living tissue at a plurality of measurement points based on a pair of frame data, and an elastic calculation for calculating elasticity information of the living tissue at each measurement point based on the displacement obtained by the displacement measuring means Diagnostic means comprising: means; an elasticity image generating means for generating an elasticity image based on the elasticity information obtained by the elasticity calculating means; and a display means for displaying the elasticity image generated by the elasticity image generating means In the device
  A balloon catheter is inserted into a body cavity different from the body cavity present in the field of view of the cylindrical probe, fluid is taken in and out of the balloon catheter, and a compression force is applied to the subject;
The elasticity calculation means obtains strain at a measurement point in a reference region having a known stress-strain characteristic set in the field of view of the probe, and calculates the strain at the measurement point in the reference region and the stress-strain. The stress acting on the measurement point of the reference region is calculated based on the characteristics, and it is assumed that the same stress is acting on the tissue in another region existing in the same compression force direction as the reference region. The elasticity information at the measurement point of the other tissue is obtained based on the strain obtained for the measurement point of the other tissue,
The reference region is set by automatically detecting and obtaining characteristic shape information and position information of a biological tissue by performing threshold processing corresponding to the luminance of a low echo region using a B-mode image. Ultrasound diagnostic device. In claim 9 or 10 ,
An ultrasonic diagnostic apparatus, wherein an elastic reference body constituting the reference region is attached to an outer surface of the balloon catheter.

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