JP5308862B2 - Medical bed apparatus and medical image photographing apparatus - Google Patents

Description

  The present invention relates to alignment control of a medical couch device.

In recent years, various medical imaging apparatuses such as an X-ray CT apparatus, an MRI apparatus, an X-ray diagnostic apparatus, a fluoroscopic imaging apparatus, a SPECT apparatus, and a PET apparatus have been developed as apparatuses for imaging medical images.
For example, in an X-ray CT apparatus that captures a tomographic image of a subject using X-rays, the bed is moved up and down in the height direction while the subject is placed on a medical bed apparatus (hereinafter referred to as a bed). It is moved back and forth in the direction and moved left and right in the direction perpendicular to the body axis to carry it in and out of the X-ray irradiation space in the scanner.

  In such an X-ray CT apparatus, when setting the imaging position, the operator first places the subject on the bed and aligns the bed using a laser pointer or the like indicating the imaging center position. In this state, fluoroscopic imaging for fluoroscopically viewing the subject from one direction is performed, and the captured fluoroscopic image is displayed on the display screen. Then, referring to the displayed fluoroscopic image, the start position and end position of the main imaging for obtaining a tomographic image are set as the imaging range.

In particular, when the position of the bed is adjusted to the imaging center position, for example, in Patent Document 1, the position coordinates of the imaging center of the subject placed on the bed are obtained from a fluoroscopic image, and the bed is aligned based on this. A medical couch device is disclosed.
Patent Document 2 discloses a medical bed apparatus that displays an image of a subject and moves the bed position so that the specified position becomes the diagnostic center when the position is specified on the displayed image. Has been.

JP-A-7-171148 JP-A-8-308821

  However, the range in which the bed can be safely moved varies depending on the physique of the subject. For this reason, when the destination position is designated by an operation on the display screen, the actual subject (bed) position in the scanner is difficult to understand, and the subject may come into contact with the scanner. Also, if the affected area is located away from the body axis, such as the heart, it was necessary to increase the X-ray irradiation range, but in order to avoid unnecessary exposure to surrounding organs, It is desired to adjust the affected part (heart) to the imaging center position and adjust the X-ray irradiation width.

The present invention has been made in view of the above problems, and an object of the present invention is to provide a medical bed apparatus and a medical image photographing apparatus capable of safely adjusting the photographing apparatus with a simple operation.

In order to achieve the above-described object, a first invention is provided in a medical image photographing apparatus, and a bed top plate on which a subject is placed is placed on a body axis direction of the subject, a left-right direction perpendicular to the body axis, and a vertical direction. A medical couch device movable in a direction, which is a region where the couchtop can be safely moved based on display means for displaying a fluoroscopic image or cross-sectional image of a subject and the fluoroscopic image or cross-sectional image A safety region display unit that calculates a safety region and displays a guide on a fluoroscopic image or a cross-sectional image displayed on the display unit, and an arbitrary position of the fluoroscopic image or the cross-sectional image displayed on the display unit is a diagnostic center position. Designating means for designating, determining means for determining whether or not the diagnostic center position designated by the designating means is within the safety area, and the diagnostic center position is within the safety area by the judging means When judged , A diagnostic center position designated by said designation means is a medical bed apparatus characterized in that it comprises, said moving means for moving the bed top plate so as to reach the imaging center position.
According to a second aspect of the present invention, there is provided a medical device capable of moving a scanner for imaging a subject and a couch top on which the subject is placed in a body axis direction of the subject, a horizontal direction perpendicular to the body axis, and a vertical direction. Based on the bed apparatus, a display means for displaying a fluoroscopic image or a cross-sectional image of the subject, and a safety area that is an area in which the bed top plate can be moved safely based on the fluoroscopic image or the cross-sectional image, the display A safety region display means for guiding and displaying a fluoroscopic image or a cross-sectional image displayed on the means; a designation means for designating an arbitrary position of the fluoroscopic image or the cross-sectional image displayed on the display means as a diagnostic center position; and the designation Determining means for determining whether or not the diagnostic center position designated by the means is within the safety area; and when the determination means determines that the diagnostic center position is within the safety area, Specified by specifying means Said moving means diagnostic center position moves the bed top plate so as to reach the imaging center position, a medical imaging apparatus, characterized in that it comprises a.

ADVANTAGE OF THE INVENTION According to this invention, the medical bed apparatus and medical image imaging device which can adjust an imaging device safely by simple operation can be provided.

External view showing the entire configuration of the X-ray CT apparatus 1 Hardware block diagram of X-ray CT apparatus 1 A flowchart showing a flow of imaging processing executed by the system control apparatus 401 The figure which shows the safe area | region in the scanner 2 A diagram for explaining a diagnosis origin position ((a) is a coronal image, (b) is an axial image) Display example of safety area guide ((a) is coronal image, (b) is axial image) Display example of moving guide line and diagnostic center position ((a) is coronal image, (b) is axial image) Example screen for specifying the diagnostic center position and imaging range 2A and 2B are schematic diagrams of the X-ray CT apparatus 1 as viewed from the body axis direction, where FIG. 1A is a case where the body axis is taken as an imaging center, and FIG. 2B is a case where the designated diagnostic center position is taken as an imaging center.

Hereinafter, an X-ray CT apparatus 1 will be described in detail as a preferred embodiment using a medical bed apparatus according to the present invention with reference to the accompanying drawings.
In this embodiment, an X-ray CT apparatus will be described. The medical bed apparatus (hereinafter referred to as a bed) of the present invention includes various types such as an MRI apparatus, an X-ray diagnostic apparatus, a fluoroscopic apparatus, a SPECT apparatus, and a PET apparatus. Such a medical image photographing apparatus may be provided.

  First, with reference to FIGS. 1-2, the structure of the X-ray CT apparatus 1 of this Embodiment is demonstrated.

  As shown in FIG. 1, the X-ray CT apparatus 1 includes a scanner 2, a bed 3, an operation console 4, a top 5 provided on the bed 3, a display device 7, and an operation device 8. The X-ray CT apparatus 1 acquires transmission X-ray data of the subject 6 by carrying the subject 6 fixed to the top 5 on the bed 3 into the opening of the scanner 2 and scanning.

  As shown in FIG. 2, the scanner 2 includes an X-ray tube 201, an X-ray control device 202, a collimator 203, a collimator control device 204, an X-ray detector 205, a data collection device 206, a rotating plate 207, a rotating plate driving device 208, It comprises a rotation control device 209 and a drive transmission system 210.

  The X-ray tube 201 is an X-ray source, and is controlled by the X-ray control device 202 to irradiate the subject 6 with X-rays continuously or intermittently. The X-ray control device 202 controls the X-ray tube voltage and the X-ray tube current applied or supplied to the X-ray tube 201 in accordance with the X-ray tube voltage and the X-ray tube current determined by the system control device 401 of the console 4. To do.

The collimator 203 irradiates the subject 6 with X-rays radiated from the X-ray tube 201 as X-rays such as a cone beam (conical or pyramidal beam), and the aperture width is set by the collimator control device 204. Be controlled. X-rays transmitted through the subject 6 enter the X-ray detector 205.
In the present embodiment, the opening width of the collimator 203 is controlled according to the imaging range set by the system control device 401. Details will be described later.

  The X-ray detector 205 includes, for example, about 1000 X-ray detection element groups configured by, for example, a combination of a scintillator and a photodiode in the channel direction (circumferential direction), for example, about 1-320 in the column direction (body axis direction). They are arranged and arranged so as to face the X-ray tube 201 through the subject 6. The X-ray detector 205 detects X-rays emitted from the X-ray tube 201 and transmitted through the subject 6, and outputs the detected transmitted X-ray data to the data acquisition device 206.

  The data collection device 206 is connected to the X-ray detector 205, collects transmission X-ray data detected by the individual X-ray detection elements of the X-ray detector 205, and outputs it to the image reconstruction device 402.

  An X-ray tube 201, a collimator 203, an X-ray detector 205, and a data collection device 206 are mounted on the rotating plate 207. The rotating plate 207 is rotated by the driving force transmitted through the drive transmission system 210 from the rotating plate driving device 208 controlled by the rotation control device 209.

The bed 3 shown in FIG. 2 includes a top 5 on which the subject 6 is placed, a bed control device 301, a vertical movement device 302, and a top drive device 303.
The bed control device 301 controls the vertical movement device 302 so that the height of the bed 3 is appropriate. Further, the top plate driving device 303 is controlled to move the top plate 5 back and forth in the body axis direction or to move in a direction perpendicular to the body axis and parallel to the top plate 5 (left and right direction). . Thus, the subject 6 is carried into and out of the X-ray irradiation space of the scanner 2 and is aligned with the imaging center position.

  The imaging center position means the X-ray irradiation center. In the following description, the coordinates representing the position of the couch 5 in the real space are the z direction in the body axis direction, the direction perpendicular to the body axis, and the direction parallel to the couch 5 (left and right direction) in the x direction. A direction (vertical direction) perpendicular to the body axis and perpendicular to the top plate 5 is defined as the y direction. The coordinates of the display screen are the X direction in the horizontal direction and the Y direction in the vertical direction.

In the following description, the position of the top plate 5 of the bed 3 at the start of fluoroscopic imaging is referred to as “imaging origin”, and the coordinates thereof are (x ₀ , y ₀ , z ₀ ). The “diagnosis origin position” is the center position of a fluoroscopic image displayed on the display screen, and the coordinates on the display screen are (X ₀ , Y ₀ ). The “diagnosis center position” is a designated position on the display screen designated so as to reach the photographing center position at the time of actual photographing, and the coordinates thereof are (X ₁ , Y ₁ ). The coordinates in the real space corresponding to the diagnostic center position (X ₁ , Y ₁ ) are (x ₁ , y ₁ , z ₁ ).

  The console 4 includes a display device 7, an operation device 8, a system control device 401, an image reconstruction device 402, and a storage device 404. The console 4 is connected to the scanner 2 and the bed 3.

  The display device 7 includes a display device such as a liquid crystal panel and a CRT monitor, and a logic circuit for executing display processing in cooperation with the display device, and is connected to the system control device 401. The display device 7 displays a reconstructed image and a scanogram image (perspective image) output from the image reconstructing device 402 and various information handled by the system control device 401.

  The operation device 8 includes, for example, a keyboard, a pointing device such as a mouse, an input device such as a numeric keypad, and various switch buttons. The operation device 8 outputs various instructions and information input by the operator to the system control device 401. The operator interactively operates the X-ray CT apparatus 1 using the display device 7 and the operation device 8. For example, the operation device 8 receives a designation operation for moving the bed position to a desired position based on the fluoroscopic image obtained by the image reconstruction device 402.

  The system control device 401 includes a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like. The system control device 401 controls the X-ray control device 202, the collimator control device 204, the data collection device 206, the X-ray detector 205, and the rotation control device 209 in the scanner 2, and the bed control device in the bed 3. 301 is controlled.

  In addition, the system control device 401 executes a photographing process (see FIG. 3) described later. In the imaging process, the system control apparatus 401 scans a scanned sagittal plane (z-x plane) or coronal plane (yz plane) (hereinafter referred to as a fluoroscopic image), or a tomographic image (axial plane (xy). Surface)), the body thickness and body width of the subject 6 are acquired. In addition, the system control device 401 calculates a safety region in the vertical direction (y direction) based on the body thickness, and calculates a safety region in the left and right direction (x direction) based on the body width, so that the safety is displayed on the display screen. An area guide is displayed (see FIG. 6).

In addition, the system control apparatus 401 accepts designation of the diagnostic center position for the fluoroscopic image of the subject 6 displayed on the display screen. When an arbitrary diagnostic center position (X ₁ , Y ₁ ) of the fluoroscopic image is designated by operating a pointing device such as a mouse, the system control device 401 makes the designated diagnostic center position reach the imaging center position. The movement amount of the bed 3 is calculated, and the bed 3 is moved.

  Further, the system control apparatus 401 accepts designation of an imaging range centered on the designated diagnostic center position. Here, the photographing range can be specified in at least two directions among the body axis (z) direction, the vertical (y) direction, and the left and right (x) direction. The system control apparatus 401 sends an instruction signal for irradiating X-rays with an irradiation width corresponding to the designated imaging range to the collimator control apparatus 204.

  The image reconstruction device 402 acquires transmission X-ray data collected by the data collection device 206 in the scanner 2 under the control of the system control device 401. At the time of scanning a scanogram (fluoroscopic image), a fluoroscopic image is created using the fluoroscopic projection data collected by the data collecting device 206. Further, at the time of actual imaging, a tomographic image is reconstructed using transmission X-ray data of a plurality of views collected by the data collection device 206.

  The storage device 404 is configured by a hard disk or the like, and is connected to the system control device 401. The storage device 404 stores perspective projection data, perspective images, transmission X-ray data, tomographic images, and the like collected by the data collection device 206. In addition to these various image data, a tomographic image generated by the image reconstruction device 402, a program for realizing the functions of the X-ray CT apparatus 1, and the like are stored.

  Next, the operation of the X-ray CT apparatus 1 will be described with reference to the flowchart of FIG. 3 and FIGS. 4 to 9.

  The system control apparatus 401 of the X-ray CT apparatus 1 according to the present embodiment executes the imaging process shown in FIG. In other words, the system control device 401 reads a program and data related to shooting processing from the storage device 404 and executes shooting processing based on the program and data.

First, the top 5 is carried into the scanner 2 with the subject 6 placed on the top 5 of the bed 3. At this time, the operator aligns the predetermined position on the body axis of the subject 6 to the imaging center position, and the position of the bed 3 at this stage is set as the imaging origin (x ₀ , y ₀ , z ₀ ). Stored in RAM.

  The system control device 401 performs fluoroscopic imaging (scanogram imaging) of a predetermined range of the subject 6 and acquires fluoroscopic projection data (step S1). The system control device 401 sends the acquired perspective projection data to the image reconstruction device 402. The image reconstruction device 402 creates a perspective image 11 based on the perspective projection data and stores it in the storage device 404.

  Next, the system control device 401 calculates a safe area in which the bed 3 can move (step S2). Here, the body width of the subject 6 can be acquired from the coronal image (z-x plane) or tomographic image (axial image; xy plane) taken from the front of the subject, and sagittal taken from the body side direction. The body thickness of the subject 6 can be acquired from the image (yz plane) and tomographic image (axial image; xy plane). In addition, when using an axial image, it is necessary to image the subject 6 while rotating the rotating plate 207 instead of the fluoroscopic imaging in step S1.

  From the acquired body width or thickness, the position of the top 5 (imaging origin), and the inner peripheral position of the scanner 2, the system control device 401 determines that the subject 6 (or the top 5) and the inner periphery of the scanner 2 are A safe area that can be moved while maintaining a predetermined safe distance is calculated. As shown in FIG. 4, the safety region in the left and right (x) direction is determined by the width of the top plate 5 when the body width is smaller than the width of the top plate 5, and the body width is equal to or larger than the width of the top plate 5. The case is determined by the body width of the subject 6. Further, the safety area in the vertical (y) direction is determined by the vertical position of the top 5 and the acquired body thickness.

Next, the system control device 401 displays the fluoroscopic image taken in step S1 on the display device 7 (step S3).
At this time, as shown in FIG. 5, center guide lines 61 and 62 may be displayed on the display screen at the center position in the X direction and the center position in the Y direction, respectively. The intersection of the center guide lines 61 and 62 is the diagnosis origin position (X ₀ , Y ₀ ).

  The fluoroscopic image displayed here may be a coronal image (zx plane) 11 taken from the front parallel to the body axis of the subject 6 as shown in FIG. It is good also as a sagittal image (zy plane) (not shown) image | photographed from the direction of the side surface of the subject 6 in parallel with the body axis. Instead of the fluoroscopic image, a cross-sectional image (axial image) 13 of the body axis vertical cross section of the subject 6 as shown in FIG.

Further, when displaying the fluoroscopic image in step S3, as shown in FIG. 6, safety area guides 81, 82, and 83 indicating the bed movement safety area calculated in step S2 are superimposed and displayed on the fluoroscopic image.
FIG. 6A is a display example in which the safety region guides 81 and 82 in the left and right direction (x direction) are superimposed on the coronal image 11, and FIG. 6B is the left and right (x) direction and height in the axial image 13. This is a display example in which a safety region guide 83 in the (y) direction is superimposed.

Next, the system control device 401 accepts an instruction input for the diagnostic center position (step S4). When an arbitrary position in the display screen is designated by a mouse pointer or the like, the system control device 401, as shown in FIG. 7, a movement guide line 71 indicating the X position and the Y position of the designated point (diagnostic center position), 72 and a diagnostic center position mark 73 are displayed. Also, the coordinates (x ₁ , y ₁ , z ₁ ) in the real space corresponding to the designated point are acquired.

  The movement guide line 71 shown in FIGS. 7A and 7B is a straight line indicating the X coordinate of the designated diagnostic center position, and the movement guide line 72 is a straight line indicating the Y coordinate of the designated diagnostic center position. It is. The intersection of the movement guide lines 71 and 72 is the diagnostic center position.

  Furthermore, the system control device 401 accepts an input of the shooting range from the operator (step S5). The shooting range is a shooting range in actual shooting, and as shown in FIG. 8, at least two ranges of the z direction, the x direction, and the y direction can be input. That is, in the perspective image of the coronal image (xz plane), the imaging range in the x direction and the z direction can be specified, and in the perspective image of the sagittal image (yz plane), the imaging range in the y direction and the z direction. Can be specified, and in the perspective image of the axial image (xy plane), the imaging ranges in the x direction and the y direction can be specified.

  When designating the imaging range, the system control apparatus 401 displays an imaging range line 85 surrounding the designated point 73 on the display screen as shown in FIG. 8, for example, and the size of the imaging range line 85 is set to a mouse wheel or the like. The shooting range is designated by appropriately changing the operation.

  Next, the system control device 401 determines whether or not the diagnostic center position designated in step S4 and the imaging range designated in step 5 are within the safe area (step S6). If it is not within the safe area (step S6; No), the process returns to step S4 to accept the input of the diagnostic center position and the imaging range again.

When the designated diagnosis center position and imaging range are within the safety area (step S6; YES), the system control device 401 moves the bed 3 so that the diagnosis center position reaches the imaging center position.
That is, the system control device 401 uses the real space coordinates (x ₀ , y ₀ , z ₀ ) of the diagnosis origin position (X ₀ , Y ₀ ) on the display screen and the specified diagnosis center position (X ₁ , Y ₀ ). ₁ ) real space coordinates (x ₁ , y ₁ , z ₁ ) and the x-direction movement amount, y-direction movement amount, and z-direction movement amount of the top 5 are calculated, and the calculated movement amounts are controlled by the bed. Send to device 301. The bed control device 301 moves the position of the top 5 according to the input movement amount (step S7).

  Next, the system control device 401 controls the opening width of the collimator 203 according to the imaging range specified in step S5 (step S8). That is, the corresponding range (z range, x range, or y range) in real space is calculated from the imaging range (X range, Y range) on the display screen, and the calculated range is irradiated with X-rays. The opening width of the collimator 203 is calculated.

  As shown in FIG. 8, when the heart of the subject 6 is designated as the diagnostic center position and the imaging range, the bed 3 is moved to the position shown in FIG. 9B, and the opening width of the collimator 203 is further increased. Is controlled.

  When the designated diagnostic center position is moved so as to reach the imaging center position and the opening width of the collimator 203 is adjusted, the system control device 401 starts the imaging operation (step S9). Thereafter, an image such as a tomographic image obtained by the main imaging is displayed on the display screen (step S10), and a series of imaging processing is completed.

  For example, when it is desired to image the heart, as shown in FIG. 9 (a), the conventional method for imaging the heart with the body axis as the imaging center required irradiation of X-rays over a wider range. However, as shown in FIG. 9B, when the position of the bed 3 is moved so that the heart part is at the photographing center position, the opening width of the collimator 203 is set to be small so that the main photographing can be performed. X-ray irradiation dose can be reduced.

  As described above, in the X-ray CT apparatus 1 of the present embodiment, the system control apparatus 401 uses the captured fluoroscopic image (sagittal image, coronal image) or tomographic image (axial image) to detect the body of the subject 6. The thickness and body width are acquired, the vertical safety area is calculated from the calculated body thickness, the horizontal safety area is calculated from the body width, and the safety area guide lines 81, 82, 83 are converted into a fluoroscopic image. Overlapping display. For this reason, the operator can specify the diagnostic center position and the imaging range while referring to the safety area displayed as a guide, so that the subject 6 can be safely moved to a desired position.

Further, the system control apparatus 401 causes the designated position to reach the imaging center position in accordance with the position designation operation on the fluoroscopic image (sagittal image, coronal image, axial image) of the subject 6 displayed on the display screen. The top plate 5 is moved. Further, the system control device 401 controls the aperture width of the collimator 203 so as to irradiate X-rays with an irradiation width corresponding to the specified imaging range in accordance with an imaging range specifying operation for the fluoroscopic image.
Therefore, the operator can safely move the top plate 5 to a desired position with a simple operation, and the opening width of the collimator 203 is appropriately controlled according to the imaging region. Can prevent unnecessary X-ray irradiation.

As mentioned above, although preferred embodiment of the medical couch apparatus concerning this invention was described, this invention is not limited to the above-mentioned embodiment. For example, in the above-described embodiment, the gantry type X-ray CT apparatus has been described, but a C-arm type X-ray CT apparatus may be used. Further, the display format such as guide display in the above-described embodiment is an example, and other display formats (color, line type, etc.) may be used.
In addition, it is obvious for those skilled in the art that various changes or modifications can be conceived within the scope of the technical idea disclosed in the present application, and these naturally belong to the technical scope of the present invention. It is understood.

DESCRIPTION OF SYMBOLS 1 ... X-ray CT apparatus 2 ... Scanner 3 ... Sleeper 4 ... Operation desk 5 ... Top plate 6 ... Test subject 7. ···· Display device 8 ··· Operating device 201 ··· X-ray tube (X-ray source)
DESCRIPTION OF SYMBOLS 203 ... Collimator 204 ... Collimator control apparatus 205 ... X-ray detector 401 ... System control apparatus 402 ... Image reconstruction apparatus 404 ... Memory | storage device 11 ... Perspective image (coronal) image)
13 .... Cross-section image (axial image)
61, 62... Center guide line 71, 72... Movement guide line 72. 85 ..... Shooting range line

Claims (3)

A medical couch device that is provided in a medical imaging apparatus and is capable of moving a couch top on which a subject is placed in a body axis direction of the subject, in a horizontal direction perpendicular to the body axis, and in a vertical direction,
Display means for displaying a fluoroscopic image or a cross-sectional image of the subject;
Safety area display means for calculating a safety area that is an area in which the bed top plate can be safely moved based on the fluoroscopic image or the cross-sectional image, and for displaying a guide on the fluoroscopic image or the cross-sectional image displayed on the display means; ,
Designating means for designating an arbitrary position of a fluoroscopic image or a cross-sectional image displayed on the display means as a diagnostic center position;
Determination means for determining whether or not the diagnostic center position designated by the designation means is within the safety region;
When the determination means determines that the diagnosis center position is within the safety area, the bed top plate is moved so that the diagnosis center position specified by the specification means reaches the imaging center position. Transportation means;
A medical couch device comprising: The medical bed apparatus is provided in an X-ray imaging apparatus including a collimator that adjusts an X-ray irradiation width,
A range designating unit that designates an imaging range in at least two directions among a body axis direction, a left-right direction perpendicular to the body axis, and an up-down direction centered on the diagnostic center position designated by the designation unit;
Collimator control means for controlling the aperture width of the collimator according to the photographing range designated by the range designation means;
The medical couch device according to claim 1 , further comprising: A scanner for imaging the subject;
A medical couch device capable of moving a couch top for placing the subject in the body axis direction of the subject, the left-right direction perpendicular to the body axis, and the up-down direction;
Display means for displaying a fluoroscopic image or a cross-sectional image of the subject;
Safety area display means for calculating a safety area that is an area in which the bed top plate can be safely moved based on the fluoroscopic image or the cross-sectional image, and for displaying a guide on the fluoroscopic image or the cross-sectional image displayed on the display means; ,
Designating means for designating an arbitrary position of a fluoroscopic image or a cross-sectional image displayed on the display means as a diagnostic center position;
Determination means for determining whether or not the diagnostic center position designated by the designation means is within the safety region;
When the determination means determines that the diagnosis center position is within the safety area, the bed top plate is moved so that the diagnosis center position specified by the specification means reaches the imaging center position. Transportation means;
A medical image photographing apparatus comprising:

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