JP5422145B2 - Medical image processing device - Google Patents

Description

  The present invention relates to an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, or an apparatus that displays an image acquired and reconstructed based on the same principle, and particularly using a lung field CAD. The present invention relates to a medical image display / processing device for diagnosing a lesion in a lung field.

A technique for displaying a nodule candidate by CAD (Computer Aided Design) on an MPR (Multi Planar Reformat) image or a VR (Volume Rendering) image is generally known. The doctor makes a treatment plan from these screens. As a method for treating pulmonary nodules, there are generally the following methods.
Partial lung resection (excision of part of the lung)
Lung segmentectomy (resection with lung segment as a unit)
Lung lobectomy (resection in lung lobe units)
By the way, there are veins that should not be excised at the time of excision of the lung, and it is necessary to determine the excision range while paying attention to this. This determination of the extent of resection often depends on the physician's experience. However, on the other hand, the movement of the pulmonary arteriovenous structure of the lung is complicated and there are individual differences.

  It is generally known that arteries pass near the center of the area and veins pass around the periphery of the area. When segmental resection is performed, it is natural that the arterial artery in the segment is cut and hemostasis is performed, and there is no problem. On the other hand, in veins, veins that flow out of the excision range may be cut to stop the blood flow, but if the veins that flow into the excision area are cut and the blood flow is stopped, they will be preserved upstream. Since the blood flow in the power region is stopped, blood circulation becomes insufficient.

  Therefore, excision of veins that should not be resected may cause edema and necrosis. In particular, it is known that vein travel varies greatly among individuals, and even when a skilled doctor determines an ablation line based on experience, it often occurs that a vein that should not be excised is cut.

  Therefore, it is important that doctors analyze CT images in detail before surgery and examine and plan the excision range based on the location of the tumor and the surrounding blood vessels before surgery.

  FIG. 16 is a diagram showing an example of a CT image used for such a purpose.

In order to determine the three-dimensional movement of the vein such as the three-dimensional image shown in FIG. 16B from the cross-sectional image shown in FIG. 16A, first, the ablation zone is moved while moving the slice position. Determine the arteries and veins associated with the. This determination can be made by tracing the artery and vein to the heart. Next, the determined three-dimensional running of the artery and vein is judged and stored while moving the slice position again.
JP 2004-180932 A

  However, as described above, in lung resection using a lung field CT image, there are problems in that the work is complicated and the work largely depends on the capacity of space grasp and storage.

  The maximum CT projection image (MIP (Maximum Intensity Projection) image) is advantageous in terms of space grasping, but as shown in FIG. 16 (b), because more blood vessels than necessary are displayed, As a result, it was difficult to judge arteries and veins. In addition, since many blood vessels other than the resection area are also displayed, it may be an obstacle to determine the travel of the blood vessels related to the resection area. Further, in the case of thoracoscopic surgery without thoracotomy, it is difficult to cope with hemostasis because the visual field is narrow. Accordingly, there is a need for a technique for displaying, hiding, and highlighting arteriovenous veins necessary for assisting the excision range.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a medical image processing apparatus that can identify and present a pulmonary artery and vein running in a specific lung area to a doctor without the doctor's judgment. It is to be.

That is, the present invention includes a partial region extraction unit that extracts a partial region of a lung, a blood vessel division unit that extracts a blood vessel of the extracted partial region of the lung and divides the extracted blood vessel into a plurality of portions, and the extracted and the boundary of the lung of a partial region, based on the positional relationship of the divided blood vessel partial region by the vessel dividing means, determination means for determining the type of the display state of each vessel segment region, it is determined by said determining means A projection image generation unit that generates a projection image of a different display form for each region based on the result; and a display unit that displays the projection image generated by the projection image generation unit ; The blood vessel partial region straddling the boundary of the lung partial region is determined to be a different region, and the display means displays the display of the blood vessel partial region straddling the boundary of the lung partial region, Lung region Boundary to be different from the display of the blood vessel partial areas do not cross, and displaying the blood vessel partial area as a unit, a is wherein there.

  According to the present invention, it is possible to provide a medical image processing apparatus capable of specifying a pulmonary artery and vein running in a specific lung area and presenting it to a doctor without the doctor's judgment. This makes it easier to understand the driving of the patient and improves the efficiency of treatment planning.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  FIG. 1 is a block diagram showing a configuration example of a medical image processing apparatus according to an embodiment of the present invention.

  In FIG. 1, the medical image processing apparatus 10 includes a user operation input unit 11, a user operation decoding unit 12, an image storage unit 13, a VR (Volume Rendering) unit 14, a CAD unit 15, and a lung region. The specifying unit 16, the blood vessel processing unit 17, the nodule (candidate) drawing unit 18, the lung area drawing unit 19, the diagnostic report creation unit 20, the display image creation unit 21, the display unit 22, and the control unit 23 , And is configured.

  The user operation input unit 11 includes, for example, a mouse and a keyboard, and is an input unit for a user to perform an input operation to the medical image processing apparatus 10. The user operation decoding unit 12 is input by the user operation input unit 11, for example, an operation such as a mouse event, that is, an operation button selection decision operation on the application menu display displayed on the display unit 22, and the display unit 22 A drag operation or the like on the displayed image is decoded, and parameters necessary for various subsequent processes are calculated.

  Here, the parameters calculated by the user operation decoding unit 12 are, for example, the following parameters. The correspondence between various operations and calculated parameters is shown. Various operations described below are performed by the user using the user operation input unit 11.

-Click operation on the patient information screen displayed on the display unit 22 in the image selection mode → image selection parameter calculation
-Click operation on the VR image and the nodule candidate display image displayed on the display unit 22 in the diagnosis mode → nodule determination / nodule coordinate value parameter calculation
Various input operations in diagnostic report creation mode → diagnosis result parameters Here, examples of the method of changing the mode to the various modes include the following methods.
The mode is changed by selecting and determining the mode designation button on the application menu display described above.
When processing in a certain mode is completed, processing for automatically changing the mode to a predetermined next mode is performed.

  The image storage unit 13 is a database for storing various image data, patient information, and the like. The VR unit 14 performs a so-called volume rendering process on the image data output from the image storage unit 13 to generate a VR image that is a three-dimensional display image.

  The CAD unit 15 calculates the nodule candidate coordinates (hereinafter referred to as nodule candidate coordinates) in the image data output from the image storage unit 13. The lung area specifying unit 16 calculates a lung area where predetermined coordinates exist in the lung field. Specifically, the lung area specifying unit 16 is based on the lung field image data output from the image storage unit 13 and coordinates determined by the user as nodule coordinates (hereinafter referred to as nodule coordinates). The lung area where the nodule coordinates exist is calculated. The details of the lung area calculation processing by the lung area specifying unit 16 will be described later.

  The blood vessel processing unit 17 performs processing such as extracting blood vessels in the lung area and dividing the blood vessels into a plurality of parts in order to display an image. The nodule (candidate) drawing unit 18 draws nodule candidates based on the nodule candidate coordinates calculated by the CAD unit 15. The lung area drawing unit 19 draws a lung area to be presented to the user based on the output from the lung area specifying unit 16.

  The diagnostic report creating unit 20 creates a predetermined diagnostic report based on, for example, a diagnostic result input by a user and a lung area where nodule coordinates calculated by the lung area specifying unit 16 are present. The image drawn by the lung area drawing unit 19 may be taken into the diagnostic report when the diagnostic report creating unit 20 creates the diagnostic report.

  The display image creation unit 21 includes a VR image generated by the VR unit 14, a blood vessel image processed by the blood vessel processing unit 17, a nodule (candidate) image created by the nodule (candidate) drawing unit 18, For the image or data showing the lung area created by the lung area drawing unit 19 and the diagnostic report created by the diagnostic report creating unit 20, these are displayed on the display unit 22 (display image). ) Is performed. Further, as will be described later, the display image creation unit 21 creates an image to be displayed on the display unit 22 from the line-of-sight direction determined based on the shape of the lung partial region together with the control unit 23.

  The display unit 22 is a monitor that displays the display image created by the display image creation unit 21. The actual diagnosis report displayed on the display unit 22 includes, for example, a target tissue image indicating a target tissue, a menu image indicating predetermined various menus, and a report display image indicating a diagnosis result as a diagnosis report. The The control unit 23 is responsible for overall control of the medical image processing apparatus 10, and performs state determination, control, and the like in each unit described above.

  Here, display / non-display of the pulmonary artery and vein around the nodule, which is a feature of the present embodiment, will be described.

The display / non-display of the pulmonary artery and vein is determined under the following conditions.
Display object: Pulmonary artery and vein passing through the excision area (hereinafter referred to as nodule area) and its surroundings Non-display object: Pulmonary artery and vein distant from the nodule area Based on the CT image, 3 blood vessels are created using volume rendering and MIP When displaying dimensions, the arteries in the excision area where the tumor is present are displayed, and the veins that pass around the excision area are displayed to hide the arteries other than the excision area, and the veins that do not pass through the excision area are hidden. To. In this image, only blood vessels for which traveling is to be determined are displayed, so that it is easy to determine three-dimensional traveling and determine a safe ablation line.

In addition, the following processing is additionally performed to assist in determining whether or not pulmonary arteriovenous resection is possible.
(I) Highlight the pulmonary veins that run on the border of the nodule area
(Ii) 3D display of the border line of the nodule area
(Iii) Determine the line-of-sight direction using information on the nodal zone boundary. Here, (i) indicates that the pulmonary veins that run on the zone boundary are not preferably removed or are highlighted for caution. The purpose of (ii) and (iii) is to grasp the positional relationship between the area boundary and the blood vessel.

  FIG. 2 is a diagram showing a display example of pulmonary arteriovenous according to the present embodiment. FIG. 2A shows an example of a screen displayed before execution of the present embodiment. Viewing this image, the user designates the nodule position 31. FIG. 2B is a result image of the present embodiment. An image obtained by removing a non-displayed blood vessel based on the above-described conditions of the pulmonary arteriovenous region around the nodule in FIG. It is displayed using the value projection (MIP) method.

  Next, the operation of the medical image processing apparatus 10 of the present embodiment will be described with reference to the flowchart of FIG.

  In this sequence, lung field CT and MRI images are input.

  When this sequence is started, first, in step S1, a nodule area is specified by a lung field image bronchus and lung nodule coordinates. Here, a lung area at an arbitrary point in the lung field is calculated. Specifically, the area name of the lung area where the nodule coordinate is placed is determined from the image data of the lung field and the nodule coordinate determined by the user as the nodule. The determination of the area name of the lung area is described in Japanese Patent Application No. 2007-215095, which is an earlier application by the present applicant.

  That is, the following processing is performed in the lung region specifying unit 16 in order to specify the lung region where the nodule exists.

  As shown in FIG. 4, the lung area specifying unit 16 searches for the bronchi closest to the nodule coordinate A determined by the user. In general, since the bronchial secondary area and the lung area correspond to each other, the lung area corresponding to the closest bronchus is the lung area where the nodule exists.

  The correspondence between the bronchial secondary area and the lung area is as shown in FIGS. 5 (a) and 5 (b).

That is, with respect to the right lung, as shown in FIG. 5A, in the upper right lobe, B ¹ , B ² , and B ³ in the bronchial secondary region are respectively represented by the pulmonary apex (S ¹ ), posterior superior lobe (S ² ), anterior superior lobe (S ³ ) correspond, and B ⁴ , B ⁵ , B ⁶ in the bronchial secondary region in the right middle lobe, respectively in the lung region The outer middle lobe section (S ⁴ ), the inner middle lobe section (S ⁵ ), and the upper-lower lobe section (S ⁶ ) correspond to each other. In the lower right lobe, B ⁷ , B ⁸ , B ⁹ , the B ^10, respectively in the inner extrapulmonary Ward lung segment (S ^7), before the basal segment (S ^8), the outer basal segment (S ^9), the rear basal segment (S ¹⁰⁾ correspond.

Similarly, with respect to the left lung, as shown in FIG. 5 (b), in the upper left lobe, B ¹ , B ² , B ³ , B ⁴ , and B ⁵ in the bronchial secondary region are respectively in the lung region. in apical gu (S ^{1 +} 2), apical gu (S ^{1 +} 2), before the leaf Zone (S ^3), upper tongue gu (S ^4), Shitashita gu (S ⁵⁾ corresponds, In the left lower lobe, B ⁶ , B ⁷ , B ⁸ , B ⁹ , and B ¹⁰ in the bronchial secondary region are respectively represented by the upper-lower lobe segment (B ⁶ ) and the inner extrapulmonary segment (S ⁷ ) in the lung segment. ), Anterior inner floor segment (S ⁸ ), outer lung floor area (S ⁹ ), and rear lung floor area (S ¹⁰ ).

For example, in the example shown in FIG. 4, since the bronchi closest to the input nodule coordinate A is B ³ , a nodule exists in the corresponding lung region, ie, “anterior upper lobe (S ³ )”. The lung area.

  In other words, the detailed bronchial region close to the nodule is searched, the branch to which the detailed bronchial region is connected is searched, and the lung area where the nodule exists based on the connected branch name Specify the name.

  Here, for example, the lung area of the nodule to be treated is defined as segment 9 (SG9).

  Next, in step S2, the adjacent area is specified from the lung nodule area name obtained in step S1. In the adjacent area specification, the area name of the lung area adjacent to the lung area specified in step S1 is determined. Adjacent lung areas are necessarily determined from the general lung structure as shown in FIG.

  6A and 6B show the structure of the lungs and the area support, in which FIG. 6A is a three-dimensional view of the bronchus, FIG. 6B is a side view showing the area support of the right lung, and FIG. The side view which showed the area support from the center side, (d) is the side view which showed the area support of the left lung, (e) is the side view which showed the area support of the left lung from the center side. As shown in FIGS. 6A to 6E, the left and right lungs are each divided into 10 sections. However, in the same figure, the numbers of the segments (SG) representing each lung area are shown only by numbers.

  For example, it can be seen from FIG. 6 that the lung sections adjacent to the aforementioned lung section SG9 are SG6, SG7, SG8, and SG10.

  In step S3, region division of the nodule area is performed. Here, on the 3D image, the lung area (SG9) specified in step S1 is divided into regions. At this time, in order to determine the region of SG9, only SG9 and the regions of SG6, SG7, SG8, and SG10 adjacent thereto need to be targeted.

  Here, the region division of the nodule area will be described.

  The division of the lung area, in particular the nodule area and its surrounding area, is determined by the following policy.

  First, a detailed branching structure of the bronchi traveling in the nodule area and the surrounding area is extracted. The detailed branch structure of each area is bolded, the boundary with the adjacent area is determined, and the nodule area is divided into regions.

  Hereinafter, with reference to the flowchart of FIG. 7, the details of the processing operation of the subroutine “nodule area division” in step S3 of the flowchart of FIG. 3 will be described.

  When this subroutine is entered, extraction of a detailed bronchial branch structure of a nodule area and thickening are first performed in step S21. That is, first, a detailed branching structure of the bronchi traveling in the nodule area is extracted. This can be acquired as an intermediate output of “identification of nodule area” in step S1 of the flowchart of FIG. 3 described above.

  Next, the detailed branch structure of the bronchus 33 running through this nodule area is thickened. A dilation process is applied to the detailed branch structure after the area support to form a single area. This is the temporary nodule area 34 (see FIG. 8).

  In addition, the region can be efficiently divided by changing the size of the structural element according to the thickness of the bronchus during the dilation. For example, as shown in FIG. 9, when the relationship between the thickness of the bronchus and the size of the structural element is shown, the structural element is large when the bronchus is thin, and the structural element is small when the bronchus is thick.

  Next, in step S22, extraction and thickening of the bronchial detailed branch structure in the adjacent area are performed. Here, the same processing as in step S21 is executed for each adjacent area. That is, the detailed branch structure of the bronchus that travels in the area is extracted, and the dilation process is performed on the detailed branch structure after the area support to form a single region. This is a temporary adjacent area 38 as shown in FIG. This procedure is applied to each adjacent area to form a temporary adjacent area 38.

  In step S23, as shown in FIG. 10A, the overlapping area 39 is divided and the nodule area 37 is determined. In this step S23, as shown in FIG. 10B, an overlapping area 39 that combines the areas of the sections configured in steps S21 and S22 described above and divides the area overlapping with the nodule area equally. A point that bisects the normal vector of the boundary surface of each region is calculated, and a surface connecting these points is defined as a new boundary surface 40. As a result, the display area is equally divided and the nodule area 37 is determined.

  Thus, for example, the region of the nodule area SG9 is determined on the 3D image.

  In step S4, a blood vessel (artery / vein) to be displayed to the user is determined. Here, the blood vessel region is first extracted by the blood vessel processing unit 17 using the region expansion method. In this case, as the simplest example, a method can be used in which the threshold value is determined based on image display conditions (window width and window level for MIP, opacity window width and opacity window level for volume rendering).

  Next, the tree structure of blood vessels is searched to extract branch points. As for this extraction method, Hidenori Shikata et al., Blood vessel bifurcation position detection algorithm for non-rigid registration of lung, IEICE Transactions, Vol.J85-D-II, No.10, pp1613-1623, 2002 It is described in. The position of the branch point is used to divide the extracted blood vessel into a number of regions sandwiched between the branch points. Hereinafter, display / non-display determination, non-display processing, coloring processing, and the like are performed and applied in units of blood vessel regions (segments) divided in this way.

  The image divided in the above-described step S3 and the artery / vein image are superimposed, and display / non-display is determined according to the running condition of the blood vessel. These conditions are as shown in the table of FIG.

  According to this, blood vessels of level 1 to 3 are to be displayed, and blood vessels of level 4 are to be non-displayed.

  Next, the blood vessel is displayed three-dimensionally using the MIP method. Whether to display or not is determined for each blood vessel segment divided in step S3. When the maximum value is projected, the maximum value is searched by excluding non-display voxels. Whether the voxel having the maximum value is displayed or highlighted is checked, and display is performed by applying a different color lookup table depending on the determination result.

  When volume rendering is used, a well-known multi-object display method can be used to distinguish and display the two areas of non-display and display.

  Next, in step S5, it is determined whether or not to highlight the blood vessel to be noted when determining the resection range (by user operation). Here, when highlighting is performed, the process proceeds to step S6, and when highlighting is not performed, the process proceeds to step S7.

  In step S6, among the blood vessels determined as “display” in step S4, a blood vessel to be noted when determining the resection range is determined. Since each display blood vessel region is classified into levels 1 to 3 shown in FIG. 11 in step S4, different color look-up tables are applied depending on this level.

  FIG. 12 shows an example in which this three-dimensional display process is performed. For level 2 and level 3, arteries and veins are distinguished and displayed.

  Next, in step S7, it is determined whether or not the initial gaze direction is determined. Here, when the initial gaze direction determination is performed, the process proceeds to step S8. On the other hand, if not, the initial line-of-sight direction is set as the default direction, for example, the same direction as the input image, and the process proceeds to step S9.

  In step S8, a line-of-sight direction is determined so that a blood vessel traveling along the nodal zone boundary can be seen. Here, there are options as shown in FIG.

  That is, in the case of the direction from the outside of the lung toward the hilar part shown by the arrow 45 in FIG. 13, the viewpoint is the outer side of the nodule area, and the visual line direction is parallel to the artery or bronchus from the nodal area to the hilar part. It becomes.

  In the case of the direction parallel to the boundary surface of the nodule area shown by the arrow 46 in FIG. 13, the viewpoint is near the highlighted blood vessel, and the line-of-sight direction is parallel to the boundary surface of the nodule area.

  In the line-of-sight direction indicated by the arrow 45, all the highlighted blood vessels can be confirmed at once around the nodule area. Further, in the line-of-sight direction indicated by the arrow 46, the direction of the highlighted blood vessel that crosses the specific boundary surface can be confirmed in detail. In the case of the arrow 46, since there are as many line-of-sight directions as the number of highlighted blood vessels, it is necessary to create images for the number of highlighted blood vessels.

  In step S9, stereoscopic display creation and drawing image creation are performed.

  The wire frame display is used for the stereoscopic display for stereoscopically displaying the nodule area divided in step S3. At this time, the surface model is created and the hidden line removal process is performed, so that the front line is highlighted as shown in FIG.

  The following simple method can be used for the hidden line removal of the wire frame 43.

  Numbers “1”, “2”, and “3” shown in FIG. 15 are symbols representing the determined areas. The manner in which each number is assigned to each voxel is shown in two dimensions for ease of explanation.

  Since the illustrated point 50 is adjacent to the three areas “1”, “2”, and “3” described above, it can be determined that the point 50 is a part of the boundary line. If all the surroundings are the same area, it is inside the area, and the points adjacent to the two areas are on the boundary surface. For example, when the area 1 is displayed, a wire frame of the area 1 can be drawn by connecting and connecting points adjacent to three areas including the area 1 and drawing a line.

  The determination of the hidden line is performed as follows. That is, consider the case where the area indicated by the symbol “1” is displayed using the viewing direction of the figure. A half line from the point 50 in the direction opposite to the line-of-sight direction passes through the area 1. Therefore, it is determined that the point 50 is behind the area 1. If the boundary of “1” is displayed, the point 50 is determined as a hidden line.

  Since this method does not require the construction of a surface model, it is characterized in that high-speed processing is possible. In addition, since the search is performed in a method along the line-of-sight direction in order to determine the hidden line, it is possible to have a configuration that can be performed simultaneously with the projection processing of MIP or volume render link that performs a similar search, and such a configuration should be used. The feature is that higher speed processing is possible.

  For drawing image creation, the blood vessel in step S7 is combined with the above-described stereoscopic display of the nodule area. This is configured and displayed according to the line-of-sight direction determined in step S8.

  Thus, according to the present embodiment, it becomes easier to grasp the movement of the arteriovenous region in the lung area to be excised, and the efficiency of the treatment plan is improved.

  Although the embodiments of the present invention have been described above, the present invention can be variously modified without departing from the gist of the present invention other than the above-described embodiments.

  Further, the above-described embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements. For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, the problem described in the column of the problem to be solved by the invention can be solved, and the effect described in the column of the effect of the invention Can be extracted as an invention.

1 is a block diagram illustrating a configuration example of a medical image processing apparatus according to an embodiment of the present invention. 4A and 4B show examples of pulmonary arteriovenous display according to an embodiment of the present invention, in which FIG. 5A shows an example of a screen displayed before execution, and FIG. 5B shows a result image. It is a flowchart for demonstrating operation | movement of the medical image processing apparatus in one Embodiment of this invention. It is a figure which shows the search of the bronchi nearest to the nodule coordinate by the lung area specific | specification part. It is a figure which shows the correspondence of a bronchial secondary area and a lung area. The structure of the lungs and the regional support are shown, (a) is a diagram showing the bronchus in three dimensions, (b) is a side view showing the regional support of the right lung, and (c) is the regional support of the right lung. The side view shown from the center side, (d) is the side view which showed the area support of the left lung, (e) is the side view which showed the area support of the left lung from the center side. FIG. 4 is a flowchart for explaining details of a processing operation of a subroutine “nodule area division” in step S5 of the flowchart of FIG. 3; It is a figure for demonstrating thickening of the bronchus which drive | works a nodule area. It is the figure which showed the relationship between the thickness of a bronchus and the magnitude | size of a structural element. It is a figure for demonstrating the division | segmentation of an overlapping area | region, and the determination of a nodule area area | region. 6 is a table showing conditions for determining display / non-display / highlight display according to a running condition of a blood vessel by superimposing an area-divided image and an artery / vein image. It is a figure for demonstrating the determination of a display and an emphasis display blood vessel. It is a figure for demonstrating determination of an initial gaze direction. It is a figure for demonstrating 3D display creation. It is a figure for demonstrating the hidden line removal of a wire frame. The example of a general lung field CT image is shown, (a) is a cross-sectional image, (b) is a three-dimensional image.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Medical image processing apparatus, 11 ... User operation input part, 12 ... User operation decoding part, 13 ... Image storage part, 14 ... VR part, 15 ... CAD part, 16 ... Lung area specific | specification part, 17 ... Blood vessel processing part, DESCRIPTION OF SYMBOLS 18 ... Nodule drawing part, 19 ... Lung area drawing part, 20 ... Diagnostic report preparation part, 21 ... Display image preparation part, 22 ... Display part, 23 ... Control part, 31 ... Nodule position, 33 ... Bronchi, 34 ... Temporary Nodule area 37, nodule area 38, temporary adjacent area 39, overlap area.

Claims (4)

Partial area extraction means for extracting a partial area of the lung;
A blood vessel dividing means for extracting blood vessels of the extracted partial region of the lung and dividing the extracted blood vessels into a plurality of parts;
Boundary of the extracted lung partial regions, based on the positional relationship of the divided blood vessel partial region by the vessel dividing means, determining means for determining a display state of each vessel partial regions,
A projection image generating means for generating a projection image of a different display form for each region based on the result determined by the determination means;
Display means for displaying the projection image generated by the projection image generation means;
Equipped with,
The determining means determines that the blood vessel partial region straddling the boundary of the lung partial region and the blood vessel partial region that does not straddle are different regions ,
The display means displays the blood vessel partial region that crosses the boundary of the lung partial region in units of the blood vessel partial region so that the display is different from the display of the blood vessel partial region that does not cross the boundary of the lung partial region. To do,
Medical image processing apparatus said.   2. The medical device according to claim 1, wherein the determination unit determines that a blood vessel partial region that passes through the partial region of the lung is displayed, and determines that a blood vessel partial region that does not pass through the partial region of the lung is not displayed. Image processing device.   The medical image processing apparatus according to claim 1, wherein the display unit superimposes and displays a boundary line of the partial region of the lung.   The medical image processing apparatus according to claim 1, further comprising a gaze direction determining unit that determines a gaze direction based on a shape of the partial region of the lung.

Images