JP5483766B2 - Image display device and image display system - Google Patents

Description

  Embodiments described herein relate generally to an image display device and an image display system for assisting catheter operation.

  An IVR (InterVentional Radiology) technique for treating a lesion using an image generation apparatus such as an X-ray diagnostic apparatus is actively performed. In the IVR procedure, blood vessel formation, vascular embolization, and the like are performed by catheter operation. In recent years, various techniques for supporting advancement of medical instruments such as catheters to lesions in IVR procedures have been proposed (see, for example, Patent Document 1). As a system for performing the IVR technique, there are the above-described image generation apparatus, an image management apparatus (PACS: Picture Archiving and Communication System) for managing images, and an image observation apparatus for observing images. The image management apparatus stores images obtained during the procedure. The image observation apparatus is installed in an examination room for performing a procedure.

  During a procedure, a doctor may want to refer to an image obtained during a past procedure as procedure support information. In order to refer to an image obtained during a past procedure, it is necessary to manually input the identification information to the image observation apparatus every time the image is displayed. However, the doctor's hand during the procedure is not free due to catheter operation and the like. Therefore, the image to be referred to is limited to a preset image. Although an engineer may perform an input operation under the direction of a doctor, it takes time to search for an image suitable for the procedure. During that time, the procedure is temporarily interrupted, resulting in disadvantages such as a decrease in procedure efficiency and an increase in patient burden.

JP 2000-342565 A

  An object of the present invention is to provide an image display device and an image display system that can improve the procedure efficiency in the IVR procedure.

  The image display apparatus according to the present embodiment includes storage means for storing data of a plurality of past images related to a plurality of positions generated during a previous catheterization, and a catheter image from a current image generated during the current catheterization. Specifying means for specifying a specific portion; and display means for reading out and displaying data of the past image according to the position of the specified specific portion; and the display means is provided at the position of the specified specific portion. When there are a plurality of corresponding past image data, the past image data is displayed in descending order of specific information included in the accompanying information of the past image data.

The figure which shows the structure of the image display system which concerns on embodiment of this invention. FIG. 2 is a diagram showing a general process of the image display system in FIG. 1. The figure which shows the structure of the image management apparatus of FIG. The figure which shows the flow of the route map production | generation process by the route map production | generation part of FIG. The figure which shows the table which shows a response | compatibility with the image number and the past image memorize | stored in the memory | storage part of FIG. The figure which shows an example of the route map produced | generated by the route map production | generation part of FIG. The table which shows a response | compatibility with a route map and test | inspection identification information memorize | stored in the memory | storage part of FIG. The figure for demonstrating step SA8 (route interpolation process) of FIG. FIG. 5 is another diagram for explaining step SA8 (route interpolation processing) in FIG. 4; FIG. 5 is another diagram for explaining step SA8 (route interpolation processing) in FIG. 4; The figure which shows the flow of the automatic search and transmission process of the past image by the control part 21 of FIG. The figure for demonstrating concretely the process to step SB7-step SB10 of FIG. The figure which shows the route map in the route map production | generation process different from FIG. The figure which shows the structure of the image display system which concerns on the modification 1. As shown in FIG. The figure for demonstrating calculation of a barber and imaging | photography position with the camera apparatus of FIG. The figure which shows the structure of the image display system which concerns on the modification 2. As shown in FIG. The figure which shows the structure of the other image display system which concerns on the modification 2. As shown in FIG. The figure which shows the structure of the other image display system which concerns on the modification 3. FIG. The figure for demonstrating the imaging | photography position provision process which concerns on the modification 3. FIG.

  Hereinafter, this embodiment of the present invention will be described with reference to the drawings. The image display system according to the present embodiment is a navigation system for assisting a doctor to advance a medical instrument such as a catheter or a guide wire to a lesion part in an IVR procedure. Usually, the IVR procedure is not performed once for the same subject, but is performed several times over a certain period (for example, one month, six months, etc.). Also, images generated during the IVR procedure are stored.

  In the present embodiment, in the current IVR procedure, an image corresponding to the position of the catheter of the current IVR procedure is automatically selected and displayed from a plurality of images generated in the past IVR procedure.

  FIG. 1 is a diagram illustrating a configuration of an image display system according to the present embodiment. As shown in FIG. 1, the image display system includes an image generation apparatus (X-ray diagnostic apparatus) 10, an image management apparatus (PACS) 20, and an image observation apparatus 30 that are connected to each other via a network.

  The image generation apparatus 10 performs X-ray imaging or X-ray fluoroscopy of a subject during an IVR procedure, and generates image data such as a captured image and a fluoroscopic image. The image position is associated with the image data. The imaging position is, for example, the position of the X-ray detector of the image generation apparatus 10 during X-ray imaging or X-ray fluoroscopy. During the IVR procedure, the image generation apparatus 10 generates data of a plurality of images related to a plurality of locations from a catheter insertion portion to a lesioned portion (for example, pulmonary blood vessel), for example. Each image includes a catheter image.

  Hereinafter, a set of a plurality of images generated by one IVR procedure is referred to as a procedure image set. In particular, an image generated in the current IVR procedure is called a current image, and an image generated in the past IVR procedure is called a past image.

  The image management apparatus 20 manages data of a plurality of images of a plurality of procedure image sets generated by the image generation apparatus 10 in a format conforming to, for example, DICOM (Digital Imaging and Communication in Medicine) standards. The image management apparatus 20 generates one route map based on a plurality of past images included in one procedure image set. The route map is generated by arranging a plurality of catheter images included in a plurality of past images according to a relative positional relationship between the plurality of catheter images. The route map indicates a distribution of a plurality of catheter images, that is, a route through which the catheter has passed in the corresponding past IVR procedure. In the current IVR procedure, the image management apparatus 20 receives the data of the current image, specifies the current category position from the current image using the route map, and displays the past image corresponding to the identified current category position. It has a function of automatically selecting from a plurality of past images and transmitting it to the image observation apparatus 30. Details of the automatic selection / transmission function will be described later.

  The image observation apparatus 30 is installed in an examination room where a procedure is performed, and displays a current image, a past image, a route map, and the like received from the image generation apparatus 10 and the image management apparatus 20.

  As described above, the image generation apparatus 10, the image management apparatus 20, and the image observation apparatus 30 are separate apparatuses connected to each other via a network. However, the image generation apparatus, the image management apparatus, and the image observation apparatus May be an apparatus (image display apparatus) integrated with the above.

(Catheter operation procedure)
First, the procedure of catheter operation in the IVR procedure will be described.

  Procedure 1 (DSA imaging): It is necessary to generate blood vessel image data for grasping the blood vessel form by the image display device 10 before the catheter is advanced. The blood vessel image is generated by the following procedure. 1. Prior to advancing the catheter, the image generation apparatus 10 performs X-ray imaging to generate mask image data. 2. A doctor or the like injects a contrast medium from a catheter tip. 3. The image generator 10 generates contrast image data. 4). The image generation device 10 generates blood vessel image data for confirming the blood vessel morphology by subtracting the contrast image from the mask image.

  Procedure 2 (catheter movement): When blood vessel image data is generated, the image generating apparatus 10 X-rays the subject to generate data of a fluoroscopic image (current image) in real time. A doctor or the like advances the catheter toward the lesion while referring to the blood vessel image and the fluoroscopic image. When a detailed image is desired during the movement of the catheter, an X-ray image may be generated to generate a captured image.

  Procedure 3: When the catheter moves to a position where the blood vessel form is desired, the doctor or the like causes the image generation apparatus 10 to temporarily stop X-ray fluoroscopy. Then, procedure 1 (DSA imaging) is performed again to generate new blood vessel image data. Then, procedure 2 (catheter movement) is performed. By repeating this operation, the doctor makes the catheter reach the lesion.

(Processing overview of image display system)
FIG. 2 is a diagram showing an outline of route map generation by the image display system according to the present embodiment, and automatic selection / display processing of past images in the current IVR procedure.

  First, a route map is generated in advance before performing the current IVR procedure. For simplicity of explanation, the past images constituting the route map are a first past image PI1, a second past image PI2, and a third past image PI3. The first past image includes the catheter insertion portion SP, and the third past image includes the lesioned portion GP. These three past images are X-ray images relating to different imaging regions of the subject and include catheter images. These past images may be fluoroscopic images or captured images such as mask images. The image management apparatus 20 generates a route map RM by arranging these past images PI1, PI2, and PI3 on the route map plane RP according to the shooting position. In other words, the image management apparatus 20 generates a route map RM by connecting the three catheter images included in the past images PI1, PI2, and PI3.

  During the current IVR procedure, the image generation device 10 generates a current image CI of the subject P and transmits the generated current image CI to the image management device 20. The current image CI may be a fluoroscopic image or a captured image such as a mask image. The image management apparatus 20 calculates the position on the route map RM where the specific portion (typically, the catheter tip) of the catheter image included in the current image CI is located, and the next stage of the current catheter tip location CP. The past image (for example, the second past image PI2) is selected from a plurality of past images, and the selected past image is transmitted to the image observation device 30. The image observation apparatus 30 displays the transmitted past image.

(Configuration of Image Management Device 20)
FIG. 3 is a diagram illustrating a configuration of the image management apparatus 20. As shown in FIG. 3, the image management apparatus 20 has a communication unit 22, a storage unit 23, a route map generation unit 24, a category destination specifying unit 25, a category destination position calculation unit 26, and an image selection unit 29 with the control unit 21 as a center. Is provided.

  The communication unit 21 transmits and receives various data such as image data to and from the image generation device 10 and the image observation device 30.

  The storage unit 23 stores technique identification information such as an examination ID in association with a technique image set, and stores image identification information such as an image ID and a shooting position in association with past images included in the technique image set. In addition, the storage unit 23 stores technique identification information in association with a route map generated by a route map generation unit 24 described later. In addition, the storage unit stores the image identification information and the shooting position in association with the current image.

  The route map generation unit 24 generates one route map based on a plurality of past images included in one procedure image set by route map generation processing. Specifically, the route map generation unit 24 arranges a plurality of catheter images included in a plurality of past images on a route map plane according to a relative positional relationship (capture positions of past images) between the plurality of catheter images. To generate a route map. The route map plane is a space on a memory where a plurality of past images are arranged. The route map plane is expressed in a patient coordinate system in which the long axis of the bed on which the subject is placed is defined as the Z axis and the short axis of the bed is defined as the X axis. The route map may use all the past images included in the corresponding procedure image set, or may use a plurality of past images appropriately selected (for example, a predetermined time interval, position interval, etc.). The image identification information of the past image that is the basis of each route is assigned to the pixels of each route portion constituting the route of the route map. Details of the route map generation processing will be described later.

  The cat tip specifying unit 25 specifies the cat tip image included in the current image based on the shape of the cat tip.

  The cat tip position calculation unit 26 calculates the cat tip position on the route map based on the shooting position of the current image and the cat position on the current image.

  The image selection unit 27 selects a past image at a position corresponding to the calculated position on the route map from among a plurality of past images stored in the storage unit 23. For example, the image selection unit 27 identifies the image identification information assigned to the pixel located at a position a predetermined distance on the route from the current cat tip position to the lesion, and stores the identified image identification information as a key. 23 is searched and the corresponding past image is specified. The selected past image is transmitted to the image observation apparatus 30 via the communication unit 22.

(Route map generation process)
Next, details of the route map generation process will be described. FIG. 4 is a diagram showing a flow of route map generation processing. The control unit 21 waits for a route map generation request (step SA1). When a doctor or the like requests the start of route map generation from the image management device 20 via the image observation device 30 (step SA1: YES), the control unit 21 causes the route map generation unit 24 to perform route map generation processing. To do. A request to start the route map generation process is made by inputting procedure identification information of a procedure image set that is a basis of a route map to be generated from a doctor or the like via the image observation apparatus 30. The procedure identification information is specifically at least one of a patient ID, an examination ID, an examination date, a Study / Series UID, and the like.

  First, the route map generation unit 24 selects and reads a past image necessary for route map generation (step SA2). For example, the route map generation unit 24 searches for a corresponding procedure image set from the storage unit 23 using the procedure identification information as a key, and reads a plurality of past images included in the specified procedure image set.

  The route map generation unit 24 determines the coordinates and size of the route map plane based on the shooting positions and sizes of all the read past images (step SA3). The route map generation unit 24 assigns image identification information such as image numbers to the plurality of read past images in order of their photographing times (step SA4).

  FIG. 5 is a diagram illustrating an example of a table (hereinafter referred to as an image number correspondence table) indicating correspondence between image numbers and past images. As shown in FIG. 5, the image number correspondence table includes items of a route map ID for identifying a route map, an image number, and a file name of a past image. For example, an image number 1 is assigned to a past image having the file name “Image05.dcm”. This image number correspondence table is stored in the storage unit 23.

  The route map generator 24 performs image processing such as binarization on the plurality of past images, respectively, and extracts a plurality of catheter images (step SA5). For example, the pixel value 1 is assigned to the pixels of the catheter image, and the pixel value 0 is assigned to the pixels other than the catheter image. The route map generation unit 24 generates a route map by arranging the extracted plurality of catheter images on the route map plane according to the relative positional relationship between the plurality of catheter images (imaging position of the past image) (step) SA6).

  Specifically, first, the route map generation unit 24, for each pixel constituting the catheter image, captures the past image on which the catheter image is drawn and the past image represented by the past image coordinate system. The position of the catheter image on the route map (patient coordinate system) is calculated on the basis of the distance from the base point (for example, the end point or the midpoint) to the pixel. Then, the route map generation unit 24 assigns an image number to a pixel at a position on the calculated route map. In this way, the catheter image is arranged on the route map. The catheter image arranged on the route map is called a route portion. In some cases, at least a part of the root part related to the nth image number and the root part related to the (n−1) th image number overlap. In this case, one of the overlapped image numbers (for example, the smaller number (n-1)) is adopted.

  When all the catheter images are arranged on the route map plane, the route map generation unit 24 determines whether or not the route is interrupted by performing image processing such as segmentation (step SA7). When it is determined that the route is interrupted (step SA7: YES), the route map generation unit 24 interpolates the interrupted interval based on the slopes of the two adjacent route portions across the interrupted interval (step SA8). ). Details of the route interpolation processing will be described later.

  If it is determined that the route is not interrupted (step SA7: NO), the route map is completed, and the route map generation process ends.

  If it is determined in step SA7 that there is no interruption (step SA7: NO), or if the interrupted section is interpolated (step SA8), the route map is completed, and the route map generation unit 24 ends the route map generation processing. FIG. 6 is a diagram illustrating an example of a route map. As shown in FIG. 6, the route map shows the route of the catheter in the past IVR procedure derived from the route map. The number of the past image is given to the pixels constituting the route. For example, the first root portion RS1 is derived from the catheter image included in the past image having the image number “1”.

  The generated route map is stored in the storage unit 23 in association with examination identification information such as patient ID and examination ID. FIG. 7 is a diagram illustrating an example of a table (hereinafter referred to as a route map correspondence table) indicating correspondence between a route map and examination identification information. As shown in FIG. 7, the route map correspondence table includes items of patient ID, IVR procedure examination ID, and route map ID. For example, the route map ID “001” is associated with the patient ID “00000001” and the examination ID “100”.

  Next, step SA8 (route interpolation processing) of route map generation processing by the route map generation unit 24 will be described in detail. FIG. 8 is a diagram illustrating a route map having a discontinuous portion. As shown in FIG. 8, the route portion RS2 to which the image number “2” is assigned and the route portion RS3 to which the image number “3” is assigned are interrupted. As shown in FIG. 8, first, the route map generator 24 identifies the end points EP2 and EP3 of each route. Specifically, the route map generator 24 first thins the route portions RS2 and RS3. Pixels constituting the thin lines (hereinafter referred to as thin line pixels) are pixels indicated by bold image numbers in FIG. Then, the route map generation unit 24 sets a thin line pixel having only one adjacent thin line pixel as the end point EP.

  Next, in order to obtain the slopes of the route portions RS2 and RS3, the route map generation unit 24 is separated from the end point EP by a predetermined distance (for example, 4 pixels) with respect to each route portion RS2 and RS3 as shown in FIG. Fine line pixels GP2 and GP3 (hereinafter referred to as guide points) are set. The guide point is a pixel indicated by an underlined image number in FIG. Then, the route map generator 24 sets straight lines L2 and L3 (inclinations) extending from the guide points GP2 and GP3 toward the end points EP2 and EP3 for the route portions RS2 and RS3. The two straight lines L2 and L3 are extended one pixel at a time until they intersect each other. An image number “A” indicating the interpolation is assigned to a pixel on the extension line (hereinafter referred to as an interpolation pixel). In this way, the route portions RS2 and RS3 are connected by the extension line constituted by a plurality of interpolation pixels.

  Then, as shown in FIG. 10, the route map generation unit 24 interpolates the discontinuous portion by expanding the extension line constituted by the interpolation pixels to the thickness of the adjacent route portions RS2 and RS3. Specifically, an image number “A” is assigned to a pixel to which an image number is not assigned and is adjacent to the extension line in the vertical or horizontal direction. As a result, the extension line is inflated to form the root portion RSA.

  As described above, in step SA7, the route map generation unit 24 interpolates the interrupted portion with the route portion RSA based on the inclination of the route portion RS2 and the inclination of the route portion RS3. This completes the interpolation process in step SA9. Note that the image number “A” included in the interpolation portion may be replaced with the image number (image number 2 or 3) included in the route adjacent to the interpolation portion. Further, although the above interpolation method linearly interpolates between the root part RS2 and the root part RS3, it may be interpolated in a high dimension by a quadratic curve, a cubic curve or the like. Further, the route map generation unit 24 can manually correct the interpolated route portion RSA via the image observation device 30 by a doctor or the like.

(Past image selection / display processing)
Next, clinical use examples of past image automatic selection / display processing using a route map in the current IVR procedure will be described. A doctor or the like may want to confirm the contents of past IVR procedures during the current IVR procedure. For example, the route through the catheter in the past IVR procedure, the presence or absence of embolization in the blood vessel portion that will reach from now on, the state of stent placement, the state of the surgery performed in the past, and the like.

  FIG. 11 is a diagram illustrating a flow of automatic search / transmission processing of past images by the control unit 21 of the image management apparatus 20. First, the control unit 21 receives data of a current image transmitted from the image generation device 10 via the communication unit 22 (step SB1). The current image may be a fluoroscopic image or a contrast image. The current image to be received is attached with image identification information such as the patient ID of the subject, the shooting position of the current image, and the like. The received current image is stored in the storage unit 23 in association with the image identification information and the shooting position.

  When the current image is received, the control unit 21 causes the category destination specifying unit 25 to perform category destination specifying processing, and causes the image selection unit 27 to perform route map reading processing.

  In the category point identification process, the category point identification unit 25 identifies a category point image included in the current image based on the shape of the category point (step SB2). In the route map reading process, the image selection unit 27 searches the storage unit 23 using the patient ID attached to the current image as a key, specifies a route map having the corresponding patient ID, and reads the specified route map (step SB3). ).

  When step SB2 and step SB3 are completed, the control unit 21 causes the cat tip position calculating unit 26 to perform the cat tip position calculating process. In the category position calculation process, the category position calculation unit 26 calculates the category position on the route map based on the shooting position of the current image and the category position on the current image (step SB4). Specifically, the categorical point position calculation unit 26 sets a categorical point position on the current image to the shooting position of the current image and a base point (for example, an end point or the like) in the current image represented by the coordinate system of the current image. Based on the distance from the middle point) to the target position, the position of the current target position on the route map (patient coordinate system) is calculated. In addition, when there is a difference between the shooting position of the past image and the shooting position of the current image, the correction value of the shift is, for example, an anatomically identical point drawn in the image (for example, a bone of the same part) It is obtained by calculating the amount of positional deviation. Then, based on the shooting position of the current image, the distance from the base point on the current image to the category position, and the correction value, the current category position on the route map is calculated.

  When calculating the category position on the route map, the control unit 21 causes the image selection unit 27 to perform image number presence / absence determination processing. In the image number presence / absence determination process, the image selection unit 27 determines whether or not an image number is assigned to the pixel at the category position on the route map (step SB5).

  If it is determined that no image number is assigned (step SB5: NO), the control unit 21 transmits a notification that there is no corresponding past image to the image observation device 30 via the communication unit 22 (step SB5). SB6). The transmitted notification is displayed on the image observation device 30.

  When it is determined that an image number is assigned (step SB5: NO), the control unit 21 causes the image selection unit 27 to perform an image number comparison process. In the image number comparison process, the image number selection unit 27 searches for a neighboring pixel at the categorical position, and determines whether the image number of the neighboring pixel is larger than the image number of the pixel at the categorized position (step SB7). It is assumed that the neighboring pixels are pixels that are on the route and are separated from the catheter tip position by a predetermined distance (for example, 5 pixels) toward the lesion. The predetermined distance can be arbitrarily set through the image observation apparatus 30 by a doctor or the like.

  When it is determined that the image number of the neighboring pixel is larger than the image number of the pixel at the catheter tip position (step SB7: YES), the control unit 21 causes the image selection unit 27 to perform the first past image selection process. . In the past image selection process, the image selection unit 27 searches the storage unit 23 using the image number of the neighboring pixel as a key, and specifies a past image having the corresponding image number from a plurality of past images (step SB8). .

  When it is determined that the image number of the pixel at the catheter tip position is not larger than the image number of the neighboring pixel, that is, the same (step SB7: NO), the control unit 21 causes the image selection unit 27 to perform the second past image selection process. To do. In the second past image selection process, the image selection unit 27 searches the storage unit 23 using the image number of the pixel at the category position as a key, and selects a past image having the corresponding image number from a plurality of past images. Specify (step SB9).

  When step SB8 or step SB9 ends, the control unit 21 transmits the identified past image to the image observation apparatus 30 via the communication unit 22 (step SB10). The received past image is displayed on the image observation device 30. The image observation apparatus 30 may display the past image route map simultaneously with the past image and the current image. When there is an interpolation part in the route map, the interpolation part may be displayed separately from other route parts.

  The processing of step SB7 to step SB10 is as follows: “Past image is displayed for grasping in advance the state of the blood vessel to be entered. Therefore, the past image to be displayed is an image relating to a position ahead of the current cat position. However, it is meaningless to display an image that is too far away from the current position of the catheter.

  FIG. 12 is a diagram for specifically explaining the processing from step SB7 to step SB10. As shown in FIG. 12, consider a pixel CP1 and a neighboring pixel NP1 corresponding to the pixel CP1 at the first category position, and a neighborhood pixel NP2 corresponding to the pixel CP2 and the pixel CP2 at the second category position. It is assumed that the neighboring pixel is set at a position 5 pixels away from the position of the cat tip.

  As shown in FIG. 12, the first pixel CP1 is on the root portion RS2, and its neighboring pixel NP1 is on the root portion RS3. In this case, since the image number “3” of the neighboring pixel NP1 is larger than the image number “2” of the pixel CP1, the past image having the image number “3” is selected in step SB8. In other words, a past image relating to a position slightly advanced from the current position of the cat tip is displayed. Further, as shown in FIG. 12, the second pixel CP2 is on the root portion RS2, and is separated by 6 pixels or more to the root portion RS3. Therefore, the neighboring pixel NP2 corresponding to the pixel CP2 is also on the root portion RS2. In this case, since the image number “2” of the pixel CP1 and the image number “2” of the neighboring pixel NP1 are the same, the past image having the image number “2” is selected in step SB9. Therefore, according to the above-described automatic selection / display processing, a past image relating to an appropriate position corresponding to the current category position is automatically selected and displayed.

  The past image automatic selection / display process is not limited to the above method. For example, a past image corresponding to the categorical point position may be searched when the categorized point position has reached a certain position on the route map. FIG. 13 is a diagram showing a route map in another automatic search / transmission process. As shown in FIG. 13, pixels BP1 and BP2 (pixels indicated by diagonal lines in FIG. 13) at the boundary between the route portions RS1 and RS2 (immediately before the next route portion) in other route maps are Set to trigger pixel. When the catheter tip reaches the trigger pixel, the image selection unit 27 searches for a past image having an image number that is one larger than the image number assigned to the reached trigger pixel. For example, when the image number assigned to the trigger pixel is “1”, the image number of the past image to be searched is “2”. In the above description, the trigger pixel is at the boundary of the root portion, but the trigger pixel can be set at an arbitrary place.

  In addition, when a plurality of past images are associated with the same position, for example, it is preferable to display the images in order from the largest amount of specific information (for example, procedure contents) recorded in the supplementary information of the image.

  According to the above configuration, the image display system automatically selects and displays an appropriate past image corresponding to the current position of the catheter using the route map, thereby supporting the IVR procedure by the doctor, It is possible to effectively use data of a large number of past images. Thus, according to the present embodiment, the procedure efficiency in the IVR procedure can be improved.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage.

(Modification 1)
In the first modification, an example in which a shooting position is not added to an image transmitted from the image generation device 10 will be described. FIG. 14 is a diagram illustrating a configuration of an image display system according to the first modification. As illustrated in FIG. 14, the image display system according to the first modification includes a camera device 40 in addition to the image generation device 10, the image management device 20, and the image observation device 30. The camera device 40 is installed in the examination room. The camera device 40 takes a video of the tip of the arm (for example, an X-ray detector) of the image generation device 10 that is currently taking an image and a bed, and generates video data. The generated video data is transmitted to the image management device 20. The image management apparatus 20 includes an image position calculation unit (not shown). The image position calculation unit calculates the imaging position of the image based on the relative positional relationship between the X-ray detector and the bed on the video data. The calculated shooting position is attached to the image transmitted from the image generation device 10.

  FIG. 15 is a diagram for explaining the calculation of the shooting position using the camera device 40. As shown in FIG. 15, the camera device 40 includes a first camera device 40-1 and a second camera device 40-2. The first camera device 40-1 images the marker M1A attached to the X-ray detector and the marker M1B attached to the bed from the lateral direction of the bed. The second camera device 40-2 images the marker M2A attached to the X-ray detector and the marker M2B attached to the bed from the bed vertical direction. The markers M1A, M1B, M2A, and M2B are spherical markers having a predetermined size. The image position calculation unit stores the size of the markers M1A, M1B, M2A, and M2B on the video at the reference position. The image position calculation unit is configured to determine whether the first camera apparatus and the markers M1A and M1B are based on the difference between the sizes of the M1A and M1B images at the reference position and the comparison positions M1A and M1B. Calculate the distance. Then, the image position calculation unit calculates the distance between the X-ray detector and the bed in the Z direction based on the calculated distances. The distance between the X-ray detector and the bed in the X direction is calculated similarly.

  The calculated shooting position is attached to an image having a shooting time substantially the same as the shooting time of the video data. Subsequent processing (for example, route map generation processing in FIG. 4 and automatic selection / display processing in FIG. 11) can be performed.

  In addition, the camera apparatus 40 performed camera photography in order to calculate the positions of the X-ray detector and the bed. However, the position of the X-ray detector and the bed may be calculated by irradiation / detection of ultrasonic waves or infrared rays, or detection such as geomagnetism or magnetic force line conversion.

  With the above configuration, even when the imaging position is not added to the image transmitted from the image generation device 10, the imaging position is calculated by calculating the position between the bed and the tip of the arm (X-ray detector) and added to the image. To do.

  Note that a contact type or non-contact type displacement sensor (measuring instrument: rotation angle sensor, tilt angle sensor, linear displacement sensor, etc.) is attached to each axis and bed of the image generating apparatus 10, and coordinates are calculated from each measuring instrument. It is good.

(Modification 2)
In the second modification, the image management device 20 is not currently connected to the image management device 20 via a network, or the image management device 20 is not able to transfer image data during shooting. An example in the case where the message cannot be received will be described. FIG. 16 is a diagram illustrating a configuration of an image display system according to the second modification. As shown in FIG. 16, the image display system includes a camera device 50 in addition to the image generation device 10, the image management device 20, and the image observation device (monitor) 30. The image generation device 10 and the image observation device 30 are connected by a cable or the like. In the current IVR procedure, the image generation device 10 generates data of the current image and transmits it to the image observation device 30. The image observation device 30 displays the received current image.

  The image management device 30 and the camera device 50 are connected via a network. The camera device 50 takes a video of the current image displayed on the image observation device 30 and generates video data. The generated video data is transmitted to the image management apparatus 20 via the network as current image data. Processing similar to the subsequent processing (for example, automatic selection / display processing in FIG. 11) can be performed.

  FIG. 17 is a diagram illustrating a configuration of another image display system according to the second modification. Another image display system includes an image generation device 10, an image management device 20, and an image observation device (monitor) 30. The image generation device 10 and the image observation device 30 are connected by a cable or the like. In the current IVR procedure, the image generation device 10 generates data of the current image and transmits it to the image observation device 30. The image observation device 30 displays the received current image. The current image displayed on the image observation device 30 is transmitted from the output terminal provided in the image observation device 30 to the image management device 20 via a cable.

  With the above configuration, even when the current image data cannot be transmitted from the image generation device 10 to the image management device 20, the current image displayed on the image observation device 30 is captured by the camera, and the video data is used as the current image data. It is possible to transmit to the image management apparatus 20.

(Modification 3)
The third modification is a modification in the case where the shooting position cannot be added to the current image even by the method of the present embodiment and the first modification. In the following description, components having substantially the same functions as those in the present embodiment are denoted by the same reference numerals, and redundant description will be given only when necessary.

  The image display system according to the modified example 3 is based on the concept that “the main blood vessel forms of the human body are different depending on the part, and the part can be identified if the form of the blood vessel is known”.

  FIG. 18 is a diagram illustrating a configuration of an image management apparatus 60 according to the third modification. As shown in FIG. 18, the image management device 60 is centered on the control unit 21, and includes a communication unit 22, a storage unit 61, a cat tip specifying unit 62, a blood vessel image extracting unit 63, a route map generating unit 24, and a cat tip location calculation. Part 64, photographing position giving part 65, and image selecting part 27.

  The storage unit 61 stores a map (hereinafter referred to as a template map) that shows a general form and a anatomical position of a main blood vessel of a human body. The template map is general rather than patient specific. The template map is expressed in the coordinate system of the template map.

  The catheter tip specifying unit 62 specifies the catheter tip image by subtracting the mask image from the fluoroscopic image photographed at the same position immediately before the mask image.

  The blood vessel image extracting unit 63 extracts a blood vessel image through which the catheter has passed from the image based on the catheter tip position specified by the catheter tip specifying unit 62.

  The route map generation unit 24 generates a route map by arranging a plurality of catheter images included in a plurality of past images on a route map plane according to the imaging position.

  The catheter tip position calculation unit 64 performs template matching processing using the template map as a template and a blood vessel image as a comparison image, and calculates the position of the blood vessel image on the template map.

  The imaging position assigning unit 65 attaches the position of the blood vessel image on the template map to the past image as the imaging position.

  A shooting position providing process according to the third modification will be described. The route map generation process is performed on a plurality of past images included in one procedure image set stored in the storage unit.

  FIG. 19 is a diagram illustrating an outline of the photographing position providing process according to the third modification. As shown in FIG. 19, first, the image generating apparatus 10 generates image BI data related to a blood vessel image contrasted with a contrast agent. The image BI also includes a catheter image. The blood vessel image extraction unit 63 extracts a blood vessel image CB through which the catheter has passed from the image BI based on the catheter tip position specified by the catheter tip specifying unit 62. The catheter tip position calculation unit 64 specifies the position of the blood vessel image on the template map TM by template matching processing using the template map TM as a template and the blood vessel image BI comparison image. If a single site cannot be identified by the shape of the blood vessel alone, bones drawn around are extracted and used for template matching processing. The imaging position assigning unit 65 assigns the position of the blood vessel image on the template map TM to the image as the imaging position PP. The position of the blood vessel image on the template map is, for example, the position of the end point of the blood vessel image on the template map. When the shooting position is assigned, the route map generator 24 generates a route map by performing the processing after step SA5 in FIG. At this time, the coordinate system of the route map is the same as the coordinate system of the template map.

  Note that the category specifying process by the category specifying unit 62 is not limited to the above method. For example, on the assumption that the catheter is inserted from a certain direction, the catheter tip specifying unit 62 may set the end point of the blood vessel image along the direction as the catheter tip position. Further, a doctor or the like may point the position of the catheter tip on the image.

  With the above configuration, even when a shooting position is not added to an image transmitted from the image generation device 10, it is possible to calculate the shooting position of the image by using the template map and to add the calculated shooting position to the image. It becomes.

  In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

  DESCRIPTION OF SYMBOLS 10 ... Image generation apparatus, 20 ... Image management apparatus, 21 ... Control part, 22 ... Communication part, 23 ... Memory | storage part, 24 ... Route map production | generation part, 25 ... Category destination identification part, 26 ... Category destination position calculation part, 27 ... Image selection unit, 30 ... Image observation apparatus

Claims (11)

Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
Identifying means for identifying a particular portion of the catheter image from a current image generated during the current catheterization;
Display means for reading out and displaying the data of the past image according to the position of the specified specific part;
With
The display means, when there are a plurality of data of the past image corresponding to the position of the specified specific portion, to display in order from the one with a lot of specific information included in the incidental information of the data of the past image. An image display device. Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
Identifying means for identifying a particular portion of the catheter image from a current image generated during the current catheterization;
Display means for reading out and displaying the data of the past image according to the position of the specified specific part;
With
When there are a plurality of data of the past image corresponding to the position of the specified specific part, the display unit is configured to store the specific past image based on information on the procedure content included in the incidental information of the data of the past image. An image display device characterized by displaying data. Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
Route map generation means for generating a route map indicating the distribution of the plurality of first catheter images or blood vessel images by arranging a plurality of first catheter images or blood vessel images included in the plurality of past images according to the plurality of positions. When,
Identifying means for identifying a specific portion of the second catheter image on the current image from a current image generated during the current catheterization;
Position calculating means for calculating the position of the specific part on the route map based on the position of the specified specific part and the position of the current image;
Display means for displaying a specific past image according to the position of the specific portion on the calculated route map;
With
The display means, when there are a plurality of data of the past image corresponding to the position of the specified specific portion, to display in order from the one with a lot of specific information included in the incidental information of the data of the past image. An image display device.   The image display apparatus according to claim 1, wherein the specific information is information related to a procedure content. Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
Route map generation means for generating a route map indicating the distribution of the plurality of first catheter images or blood vessel images by arranging a plurality of first catheter images or blood vessel images included in the plurality of past images according to the plurality of positions. When,
Identifying means for identifying a specific portion of the second catheter image on the current image from a current image generated during the current catheterization;
Position calculating means for calculating the position of the specific part on the route map based on the position of the specified specific part and the position of the current image;
Display means for displaying a specific past image according to the position of the specific portion on the calculated route map;
With
When there are a plurality of data of the past image corresponding to the position of the specified specific part, the display unit is configured to store the specific past image based on information on the procedure content included in the incidental information of the data of the past image. An image display device characterized by displaying data. The route map generating means assigns identification information of a past image derived from the first catheter image or blood vessel image to the first catheter image or blood vessel image on the route map,
The display means includes identification information assigned to a pixel of the second catheter image on the route map and identification information assigned to a pixel separated by a predetermined distance from the pixel. 6. The image display device according to claim 3, wherein the related past image is displayed.   The route map generation means, when there is a discontinuity in the route map, interpolates the discontinuity based on the inclination of two first catheter images adjacent to each other across the discontinuity. The image display device according to claim 3 or 5.   The image display device according to claim 3, wherein the display unit displays the route map. An image display system comprising an image generation device, an image management device, and an image observation device connected to each other via a network,
The image generating device includes:
Generating means for generating data of current images during current catheterization;
First transmission means for transmitting the generated current image data to the image management device;
The image management device includes:
Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
A specifying means for specifying a catheter image specifying portion from the transmitted current image;
Selecting means for selecting data of a specific past image according to the position of the specified specific part;
Second transmission means for transmitting data of the selected specific past image to the image observation device;
Have
The image observation apparatus includes:
Display means for displaying the transmitted specific past image;
The selection means, when there is a plurality of data of the past image corresponding to the position of the specified specific portion, to select in order from the specific information included in the incidental information of the data of the past image,
The second transmission means transmits data of the selected specific past image to the image observation device,
The image display system, wherein the display means displays the transmitted specific past image.   The image display system according to claim 9, wherein the specific information is information related to a procedure content. An image display system comprising an image generation device, an image management device, and an image observation device connected to each other via a network,
The image generating device includes:
Generating means for generating data of current images during current catheterization;
First transmission means for transmitting the generated current image data to the image management device;
The image management device includes:
Storage means for storing data of a plurality of past images related to a plurality of positions generated during past catheterization;
A specifying means for specifying a catheter image specifying portion from the transmitted current image;
Selecting means for selecting data of a specific past image according to the position of the specified specific part;
Second transmission means for transmitting data of the selected specific past image to the image observation device;
Have
The image observation apparatus includes:
Display means for displaying the transmitted specific past image;
When there is a plurality of data of the past image corresponding to the position of the specified specific part, the selection unit selects the specific past image based on information on the procedure content included in the incidental information of the data of the past image. Select the data
The second transmission means transmits data of the selected specific past image to the image observation device,
The image display system, wherein the display means displays the transmitted specific past image.

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