JP5487339B2 - Medical image processing device - Google Patents

Description

  Embodiments described herein relate generally to a medical image processing apparatus.

  Ultrasound diagnostic apparatuses and X-ray computed tomography apparatuses are used for observation and diagnosis of heart diseases. Among them, an ultrasonic diagnostic apparatus is mainly used for observing and diagnosing heart wall motion abnormality and wall thickness abnormality. The abnormal site included in the volume data generated by the ultrasonic diagnostic apparatus is specified by using a technique called tissue Doppler imaging (hereinafter referred to as TDI), for example. Hereinafter, a technical example relating to diagnosis of an abnormal site using TDI will be briefly described.

  Technical example 1: By simply observing the display screen, it is possible to easily grasp the motion state of the tissue at the diagnosis site, and it is possible to quantitatively, highly accurately and quickly evaluate the functional deterioration or abnormality of the tissue (for example, Patent Document 1). reference).

  Technical Example 2: The display capability of the low-speed region obtained by TDI is improved, and normal / abnormal determination of the region of interest is facilitated (see, for example, Patent Document 2).

  When diagnosing an affected part of heart wall motion abnormality or wall thickness abnormality with an ultrasonic diagnostic device, the affected part can be roughly observed by displaying a three-dimensional image, but in order to grasp the more detailed state of the affected part, It is necessary to display a moving image of the MPR image. However, when diagnosing an image generated in real time and displayed on the monitor, the operator must operate the probe with one hand and specify the cross-sectional position of the image displayed on the monitor with the other hand. The operation for specifying the cross-sectional position is complicated and complicated. In addition, the probe capable of 3D scanning can freely change the position and orientation of the cross section in real time in addition to the position and orientation of the probe. Therefore, the degree of freedom is higher than that of a probe capable of only 2D scanning, but the operation is complicated.

JP-A-08-84729 Japanese Patent Application Laid-Open No. 08-66397

  An object is to provide a medical image processing apparatus that can easily provide an image suitable for diagnosis of functional information such as the heart.

  The medical image processing apparatus according to the present embodiment includes an extraction unit that extracts an abnormal part based on exercise information from first volume data generated by the first medical image diagnostic apparatus and related to the abnormal part of the subject that moves. Image generation for generating image data related to the subject based on at least one of a gray value, opacity, and color information from the second volume data including the abnormal part, generated by the second medical image diagnostic apparatus And a determination unit that determines whether or not a region that inhibits scanning by the probe is included in the scan plane based on at least one of a gray value, opacity, and color information included in the second volume data And the position and orientation of a probe that crosses the extracted abnormal site and does not include the inhibition region in the scan plane based on the determination result of the determination unit. A determination unit for determining a comprises a display unit for displaying superimposed in alignment on the image relating to the subject position and a mark indicating an orientation of the probe.

The figure which shows the structure of the medical image processing system and medical image processing apparatus which concern on 1st Embodiment of this invention. The figure which shows the flow of operation | movement of the display process of the image regarding the diagnostic cross section by the system control part. The figure which shows the cross-section setting image containing one abnormal site area | region displayed in step SA7 of FIG. The figure which shows the cross-section setting image containing multiple abnormal region area | regions displayed in step SA7 of FIG. The figure which shows the specific example of the position and direction of a diagnostic cross section which concern on step SA8 of FIG. The figure which shows the superimposition display of an ultrasonic cross-sectional image, CT cross-sectional image, and an abnormal site | part image based on step SA10. The figure which shows the parallel display of the superimposition image of an ultrasonic cross-sectional image and an abnormal site | part image, and the superimposed image of CT cross-sectional image and an abnormal site | part image based on step SA10. The figure which shows the structure of the medical image processing system and medical image processing apparatus which concern on the 2nd Embodiment of this invention. The figure which shows the flow of the display process of the probe mark which concerns on 2nd Embodiment by the system control part of FIG. The figure which shows the flow of the determination process of the probe position and direction performed by the probe position and orientation determination part of FIG. 9 in step SB9 of FIG. The figure for demonstrating the moving process of the diagnostic cross section which concerns on step SC2 of FIG. FIG. 11 is another view for explaining the diagnostic cross-section moving process according to step SC2 of FIG. 10; The figure which shows the probe mark which shows the probe mark which shows the position of the probe based on step SB10 of FIG. The figure which shows the probe mark which shows the position and the probe mark which shows the position of the probe which overlap and are displayed on the body surface image regarding the patient left side surface direction based on step SB10 of FIG. The figure which shows the probe mark which shows the position of the probe based on step SB10 of FIG. The figure which shows the probe mark which shows the probe mark which shows the position of the probe based on step SB10 of FIG. The figure which shows an example of the display layout of a probe mark based on step SB10 of FIG. The figure which shows the other example of the display layout of a probe mark based on step SB10 of FIG.

  Hereinafter, medical image processing apparatuses according to first and second embodiments of the present invention will be described with reference to the drawings. The medical image processing apparatus according to the first and second embodiments uses volume data generated by a medical image diagnostic apparatus such as an ultrasonic diagnostic apparatus, an X-ray computed tomography apparatus, a magnetic resonance imaging apparatus, or a nuclear medicine diagnostic apparatus. It is included in the medical image processing system to be processed.

(First embodiment)
FIG. 1 is a diagram illustrating a configuration of a medical image processing system and a medical image processing apparatus 1 according to the first embodiment. As shown in FIG. 1, the medical image processing apparatus 1 is electrically connected to the ultrasonic diagnostic apparatus 100 and the X-ray computed tomography apparatus 200 directly or via an electrical communication line.

  The ultrasound diagnostic apparatus 100 scans a 3D scan region including a heart of a subject with a probe, and thereby analyzes at least one volume for analyzing functional information of the heart for tissue Doppler imaging (hereinafter referred to as TDI) processing. Generate a data file. Hereinafter, the volume data file generated by the ultrasonic diagnostic apparatus 100 will be referred to as an ultrasonic volume data file. In this case, the ultrasound diagnostic apparatus 100 performs TDI processing on a plurality of ultrasound volume data files and generates data of function information (hereinafter referred to as ultrasound function information). The ultrasonic function information indicates heart wall motion information (for example, the moving speed of the heart wall). The ultrasonic function information data is volume data in which the value of the ultrasonic function information is assigned to each voxel constituting the ultrasonic volume data file.

  Subsequent to the TDI scan, the ultrasound diagnostic apparatus 100 repeatedly scans the same 3D scan region with a probe, thereby generating a plurality of ultrasound volume data files having different scan times.

  The X-ray computed tomography apparatus 200 generates a plurality of volume data files with different imaging times by repeatedly scanning the 3D scan region with X-rays in order to analyze the functional information of the heart. Hereinafter, a volume data file generated by the X-ray computed tomography apparatus 200 will be referred to as a CT volume data file. The X-ray computed tomography apparatus 200 uses existing techniques (for example, techniques described in Japanese Patent Application Laid-Open No. 2007-202957, Japanese Patent Application Laid-Open No. 2006-110190, and Japanese Patent Application Laid-Open No. 2006-61581). It is applied to a CT volume data file, and data of cardiac function information (hereinafter referred to as CT function information) is generated.

  Further, the X-ray computed tomography apparatus 200 generates a CT volume data file related to the end diastole of the heart by reconstructing the electrocardiogram synchronously with the projection data collected by repeatedly scanning the 3D scan region.

  The medical image processing apparatus 1 uses the ultrasound volume data, the ultrasound function information data, the CT volume data, and the CT function information data to determine the position and orientation of an appropriate cross section for diagnosing the heart function information. Calculate and display an image of the calculated cross section.

  As shown in FIG. 1, the medical image processing apparatus 1 includes an ultrasonic volume data storage unit 10, an ultrasonic function information data storage unit 12, a CT volume data storage unit 14, a CT function information data storage unit 16, and an abnormal part extraction unit. 18, a specific part extraction unit 20, a long axis calculation unit 22, an alignment unit 24, a cross section calculation unit 26, an image generation unit 28, an input unit 30, a display control unit 32, a display unit 34, and a system control unit 36.

  The ultrasonic volume data storage unit 10 stores a plurality of ultrasonic volume data files generated by the ultrasonic diagnostic apparatus 100.

  The ultrasonic function information data storage unit 12 stores ultrasonic function information data generated by the ultrasonic diagnostic apparatus 100.

  The CT volume data storage unit 14 stores a CT volume data file generated by the X-ray computed tomography apparatus 200. The CT volume data file is transmitted from the X-ray computed tomography apparatus 200 or recorded on a recording medium such as a magnetic disk, an optical disk, or a semiconductor memory, and transferred from this recording medium to the CT volume data storage unit 14.

  The CT function information data storage unit 16 stores CT function information data generated by the X-ray computed tomography apparatus 200.

  The abnormal part extraction unit 18 extracts the abnormal part region from the ultrasonic volume data file based on the ultrasonic function information data by the method described in Patent Document 1 or Patent Document 2. For example, the abnormal part extraction unit 18 extracts an abnormal part region of the heart wall motion by extracting voxels having ultrasonic function information larger or smaller than a preset threshold value of the ultrasonic function information. Moreover, the abnormal part extraction part 18 extracts an abnormal part area | region from CT volume data file based on the data of CT function information.

  The specific part extracting unit 20 extracts a specific part region from the ultrasonic volume data file or the CT volume data file based on at least one of the gray value, the opacity, and the color information. The specific site is the entire heart, the left ventricle, the right ventricle, or the like. Hereinafter, it is assumed that the region of the specific part to be extracted is the left ventricular region. It is assumed that the left ventricular region includes an abnormal region region of wall motion.

  The long axis calculation unit 22 is derived from the long axis of the left ventricle region (hereinafter referred to as the US long axis) derived from the ultrasound volume data file or the CT volume data file based on the extracted shape of the left ventricle region. The major axis of the left ventricular region (hereinafter referred to as the CT major axis) is calculated. As a long axis calculation method, for example, an ellipsoidal approximation of the left ventricular region is used.

  The alignment unit 24 aligns the ultrasonic volume data file and the CT volume data file based on the calculated US long axis and CT long axis. The alignment process may be performed by pattern matching based on a heart region included in each data file. Note that the ultrasonic function information data file and the ultrasonic volume data file are derived from scans at the same probe position and the same scan range, and are therefore aligned without performing alignment processing. .

  The cross section calculation unit 26 calculates the position and orientation of the cross section of the ultrasonic volume data file or CT volume data file perpendicular to the US long axis or CT long axis and intersecting the abnormal region. Since this cross section is a cross section for diagnosing an abnormal site, it is hereinafter referred to as a diagnostic cross section.

  Based on the calculated position and orientation of the diagnostic slice, the image generation unit 28 creates an image related to the diagnostic slice from the ultrasound volume data file (hereinafter referred to as an ultrasound slice image), and an image related to the diagnostic slice from the CT volume data file. (Hereinafter referred to as a CT cross-sectional image), an image related to an abnormal part from an abnormal part region included in the ultrasonic volume data file (hereinafter referred to as an ultrasonic abnormal part image), and an abnormality from an abnormal part region included in the CT volume data file Data of an image related to a region (hereinafter referred to as an abnormal CT region image) is generated. The generated various image data is transmitted to the display control unit 32.

  The input unit 30 includes an input device such as a mouse or a keyboard, and inputs various instructions from the operator. For example, the input unit 30 instructs to set display conditions such as a threshold value of function information, opacity, and color information, an instruction to change the position and orientation of a cross section of a displayed image, a display layout (for example, superimposed display or parallel display). Display) setting instructions.

  The display control unit 32 displays the generated image on the display unit 34. Specifically, the display control unit 32 displays the ultrasonic cross-sectional image related to the diagnostic cross-section, the ultrasonic abnormal region image, and the CT abnormal region image in a color or the like so as to overlap each other and display on the display unit 34. In addition, the display control unit 32 superimposes and displays the ultrasonic cross-sectional image and the CT cross-sectional image, and displays the superposed ultrasound abnormal part image and the CT abnormal part image in a superimposed manner. The display control unit 32 displays in parallel the superimposed image of the ultrasonic cross-sectional image and the ultrasonic abnormal part image and the superimposed image of the CT cross-sectional image and the CT abnormal part image.

  The display unit 42 includes a display device such as a CRT (Cathode-Ray Tube).

  The system control unit 36 functions as the center of the medical image processing apparatus 1 and controls each component of the medical image processing apparatus 1 so as to realize the operation as the medical image processing apparatus 1.

  Hereinafter, a clinical operation example of image display processing relating to a diagnostic slice performed under the control of the system control unit 36 will be described. Specifically, in the present display process, the medical image processing apparatus 1 displays a moving image of an image related to a diagnostic cross section that is optimal for diagnosis of a local wall motion disease of the heart under a 3D scan of the heart by the ultrasonic diagnostic apparatus 100. And

FIG. 2 is a diagram showing the flow of operation of image display processing related to a diagnostic section by the system control unit 36. Prior to step SA1, the CT volume data file is stored in the CT volume data storage unit 14, the CT long axis is calculated by the long axis calculation unit 22, and the normal ultrasonic region and the abnormal CT region are extracted as abnormal regions. It is assumed that it is extracted by the unit 18.

  When the surgeon operates the probe of the ultrasonic diagnostic apparatus 100, the ultrasonic diagnostic apparatus 100 generates a plurality of ultrasonic volume data files having different scan times in real time. It is assumed that the probe during scanning is applied to a standard position when observing the heart, for example, the parasternal left edge approach position. The system control unit 36 inputs a plurality of ultrasonic volume data files generated in real time by the ultrasonic diagnostic apparatus 100 (step SA1).

  When the ultrasonic volume data file is input, the system control unit 36 causes the specific part extraction unit 20 to perform the left ventricle extraction process. In the left ventricle extraction process, the specific part extraction unit 20 extracts a left ventricular region from each ultrasonic volume data file (step SA2).

  When the left ventricular region is extracted, the system control unit 36 causes the long axis calculation unit 22 to perform a long axis calculation process. In the long axis calculation process, the long axis calculation unit 22 calculates the US long axis of the extracted left ventricular region (step SA3).

  When the US major axis is calculated, the system control unit 36 causes the alignment unit 24 to perform alignment processing. In the alignment process, the alignment unit 24 aligns the ultrasonic volume data file and the CT volume data file based on the US long axis and the CT long axis (step SA4).

  When the alignment process is performed, the system control unit 36 causes the image generation unit 28 to perform a cross-section setting image generation process for setting a diagnostic cross-section. In the generation processing of the cross-section setting image, the image generation unit 28 generates ultrasonic cross-section image data related to a cross-section (for example, a cross section in the patient front direction) parallel to the US major axis based on the ultrasonic volume data file, Based on the region, ultrasonic abnormal region image data relating to a cross section parallel to the US major axis is generated (step SA5). Further, in the cross-section setting image generation processing, the image generation unit 28 generates CT cross-section image data relating to a cross-section parallel to the CT long axis based on the CT volume data file, and the CT abnormal region region image based on the CT abnormal region region. Generate data.

  When the processing for generating the cross-section setting image is performed, the system control unit 36 causes the display control unit 32 to perform processing for displaying the cross-section setting image. In the display processing of the cross-section setting image, the display control unit 32 aligns the ultrasonic cross-sectional image, CT cross-sectional image, ultrasonic abnormal site image, or CT abnormal site image generated in step SA5 in a superimposed manner on the display unit 34. (Step SA6). At this time, the display control unit 32 displays the left ventricular region of the ultrasonic cross-sectional image and the left ventricular region of the CT cross-sectional image in different colors so that the operator can discriminate each, or displays the left ventricular region on each left ventricular region. Add contour lines and grid lines to display. Alternatively, either one of the ultrasonic cross-sectional image and the CT cross-sectional image may be displayed translucently.

  When the cross-section setting image is displayed on the display unit 30, it waits for the operator to set the range of the abnormal region through the input unit 30 (step SA7). At this time, the surgeon operates the input unit 30 with the other hand while operating the probe with one hand and sets the range of the abnormal region. It is assumed that the abnormal region region range setting process is performed for either the ultrasonic abnormal region or the CT abnormal region.

  3 and 4 are cross-sectional setting images displayed in step SA7. As shown in FIGS. 3 and 4, the range of the abnormal region IR is a distance along the long axis direction sandwiched between two straight lines L perpendicular to the long axis direction. The surgeon moves the two straight lines L on the screen via the input unit 30 to set the range of the abnormal part region IR. As shown in FIG. 4, when a plurality of large and small abnormal part regions IR are scattered in the cross-section setting image, the abnormal part region IR may be narrowed down by adjusting the threshold value of the function information. . Further, the abnormal region IR may be narrowed down by an existing clipping process or a connected area extraction process.

  When the range of the abnormal region is set via the input unit 30 (step SA7: YES), the system control unit 36 causes the cross section calculation unit 26 to perform a diagnostic cross section calculation process. In the diagnostic cross-section calculation process, the cross-section calculator 26 calculates the position and orientation of the diagnostic cross-section that is perpendicular to the US major axis or CT major axis and intersects the abnormal region (step SA8).

  FIG. 5 is a diagram showing a specific example of the position and orientation of the diagnostic section. FIG. 5A is a diagram showing a diagnostic section SC that is perpendicular to the long axis (US long axis or CT long axis) and passes through the center of the long axis within the range R of the abnormal region IR. FIG. 5B is a diagram showing a diagnostic section SC that is perpendicular to the long axis and has the maximum area of the abnormal region IR within the range R of the abnormal region IR. FIG. 5C is a diagnostic section SC that is perpendicular to the long axis and passes through the center of gravity of the shape of the abnormal region IR. FIG. 5D is a diagram showing a diagnostic section SC that passes through the end L of the range R of the abnormal site region IR perpendicular to the long axis. The type of position and orientation of these diagnostic sections SC can be arbitrarily set by the operator via the input unit 30.

  In addition, the cross section calculation unit 26 may calculate the position and orientation of the diagnostic cross section based on the value of the function information. For example, the cross section calculating unit 26 sets a plurality of cross sections perpendicular to the long axis, and calculates the total of the function information values of the plurality of voxels constituting the cross section for each cross section. Then, the cross section calculation unit 26 determines a cross section having a predetermined total value (for example, a maximum total value, a minimum total value, a center total value, etc.) as a diagnostic cross section. Further, the number of abnormal part regions may be calculated for each cross section, and a cross section having a predetermined number (for example, the maximum number, the minimum number, the center number, etc.) may be determined as a diagnostic cross section. In addition, the cross section calculation unit 26 may determine a cross section that is perpendicular to the long axis and includes the center of gravity of the value of the function information in the abnormal region as the diagnostic cross section. In addition, the section calculation unit 26 assigns priority to the value of the function information, the section having the highest priority value, the section including the interpolation position by priority weighting, and the value of the function information in the abnormal part region A cross section including the center value may be determined as a diagnostic cross section.

  In addition, the cross section calculation unit 26 may set a solid figure circumscribing the abnormal region, and may set a cross section perpendicular to the long axis including a reference point such as the center and the center of gravity of the set solid figure as a diagnostic cross section. . The solid figure is a cube, a rectangular parallelepiped, a sphere, an elliptic sphere, or the like.

  When the cross section calculation process is performed, the system control unit 36 causes the image generation unit 28 to perform a diagnostic image generation process. In the diagnostic image generation process, the image generation unit 28 performs MPR processing on the ultrasonic volume data file and the CT volume data file based on the position and orientation of the diagnostic cross section calculated in step SA8, thereby obtaining an ultrasonic cross section. Data of the image and the CT cross-sectional image are respectively generated (step SA9). Further, the image generation unit 28 generates data of the abnormal ultrasound region image from the abnormal ultrasound region region and data of the abnormal CT region image from the abnormal CT region region based on the position and orientation of the diagnostic section. Note that the cross-sectional image generated here may be a cross-sectional image with thickness. Examples of types of images with thickness include maximum value projection, minimum value projection, and average value projection within the thickness range.

  When the ultrasonic cross-sectional image, CT cross-sectional image, ultrasonic abnormal part image, and CT abnormal part image data in the diagnostic cross section are generated, the system control unit 36 causes the display control unit 32 to perform diagnostic image display processing. In the diagnostic image display process, the display control unit 32 displays the ultrasonic cross-sectional image, CT cross-sectional image, ultrasonic abnormal region image, and CT abnormal region image generated in step SA9 on the display unit 34 (step SA10). .

  FIG. 6 is a diagram showing a superimposed display of the ultrasonic cross-sectional image, the CT cross-sectional image, and the abnormal part image displayed in step SA10. As shown in FIG. 6, the display control unit 32 derives the abnormal site image II from the left ventricular region SR1 derived from the ultrasonic cross-sectional image or the CT cross-sectional image so that the surgeon can identify the abnormal site image II. It is displayed in a color different from that of the left ventricle region SR2. Since the left ventricular region SR1 is generated in real time simultaneously with the ultrasound scan, it is displayed as a moving image. The abnormal part image II and the left ventricular region SR2 are still images. The abnormal part image II may be an ultrasonic abnormal part image or a CT abnormal part image. Further, as shown in FIG. 7, the display control unit 32 parallels the superimposed image UI of the ultrasonic cross-sectional image and the ultrasonic abnormal part image II1 and the superposed image CI of the CT cross-sectional image and the CT abnormal part image II1. It may be displayed.

  When a diagnostic image as shown in FIG. 6 or FIG. 7 is displayed, the surgeon operates the input unit 30 to move or rotate the cross-sectional position of the diagnostic image, reverse the display, etc. Make a detailed observation. Cross-sectional movement is performed along the long axis. The operation range for cross-sectional movement and rotation may be limited to the range of the abnormal region set in step SA7. Further, the operation range may be somewhat narrowed or widened. In the rotation operation, the rotation center axis is an axis including the center of the display screen, the center of the heart region, the center of the range of the abnormal region, the center of the ventricle region, the intersection of the long axis and the diagnostic section, and the like. As described above, by limiting the movement axis, the movement range, the rotation axis, and the rotation range of the cross section to the periphery of the abnormal part, the operation of the operator can be simplified.

  With the above-described configuration, the medical image processing apparatus 1 according to the first embodiment has the optimal cross-sectional position and the position for diagnosing abnormal sites related to functional information such as the heart based on volume data generated by various medical image diagnostic apparatuses. The direction is calculated, and an image related to the calculated cross section is displayed. Further, the volume data is functionally analyzed by a function information analysis method unique to each medical image diagnostic apparatus, and the function image and the morphological image are aligned and displayed.

  Thus, according to the first embodiment, the medical image processing apparatus 1 simply provides a diagnostic image suitable for diagnosing an abnormal site related to functional information such as the heart simply by setting the range of the abnormal site region by the operator. Is possible.

  In the above description, the range of the abnormal region is set by the operator via the input unit 30. However, the present invention is not limited to this, and the range of the abnormal part region may be automatically determined based on the coordinates of the contour part of the abnormal part region without using the input unit 30. Further, the position and orientation of the diagnostic section may be calculated without setting the range of the abnormal region. The diagnostic cross section in this case may be a cross section perpendicular to the long axis and passing through the center of gravity of the abnormal region.

  In the above description, an ultrasonic cross-sectional image and a CT cross-sectional image are displayed. However, it is not necessary to limit to this, and only one cross-sectional image may be displayed. In this case, the alignment process between the ultrasonic cross-sectional image and the CT cross-sectional image is not necessary, and the workflow is improved.

(Second Embodiment)
The medical image processing apparatus 1 according to the second embodiment provides the surgeon with information indicating the position and orientation of the probe for assisting the diagnosis of abnormal sites related to functional information such as the heart by the ultrasonic diagnostic apparatus 100. By providing such information, as a result, the operator can observe an image suitable for diagnosis of an abnormal site. In the following description, components having substantially the same functions as those in the first embodiment are denoted by the same reference numerals, and redundant description will be given only when necessary.

  FIG. 8 is a diagram illustrating a configuration of the medical image processing apparatus 1 according to the second embodiment. As shown in FIG. 8, the medical image processing apparatus 1 includes an ultrasonic volume data storage unit 10, an ultrasonic function information data storage unit 12, a CT volume data storage unit 14, a CT function information data storage unit 16, and an abnormal part extraction unit. 18, specific part extraction unit 20, long axis calculation unit 22, alignment unit 24, cross section calculation unit 26, image generation unit 28, input unit 30, display control unit 32, display unit 34, system control unit 36, and probe position -It has direction determination part 38.

  The specific part extraction unit 20 extracts a specific part region from the ultrasonic volume data file or the CT volume data file based on at least one of the gray value, the opacity, and the color information. Specific sites are the entire heart, left ventricle, right ventricle, bone, body surface, and the like.

  The image generator 28 renders the body surface data extracted from the CT volume data file and generates body surface image data. The observation direction of the body surface image is a direction suitable for the diagnosis of the heart, typically a patient front direction, a left side direction, or the like.

  The probe position / orientation determination unit 38 determines the position and orientation of the probe with the desired cross section as the scan plane based on the positional relationship between the desired cross section (typically a diagnostic cross section), the body surface, and the CT major axis. To decide. Further, the probe position / orientation determination unit 38 determines whether or not the diagnostic section includes an area related to an object that obstructs the ultrasound scan based on at least one of the gray value, the opacity, and the color information. If it is determined that it is included, the diagnostic section is moved to a position where the inhibition region is not included.

  The display control unit 28 causes the display unit 34 to display a mark indicating the position and orientation of the determined probe (hereinafter referred to as a probe mark) on the body surface image.

  Hereinafter, a clinical operation example of the probe mark display process performed under the control of the system control unit 36 will be described. FIG. 9 is a diagram showing a flow of operation of probe mark display processing by the system control unit 36.

  As shown in FIG. 9, the processing contents of steps SB1 to SB8 are the same as the processing contents of steps SA1 to SA8 in FIG. It is assumed that body surface image data has been generated before the start of step SB1.

  When the position and orientation of the diagnostic section are calculated in step SB8, the system control unit 36 causes the probe position / orientation determining unit 38 to perform the probe position and orientation determining process. In the probe position / orientation determination process, the probe position / orientation determination unit 38 determines the position of the probe with the diagnostic cross section as the scan plane based on the position and orientation of the diagnostic cross section calculated in step SB8 and the shape of the body surface. Then, the direction is determined (step SB9).

  Hereinafter, the probe position / orientation determination process executed by the probe position / orientation determination unit 38 in step SB9 will be described in detail with reference to FIG. FIG. 10 is a diagram showing a flow of probe position and orientation determination processing. First, the probe position / orientation determination unit 38 determines whether or not the diagnostic section in the CT volume data file includes a region related to an object that obstructs the ultrasonic scan, based on the gray value (CT value) (step SC1). ). The area where the ultrasound scan is inhibited has a higher or lower CT value than the area where the ultrasound scan is not inhibited. Specifically, the inhibition area is an area of bone, air, gas, or the like. The shade values (CT values) of these inhibition regions are known. Therefore, the probe position / orientation determination unit 38 can extract the inhibition region from the CT volume data file based on the gray value (CT value).

  If it is determined that the inhibition region is not included (step SC1: NO), the probe position / orientation determination unit 38 proceeds to step SC3.

  When it is determined that the inhibition region is included (step SC1: YES), the probe position / orientation determination unit 38 sets the diagnostic cross section as a major axis at a position where the inhibition region is not included (for example, a so-called acoustic window such as an intercostal space). (Step SC2). FIG. 11 is a diagram for explaining the process of moving the diagnostic cross section. As shown in FIG. 11, it is assumed that the initial diagnostic section IC includes a bone region BR that is a region that inhibits ultrasound in addition to the left ventricular region SR and the abnormal region IR. The initial diagnostic section IC and the long axis TA are orthogonal to each other. First, the probe position / orientation determination unit 38 sets the intersection point RP1 formed by the initial diagnostic section IC and the long axis TA as the center of rotation. Next, the probe position / orientation determination unit 38 tilts the diagnostic section IC in the direction of the major axis TA about the determined rotation center RP1 until the bone area BR is not included in the diagnostic section IC. Typically, the diagnostic cross section IC is tilted immediately after the bone region BR is not included or to the center of the interval between the adjacent bone regions BR. The angle of the diagnostic section JC with respect to the initial diagnostic section (plane orthogonal to the long axis TA) IC is preferably within 60 degrees.

  Next, as shown in FIG. 12, the probe position / orientation determination unit 38 sets an axis that includes the intersection point IP of the tilted diagnostic section JC and the body surface TR and is orthogonal to the long axis TA as a rotation axis. The diagnostic section JC is tilted about the rotation axis until the angle with respect to the long axis TA is the most vertical. The position and inclination of the diagnostic section KC after being tilted about the rotation center IP is set to the normal diagnostic section KC.

  When it is determined in step SC1 that the diagnostic cross section does not include the inhibition region, or when the diagnostic cross section is moved to a position where the inhibition region is not included in step S2, the probe position / orientation determination unit 38 Based on the position and orientation of the diagnostic section and the shape of the body surface, the position and orientation of the probe mark are determined (step S3). Specifically, the probe position / orientation determination unit 38 determines the position of the probe mark at a predetermined position on the intersection line between the diagnostic section and the body surface. The predetermined position is, for example, a position on the body surface at the shortest distance from the CT major axis. The probe position / orientation determination unit 38 determines the direction of the probe mark in the depth direction of the diagnostic section.

  When the position and orientation of the probe are determined, the system control unit 36 causes the display control unit 32 to perform probe mark display processing. In the probe mark display process, the display control unit 32 displays a probe mark indicating the position and orientation on the body surface image in a superimposed manner (step SB10).

  FIG. 13 is a diagram illustrating a probe mark PM indicating the position of the probe and a probe mark DM indicating the direction displayed on the body surface image TI related to the patient front direction. As shown in FIG. 13, by displaying the probe marks PM and DM, the operator can know the position and orientation of the probe for obtaining a scan plane suitable for diagnosis of an abnormal site. The surgeon performs a two-dimensional scan in accordance with the position and orientation of the probe indicated by the probe marks PM and DM, thereby obtaining a cross-sectional image with a higher scanning speed and higher resolution than the three-dimensional scan. Can do.

  Further, as shown in FIG. 13, in order to quickly and accurately place the probe at the position indicated by the probe mark, the anatomical reference position (the center of the subject) on the body surface image (typically, the front direction of the patient). The positional relationship between the line ML, the tip position XP of the sword-like projection (groove), and the probe marks PM and DM may be displayed on the body surface image TI. Specifically, the distance along the body surface between the probe mark PM and the median line ML (118 mm in FIG. 13), or the distance along the body surface between the probe mark PM and the tip position XP of the sword-shaped projection (FIG. 13). 113 mm) or the like is displayed. Although the anatomical reference position on the body surface image is the midline ML of the subject and the tip position XP of the xiphoid process (groove), other reference positions such as a nipple or a navel are used. Etc.

  Further, when the probe is provided with a position sensor, as shown in FIG. 14, even if the angle difference (43 ° in FIG. 14) between the actual probe orientation (tilt angle) and the probe mark orientation is displayed. Good.

  Instead of FIGS. 13 and 14, as shown in FIGS. 15 and 16, a bone region BR, a heart region HR, a left ventricular region, and the like extracted from the CT volume data file may be displayed. Further, instead of the bone region BR, the heart region HR, the left ventricular region, and the like, a schema schematically showing the forms of the bone, heart, left ventricle, and the like generated in advance may be used.

  As shown in FIG. 17, it is clinically effective to display these body surface images in parallel with a superimposed image of an ultrasonic cross-sectional image and an abnormal part image. The surgeon can set the probe at an optimal position and angle while observing various marks and numerical values displayed on the superimposed image UI, the body surface image SI, and the image Si. At this time, the ultrasonic diagnostic apparatus 100 can also perform ultrasonic scanning by automatically setting the position and orientation of the scan surface of the probe to the calculated position and orientation of the diagnostic section.

  Although the position and orientation of the probe mark are for 2D scanning, the position and orientation of the probe mark for 3D scanning may be calculated. The range of 3D scanning is the probe position. The direction determination unit 38 determines as follows. First, as shown in FIG. 12, the diagnostic section KC is tilted around the rotation axis until the abnormal section region IR is not included in the diagnostic section KC. Then, the positions and orientations of the two boundary sections KC having the maximum inclination angle are determined. A fan-shaped range sandwiched between the two calculated boundary sections KC is determined as a 3D scan range. The determined 3D scan range is displayed so as to overlap the body surface image TI, as shown in FIG. 18, for example. The display control unit 32 may cause the display unit 34 to display a cross-sectional image related to the boundary cross-section KC generated by the image generation unit 28 as necessary.

  Thus, according to the second embodiment, the medical image processing apparatus 1 can provide an image that supports the provision of an image suitable for diagnosis of an abnormal site related to functional information of the heart by the ultrasonic diagnostic apparatus 100.

  In the above description, the body surface image is generated based on the body surface data extracted from the CT volume data file. However, the present invention is not limited to this, and it may be generated based on body surface data extracted from the ultrasonic volume data file.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

  DESCRIPTION OF SYMBOLS 1 ... Medical image processing apparatus, 10 ... Ultrasonic volume data storage part, 12 ... Ultrasonic function information data storage part, 14 ... CT volume data storage part, 16 ... CT function information data storage part, 18 ... Abnormal site extraction part, DESCRIPTION OF SYMBOLS 20 ... Specific site | part extraction part, 22 ... Long axis calculation part, 24 ... Position alignment part, 26 ... Cross-section calculation part, 28 ... Image generation part, 30 ... Input part, 32 ... Display control part, 34 ... Display part, 36 ... System control unit 38... Probe position / orientation determination unit 100. Ultrasonic diagnostic apparatus 200. X-ray computed tomography apparatus.

Claims (5)

An extraction unit that extracts an abnormal part based on the exercise information from the first volume data generated by the first medical image diagnostic apparatus and relating to the abnormal part of the subject moving;
Image generation for generating image data related to the subject based on at least one of a gray value, opacity, and color information from the second volume data including the abnormal part, generated by the second medical image diagnostic apparatus And
A determination unit that determines whether or not a region that inhibits scanning by a probe is included in a scan plane based on at least one of a gray value, opacity, and color information included in the second volume data;
Based on the determination result of the determination unit, a determination unit that determines the position and orientation of the probe that intersects the extracted abnormal site and does not include the inhibition region in the scan plane;
A display unit for displaying a mark indicating the position and orientation of the probe superimposed on an image related to the subject,
A medical image processing apparatus comprising: The image generation unit generates body surface image data relating to the body surface of the subject as an image relating to the subject,
The display unit displays a mark indicating the position and orientation of the probe in an aligned manner on the body surface image,
The medical image processing apparatus according to claim 1.   The medical image processing apparatus according to claim 1, wherein the determination unit moves the scan plane to a position not including the inhibition area when it is determined that the inhibition area is included.   The medical image processing apparatus according to claim 1, wherein the determination unit determines the position and orientation of the probe based on the shape of the body surface.   2. The display unit according to claim 1, wherein the display unit displays at least one of a symbol, a figure, and a character indicating a positional relationship between the mark and a reference position on the body surface of the subject. Medical image processing apparatus.

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