JP5492729B2 - Endoscopic image recording apparatus, operation method of endoscopic image recording apparatus, and program - Google Patents

Description

The present invention relates to an endoscope image recording apparatus, an operation method of the endoscope image recording apparatus, and a program.

  When performing an endoscopic examination, one or a plurality of examination target parts are determined in advance for each patient as a subject, and the image of the examination target part is imaged by imaging the inside of the patient's body cavity in a prescribed procedure. Specifically, an endoscope operator inserts an endoscope insertion part into a body cavity in a patient and confirms the position of the distal end of the insertion part of the endoscope in the body cavity while determining a predetermined examination target. Reach the site. Then, each time it arrives, while confirming the image on the monitor screen, a still image shooting button is pressed while finely adjusting the shooting position and direction, and a still image is shot.

  The number of captured images may vary from several to 20 or more in a single examination, and it is desirable for a surgeon to examine many people in a short time. Imaging work is required. Under such circumstances, troubles such as failing to image a part of the examination site are particularly likely to occur, and if an image is missed at a necessary examination site, accurate diagnosis becomes difficult. In addition, in order to obtain a missed image again by re-examination with an endoscope, the burden on the patient increases.

  On the other hand, various apparatuses for detecting the position of an endoscope in a body cavity have been developed as a technique for accurately guiding the distal end portion of the endoscope to a desired examination site. For example, in the position detection device of Patent Document 1, a magnetism generation unit is provided at an insertion portion of an endoscope, and a magnetic sensor is provided at an examination table. Detect position.

  Further, in Patent Document 2, a three-dimensional image of a pipeline in a subject is created based on image data of a three-dimensional region of the subject, and a route to a target point along the pipeline on the three-dimensional image. An endoscope insertion support apparatus that creates a virtual endoscopic image based on image data has been proposed. According to this endoscope insertion support apparatus, the endoscope can be moved to a desired position.

JP 2000-81303 A JP 2000-135215 A

  However, at the time of the above-mentioned endoscopy, imaging should be performed when the operation of the button for taking a still image is uncertain, when the operator misrecognizes the operation, or when the operator makes a mistake in the judgment. The number of still images may be insufficient. In addition, there may be a case where the imaged location recognized by the surgeon and the actual imaging location do not match due to this.

  Therefore, it is conceivable to accurately grasp the examination site by using the devices of Patent Documents 1 and 2, but in the position detection device of Patent Document 1, it corresponds to the entire patient's body on the examination table or the like. Therefore, it is necessary to provide a magnetism generating means and a magnetic sensor, and the apparatus becomes large. Further, in the endoscope insertion support apparatus of Patent Document 2, it is necessary to generate inspection image data by a CT apparatus in advance, and none of them can be easily used.

The present invention provides a deficient still image even when it is found that after the endoscopic examination is completed, the still image of the examination part is insufficient at the time of the endoscopy in which the necessary examination part is designated in advance. It is an object of the present invention to provide an endoscopic image recording apparatus, an operation method of the endoscopic image recording apparatus, and a program that can support the operation of supplementing the image from moving image data.

The present invention has the following configuration.
(1) Endoscopic image recording for recording examination image data including still images of a plurality of predetermined examination parts based on an image signal output from an endoscope when performing an endoscopic examination of a subject. A device,
Data storage means for storing moving image data recording a moving image based on the image signal and still image data recording a still image at a timing according to a predetermined instruction;
Recording number detection means for detecting the number of recorded still images from the still image data stored in the data storage means;
By comparing the number of recorded still images plurality number of still images to be captured that is previously defined for each inspection site of the respectively summed predetermined number the recording number detecting means detects, records the still image A sheet number comparing and determining means for determining whether or not the number of sheets is less than the specified number ;
When the number comparison determination unit determines that the number of still images to be recorded is smaller than the specified number , the scene corresponding to the insufficient still image is extracted from the moving image data, and the extracted moving image A moving image still image conversion means for converting the scene into a new still image;
Means for incorporating the new still image into the inspection image data;
An endoscopic image recording apparatus comprising:
(2) An endoscope that automatically records examination image data including still images of a plurality of predetermined examination parts based on an image signal output from the endoscope when performing an endoscopic examination of a subject. A method of operating a mirror image recording device, comprising:
Based on the image signal, moving image data recording moving images and still image data recording still images taken at a predetermined timing are stored in the respective data storage means. To detect the number of still images recorded,
The number comparison determination means compares the prescribed number of the total number of still images to be photographed that are prescribed in advance for each of the plurality of examination sites with the number of still images recorded by the recording number detection means. ,
When the number of recorded still images is less than the specified number, the moving image still image conversion means extracts a scene corresponding to the insufficient still image from the moving image data, and the extracted moving image Convert the scene into a new still image,
An operation method of an endoscopic image recording apparatus that incorporates the new still image into the inspection image data.

(3) A program for causing a computer to execute the procedure of the operation method of the endoscope image recording apparatus according to (2).

  According to the present invention, at the time of an endoscopic examination in which a necessary examination part is designated in advance, even if the still picture of the examination part is insufficient after the endoscopic examination is completed, this insufficient still image Can be supplemented from moving image data. As a result, still images of all examination parts can always be obtained reliably, and the burden on the subject such as performing an endoscopic reexamination for re-taking the lacking image without lowering the diagnostic accuracy. Can be reduced.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure for describing embodiment of this invention, and is the whole block diagram which shows the structure of the endoscope image recording apparatus containing an endoscope system, and a hospital system. (A), (B), (C) is explanatory drawing which shows one procedure of the endoscopy performed by the endoscopic examination of the upper gastrointestinal tract. It is a schematic diagram showing the specific example of the test | inspection site | part division of the upper digestive tract shown in FIG. It is a flowchart showing the process sequence of the endoscopy performed by the endoscopic examination of an upper digestive tract. It is a flowchart which shows the content of the main processes of a terminal device. It is a schematic diagram which shows the specific example of the still image group recorded by the image recording device in the case of endoscopy. It is explanatory drawing which shows typically the shape and positional relationship of an endoscope insertion part in the case of image | photographing a gastric cardia part in the state which inserted the endoscope front-end | tip part in the stomach, and an observation image. It is a block diagram of the endoscope provided with the function which detects an insertion position. It is sectional drawing which shows the mouthpiece used in order to detect the insertion position of an endoscope. It is a schematic diagram showing the correspondence between the maximum insertion length of the endoscope and the examination site.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a diagram for explaining an embodiment of the present invention, and is an overall configuration diagram showing configurations of an endoscope image recording apparatus including an endoscope system and a hospital system.

  In the hospital system, an endoscope system 100, an image recording device 200, and an endoscope image recording device 400 including a terminal device 300 are arranged in an endoscope department, and these endoscope image recording devices 400 are provided. A server 500 is connected to each device. Each device is connected via a network and can communicate with each other. A report database 510 is connected to the server 500.

  The endoscope system 100 includes an endoscope 11 including an imaging optical system and an illumination optical system, an endoscope control device 13 that controls the endoscope 11, and a display unit 15 that displays image information and the like. . Also, the endoscope control device 13 to which the endoscope 11 is connected is connected to the image recording device 200, the terminal device 300, and the server 500 via a network, and various information can be input and output.

  The endoscope 11 includes a main body operation unit 19 and an endoscope insertion unit 21 connected to the main body operation unit 19 and inserted into a body cavity. One end of the universal cord 23 is connected to the main body operation unit 19, and the other end of the universal cord 23 is connected to the endoscope control device 13 via the connector 25.

  The main body operation unit 19 of the endoscope 11 includes a button for performing suction, air supply, and water supply on the distal end side which is a distal end of the endoscope insertion unit 21 with respect to the main body operation unit 19, and a shutter button during imaging. Various operation buttons 27 such as a procedure end button for notifying the end of the procedure are provided side by side, and a pair of angle knobs 31 and 33 are provided.

  The endoscope insertion portion 21 is configured by a flexible portion 35, a bending portion 37, and a distal end portion 39 (hereinafter also referred to as an endoscope distal end portion) in order from the main body operating portion 19 side. By bending the angle knobs 31 and 33 of the unit 19, the bending operation is performed remotely. Thereby, the endoscope front-end | tip part 39 can be turned to a desired direction.

  Although not shown, the endoscope distal end portion 39 is provided with an observation window for an imaging optical system and a light irradiation window for an illumination optical system. The imaging optical system images the reflected light from the observation region in the body cavity by the illumination light irradiated from the light irradiation window through the observation window. The imaging optical system includes an imaging unit having an imaging element such as a CCD (charge coupled device) or CMOS (Complementary Metal-Oxide Semiconductor) and an optical member such as an imaging lens disposed in front of the optical path of the imaging element. The observation image from the observation window is acquired and output as an imaging signal. This imaging signal is transmitted to the endoscope control device 13 via the universal code 23, subjected to appropriate image processing by an image processing circuit included in the endoscope control device 13, and then displayed on the display unit 15. .

  The illumination optical system of the endoscope 11 guides the illumination light guided from the endoscope control device 13 through the universal cord 23 to the endoscope distal end portion 39, and directs it from the light irradiation window toward the observation region. Exit. As the light source mounted on the endoscope control device 13, a white light source such as a xenon lamp, a halogen lamp, or a metal halide lamp, a light source using a semiconductor light emitting element such as a laser light source or a light emitting diode, or the like is used.

  When performing endoscopy using the endoscope system 100 having this configuration, the endoscope operator inserts the endoscope insertion portion of the endoscope into the body cavity of the patient who is the subject. A predetermined examination site is sequentially photographed while adjusting the position of the distal end portion of the endoscope in which the image capturing unit is incorporated. Image data obtained by this examination (imaging) is input from the endoscope system 100 to the image recording apparatus 200 and stored. The stored image data is used at the time of endoscopic diagnosis and creation of a report which is a report of endoscopic examination results to be performed later.

  The image data recorded by the image recording apparatus 200 is composed of moving image data and still image data. The moving image data is a constant frame rate (for example, 30 frames / second) from the start of the examination to the end of the examination, that is, from the insertion of the endoscope insertion portion 21 into the body cavity (or the arrival of the first examination site). The moving image data is continuously captured and recorded in the image data, and is composed of data of a large number of image frames arranged in time series. The still image data is still image data that is captured at a specific timing, for example, when a doctor operates a predetermined operation button (shutter button) of an endoscope.

  Of the image data recorded by the image recording apparatus 200, still image data is “inspection image data” that is treated as image data of an endoscopic inspection result. In the endoscope image recording apparatus 400 of this configuration, when the number of recorded still images is insufficient as compared with a predetermined number, it is determined that a shooting failure has occurred and the shooting has failed. Support for supplementing still image with inspection image data.

  Specifically, the endoscopic image recording apparatus 400 provides support for extracting a missing still image from already recorded moving image data. If the recorded still image data is used to supplement the insufficient still images, the necessary still images are always prepared without being insufficient, and the accuracy of the endoscopic diagnosis is not lowered. In addition, endoscope reexamination such as re-taking is not necessary, and the burden on the patient is reduced.

  The outline of the above support is as follows. First, an examination order indicating the contents of the endoscopic examination is transmitted from the server 500 to the terminal device 300. Based on this examination order, an endoscopic examination of the patient is performed in the endoscopic department. The examination order includes patient ID information, and the patient who performs each examination order is specified.

  Based on this examination order, the endoscope operator performs an endoscopic examination on a designated patient. At this time, the image data (still image and moving image) output from the endoscope 11 is recorded by the image recording apparatus 200 together with the patient ID information. The image data can also be recorded by the endoscope control device 13.

  After the end of the endoscopic examination, the operator of the terminal device 300 in the endoscopic department reads out the patient image data recorded in the image recording apparatus 200 corresponding to the examination order, using the ID information as a tag, The number of recorded still image data included in the data is counted. When the terminal device 300 compares the number of recorded still images with the prescribed number specified by the inspection order and determines that the number of recorded images is insufficient, the terminal device 300 records on the display unit 41. Display that the number of sheets is insufficient.

  The operator of the terminal device 300 reads the moving image data of the image data recorded in the image recording device 200 based on the display indicating that the number of recorded sheets is insufficient, and extracts a still image of a scene corresponding to the insufficient still image. . Then, the moving image still image conversion unit 310 converts the moving image into a still image. The still image generated in this way is incorporated into the above-described still image data to create inspection image data that becomes a predetermined number of still image data.

  The inspection image data is used for creating a report of endoscopic inspection results. In the created report, position information indicating the photographing target position is recorded together for each inspection image. The report data is sent from the terminal device 300 to the server 500 and stored in the report database 510 as an endoscopic examination result.

  Next, a detailed example of an examination procedure when performing an endoscopic examination of a patient using the endoscope image recording apparatus 400 having the above configuration will be described.

  2A, 2B, and 2C are explanatory views showing a procedure of endoscopy performed by endoscopic examination of the upper digestive tract. In the endoscopic examination performed by the endoscopic examination of the upper gastrointestinal tract exemplified here, as shown in FIG. 2A, first, the endoscope insertion portion 21 is inserted into the duodenum Duo through the esophagus Es and the stomach St. Insert to the deepest inspection position P0. When reaching the inspection deepest position P0, the operator takes a still image of the observation image at the inspection deepest position P0. Then, the endoscope insertion portion 21 is gradually extracted and moved in the body cavity, and the region of the stomach St is imaged as shown in FIG. 2 (B), and then the region of the esophagus Es as shown in FIG. 2 (C). Are sequentially imaged. Finally, the endoscope insertion part 21 is pulled out of the body cavity.

  Examples of specific examination sites for endoscopic examination based on the above procedure are shown in FIG. Endoscopic examination parts are divided into a plurality of regions A1 to A13 in order from the examination deepest position P0 in each of the esophagus, stomach, and duodenum.

  The operator of the endoscope 11 moves the endoscope distal end portion 39 of the endoscope 11 to each of the examination sites and presses the shutter button at each position to capture a still image necessary for diagnosis. . A still image of each examination site is recorded by the endoscope control device 13 in the image recording device 200 together with ID information for patient identification. In addition, from the start to the end of the endoscopy, the video output from the endoscope 11 is a continuous image, that is, an endoscope as moving image data that changes in time series. It is output from the control device 13 and recorded in the image recording device 200 together with ID information. In other words, during the endoscopy, moving image recording is performed in parallel with still image recording. The surgeon creates an endoscopy report using the terminal device 300 based on the recording information (usually only still image data) of the image recording device 200.

  FIG. 4 is a flowchart showing the procedure of endoscopy. The procedure for performing an endoscopic examination of the examination site shown in Table 1 will be described with reference to FIG. In the example shown in FIG. 4, it is assumed that the endoscope control device 13 has a built-in function of the number counter for counting the number of still images taken and the current number of shots can be displayed on the display unit 15.

  When performing endoscopy, first, a predetermined pretreatment is performed on a patient. Thereafter, the endoscope control device 13 resets the count value of the internal number counter (S11). Then, the endoscope operator inserts the endoscope insertion portion 21 into the body cavity (S12), and confirms the observation image output from the endoscope 11 on the display portion 15 while confirming the observation tip portion 39 of the endoscope. Is made to reach the examination deepest position P0 (see FIG. 2) in the patient body cavity (S13). Here, the endoscope distal end portion 39 is inserted to a position below the posterior duodenum sucking portion.

  After the distal end portion 39 of the endoscope insertion portion 21 reaches the deepest examination position, the operator presses a shutter button that is one of the operation buttons 27 of the main body operation portion 19 of the endoscope 11 to capture a still image. Perform (S14). The shutter button pressing signal at this time is the first imaging instruction signal sent to the endoscope control device 13. Using this signal as a trigger, the image recording apparatus 200 starts recording a moving image (S15).

  The endoscope control device 13 records still image capturing of the examination site for the region A1 in the image recording device 200. Further, the number counter in the endoscope control device 13 automatically changes the count value to “first sheet” on the assumption that the first still image has been captured (S16). The count value of the number counter is output and displayed on the display unit 15.

  The surgeon moves the distal end 39 of the endoscope insertion section 21 to the next area A2 after the still image capturing in the area A1 is completed (S17). Then, a still image is picked up by pressing the shutter button again on the observation site in the area A2 (S19). At this time, the count value of the sheet counter is added as “second sheet” (S20).

  The processes of S17 to S20 are repeated for all examination sites. The endoscope control device 13 displays the content of the image captured at the current position of the distal end portion 39 of the endoscope and the current number of still images captured (the count value of the counter) on the display unit 15 during the examination. ) And the number of all examination sites are displayed as progress information.

  When the surgeon determines that the imaging of all the examination sites has been completed (S21), the surgeon presses a procedure end button that is one of the operation buttons 27. When a signal by pressing the procedure end button is input from the endoscope control apparatus 13 to the image recording apparatus 200, the image recording apparatus 200 ends the moving image recording operation (S22).

  Accordingly, the moving images recorded by the image recording apparatus 200 are continuously recorded from the start of recording at S15 to the stop at S22. That is, the moving image data recorded in the image recording apparatus 200 was observed by the endoscope 11 during the period from the time when the first still image was recorded to the time when the last still image was recorded. All image information is included. In addition, in each still image, information on what number of images is recorded may be recorded as metadata, and information on the total number of shots may be recorded in still image data.

  The above examination example is an example, and in actual endoscopic examination, as many as 20 to 30 still images may be taken in total. Further, the number of still images to be imaged is defined in advance for each organ or each imaging region. If the number of still images is less than the specified number, the amount of information is insufficient and the doctor cannot make a correct diagnosis. Therefore, accurate diagnosis cannot be performed in a state where the number of still images recorded at the time of endoscopy is less than the prescribed number, that is, in a state where a still image is missed. In such a case, another endoscopic examination is performed, but this places a burden on the patient.

  Therefore, in the endoscopic image recording apparatus of this configuration, even when the above-described still image is missed, support for complementing the missing still image without performing re-examination with the endoscope It has a function.

  As shown in FIG. 1, the endoscope image recording device 400 is realized as a function of the endoscope system 100, the image recording device 200, and the terminal device 300. In other words, as described above, the image recording device 200, based on the image signal output from the endoscope 11 during observation, the moving image data representing the continuously recorded moving image and the predetermined instruction (shutter button). And a function of data storage means for storing still image data representing a still image obtained at a timing corresponding to the pressing of the button.

  Also, the total number of shots determined in advance according to the function of the number-of-records detecting means for detecting the number of recorded still images from the still image data recorded in the image recording apparatus 200 and the inspection conditions such as the observation site to be imaged. And the number of still images recorded by the number-of-records detection means to determine whether the number of still images recorded is smaller than the total number of shots. The terminal device 300 has a function of signal output means for outputting an image acquisition support signal for acquiring an insufficient still image when it is determined that the number is less than the total number of shots.

  FIG. 5 is a flowchart showing an outline of processing in the terminal device 300. The processing shown in FIG. 5 is performed after endoscopic examination of a patient is performed and image data of a still image and a moving image is recorded in the image recording device 200.

  First, the terminal device 300 accesses the image recording device 200 via a network, searches for image data that is a result of endoscopic examination of a specific patient based on the ID information, and is included in the extracted image data. Still image data is read from the image recording apparatus 200 (S31).

  The total number of still images taken is detected from the number of still image data read out in S31 by the terminal device 300 (S32). The total number of shots can be obtained, for example, by counting the number of still image files. In addition, when information on the total number of shots is recorded in still image data, the recorded information may be read out.

  Next, the total number of still images detected by the terminal apparatus 300 in S32 is compared with the total number of captured images corresponding to a plurality of pre-defined examination sites, that is, the predetermined number of still images necessary for diagnosis ( S33). The specified number of sheets is determined in advance according to the contents of the examination order of the corresponding patient. For example, when the patient performs an endoscopic examination of the upper gastrointestinal tract shown in Table 1 above, 13 examination sites are defined in advance, and the prescribed number is 13. If the total number of shots matches the specified number, there is no shortage and the process ends.

  If the total number of shots is less than the specified number, the terminal device 300 determines that a still image has been missed and outputs an image acquisition support signal for complementing the insufficient still image (S34). .

  Then, the terminal device 300 accesses the image recording device 200 via the network LAN, and the entire moving image data recorded during the endoscopic examination of the corresponding patient (moving image during the period from the start of the examination to the end of the examination). ) Is acquired (S35).

  Next, the moving image still image conversion unit 310 in the terminal device 300 extracts data corresponding to the missing still image from the moving image data acquired in S34, and generates a new still image (S36). ).

  That is, the moving image data to be processed includes image data taken over the period from the start of the inspection to the end of the inspection. Information on a specific image frame corresponding to the image is also included. Therefore, if the inspection target part of the still image that is lacking is known, the corresponding image frame can be specified, and the information of the still image can be extracted from the moving image data.

  Since the inspection target part of the missing still image can be identified by various methods as will be described later, the moving image still image conversion unit 310 (see FIG. 1) converts the missing still image into the moving image data. It can also be extracted automatically from inside. Of course, for example, information that is useful for extracting a missing still image is displayed, an image frame to be extracted is specified according to an input operation from an operator who operates the terminal device 300, and the still image is extracted from the moving image data. It may be generated.

  Further, the same ID information as the patient ID information included in the moving image data to be processed is assigned to the still image extracted by the moving image still image conversion unit 310 in S36. That is, when performing endoscopic examination of each patient, ID information for identifying the patient to be examined is output from the server 500, and the specific ID information is also recorded in the moving image data recorded by the image recording device 200. . Thus, by giving the same patient ID information as the moving image data to the still image extracted from the moving image data, the occurrence of a misdiagnosis can be prevented.

  Next, the terminal device 300 incorporates the still image extracted in S36 into the other still image group read from the image recording device 200 in S31 so that it can be output as examination image data of the same patient (S37). ). This inspection image data is also used for report creation. In the report, the position information of the inspection image is recorded together with the inspection image.

  FIG. 6 is an explanatory view schematically showing a still image group recorded by the image recording apparatus 200 at the time of endoscopy. In the illustrated example, the case of endoscopic examination performed by the above-described endoscopic examination of the upper digestive tract is assumed, and 13 examination target parts are defined in advance. That is, as in the data group DA shown in the upper part of FIG. In this case, as in the case of the data group DB shown in the lower part of FIG. 6, as a still image that is actually recorded, an insufficient image is generated when the stomach is photographed, and only 11 still images are obtained. Is assumed.

  When the terminal device 300 processes still image data, it is detected in S33 of FIG. 5 that the total number (11) of still images and the prescribed number (13) do not match, which is insufficient. An image acquisition support signal for complementing the two still images is output.

  In order to identify the position of the missing still image, the work can be simplified by distinguishing which organ the imaging target of the missing still image belongs to. This distinction can be automatically identified as described below.

<First position specifying method>
For example, in the case of endoscopic examination of the upper gastrointestinal tract, the color tone of images taken for each organ of the esophagus, stomach, and duodenum is different. The esophagus has a strong white taste, a strong redness in the stomach, and a yellowish bile in the duodenum.

  Therefore, by comparing the color tone information obtained by image processing of each still image with the above characteristics, which organ was obtained by photographing each still image, or a rough difference in the imaging region Can be automatically distinguished.

  By performing the above-described discrimination processing, the first to third still images in the data group DB shown in the lower part of FIG. 6 are “esophagus”, the fourth to eighth are “stomach”, and the ninth to eleven are “duodenum”. ", Respectively. Therefore, it is automatically determined that 2 out of 7 still images are insufficient for the imaging region belonging to “stomach”. That is, in this case, the search range of moving image data for extracting the missing still image can be limited to the imaging range belonging to “stomach”. That is, the number of still images required for each organ is obtained, and the number of the still images obtained by actually photographing each organ and the number of each organ are compared, and these are compared for each divided organ. It is possible to specify which organ still image is insufficient.

  As support for complementing the insufficient still image, information indicating that the corresponding imaging range is “stomach” is notified to the operator of the terminal device 300 by display or the like. Then, the range of the moving image data to be searched is limited to the range of the previously divided organs.

<Second position specifying method>
FIG. 7 shows the shape and positional relationship of the endoscope insertion portion when photographing the gastric cardia portion 43 with the endoscope distal end portion 39 inserted into the stomach St, and the observation image photographed in this state. It is explanatory drawing shown typically.

  At the time of photographing the gastric cardia part, the rear part of the endoscope is photographed in a state where the endoscope distal end part 39 is greatly curved. Therefore, the endoscope insertion unit 21 is displayed in the image to be taken.

  Therefore, when the terminal device 300 handles each frame of a still image or a moving image, the shape and color of the endoscope insertion unit 21 itself are included in the feature amount of the image pattern extracted by performing image processing. By identifying whether or not a feature is included, it is possible to detect whether or not the endoscope insertion unit 21 is projected in the image. That is, it is possible to automatically specify whether or not the examination target portion of the corresponding image is the gastric cardia 43. Such a process can also be used to support the supplement of the missing still image.

<Third location specifying method>
Position information corresponding to the insertion length of the endoscope insertion portion into the body cavity can also be used in order to identify the region to be imaged when the endoscope insertion portion is inserted into the body cavity for imaging. . For example, by using the endoscope 11B as shown in FIG. 8 and the mouthpiece 51 shown in FIG. 9, the insertion length of the endoscope insertion portion into the body cavity can be detected.

  That is, the mouthpiece 51 is attached to the patient's oral cavity before performing the examination with the endoscope 11B. Then, the endoscope insertion part 21 is inserted into the body cavity of the patient via the mouthpiece 51. In that case, as shown in FIG. 9, the endoscope insertion portion 21 is inserted through the opening 51 a of the mouthpiece 51.

  On the outer peripheral surface of the endoscope insertion portion 21 of the endoscope 11B, marking portions 22 formed at regular intervals in the longitudinal direction of the endoscope insertion portion 21 are provided as shown in FIG. The marking portion 22 is formed, for example, by arranging a predetermined magnetic recording medium at a constant interval. On the other hand, the mouthpiece 51 is provided with a sensor 52 as shown in FIG. When the marking unit 22 is composed of a magnetic recording medium, a magnetic sensor is used as the sensor 52.

  Accordingly, in the state where the endoscope insertion portion 21 is inserted inside the mouthpiece 51 as shown in FIG. 9, the sensor 52 detects the marking portion 22 so that the endoscope insertion portion 21 is moved within the body cavity of the patient. When moving, the position of the marking unit 22 facing the sensor 52 is sequentially changed, and a pulsed electric signal is output from the sensor 52. By counting the number of pulses output from the sensor 52, the movement amount of the endoscope insertion portion 21, that is, the insertion length can be grasped from a specific reference position.

  From the insertion length of the endoscope insertion portion 21 into the body cavity, it is possible to specify the part (organ) in the living body where the endoscope distal end portion 39 is located.

  The marking unit 22 and the sensor 52 may be configured to detect the position by reading optical information in addition to the magnetic recording information. For example, as the marking portion, a plurality of optical information recording media colored in a color different from the surface color are arranged along the longitudinal direction of the endoscope insertion portion 21. Further, an optical sensor that reads optical information from the marking portion is arranged on the mouthpiece 51 by irradiating the marking portion with light and detecting reflected light. By reading these optical information recording media with an optical sensor, the insertion length of the endoscope insertion portion 21 can be detected in the same manner.

  When the insertion length of the endoscope insertion portion 21 into the body cavity is detected by the endoscope 11B, the relative position (insertion length or distance) between the mouthpiece 51 and the distal end portion 39 of the endoscope insertion portion, and the imaging region The relationship between and varies depending on the patient, depending on age, height, and pre-existing conditions (eg, gastric drooping). Therefore, by correcting the detected insertion length in advance in consideration of the patient's age, height, and past illness, and specifying the imaging site using the result, the site in the living body can be specified with higher accuracy.

Hereinafter, an example of a method for detecting the insertion length of the endoscope insertion portion into the body cavity will be described.
The relationship between the insertion length of the endoscope and the imaging region is affected by the patient's body shape and the like. The distance to the mirror tip 39 is obtained as the maximum insertion length L, and the imaging region is managed as a ratio to the maximum insertion length L.

  FIG. 7 schematically shows the relationship between the insertion length of the endoscope insertion portion 21 and the body cavity positions P0 to P13 of each examination site. The body cavity positions P0 to P13 of each examination site can be expressed as the insertion length of the endoscope insertion portion 21. In the figure, the body cavity positions P0 to P13 are sequentially arranged from the distal end portion 39 of the endoscope insertion portion 21. Is shown. Here, the insertion length of the endoscope insertion portion 21 into the body cavity is expressed as an actual ratio R0 to R13 that is a ratio of the detected deepest examination position P0 to the maximum insertion length L with respect to the position of the mouthpiece 51. ing. For example, the actual ratio R1 is a value of L1 / L that represents the insertion length L1 of the endoscope insertion portion 21 from the mouthpiece 51 to the examination position P1 as a ratio to the maximum insertion length L.

  Each value of the actual ratios R0 to R13 is stored as a constant by the endoscope control device 13. For example, the values of the actual ratios R0 to R13 are stored with respect to 13 imaging parts from No. 1 to No. 13 shown in Table 1 above. Thereby, the endoscope control apparatus 13 compares the detection ratio obtained by the ratio of the maximum insertion length L with the insertion length that changes with the movement of the endoscope insertion portion 21 and the value of each actual ratio. Thus, the photographing position corresponding to the current insertion length can be specified.

  When the position of the endoscope distal end 39 is detected and managed by the method as described above, each still image or moving image data recorded by the image recording apparatus 200 shown in FIG. The position information detected in step 1, that is, the detection ratio and organ division information are recorded simultaneously. In this case, when the terminal device 300 detects the shortage of still images based on the data recorded in the image recording device 200, the imaging parts corresponding to the missing still images are included in the preceding and following still images. It can be specified from the position information, and can be used to support the supplement of the missing still image. In addition, by referring to the position information included in the content of the moving image data, it is possible to specify the range of the image frame including the data corresponding to the imaging portion of the missing still image, which is necessary. It can be used for support for extracting a still image.

<Fourth location specifying method>
When the endoscope insertion unit 21 is inserted into the body cavity and imaging is performed, the image recording apparatus 200 includes information including the current date and time as the imaging time in each still image data as a time stamp. be able to. In the moving image data, a time stamp indicating the shooting time can be included in each of a large number of image frames constituting the moving image. As a time stamp, for example, it is also possible to record relative value information such as an elapsed time from the inspection (imaging) start time instead of the time.

  In the case where the above-mentioned time stamp is included in the data of each still image or moving image recorded by the image recording apparatus 200 shown in FIG. 1, the terminal device 300 supports the supplement of the missing still image. Available to: That is, since the inspection of the body cavity of a patient using an endoscope is generally performed according to a predetermined procedure, the endoscope distal end portion 39 is substantially constant from the deepest part in the body cavity. While moving in the same direction at a speed, the imaging region changes accordingly. That is, there is a correlation between changes in the elapsed time and time since the start of the examination and changes in the imaging region.

  Therefore, when the terminal device 300 detects the shortage of still images based on the data recorded by the image recording device 200, the time stamp included in the still images before and after the still image corresponding to the missing still image is detected. Can be identified from the contents of In this way, it is possible to assist in complementing the missing still image. In addition, by referring to the contents of the time stamp included in each image frame of the moving image data, it is possible to specify the range of the image frame including the data corresponding to the imaging portion of the missing still image Also in this case, it is possible to support the process of extracting a necessary still image.

  At least one of the above-described change in color tone of the image according to the difference in the organ to be imaged, the recognition result of the endoscope or the like reflected in the image, the insertion length of the endoscope, and the time stamp of each image representing the imaging time By using one piece of information or using a plurality of pieces of information in combination, it is possible to specify a photographing part that is lacking in the recorded still image group with higher accuracy. In addition, when extracting the missing still image from the moving image data, each of the above-described information can be used to specify or limit the corresponding imaging region or range from all the image frames of the moving image. .

  Accordingly, when it is determined that the number of still images recorded by the image recording apparatus 200 is insufficient, the moving image still image conversion unit 310 extracts an insufficient still image from moving image data by an operator, It can be extracted automatically and complemented efficiently and accurately.

  In that case, in order to assist the operator, necessary information, for example, information indicating the imaging part of the missing still image, information on the color tone of the imaging part of the missing still image, It is preferable that the terminal device 300 provides information to the operator by displaying information indicating the presence or absence of the endoscope to be reflected, the insertion length of the endoscope, a time stamp, and the like on the display unit. Also, the terminal device 300 specifies in advance the imaging region corresponding to the missing still image, and limits the range in which there are image frames to be extracted among many image frames in the moving image data according to the result. Alternatively, the operator may be supported by automatically selecting and displaying a specific image frame to be extracted.

  As described above, when the endoscope image recording apparatus of the present invention is configured using the image recording apparatus 200 or the terminal apparatus 300, a predetermined image acquisition is performed when the number of recorded still images is insufficient. A support signal can be output to help supplement the missing still image. In particular, by using moving image data recorded at the time of endoscopy and supplementing the missing still images, the burden on the patient can be reduced. In addition, it is possible to identify the shooting part of the still image that is lacking using various information, and to specify or limit the extraction target range in the moving image data, so that the operator can be supported Image extraction is smooth.

  For example, the procedure of support related to the processing of the terminal device 300 corresponding to the operation illustrated in FIG. 5 is stored in advance as an endoscopic image recording support program in the storage unit in the terminal device 300, and the terminal device 300 is stored in the storage unit. It can be started according to an input operation of the operator who operates, and can be executed by a computer inside the terminal device 300.

  The present invention is not limited to the above-described embodiments, and those skilled in the art can change or apply the present invention based on the description of the specification and well-known techniques. included. For example, the above-mentioned moving image shooting start timing can be changed as appropriate, for example, not from the initial still image shooting timing but to the timing to start inserting the endoscope insertion portion into the body cavity.

As described above, the following items are disclosed in this specification.
(1) Endoscopic image recording for recording examination image data including still images of a plurality of predetermined examination parts based on an image signal output from an endoscope when performing an endoscopic examination of a subject. A device,
Data storage means for storing moving image data recording a moving image based on the image signal and still image data recording a still image at a timing according to a predetermined instruction;
Recording number detection means for detecting the number of recorded still images from the still image data stored in the data storage means;
A number comparison determination for determining whether the still image is deficient in comparison with the total number of captured images by comparing the total number of captured images corresponding to the plurality of examination sites and the number of recorded still images detected by the recording number detection means. Means,
When the number comparison determination unit determines that the number of still images to be recorded is smaller than the total number of shots, an insufficient still image is obtained from the moving image data held by the data storage unit. A signal output means for outputting an image acquisition support signal;
An endoscopic image recording apparatus comprising:

  According to this endoscopic image recording apparatus, it was found that, at the time of endoscopic examination in which a necessary examination part was designated in advance, after the endoscopic examination was completed, a still image of the examination part was insufficient. Even in this case, it is possible to support the work of complementing the missing still image from the moving image data. As a result, still images of all examination parts are always obtained, and without reducing the diagnostic accuracy, it is possible to reduce the burden on the subject such as performing an endoscopic reexamination for re-taking the lacking image. .

(2) The endoscope image recording apparatus according to (1),
The recording number detection means, for each of a plurality of still images of the still image data, identify an organ segment representing a corresponding examination site, and detect the number of recordings for each organ,
The endoscope image recording apparatus, wherein the number comparison determination unit determines whether the number of still images is insufficient based on the total number of images taken for each organ.

  According to this endoscopic image recording apparatus, it is possible to detect the number of still images recorded for each organ to be examined, and to identify an insufficient still image for each organ. Thereby, when a still image is extracted from moving image data, it is possible to easily specify a scene of an examination site to be extracted.

(3) The endoscopic image recording apparatus according to (2),
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on color information of the still image.

  According to this endoscopic image recording apparatus, it is possible to identify a segment of a photographed organ by detecting a characteristic color tone that differs for each organ from a still image.

(4) The endoscopic image recording apparatus according to (2),
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on an insertion length of the endoscope into a body cavity.

  According to this endoscopic image recording apparatus, it is possible to easily specify the imaging location from the insertion length of the endoscope, that is, the insertion length from the oral cavity where the endoscope is inserted to the distal end portion of the endoscope. The organ division corresponding to the determined position can be specified.

(5) The endoscopic image recording apparatus according to (2),
An endoscopic image recording apparatus in which the recording number detecting means specifies the organ division based on a specific image pattern extracted from the still image.

  According to this endoscopic image recording apparatus, when a specific image pattern is extracted from a captured still image, the organ classification of the still image can be specified corresponding to the specific image pattern. For example, when imaging the gastric cardia part as an examination site, the gastric cardia part is imaged in a state in which the endoscope insertion portion is included in the angle of view by largely bending the distal end of the endoscope. In such a case, it is possible to specify whether or not the examination site is the gastric cardia part by detecting whether or not the captured still image includes an image pattern corresponding to the endoscope insertion part. Become.

(6) The endoscopic image recording apparatus according to (2),
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on the photographing time of the still image.

  According to this endoscopic image recording apparatus, after endoscopic examination inserts the distal end portion of the endoscope to the deepest part in the living body, each examination part is sequentially photographed while removing the endoscope little by little from the deepest part. If it is, the elapsed time from the start of the examination corresponds to the arrangement order of the examination site (organ) in the body cavity, and the classification of the taken organ is specified based on the shooting time of each still image Can do.

(7) The endoscope image recording apparatus according to any one of (2) to (6),
An endoscopic image recording apparatus in which the signal output means outputs an organ segment corresponding to the insufficient still image together with the image acquisition support signal.

  According to this endoscopic image recording apparatus, since an organ segmentation signal representing an organ segment corresponding to an insufficient still image is output together with the image acquisition support signal, when acquiring an insufficient still image from moving image data In addition, since it is known from which scene of the moving image data should be acquired, the operation of acquiring a still image is reduced.

(8) The endoscope image recording apparatus according to any one of (1) to (6),
The data storage means stores the moving image data together with ID information for specifying a subject,
An endoscope image recording apparatus in which the signal output means outputs the ID information together with the image acquisition support signal.

  According to this endoscopic image recording apparatus, it is possible to search for moving image data included in the data storage unit based on the ID information output together with the image acquisition support signal. For this reason, even if moving image data of a plurality of subjects is stored in the data storage means, there is no inconsistency in the correspondence between the subjects and the images.

(9) Endoscopic image recording for recording examination image data including still images of a plurality of predetermined examination sites based on image signals output from the endoscope when the subject is subjected to endoscopy. A support method,
Based on the image signal, after storing moving image data recording a moving image and still image data recording a still image at a timing according to a predetermined instruction,
From the stored still image data, detect the number of recorded still images,
The total number of shots corresponding to the plurality of examination regions and the number of detected still images recorded are compared. If the number of still images is less than the total number of shots, an insufficient still image is displayed as the data. An endoscopic image recording support method for outputting an image acquisition support signal for acquiring from the moving image data held by a storage means.

(10) A program for causing a computer to execute the procedure of the endoscope image recording support method of (9).

DESCRIPTION OF SYMBOLS 11 Endoscope 13 Endoscope control apparatus 15 Display part 19 Main body operation part 21 Endoscope insertion part 22 Marking part 27 Operation button 39 Endoscope tip part 41 Display part 43 Gastric cardia part 51 Mouthpiece 52 Sensor 100 Endoscope Mirror system 200 Image recording device 300 Terminal 310 Video still image conversion unit 400 Endoscopic image recording device 500 Server 510 Report database

Claims (9)

An endoscopic image recording apparatus that records examination image data including still images of a plurality of predetermined examination sites based on an image signal output from an endoscope when performing an endoscopic examination of a subject. And
Data storage means for storing moving image data recording a moving image based on the image signal and still image data recording a still image at a timing according to a predetermined instruction;
Recording number detection means for detecting the number of recorded still images from the still image data stored in the data storage means;
By comparing the number of recorded still images plurality number of still images to be captured that is previously defined for each inspection site of the respectively summed predetermined number the recording number detecting means detects, records the still image A sheet number comparing and determining means for determining whether or not the number of sheets is less than the specified number ;
When the number comparison determination unit determines that the number of still images to be recorded is smaller than the specified number , the scene corresponding to the insufficient still image is extracted from the moving image data, and the extracted moving image A moving image still image conversion means for converting the scene into a new still image;
Means for incorporating the new still image into the inspection image data;
An endoscopic image recording apparatus comprising: The endoscope image recording apparatus according to claim 1,
The recording number detection means, for each of a plurality of still images of the still image data, identify an organ segment representing a corresponding examination site, and detect the number of recordings for each organ,
The number comparison determination unit includes a recording number of the respective organ, based on the number of still images to be captured to be predefined for each of the organs, endoscopic image recording apparatus for determining the shortage of the number of the still image . The endoscope image recording apparatus according to claim 2,
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on color information of the still image. The endoscope image recording apparatus according to claim 2,
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on an insertion length of the endoscope into a body cavity. The endoscope image recording apparatus according to claim 2,
An endoscopic image recording apparatus in which the recording number detecting means specifies the organ division based on a specific image pattern extracted from the still image. The endoscope image recording apparatus according to claim 2,
An endoscopic image recording apparatus in which the recording number detecting means identifies the organ division based on the photographing time of the still image. The endoscope image recording device according to any one of claims 2 to 6,
  The data storage means stores the moving image data together with ID information for specifying a subject,
  An endoscopic image recording apparatus in which the moving image still image conversion unit assigns, to the new still image, the same ID information as patient ID information included in the moving image data to be processed. Endoscopic image recording that automatically records examination image data including still images of a plurality of predetermined examination sites based on image signals output from the endoscope when the subject is endoscopically examined A method of operating the device, comprising:
Based on the image signal, moving image data recording moving images and still image data recording still images taken at a predetermined timing are stored in the respective data storage means. To detect the number of still images recorded,
The number comparison determination means compares the prescribed number of the total number of still images to be photographed that are prescribed in advance for each of the plurality of examination sites with the number of still images recorded by the recording number detection means. ,
When the number of recorded still images is less than the specified number, the moving image still image conversion means extracts a scene corresponding to the insufficient still image from the moving image data, and the extracted moving image Convert the scene into a new still image,
An operation method of an endoscopic image recording apparatus that incorporates the new still image into the inspection image data. The program which makes a computer perform the procedure of the operating method of the endoscopic image recording apparatus of Claim 8.

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