JP5529480B2 - Medical image diagnosis support device - Google Patents

Description

  The present invention relates to a medical image diagnosis support apparatus that enables interpretation by juxtaposing images obtained by an image diagnosis apparatus (modality), and relates to a medical image diagnosis support apparatus suitable for application to an output image of a mammography apparatus, for example.

  Conventionally, an interpreting doctor (doctor) who interprets an X-ray image by displaying a current X-ray image and a past X-ray image relating to the same radiographed region side by side with the same brightness using one Schaukasten. ), And a medical image diagnosis support apparatus that improves the efficiency of searching past images to be referred to is provided (Patent Document 1).

  Moreover, in diagnosis using a monitor (soft copy), an image interpretation doctor usually uses an image displayed on the monitor for various functions of the viewer (enlargement, reduction, image gradation conversion, image juxtaposition) and diagnosis support. The final judgment is made visually while using the software (CAD: Computer-Aided Diagnostics) function (Patent Document 2).

  Furthermore, in order to efficiently perform diagnosis, a system that appropriately transmits all or a part of information to another viewer is also provided (Patent Document 3).

JP-A-7-275209 {[0010], FIG. 2 (a)} Japanese Patent Laying-Open No. 2004-33790 (FIG. 28, [0104]) JP 2008-259707 A ([0103])

  However, it is necessary to compare the images of a plurality of diagnostic monitors depending on the part to be interpreted, such as a mammography device. When images to be compared are displayed on a plurality of diagnostic monitors, the eye of the interpreting doctor moves frequently. Therefore, there is a problem that an interpreting doctor is easily fatigued.

  Also, as in Patent Document 1, when comparing a current X-ray image on a film arranged on one Schaukasten and a past X-ray image on a display panel, the images are separated from each other, and interpretation is performed. The problem that the distance that the doctor's line of sight moves becomes long and the interpretation doctor is easily fatigued has not been solved.

  The present invention has been made in consideration of such problems, and an object of the present invention is to provide a medical image diagnosis support apparatus that can reduce the fatigue of an interpreting doctor who visually compares images.

  When the medical image diagnosis support apparatus according to the present invention displays at least two related images to be interpreted on a monitor, the non-image portion on the adjacent side of the images is deleted, thereby bringing the images close to each other. Therefore, it is possible to reduce the fatigue of the image interpretation doctor who visually compares the images with each other.

  In this case, specifically, when there is one monitor, the images are displayed close to each other at the center of the screen, and when two monitors are juxtaposed, the screens of both monitors are adjacent to each other. Each image is displayed in close proximity to the side of the screen, or when the four monitors are arranged in a matrix, each image is displayed close to the center of the two sides of each screen sharing the center. Even when the number of monitors is one, two, or four, the eye movement distance of the interpreting doctor is reduced, and fatigue of the interpreting doctor who compares the images visually can be reduced.

  In addition, it has a function of enlarging an image displayed close to the image so that the image is not lost while being brought close to each other, or to enlarge an image so that the image is not lost while keeping the image displayed close together. Can be read while minimizing the movement of the line of sight.

  In this case, it is preferable to display a button capable of switching between the enlarged image display function and the pre-enlarged image display function on the screen.

  Preferably, the at least two images are a left and right breast CC (Craniocaudal) image and a left and right breast MLO (Mediatal Oblique image) image obtained by a mammography apparatus. is there.

  Further, when the two monitors are juxtaposed, with respect to the two monitors that display the images on the adjacent sides of the screens of both monitors, the frames on the adjacent sides of the two monitors are formed thin. Or, when the four monitors are arranged in a matrix, the two monitors are arranged on the two sides of each screen. By making the monitor so that the frame of the image is formed thin, it is possible to minimize the eye movement of the interpreting doctor.

  According to this invention, when displaying at least two images related to the interpretation target on the monitor, the image has a function of displaying the images close to each other. The effect of reducing the fatigue of the interpreting doctor who is visually compared is achieved.

  In addition, even when there are one, two, or four monitors, the eye movement distance of the interpreting physician can be obtained by bringing each image close to each other or displaying it close to the opposite side so that the images are close to each other. And the fatigue of the interpreting doctor who compares the images visually can be reduced.

1 is a schematic configuration diagram of a medical image diagnosis support system to which a medical image diagnosis support apparatus according to an embodiment of the present invention is applied. FIG. 2A is an explanatory diagram of an example of a function display button, and FIG. 2B is an explanatory diagram of another example of the function display button. It is a flowchart with which it uses for operation | movement description of the medical image diagnosis assistance apparatus of the example of FIG. 4A is an explanatory diagram of a one-screen two-image original display, FIG. 4B is an explanatory diagram of a one-screen two-image proximity display, FIG. 4C is an explanatory diagram of a one-screen two-image enlarged original display, and FIG. 4D is a one-screen two-image enlarged proximity display. It is explanatory drawing of. 5A is an explanatory diagram of a two-screen two-image original display, FIG. 5B is an explanatory diagram of a two-screen two-image enlarged original display, FIG. 5C is an explanatory diagram of a two-screen two-image proximity display, and FIG. 5D is a two-screen two-image enlarged proximity display. It is explanatory drawing of. It is explanatory drawing of a 1 screen 1 image and a total of 4 screen 4 image proximity | contact display. It is explanatory drawing of the monitor with a narrow one part frame suitable for performing 2 screen 2 image proximity | contact proximity display. It is explanatory drawing of the monitor with a narrow one part frame suitable for 4 screen 4 image proximity | contact display.

  Embodiments of a medical image diagnosis support apparatus according to the present invention will be described below with reference to the drawings.

  FIG. 1 is a schematic configuration diagram of a medical image diagnosis support system 12 to which a medical image diagnosis support apparatus 10 according to this embodiment is applied.

  The medical image diagnosis support system 12 includes a medical image diagnosis support device 10, and this medical image diagnosis support device 10 and an image display processing device 16 (also called a viewer) and a monitor 18 (diagnosis) capable of displaying a high-definition image. Monitor).

  In this embodiment, the monitor 18 is composed of two monitors, for example, a vertically long monitor 18A and a monitor 18B having the same specifications of about 20 inches, which are juxtaposed on the table 20, for example. The resolutions of the monitor 18A and the monitor 18B are selected to be 2500 pixels vertically and 2000 pixels horizontally, respectively. The monitor 18A and the monitor 18B are display units surrounded by upper and lower frames 17U and 17D having the same width and left and right frames 17R and 17L having the same width and these frames 17 (17U, 17D, 17R and 17L), respectively. Screens 19A and 19B.

  Each monitor 18A, 18B is formed symmetrically with respect to a center line (not shown) extending in the vertical direction. The monitors 18A and 18B are juxtaposed so that the distance d between the adjacent (opposing) left frame 17L and the right frame 17R is minimized.

  The image display processing device 16 is constituted by, for example, a personal computer, and includes a main body unit 22, a display 24, and an input unit 26 including a mouse 26A and a keyboard 26B as components, and is arranged on the table 20. The display 24 may be integrated with the monitor 18 and deleted.

  In this embodiment, on the upper side of the screen 19A of the monitor 18A on the left side, as shown in FIG. 2A, a one-screen display button 101, a screen display button 102, and an enlarged display button 103 that can be selected by the input unit 26 are displayed. The proximity display button 104 is displayed by the button display function (button display unit) of the image display processing device 16.

  In FIG. 1, an image server 30 such as PACS (Picture Archiving & Communicating System in a system for storing and transferring medical images) is connected to the main body portion 22 of the image display processing device 16. Image data in digital data is supplied from the apparatus 40, a CT (Computed Tomography: X-ray computed tomography) apparatus 42, a CR apparatus {general X-ray imaging apparatus having a Computed Radiography: IP (Imaging Plate)} 44, etc. Accumulated.

  The image data stored in the storage unit (memory) of the image server 30 is transferred from the image server 30 to the main body unit 22 of the image display processing device 16 in response to a request from the image display processing device 16, and the main body unit 22 , The image data is processed so as to be displayed on the monitors 18A and 18B so as to be easily interpreted, and the processed image data is transferred to the monitors 18A and 18B.

  It should be noted that desired image processing (enlargement, reduction, etc.) is performed on the images displayed on the monitors 18A and 18B using the input unit 26 by selecting the display buttons 101 to 104 and the function display buttons (not shown). Position setting, gradation conversion processing, and image processing by the function of the diagnosis support software) can be performed.

  The mammography apparatus 40 includes a base 46, an arm member 50 that is disposed on the base 46 and is fixed to a turning shaft 48 that can turn in the direction of arrow A, and an object (not shown) that is fixed to one end of the arm member 50. A radiation source 52 for irradiating the breast with radiation, and a flat solid state detector for acquiring radiation image information by detecting the radiation fixed to the other end of the arm member 50 and transmitted through the breast, so-called FPD (Flat) An imaging table 54 for storing a panel detector) and a pressing plate 56 that moves in the arrow B direction with respect to the imaging table 54 and presses and holds the breast M are provided.

  In such a configuration, the imaging direction with respect to the breast can be adjusted by the arm member 50 to which the radiation source 52 and the imaging table 54 are fixed turning in the direction of arrow A about the rotation axis 48.

  As the imaging direction for the breast, left and right MLO (Media Lateral Oblique) imaging of deep tissue on the upper outer side of the breast, and left and right CC (Cranio) imaging a part of the tissue under the areola, central inner side and outer side. -Caudal: head-to-tail direction) shooting or the like is selected.

  On the base 46, imaging information such as the imaging direction of the breast detected by the mammography apparatus 40, ID information of the examination subject (person) having the breast, tube voltage, tube current, target type, filter type, and the like are acquired. A display unit 58 for displaying conditions, absorbed dose of radiation, and the like, and an operation panel 60 capable of setting each information and condition are arranged.

  Imaging conditions such as the radiation image information of the breast imaged by the mammography apparatus 40 and the ID information of the examination object having the breast are supplied to the image server 30 as digital data each including image data of the breast.

  In this embodiment, it is assumed that the image data stored in the image server 30 from the mammography apparatus 40 is a left and right MLO image and a left and right CC image to be inspected.

  A display operation on the monitor 18 of the medical image diagnosis support apparatus 10 in the medical image diagnosis support system 12 basically configured as described above will be described with reference to the flowchart of FIG.

  In step S 1, when the inspection target ID information displayed on the display 24 is selected by the input unit 26, the left and right CC images and the left and right MLO images corresponding to the selected ID information are transmitted from the image server 30. It is received by the main body 22 of the display processing device 16.

  Next, in step S2, it is determined which of the display buttons 101 to 104 shown in FIG. 2A displayed on the screen 19A on the monitor 18A has been selected by a doctor or the like. Note that the one-screen display button 101 and the two-screen display button 102 are alternatively switching buttons that are always selected, and the enlargement display button 103 and the proximity display button 104 are each selected as needed. Button.

  When the one-screen display button 101 is selected by the input unit 26, it is set to the one-screen side by the determination in step S2.

  Next, in step S3, it is determined whether or not the proximity display button 104 is selected. If the proximity display button 104 is not selected, it is determined as “original display”.

  Next, in step S4, it is determined whether or not the enlarged display button 103 is selected.

  If the enlarged display button 103 has not been selected, “original display of one screen” is confirmed in step S5, and the left and right MLO images 201 are displayed vertically on the screen 19A of the monitor 18A as shown in FIG. 4A. The left and right CC images are displayed by a normal display method (original display). In this case, the interval D1 between the left and right MLO images 201 and the left and right CC images 202 is displayed as the original image interval.

  If the enlargement display button 103 has been selected in step S4, “one-screen enlargement original display” is confirmed in step S6, and as shown in FIG. 4C, enlargement is performed vertically on the screen 19A of the monitor 18A. The left and right MLO images 201a and the enlarged left and right CC images 202a are displayed by a normal display method (enlarged original display). In this case, since the center of each image is enlarged, the interval D1 is narrowed to the interval D1 ′ (D1 ′ <D1).

  On the other hand, if the proximity display button 103 has been selected in step S3, “proximity display” is selected.

  Next, in step S7, it is determined whether or not the enlarged display button 103 is selected.

  If the enlargement display button 103 has not been selected, “proximity display of one screen” is confirmed in step S8, and the left and right MLO images 201 are displayed vertically on the screen 19A of the monitor 18A as shown in FIG. 4B. The left and right CC images 202 are displayed by a proximity display method (proximity display). In this case, the interval between the left and right MLO images 201 and the left and right CC images 202 is the interval D2, which is displayed with a smaller interval than the interval D1 (D2 << D1). Note that when “one-screen proximity display” is executed, the image existence portion is actually defined by circumscribed square processing for the left and right MLO images 201 and the left and right CC images 202. It is recognized as a so-called “element missing part” that does not exist, and is deleted as an unnecessary part. The lower part of the left and right MLO images 201 and the upper part of the left and right CC images 202 are deleted as unnecessary parts. In other words, the elements on the adjacent sides of the left and right MLO images 201 and the left and right CC images 202 are deleted. By deleting the missing part as an unnecessary part, the left and right MLO images 201 and the left and right CC images 202 can be displayed in proximity.

  If the enlargement display button 103 is selected in step S7, “enlarged proximity display of one screen” is confirmed in step S10, and as shown in FIG. 4D, the image is enlarged vertically in the screen 19A of the monitor 18A. The left and right MLO images 201c and the enlarged left and right CC images 201c are displayed in a narrow interval D2 by an enlarged proximity display method (enlarged proximity display).

  Next, in step S2, it is determined which of the display buttons 101 to 104 on the monitor 18A has been selected by a doctor or the like, and for example, the two-screen display button 102 is selected by the input unit 26. If so, it is set to the second screen side in the determination of step S2.

  Next, in step S11, it is determined whether or not the proximity display button 104 is selected. When the proximity display button 104 is selected, it is determined as “proximity display”.

  Next, in step S12, it is determined whether or not the enlarged display button 103 is selected.

  If the enlargement display button 103 has not been selected, “original display of two screens” is confirmed in step S13, and the left and right MLO images 301 are displayed on the screen 19A of the monitor 18A as shown in FIG. 5A. The left and right CC images 302 are displayed on the screen 19B of the monitor 18B by a normal display method (original display) (two-screen display). In this case, the interval D3 between the left and right MLO images 301 and the left and right CC images 302 is displayed as the original image interval.

  If the enlargement display button 103 has been selected in step S12, “two-screen enlargement original display” is confirmed in step S14, and the left and right images enlarged on the screen 19A of the monitor 18A as shown in FIG. 5B. The MLO image 301a is displayed, and the left and right CC images 302a enlarged on the screen 19B of the monitor 18B are displayed in the normal display manner (enlarged original display). In this case, since the center of each image is enlarged, the interval D3 is narrowed to the interval D3 ′ (D3 ′ <D3).

  On the other hand, if the proximity display button 104 has been selected in step S11, “proximity display” is selected.

  Next, in step S15, it is determined whether or not the enlarged display button 103 is selected.

  If the enlargement display button 103 has not been selected, “two-screen proximity display” is confirmed in step S16, and as shown in FIG. 5C, the left and right MLO images 301c on the screen 19A of the monitor 18A and the monitor 18B. The left and right CC images 302c of the screen 19B are displayed by the proximity display method (proximity display). In this case, the interval between the left and right MLO images 301c and the left and right CC images 302 is displayed with a narrower interval than the interval D4 and the interval D3 (D4 <D3). Also in this case, when “two-screen proximity display” is executed, the image existence portion is actually defined by the circumscribed rectangle processing for the left and right MLO images 301 and the left and right CC images 302, and the outside of the circumscribed rectangle is determined. Is recognized as a so-called “element missing part” in which no image exists, and is deleted as an unnecessary part. The left and right MLO images 301 and the left and right CC images 302 are displayed in close proximity by deleting the right side missing portion of the left and right MLO images 301 in FIG. 5A and the left side missing portion of FIG. 5A in FIG. 5A as unnecessary portions. can do.

  If the enlargement display button 103 has been selected in step S15, “two-screen enlarged proximity display” is confirmed in step S17, and as shown in FIG. 5D, the left and right enlarged images on the screen 19A of the monitor 18A are displayed. An MLO image 301c is displayed, and the enlarged left and right CC image 302c is displayed on the screen 19B of the monitor 18B. The image interval is the same as the interval D4 in the “two-screen proximity display” in FIG. 5C and the interval D3 in the original display. Thus, the images are displayed in a narrower interval D4 by an enlarged proximity display method (enlarged proximity display).

  As described above, when the medical image diagnosis support apparatus 10 according to this embodiment displays on the monitor 18 at least two images related to the interpretation target, for example, the left and right MLO images and the left and right CC images, for example, FIG. As shown in FIG. 5C, the left and right MLO images 201 (301) and the left and right CC images 202 (302) are deleted by removing non-image portions (so-called blank portions) on the adjacent (opposite) sides. Since the image 201 (301) and the left and right CC images 202 (302) have a function of displaying them close to each other, the eye movement distance between the left and right MLO images 201 (301) and the left and right CC images 202 (302) by the interpretation doctor And the fatigue of the interpreting doctor who visually compares the images can be reduced.

  In this case, when the monitor 18 is only one monitor 18A, as shown in FIGS. 4B and 4D, the left and right MLO images 201 (201c) and the left and right CC images 202 (202c) are brought close to each other in the center of the screen. When two monitors 18 are juxtaposed with the monitors 18A and 18B, as shown in FIGS. 5C and 5D, adjacent (opposite) sides of the screens 19A and 19B of both monitors 18A and 18B The left and right MLO images 301 (301c) and the left and right CC images 302 (302c) are displayed close to each other. Even in this case, the line-of-sight movement distance between the left and right MLO images 301 (301c) and the left and right CC images 302 (302c) is reduced, and fatigue of the image interpretation doctor who compares the images simultaneously by visual observation can be reduced.

  In this case, as shown in FIG. 6, when the monitor 18 is arranged in a matrix of four monitors 18Ca, 18Cb, 18Cc, 18Cd, the two sides of each screen 19Ca, 19Cb, 19Cc, 19Cd sharing the center 21 By displaying each of the right MLO image 201R, the left MLO image 201L, the right CC image 202R, and the left CC image 202L on the center 21 side, one monitor (FIGS. 4B and 4D), Even in the case of two (FIGS. 5C and 5D) or four (FIG. 6), the eye movement distance of the interpreting doctor is reduced, and fatigue of the interpreting doctor who compares the images visually can be reduced. Although not shown, in the case of the example in FIG. 6, for example, an “enlarged display button” and a “proximity display button” are displayed on the input unit so as to be selectable on the upper side of the screen 19Ca of the monitor 18ca. The “proximity display button” is pressed.

  As described above, by using a method of deleting a void portion as an unnecessary portion using a circumscribed rectangle, an image displayed close to each other is enlarged or displayed so as not to be lost while being close to each other. Since it has a function of enlarging the image so that the image is not lost while the image is moved, comparison of the enlarged image (as shown in FIG. 4D, the enlarged left and right MLO image 201c and the enlarged left and right CC image 202c Comparison or a comparison between the enlarged left and right MLO image 301c and the enlarged left and right CC image 302c as shown in FIG. 5D can be interpreted with little movement of the line of sight.

  In this case, an enlarged display button 103 (enlarged display when pressed, non-enlarged when not pressed) on the screen can be switched between an enlarged image display function and an unenlarged image display function (original image display function). Since the original display) is displayed, the doctor can easily obtain an enlarged close-up image.

  Furthermore, as shown in FIG. 7, when two monitors 18 are juxtaposed with the monitors 18A ′ and 18B ′, the left and right MLO images are displayed on the adjacent (opposite) sides of the screens of both monitors 18A ′ and 18B ′. When the 301 and the left and right CC images 302 are displayed close to each other, the opposite side frames 17Lt and 17Rt of the monitors 18A ′ and 18B ′ are formed to be thin. Thereby, the interval between the left and right MLO images 301 and the left and right CC images 302 can be narrower than the interval D5 and the interval D4 shown in FIG. 5C (D5 <D4). Alternatively, when the monitor 18 is arranged in a matrix of four monitors 18Ca ', 18Cb', 18Cc ', 18cd' as shown in FIG. 8, the monitors 18Ca ', 18Cb', 18Cc ', 18Cd By producing the monitors 18Ca ′, 18Cb ′, 18Cc ′, and 18Cd ′ so that the frame on each of the two sides is thin, it is possible to suppress the line-of-sight movement of the image interpretation doctor to a minimum. .

  In the embodiment described above, the comparison target image is the MLO image captured this time and the CC image captured this time. However, the MLO image (CC image) captured last time and the MLO image (CC image) captured this time are used. It may be displayed as a comparison target over time, and is not limited to the comparison of output images from the mammography device 40, but is applied to the comparison of images obtained by the CT device 42 and the comparison of images obtained by the CR device 44. Also good.

  As described above, according to the embodiment described above, when displaying at least two images related to the interpretation target, for example, the left and right MLO images and the left and right CC images, the images are displayed close to each other. Since it has a function, the eye movement distance of the interpreting doctor is reduced, and fatigue of the interpreting doctor who visually compares the images can be reduced.

  At that time, even if there are one, two, or four monitors, each image is displayed close to each other or adjacent to (opposite) sides so that the images are close to each other. This reduces the visual line movement distance, and can reduce the fatigue of an interpreting doctor who compares images visually.

  Note that the present invention is not limited to the above-described embodiment, and based on the description in this specification, for example, as shown in FIG. Display button 122, 2-screen original display button 123, 2-screen original display button 123, 2-screen enlarged original display button 124, 1-screen proximity display button 111, 1-screen enlarged proximity display button 112, 2-screen proximity display button 113, 2-screen It goes without saying that various configurations can be adopted, such as changing to an enlarged proximity display button 114 and a button display that can be alternatively selected for each function.

DESCRIPTION OF SYMBOLS 10 ... Medical image diagnosis assistance apparatus 12 ... Medical image diagnosis assistance system 16 ... Image display processing apparatus 18 (18A, 18B) ... Monitor 26 ... Input part 30 ... Image server 40 ... Mammography apparatus

Claims (3)

When the CC image of the left and right breasts and the MLO image of the left and right breasts obtained by the related mammography device to be interpreted are respectively opposed to the chest wall side and displayed on two juxtaposed monitors,
On the screen of the two monitors,
A first function for displaying all the CC images of the left and right breasts and the MLO image of the left and right breasts in one screen of the two monitors, and the CC image of the left and right breasts of the two monitors A switching button capable of switching between a second function for displaying on the first monitor and displaying the MLO image of the left and right breasts on the second monitor of the two monitors;
A proximity display selection button capable of selecting a proximity display function for displaying the CC image of the left and right breasts and the MLO image of the left and right breasts;
Bei example button display function for displaying the peripheral portion of one of the screens of the two monitors,
When the first function is selected by the switching button and the proximity display function is not selected by the proximity display selection button, each image of the left and right breast CC images and the left and right breast MLO images exists. A first non-image portion that can be easily removed around a portion and displaying the images on the top and bottom of the one screen,
When the first function is selected by the switch button and the proximity display function is selected by the proximity display selection button, the left and right breast CC images and the left and right breasts of the first non-image portion By deleting the portions of the MLO images adjacent to each other, the images are displayed close to each other up and down,
When the second function is selected by the switching button and the proximity display function is not selected by the proximity display selection button, each of the left and right breast CC images and the left and right breast MLO images exists. A second non-image portion that can be easily removed around the area, and the CC image of the left and right breasts at the center of the first monitor, and the MLO image of the left and right breasts at the center of the second monitor Display each
When the second function is selected by the switch button and the proximity display function is selected by the proximity display selection button, the left and right breast CC images and the left and right breasts in the second non-image portion The left and right breast CC images are brought closer to the second monitor side and the left and right breast MLO images are brought closer to the first monitor side by deleting the adjacent portions of the MLO images. A medical image diagnosis support apparatus characterized by having a function. The medical image diagnosis support apparatus according to claim 1 ,
When the first function is selected by the switch button, the left and right breast CC images and the left and right breast MLO images are displayed with the symmetry axes of the left and right breasts aligned. Diagnosis support device. The medical image diagnosis support apparatus according to claim 1 or 2 ,
Wherein a peripheral portion of one of the screens of the two monitors, displays the enlarged display selection buttons that can switch unenlarged image display function and an enlarged image display function,
When the proximity display function is selected by the proximity display selection button and the enlarged image display function is selected by the enlarged display selection button, the CC images of the left and right breasts displayed in proximity to each other and the left and right breasts are displayed. A medical image diagnosis support apparatus having a function of enlarging an MLO image so that the image is not lost while being close to each other.

Images