JP5534703B2 - X-ray diagnostic equipment - Google Patents

Description

  The present invention relates to an X-ray diagnostic apparatus.

  Conventionally, in order to evaluate the degree of lesions such as stenosis and tissue circulation disorder, an index value indicating the flow velocity (blood flow velocity) of blood flowing in the heart coronary artery has been used. Specifically, as the index value indicating the blood flow velocity in the heart coronary artery, an index value corresponding to the time required for the contrast medium to reach the end of the heart coronary artery from the heart coronary artery entrance is used. ing.

  As such an index value, TIMI (Thrombolysis in Myocardial Infraction) frame count is generally used (see, for example, Non-Patent Document 1). When acquiring the TIMI frame count, first, the X-ray diagnostic apparatus generates a plurality of X-ray images (moving images) along the time series of the subject's heart in which a contrast medium is injected into the cardiac coronary artery. The TIMI frame count is an X-ray in which the contrast effect is depicted at the end of the coronary artery from the “X-ray image where the contrast effect is depicted at the entrance of the coronary artery” in the generated moving image. Acquired as the number of frames leading up to “image”.

  However, the blood flow in the coronary arteries varies greatly with pulsation. For example, as shown in FIG. 15, the blood flow velocity at the time when the cardiac phase is estimated to be diastole from the electrocardiogram waveform is almost zero, whereas the cardiac phase is estimated to be systole from the electrocardiogram waveform. The blood flow velocity at the time rises rapidly to near 100 ml / min. FIG. 15 is a diagram for explaining the relationship between the blood flow velocity and the cardiac phase.

  Therefore, index values such as TIMI frame count increase when the contrast medium is injected in the diastole because the blood flow velocity is slow, and increase when the contrast agent is injected during the systole. It is affected by the timing of injecting the contrast agent, such as a smaller value.

  For this reason, an ECG gated injector that can receive an electrocardiogram waveform from an electrocardiograph attached to the subject and automatically inject a contrast agent when the received electrocardiogram waveform reaches a specific phase is used. A technique for accurately obtaining an index value indicating the blood flow velocity in the coronary artery of the heart is known.

C. Michael Gibson, MS, MD; Christopher P. Cannon, MD; William L. Daley, MD, MPH; J. Theodore Dodge, Jr, MD; Barbara Alexander, MSPH; Susan J. Marble, RN, MS; Carolyn H McCabe, BS; Lori Raymond, BS; Terry Fortin, MS; W. Kenneth Poole, PhD; Eugene Braunwald, MD; for the TIMI 4 Study Group, TIMI Frame Count A Quantitative Method of Assessing Coronary Artery Flow, Circulation. 1996; 93: 879-888

  By the way, the above-mentioned ECG gated injector can inject a contrast medium at a specific phase and thus can accurately acquire an index value. However, since it is expensive, it cannot be easily installed in an X-ray diagnostic apparatus. That is, the above-described conventional technique has a problem that an accurate index value indicating the blood flow velocity in the cardiac coronary artery cannot be easily obtained.

  Therefore, the present invention has been made to solve the above-described problems of the prior art, and an X-ray diagnostic apparatus that can easily obtain an accurate index value indicating the blood flow velocity in the cardiac coronary artery. The purpose is to provide.

In order to solve the above-described problems and achieve the object, the present invention provides a cardiac phase acquisition unit that acquires a cardiac phase of a subject and the heart of the subject in which a contrast medium is injected into a cardiac coronary artery in time series. Image storage means for storing a plurality of X-ray images generated by imaging along, detection means for detecting an injection time point when a contrast medium is injected into the heart coronary artery of the subject, and the image storage means The cardiac phase acquisition means at the injection time point detected by the detection means when an index value indicating the blood flow velocity in the cardiac coronary artery is acquired from a change in the concentration of the contrast agent in the plurality of X-ray images. Correction means for correcting the index value on the basis of the cardiac phase acquired in step (1).

Further, the present invention provides a cardiac phase acquisition unit that acquires a cardiac phase of a subject, and an injection that injects a contrast agent into the cardiac coronary artery of the subject when the cardiac phase acquisition unit reaches a predetermined cardiac phase. Transmission means for transmitting a contrast medium injection instruction to the apparatus, and the subject in which the injection of the contrast medium is started at the predetermined cardiac phase from the injection apparatus that has received the contrast medium injection instruction by the transmission means Image generating means for generating a plurality of X-ray images by photographing the heart in time series, and the coronary artery from the change in the concentration of the contrast agent in the plurality of X-ray images generated by the image generating means And an index value acquisition means for acquiring an index value indicating the blood flow velocity inside.

According to the present invention, it is possible to easily obtain an accurate index value indicating the blood flow velocity in the cardiac coronary artery.

FIG. 1 is a diagram for explaining the configuration of the X-ray diagnostic apparatus according to the first embodiment. FIG. 2 is a diagram for explaining the image data generation unit. FIG. 3 is a diagram for explaining the configuration of the image processing unit according to the first embodiment. FIG. 4 is a diagram for explaining a flow velocity index value acquisition unit according to the first embodiment. FIG. 5 is a diagram for explaining an injection time point detection unit according to the first embodiment. FIG. 6 is a diagram for explaining the correction coefficient storage unit. FIG. 7 is a diagram for explaining the correction unit. FIG. 8 is a diagram for explaining a modification of the correction coefficient storage unit. FIG. 9 is a flowchart for explaining processing of the X-ray diagnostic apparatus according to the first embodiment. FIG. 10 is a diagram for explaining the configuration of the image processing unit according to the second embodiment. FIG. 11 is a diagram for explaining an injection time point detection unit according to the second embodiment. FIG. 12 is a diagram for explaining an injection time point detection unit according to the third embodiment. FIG. 13 is a diagram for explaining the configuration of the image processing unit according to the fourth embodiment. FIG. 14 is a flowchart for explaining processing of the X-ray diagnostic apparatus according to the fourth embodiment. FIG. 15 is a diagram for explaining the relationship between the blood flow velocity and the cardiac phase.

  Exemplary embodiments of an X-ray diagnostic apparatus according to the present invention will be described below in detail with reference to the accompanying drawings.

  First, the configuration of the X-ray diagnostic apparatus according to the first embodiment will be described. FIG. 1 is a diagram for explaining the configuration of the X-ray diagnostic apparatus according to the first embodiment.

  As shown in FIG. 1, the X-ray diagnostic apparatus according to the present embodiment includes a high voltage generator 11, an X-ray tube 12, an X-ray diaphragm device 13, a top plate 14, a C arm 15, and an X-ray detection. Device 16, C-arm rotation / movement mechanism 17, top-plate movement mechanism 18, C-arm / top-plate mechanism control unit 19, aperture control unit 20, system control unit 21, input unit 22, and display unit 23, an image data generation unit 24, an image data storage unit 25, and an image processing unit 26.

  In addition, the X-ray diagnostic apparatus in the present embodiment is connected to the electrocardiograph 30 and the injector 40.

  The electrocardiograph 30 acquires an electrocardiogram waveform of the subject P to which a terminal (not shown) is attached, and transmits the acquired electrocardiogram waveform together with time information to an image data generation unit 24 and an image processing unit 26 described later. .

  The injector 40 is a device for injecting a contrast medium from a catheter inserted into the heart coronary artery of the subject P. Here, the contrast agent injection start from the injector 40 may be executed in accordance with an injection start instruction received via the system control unit 21 to be described later, or an operator directly inputs to the injector 40. It may be performed in accordance with an injection start instruction. In the following, a case will be described in which the contrast agent injection start from the injector 40 is executed upon receiving an injection start instruction from the system control unit 21 described later.

  The high voltage generator 11 generates a high voltage and supplies the generated high voltage to the X-ray tube 12. The X-ray tube 12 generates X-rays by the high voltage supplied from the high voltage generator 11. That is, the high voltage generator 11 adjusts the voltage supplied to the X-ray tube 12, thereby adjusting the X-ray dose irradiated to the subject P and turning ON / OFF the X-ray irradiation to the subject P. Control.

  The X-ray diaphragm device 13 is a device for narrowing the X-ray generated by the X-ray tube 12 so as to selectively irradiate the region of interest of the subject P. For example, the X-ray diaphragm 13 has four slidable diaphragm blades, and slides these diaphragm blades to narrow down the X-rays generated by the X-ray tube 12 and irradiate the subject P.

  The top 14 is a bed on which the subject P is placed, and is placed on a bed (not shown).

  The X-ray detector 16 is an apparatus in which X-ray detection elements for detecting X-rays transmitted through the subject P are arranged, and each X-ray detection element uses the X-rays transmitted through the subject P as electrical signals. Is converted and stored, and the stored electrical signal is transmitted to the image data generation unit 24 described later.

  The C arm 15 is an arm that holds the X-ray tube 12, the X-ray diaphragm device 13, and the X-ray detector 16. The X-ray tube 12, the X-ray diaphragm device 13, and the X-ray detector 16 are the C arm. 15 so as to face each other across the subject P.

  The C-arm rotation / movement mechanism 17 is a device for rotating and moving the C-arm 15, and the top plate moving mechanism 18 is a device for moving the top plate 14.

  The C-arm / top plate mechanism control unit 19 controls the C-arm rotation / movement mechanism 17 and the top-plate movement mechanism 18 to perform rotation adjustment and movement adjustment of the C-arm 15 and movement adjustment of the top plate 14. .

  The diaphragm control unit 20 controls the X-ray irradiation range by adjusting the opening degree of the diaphragm blades of the X-ray diaphragm device 13.

  The image data generation unit 24 generates an X-ray image using an electrical signal converted from the X-rays transmitted through the subject P by the X-ray detector 16 and stores the generated X-ray image in the image data storage unit 25. To do. Specifically, the image data generation unit 24 performs current / voltage conversion, A / D conversion, and parallel / serial conversion on the electrical signal received from the X-ray detector 16 to generate an X-ray image.

  In this embodiment, the X-ray tube 12 irradiates the heart of the subject P in which a contrast medium is injected into the heart coronary artery, and the X-ray detector 16 transmits the heart of the subject P. X-rays are detected. Then, the image data generation unit 24 generates a plurality of X-ray images obtained by photographing the heart of the subject P in which the contrast medium is injected into the heart coronary artery in time series. For example, as shown in FIG. 2A, the image data generation unit 24 has a contrast agent injected into LCX (left circumflex artery), RCA (right coronary artery), or LAD (left anterior descending artery). An X-ray image obtained by continuously photographing the heart of the subject P is generated in time series. FIG. 2 is a diagram for explaining the image data generation unit.

  The image data generation unit 24 stores the generated X-ray image in the image data storage unit 25. The image data generation unit 24 in this embodiment receives the generated X-ray image from the electrocardiograph 30. The electrocardiogram waveform and the time information are stored in the image data storage unit 25 in association with each other. For example, as shown in FIG. 2B, the image data generation unit 24 generates a plurality of X-ray images (X-ray image 1, X-ray image 2, X-ray image 3,. -) For each, the time at the time of imaging and the electrocardiographic waveform at the time of imaging are associated and stored in the image data storage unit 25.

  The image data storage unit 25 stores the X-ray image generated by the image data generation unit 24 in association with the imaging time and the electrocardiogram waveform at the imaging time.

  The image processing unit 26 is a processing unit that executes various types of image processing on the X-ray images stored in the image data storage unit 25. For example, the image processing unit 26 generates a moving image by processing a plurality of X-ray images along the time series stored in the image data storage unit 25. The image processing unit 26 will be described in detail later.

  The input unit 22 includes a mouse, a keyboard, a button, a trackball, a joystick, and the like for an operator such as a doctor or engineer who operates the X-ray diagnostic apparatus to input various commands. It transfers to the system control part 21 mentioned later.

  The display unit 23 displays a GUI (Graphical User Interface) for receiving a command from the operator via the input unit 22, or is subjected to image processing by the X-ray image and image processing unit 26 stored in the image data storage unit 25. A monitor for displaying a moving image of the X-ray image.

  The system control unit 21 controls the operation of the entire X-ray diagnostic apparatus. That is, the system control unit 21 controls the high voltage generator 11, the C arm / top plate mechanism control unit 19, and the aperture control unit 20 based on the command from the operator transferred from the input unit 22. Adjustment of X-ray dosage and ON / OFF control of X-ray irradiation, adjustment of rotation / movement of C-arm 15 and movement adjustment of top plate 14 are performed. Accordingly, the X-ray diagnostic apparatus continuously images the heart of the subject P in which the contrast medium is injected into the coronary artery.

  The system control unit 21 controls image generation processing in the image data generation unit 24 and image processing in the image processing unit 26 based on a command from the operator. Further, the system control unit 21 displays a GUI for receiving a command from the operator, an X-ray image stored in the image data storage unit 25 and a moving image image-processed by the image processing unit 26 on the monitor of the display unit 23. Control to display.

  As described above, the X-ray diagnostic apparatus according to the present embodiment generates a plurality of X-ray images in time series by continuously imaging the heart of the subject P in which the contrast medium is injected into the cardiac coronary artery. Stored in the image data storage unit 25.

  The X-ray diagnostic apparatus according to the present embodiment will be described in detail below from changes in contrast agent concentration in a plurality of X-ray images (a plurality of contrast images) along the time series stored in the image data storage unit 25. The main feature is that it is possible to easily obtain an index value (hereinafter referred to as a flow velocity index value) indicating an accurate blood flow velocity in the coronary artery by the processing of the image processing unit 26.

  Hereinafter, this main feature will be described with reference to FIGS. 3 is a diagram for explaining the configuration of the image processing unit in the first embodiment, FIG. 4 is a diagram for explaining the flow velocity index value acquiring unit in the first embodiment, and FIG. FIG. 6 is a diagram for explaining an injection time point detection unit in the first embodiment, FIG. 6 is a diagram for explaining a correction coefficient storage unit, and FIG. 7 is a diagram for explaining a correction unit. FIG. 8 is a diagram for explaining a modification of the correction coefficient storage unit.

  As shown in FIG. 3, the image processing unit 26 according to the first embodiment includes a flow velocity index value acquisition unit 26a, a cardiac phase acquisition unit 26b, an injection time point detection unit 26c, a correction coefficient storage unit 26d, and a correction unit 26e. Have

  The cardiac phase acquisition unit 26 b acquires the cardiac phase of the subject P at each time point from the electrocardiographic waveform and time information received from the electrocardiograph 30.

  Specifically, the system control unit 21 transfers in advance the average interval (average RR interval) of R waves in one heartbeat of the subject P received from the operator via the input unit 22 to the cardiac phase acquisition unit 26b. deep. Then, the cardiac phase acquisition unit 26b detects an R wave from the electrocardiogram waveform, and acquires the cardiac phase of the subject P at the present time from the elapsed time from the time when the R wave is detected and the average RR interval. For example, when the average RR interval is set to 100%, the cardiac phase acquisition unit 26b calculates how much of the average RR interval the elapsed time from when the R wave is detected corresponds to the subject P The cardiac phase at each time point is acquired.

  The flow velocity index value acquisition unit 26a acquires a flow velocity index value from the concentration change of the contrast agent in a plurality of X-ray images (a plurality of contrast images) along the time series stored in the image data storage unit 25.

  For example, based on a display request from the operator, the system control unit 21 uses a plurality of X-ray images in time series stored in the image data storage unit 25 as one X-ray image on the monitor of the display unit 23. Display. Then, as shown in FIG. 4A, the operator designates a plurality of ROIs (A0 to A7) via the input unit 22 in the X-ray image displayed on the monitor of the display unit 23. . Here, A0 is the ROI designated by the operator as a region corresponding to the entrance of the heart coronary artery, and A6 is the ROI designated by the operator as a region corresponding to the end portion of the heart coronary artery. A0 is also a region corresponding to the distal end portion of the catheter inserted to the entrance of the heart coronary artery for injecting the contrast medium.

  Then, as shown in FIG. 4B, the flow velocity index value acquisition unit 26a displays a time density curve (TDC) in which the contrast agent concentrations at A0 and A6 of each of the plurality of X-ray images are plotted in time series. create. Then, as shown in FIG. 4B, the flow velocity index value acquisition unit 26a takes the time when the contrast agent concentration is maximum at the A0 TDC (t0max) and the contrast agent concentration is maximum at the ADC TDC. The obtained time (t6max) is calculated, and “t6max−t0max” is acquired as the flow velocity index value.

  Alternatively, as shown in FIG. 4C, the flow velocity index value acquisition unit 26a performs the time (t0m) when the contrast agent concentration is half of the maximum value at the ADC TDC and the contrast agent concentration at the ADC TDC. Is the half of the maximum value (t6m), and “t6m−t0m” is acquired as the flow velocity index value.

  In this embodiment, the case where the flow velocity index value is automatically acquired by the flow velocity index value acquisition unit 26a has been described. However, the present invention is not limited to this, and the flow velocity index value is determined by the operator. May be obtained. For example, the system control unit 21 displays a moving image generated by the image processing unit 26 from a plurality of time-series X-ray images on the monitor of the display unit 23.

  For example, the operator refers to the moving image while frame-by-frame, and the X-ray image in which the contrast medium reaches the entrance of the heart coronary artery and the contrast medium reaches the end of the heart coronary artery. Designate X-ray image. Then, the operator obtains the TIMI frame count by calculating the number of frames between the two designated X-ray images. The TIMI frame count may be converted into “time” from the number of frames per second at the time of shooting.

  Returning to FIG. 3, the injection time point detection unit 26 c detects the injection time point when the contrast medium is injected into the heart coronary artery of the subject P.

  Specifically, the injection time point detection unit 26c detects an injection time point by performing image processing on a plurality of X-ray images (a plurality of contrast images) along a time series.

  More specifically, as shown in FIG. 5A, the injection time point detection unit 26c detects when the contrast agent concentration rapidly increases (for example, in the TDC of ROI (A0) set in advance by the operator) The time point when the gradient of the contrast agent concentration change becomes equal to or greater than a predetermined threshold is detected as the injection time point.

  Alternatively, as shown in FIG. 5B, the injection time point detection unit 26c compares the pixel density between each of the plurality of X-ray images, and an X-ray image in which a region where the image density suddenly decreases is detected. The imaging time is detected as the injection time.

  In addition, although the present Example demonstrates the case where a contrast agent is inject | poured by the injector 40, this invention is not limited to this, A doctor does not use the injector 40 but a doctor contrasts manually. The injection time point processing by the injection time point detection unit 26c can be applied even when injecting.

  Returning to FIG. 3, the correction unit 26 e acquires the flow velocity index value acquired by the flow velocity index value acquisition unit 26 a by the cardiac phase acquisition unit 26 b acquired at the injection time point detected by the injection time point detection unit 26 c. Correction is performed based on the cardiac phase of the specimen P.

  Specifically, the correction unit 26e refers to a correction coefficient storage unit 26d that stores a correction coefficient group set in association with each cardiac phase based on a change in blood flow velocity according to the cardiac phase. The flow velocity index value acquired by the flow velocity index value acquisition unit 26a is corrected.

  For example, as illustrated in FIG. 6, the correction coefficient storage unit 26 d stores a correction curve in which correction coefficients set in association with each cardiac phase (0 to 100%) are plotted. Then, for example, as illustrated in FIG. 7, when the cardiac phase of the subject P at the time of injection is 35%, the correction unit 26 e refers to the correction curve illustrated in FIG. 5 and “cardiac phase: 35%”. "Correction coefficient: 0.65" is extracted, and the corrected output flow velocity index is obtained by multiplying the flow velocity index value acquired by the flow velocity index value acquisition unit 26a by "correction coefficient: 0.65". calculate.

  Then, the display unit 23 outputs the output flow velocity index calculated by the correction unit 26 e through the correction process to the monitor of the display unit 23 based on the control of the system control unit 21.

  As shown in FIG. 6, the correction curve stored in the correction coefficient storage unit 26d may be common to all patients, or each cardiac phase for each physical feature of the patient to be imaged. The correction curve may be set in association with.

  For example, as shown in FIG. 8, the correction curve may be set by being classified according to physical characteristics such as sex, weight, and blood pressure of the patient. In addition to the patient's sex, weight, and blood pressure, the physical characteristics may include a case where arteriosclerosis degree, blood vessel thickness, and the like are added. The correction unit 26e corrects the flow velocity index value by referring to a correction curve corresponding to the physical characteristics of the subject P.

  In the present embodiment, the case where the correction coefficient storage unit 26d stores a correction coefficient group as a correction curve has been described. However, the present invention is not limited to this, and for example, a correction coefficient group for each cardiac phase is stored. Alternatively, it may be stored in a table format.

  Next, processing of the X-ray diagnostic apparatus according to the first embodiment will be described with reference to FIG. FIG. 9 is a flowchart for explaining processing of the X-ray diagnostic apparatus according to the first embodiment.

  As shown in FIG. 9, when the X-ray diagnostic apparatus according to the first embodiment stores a plurality of X-ray images (contrast images) in time series in the image data storage unit 25 (Yes in step S101), the flow velocity index The value acquisition unit 26a acquires a flow velocity index value from the concentration change of the contrast agent in a plurality of X-ray images (a plurality of contrast images) (step S102).

  Then, the injection time point detection unit 26c detects the injection time point when the contrast agent is injected into the heart coronary artery of the subject P by image processing (step S103), and the correction unit 26e passes through the cardiac phase acquisition unit 26c. The cardiac phase at the time of injection is acquired (step S104).

  Thereafter, the correction unit 26e refers to the correction curve stored in the correction coefficient storage unit 26d, extracts a correction coefficient corresponding to the acquired cardiac phase (step S105), and uses the extracted correction coefficient to obtain a flow velocity index value. Is corrected, the corrected flow velocity index value is output to the monitor of the display unit 23 according to the control of the system control unit 21 (step S106), and the process is terminated.

  As described above, in the first embodiment, the flow velocity index value acquisition unit 26a acquires the flow velocity index value from the contrast agent concentration change in the plurality of X-ray images stored in the image data storage unit 25, and the injection time point. The detection unit 26c detects the injection time when the contrast agent is injected into the heart coronary artery of the subject P from the change in the contrast agent concentration of the X-ray image. The correction unit 26e acquires the cardiac phase at the injection time point from the cardiac phase at each time point of the subject P acquired by the cardiac phase acquisition unit 26b.

  The correction coefficient storage unit 26d stores a correction coefficient group set in association with each cardiac phase based on a change in blood flow velocity according to the cardiac phase as a correction curve, and the correction unit 26e displays the correction curve as a correction curve. The correction coefficient corresponding to the acquired cardiac phase is extracted, and the flow velocity index value is corrected using the extracted correction coefficient. Then, the system control unit 21 performs control so that the flow velocity index value corrected by the correction unit 26e is output to the monitor of the display unit 23.

  Therefore, even without using an ECG gated injector, the acquired flow velocity index value can always be corrected as a flow velocity index value at a constant blood flow velocity regardless of the cardiac phase into which the contrast agent has been injected. As described above, it is possible to easily obtain an index value indicating the accurate blood flow velocity in the coronary artery.

  Further, by setting a correction coefficient group for each physical feature of a patient, an appropriate correction factor can be extracted according to the physical feature of the subject P to be diagnosed, and a more accurate cardiac coronary artery It is possible to easily obtain an index value indicating the blood flow velocity inside.

  In the above-described first embodiment, the case where the injection time point is detected by image processing has been described. In the second embodiment, the case where the injection time point is detected by using the instruction signal to the injector 40 is described with reference to FIGS. 10 and 11. I will explain. FIG. 10 is a diagram for explaining the configuration of the image processing unit in the second embodiment, and FIG. 11 is a diagram for explaining the injection time point detection unit in the second embodiment.

  As illustrated in FIG. 10, the injection time point detection unit 26 c of the image processing unit 26 according to the second embodiment uses information transmitted and received among the input unit 22, the system control unit 21, and the injector 40.

  That is, the injection time point detection unit 26c according to the second embodiment detects the time point when the system control unit 21 transmits the instruction received by the input unit 22 from the operator to the injector 40 as the injection time point.

  Specifically, as illustrated in FIG. 11, the system control unit 21 transmits a contrast agent injection instruction signal to the injector 40 based on the contrast agent injection instruction input by the operator via the input unit 22. At this time, the system control unit 21 notifies the injection time point detection unit 26c that the contrast medium injection instruction signal has been transmitted to the injector 40, whereby the injection time point detection unit 26c detects the injection time point.

  The processing content by the flow velocity index value acquisition unit 26a, the cardiac phase acquisition unit 26b, and the correction unit 26e and the content stored in the correction coefficient storage unit 26d are the same as those in the first embodiment, and thus the description thereof is omitted.

  The processing flow of the X-ray diagnostic apparatus according to the second embodiment is the same as the processing content of step S103 performed by the injection point detection unit 26c in the processing of the X-ray diagnostic apparatus according to the first embodiment described with reference to FIG. Since the processing contents are the same as those of the first embodiment except that the processing contents are replaced, the description thereof is omitted.

  As described above, in the second embodiment, by using the function of transmitting a contrast medium injection instruction signal to the injector 40 provided in the conventional X-ray diagnostic apparatus, the injection time point can be easily detected. It is possible to more easily acquire an index value indicating an accurate blood flow velocity in the coronary artery.

  In the second embodiment described above, the case where the injection time point is detected using the instruction signal to the injector 40 has been described. However, in the third embodiment, the case where the injection time point is detected using the signal from the injector 40 is illustrated in FIG. It explains using. In addition, FIG. 12 is a figure for demonstrating the injection | pouring time point detection part in Example 3. FIG.

  The image processing unit 26 in the third embodiment has the same configuration as the image processing unit 26 in the second embodiment described with reference to FIG. 10, but the processing of the injection time point detection unit 26 c is different from that in the second embodiment. Hereinafter, this will be mainly described.

  In Example 3, as shown in FIG. 12, the injector 40 transmits a contrast agent injection start notification indicating that the injection of contrast agent has started to the injection time point detection unit 26c. Thereby, the injection time point detection unit 26c detects the time point when the contrast agent injection start notification is received as the injection time point. Here, the contrast agent injection start notification from the injector 40 may be transmitted to the injection time point detection unit 26c via the system control unit 21.

  The processing content by the flow velocity index value acquisition unit 26a, the cardiac phase acquisition unit 26b, and the correction unit 26e and the content stored in the correction coefficient storage unit 26d are the same as those in the first embodiment, and thus the description thereof is omitted.

  The processing flow of the X-ray diagnostic apparatus in the third embodiment is the same as the processing content of step S103 by the injection time point detection unit 26c in the processing of the X-ray diagnostic apparatus in the first embodiment described with reference to FIG. Since the processing contents are the same as those of the first embodiment except that the processing contents are replaced, the description thereof is omitted.

  As described above, in the third embodiment, it is possible to easily detect the injection point by using the transmission function of the contrast agent injection start notification to the X-ray diagnostic apparatus provided in the conventional injector 40. It is possible to more easily acquire an index value indicating an accurate blood flow velocity in the coronary artery.

  In the first to third embodiments described above, the case where an accurate flow velocity index value is output by the correction process has been described, but in the fourth embodiment, the case where an accurate flow velocity index value is output without executing the correction process is illustrated in FIG. Will be described. FIG. 13 is a diagram for explaining the configuration of the image processing unit according to the fourth embodiment.

  As illustrated in FIG. 13, the image processing unit 26 in the fourth embodiment includes only a flow velocity index value acquisition unit 26 a and a cardiac phase acquisition unit 26 b as compared with the image processing unit 26 in the first to third embodiments.

  Here, in Example 4, when the operator inputs an imaging start instruction via the input unit 22, the system control unit 21 determines that the cardiac phase of the subject P acquired by the cardiac phase acquisition unit 26b is a specific phase. When the cardiac phase is reached (for example, when the cardiac phase is 50%), a contrast medium injection start instruction is transmitted to the injector 40. Thereby, the injector 40 starts inject | pouring the contrast agent from the catheter inserted in the heart coronary artery in the specific phase.

  The system control unit 21 receives the imaging start instruction or transmits the injection start instruction to the injector 40. The C arm / top plate mechanism control unit 19, the aperture control unit 20, and the high voltage By controlling the generator 11, continuous imaging is started, and the image data generation unit 24 sequentially generates a plurality of time-series X-ray images, and the generated X-ray images are stored in the image data storage unit 25. Store.

  Then, the flow velocity index value acquisition unit 26a in the fourth embodiment acquires and acquires the flow velocity index value based on the change in the concentration of the contrast agent from the X-ray image obtained by imaging the heart into which the contrast agent has been injected from the specific phase. The flow velocity index value is output to the monitor of the display unit 23.

  Next, processing of the X-ray diagnostic apparatus according to the fourth embodiment will be described with reference to FIG. FIG. 14 is a flowchart for explaining processing of the X-ray diagnostic apparatus according to the fourth embodiment.

  As illustrated in FIG. 14, when the system control unit 21 of the X-ray diagnosis apparatus according to the fourth embodiment receives an imaging start instruction from the operator via the input unit 22 (Yes in step S201), the cardiac phase acquisition unit 26b The cardiac phase of the subject P is acquired from the electrocardiographic waveform received from the electrocardiograph 30 (step S202).

  Then, the system control unit 21 determines whether or not the cardiac phase acquired by the cardiac phase acquisition unit 26b has become a specific phase (step S203).

  Here, when the cardiac phase acquired by the cardiac phase acquisition unit 26b is not the specific phase (No at Step S203), the system control unit 21 continues the determination process at Step S203.

  On the other hand, when the cardiac phase acquired by the cardiac phase acquisition unit 26b becomes a specific phase (Yes at Step S203), the system control unit 21 transmits a contrast medium injection start instruction to the injector 40, and transmits an imaging start instruction to the C-arm. It transmits to the top plate mechanism control part 19, the aperture control part 20, and the high voltage generator 11 (step S204).

  Then, when a plurality of X-ray images along the time series are stored in the image data storage unit 25 by the image data generation unit 24 (Yes in step S205), the flow velocity index value acquisition unit 26a stores a plurality of X-ray images ( The flow rate index value is acquired from the contrast agent concentration change in the plurality of contrast images, and the acquired flow rate index value is output to the monitor of the display unit 23 according to the control of the system control unit 21 (step S206). Exit.

  As described above, in the fourth embodiment, the cardiac phase is acquired by the X-ray diagnostic apparatus, and when the specific phase is reached, the injector 40 is instructed to start injecting the contrast agent. Since it can function as a gated injector and always obtain a flow velocity index value at the same blood flow velocity, it is possible to easily obtain an accurate index value indicating the blood flow velocity in the heart coronary artery It becomes possible.

  In the above-described Examples 1 to 4, the case where the time from the entrance of the cardiac coronary artery to the end of the contrast agent is used as the flow velocity index value has been described. However, the present invention is not limited to this. Alternatively, “TIMI frame count”, “corrected TIMI frame count”, “APS (Angiographic Perfusion Score)”, or the like may be used as the flow velocity index value.

  In the first to fourth embodiments, the case where the image processing unit 26 is incorporated in the X-ray diagnostic apparatus has been described. However, the present invention is not limited to this, and the image processing unit 26 is not limited to the X-ray. The flow velocity index value may be acquired from a plurality of X-ray images that are installed independently of the diagnostic device and are taken in time series by the X-ray diagnostic device.

  As described above, the X-ray diagnostic apparatus according to the present invention is useful when acquiring an index value indicating the blood flow velocity in the heart coronary artery using the X-ray image, and particularly, accurate blood in the heart coronary artery. It is suitable for easily obtaining an index value indicating the flow velocity.

DESCRIPTION OF SYMBOLS 11 High voltage generator 12 X-ray tube 13 X-ray aperture apparatus 14 Top plate 15 C arm 16 X-ray detector 17 C arm rotation and movement mechanism 18 Top plate movement mechanism 19 C arm and top plate mechanism control part 20 Aperture control part DESCRIPTION OF SYMBOLS 21 System control part 22 Input part 23 Display part 24 Image data generation part 25 Image data memory | storage part 26 Image processing part 26a Flow velocity index value acquisition part 26b Heart phase acquisition part 26c Injection time point detection part 26d Correction coefficient memory | storage part 30 Electrocardiograph 40 injector

Claims (7)

Cardiac phase acquisition means for acquiring the cardiac phase of the subject;
Image storage means for storing a plurality of X-ray images showing the heart of the subject in which a contrast medium is injected into the coronary artery;
Detection means for detecting an injection time point when a contrast medium is injected into the heart coronary artery of the subject;
When the index value indicating the blood flow velocity in the coronary artery is acquired from the change in the concentration of the contrast medium between the regions of interest in the plurality of X-ray images stored in the image storage means, the detection means detects the blood flow velocity. Correction means for correcting the index value based on the cardiac phase acquired by the cardiac phase acquisition means at the injection time point;
An X-ray diagnostic apparatus comprising: Correction coefficient storage means for storing a correction coefficient group set in association with each cardiac phase based on changes in blood flow velocity according to the cardiac phase;
The correction means extracts a correction coefficient corresponding to the cardiac phase at the injection time point from the correction coefficient group stored in the correction coefficient storage means, and corrects the index value using the extracted correction coefficient. The X-ray diagnostic apparatus according to claim 1, wherein The correction coefficient storage means stores a plurality of correction coefficient groups set for each physical feature of the subject to be imaged ,
The correction means corresponds to a cardiac phase at the time of injection from a correction coefficient group corresponding to a physical feature of the subject from which the index value is acquired, among the plurality of correction coefficient groups stored in the correction coefficient storage means. The X-ray diagnostic apparatus according to claim 2, wherein a correction coefficient to be extracted is extracted.   The X-ray diagnostic apparatus according to claim 1, wherein the detection unit detects the injection time point based on a change in the contrast agent in the plurality of X-ray images stored in the image storage unit. A transmission means for transmitting a contrast medium injection instruction signal to the injection apparatus for injecting the contrast medium;
The X-ray diagnostic apparatus according to claim 1, wherein the detection unit detects a time point when the transmission unit transmits the contrast medium injection instruction signal as the injection time point. Receiving means for receiving a contrast agent injection start notification for notifying that the injection of the contrast agent has started from the injection device for injecting the contrast agent;
The X-ray diagnostic apparatus according to claim 1, wherein the detection unit detects a time point when the reception unit receives the contrast medium injection start notification as the injection time point. Cardiac phase acquisition means for acquiring the cardiac phase of the subject;
When the cardiac phase of the subject acquired by the cardiac phase acquisition means reaches a predetermined cardiac phase, a contrast agent injection instruction is transmitted to an injection device that injects a contrast agent into the cardiac coronary artery of the subject A transmission means;
Image generating means for generating a plurality of X-ray images indicating the heart of the subject in which the injection of the contrast medium is started at the predetermined cardiac phase from the injection device that has received the contrast medium injection instruction by the transmission means. When,
Index value acquisition means for acquiring an index value indicating a blood flow velocity in the cardiac coronary artery from a concentration change of the contrast agent between regions of interest in the plurality of X-ray images generated by the image generation means;
An X-ray diagnostic apparatus comprising:

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