JP5670145B2 - Medical image processing apparatus and control program - Google Patents

Description

  Embodiments described herein relate generally to a medical image processing apparatus and a control program for the purpose of assisting catheter treatment or the like for the heart.

  Medical image diagnosis has made rapid progress with X-ray CT apparatuses, MRI apparatuses, and the like that have been put into practical use with the recent development of computer technology, and is indispensable in today's medical care. In particular, X-ray CT apparatuses and MRI apparatuses enable real-time display of image data by increasing the speed and performance of a biological information detection unit and arithmetic processing unit, and further provide three-dimensional image information (volume data). Since the collection and generation / display of 3D image data using this volume data and MPR (Multi Planar Reconstruction) image data have become easier, for example, the treatment policy can be determined for a diseased part such as an atrial septal defect. It is possible to provide effective morphological image information.

  By the way, as eleven of the catheter treatments for the defect holes of the atrial septum and the ventricular septum, there is a treatment in which an obturator is placed at an appropriate position of the defect hole, and insertion of a treatment catheter used for such treatment and The placement of the closure plug is performed under observation of X-ray image data collected by X-ray imaging of the heart region where the catheter is inserted.

  However, in the recent two-dimensional X-ray image data obtained by X-ray imaging, in particular, it is difficult to accurately grasp the positional relationship between the distal end of the catheter and the defect hole in the depth direction. Catheter by observing three-dimensional image data based on volume data collected in advance by another medical image diagnostic apparatus such as a CT apparatus or an MRI apparatus and X-ray image data collected in real time in parallel display or composite display. A method of collecting medical information effective for treatment has been developed, and a data processing method capable of performing alignment in a short time when combining the above-described three-dimensional image data and X-ray image data has also been proposed. .

JP 2010-29641 A

  A conventional method of displaying X-ray image data collected in real time by an X-ray diagnostic apparatus and three-dimensional image data based on pre-collected volume data in parallel or synthetically displays a stationary treatment target site. Can be effective means, for example, it is not necessarily effective for a treatment target site having a large pulsatile movement such as a defect hole existing in an atrial septum or a ventricular septum. When contacting the inner wall of the heart chamber, the endocardium and the like are damaged, and there is a risk of perforating the atrial septum and the ventricular septum.

  The present disclosure has been made in view of the above-described problems, and an object thereof is diagnosis by an intravascular device such as a catheter or the like (hereinafter collectively referred to as a catheter) inserted into a patient's body. Another object of the present invention is to provide a medical image processing apparatus and a control program capable of generating and displaying highly accurate navigation image data for safely and accurately performing treatment.

  In order to solve the above-described problems, the medical image processing apparatus according to the present embodiment is based on volume data collected in advance from a patient, a safety region for a catheter tip inserted into the heart chamber, and a defect hole in the heart chamber wall. Navigation data generating means for generating at least one of a suitable insertion direction or insertion timing of the catheter tip with respect to the patient as navigation data, and an X-ray image collected by X-ray imaging of the patient into which the catheter tip is inserted A navigation image data generation unit that generates navigation image data by superimposing the navigation data on data, and a display unit that displays the navigation image data are provided.

1 is a block diagram showing the overall configuration of a medical image processing apparatus in the present embodiment. The figure for demonstrating the detection method of the inner wall of the heart chamber in this embodiment. The figure which shows the setting method of the safe area | region by the safe area | region setting part of this embodiment. The figure for demonstrating the safe insertion direction set by the safe insertion direction setting part of this embodiment. The figure for demonstrating the setting method of the safe insertion period in this embodiment. The block diagram which shows the specific structure of the safety determination part with which the medical image processing apparatus of this embodiment is provided. The figure for demonstrating the determination method of the safety | security by the insertion direction determination part of this embodiment. The figure which shows the specific example of the navigation data produced | generated by the navigation data production | generation part of this embodiment. The flowchart which shows the production | generation / display procedure of the navigation image data in this embodiment. The figure which shows the modification of the navigation data in this embodiment. The figure which shows the modification of the navigation data in this embodiment. The figure which shows the modification of the navigation image data in this embodiment.

  Hereinafter, embodiments of the present disclosure will be described with reference to the drawings.

  In the medical image processing apparatus of the present embodiment described below, the distal end of the catheter in the right atrium for the purpose of treating time-series volume data and atrial septal defect holes collected in advance by a separately installed medical image diagnostic apparatus. Based on the X-ray image data collected in substantially real time by X-ray imaging of the heart region into which the catheter is inserted, a safe region, a safe insertion direction, and a safe insertion period for the catheter tip are set. Next, the safety of the catheter tip inserted into the right atrium is determined based on the setting information and the position information of the catheter tip shown in the X-ray image data, and based on the determination result The generated navigation data is superimposed on the X-ray image data and displayed on the display unit.

  In the embodiment described below, a case where a treatment catheter is inserted into the right atrium for the purpose of treating an atrial septal defect is described, but the treatment target site is not limited to an atrial septal defect, For example, it may be another diseased part such as a ventricular septal defect.

(Device configuration)
Hereinafter, the configuration and functions of the medical image processing apparatus according to the present embodiment will be described with reference to FIGS. FIG. 1 is a block diagram showing an overall configuration of the medical image processing apparatus, and FIG. 6 is a block diagram showing a specific configuration of a safety determination unit provided in the medical image processing apparatus.

  A medical image processing apparatus 100 of the present embodiment shown in FIG. 1 includes a plurality of time-series data supplied from a separately installed medical image diagnostic apparatus such as an X-ray CT apparatus or an MRI apparatus via a network or storage medium (not shown). The navigation data generation unit 1 that generates navigation data based on the three-dimensional image information (hereinafter referred to as volume data) of the heartbeat time phase, and the obtained navigation data from a separately installed X-ray diagnostic apparatus in substantially real time. The navigation image data generation unit 2 that generates navigation image data superimposed on the X-ray image data of the patient supplied in step S3, the display unit 3 that displays navigation image data, and input of patient information and various command signals An input unit 4 for performing and a system control unit 5 for controlling the above-mentioned units in an integrated manner are provided.

  Next, the configuration and function of each unit included in the navigation data generation unit 1 will be described. The navigation data generation unit 1 uses the volume data storage unit 11 for storing volume data supplied from the medical image diagnostic apparatus described above and the inner wall of the right atrium into which the catheter tip is inserted, using the volume data described above. Based on the detection result of the inner wall of the heart chamber, the safety region setting unit 13 for setting the safety region for the catheter tip based on the detection result of the inner wall of the heart chamber in each heartbeat time phase, and the detection result of the inner wall of the heart chamber. A defect hole detection unit 14 for detecting a defect hole (atrial septal defect) existing in the atrial septum of the patient, and a catheter supplied from the position and shape of the detected defect hole and a position information conversion unit 19 to be described later A safe insertion direction setting unit 15 that sets a safe insertion direction with respect to the catheter tip based on the position information of the tip, and the position of the defect hole in each heartbeat time phase And a safety insertion period setting unit 16 for setting a safety insertion period of the catheter tip relative to the deficient hole based on the distribution.

  Further, the navigation data generation unit 1 detects the position information (position and direction) of the catheter tip indicated in the X-ray image data of the patient supplied from an X-ray diagnostic apparatus installed separately. An information detection unit 17, a position shift detection unit 18 that detects a position shift between the volume data and the X-ray image data collected in the same heartbeat time phase, and an X at the distal end of the catheter based on the detection result of the position shift. The position information conversion unit 19 that converts the position information in the line image data into the position information in the volume data, the above-described safety region, safe insertion direction and safe insertion period for the catheter tip, and the position information of the catheter tip in the volume data. A safety determination unit 20 for determining safety with respect to the catheter tip inserted into the heart chamber based on the Includes a safety area guide generator 21 for generating a safe area guides, the safety insertion guide generator 22 for generating a secure insertion guide on the basis of the safety insertion direction and safety determination result based on.

  The volume data storage unit 11 stores time series volume data collected by the medical image diagnostic apparatus for the heart region of the patient as supplementary information on the heartbeat time phase of the patient.

  On the other hand, the intracardiac wall detection unit 12 has a function of detecting the inner wall of the right atrium in each volume data read from the volume data storage unit 11 along the heartbeat time phase. A processing unit, an enlargement / reduction processing unit, and a subtraction processing unit are included. FIG. 2 schematically shows a method for detecting the inner wall of the heart chamber by the inner chamber wall detecting unit 12, and binarization processing and enlargement / reduction performed by the inner chamber wall detecting unit 12 with reference to FIG. Processing (FIG. 2A) and subtraction processing (FIG. 2B) will be described.

  The above-described binarization processing unit included in the heart chamber inner wall detection unit 12 generates three-dimensional binarization data A2 by setting a predetermined threshold value for the voxel value of the volume data A1 in a predetermined heartbeat time phase. The enlargement / reduction processing unit enlarges / reduces the binarized data A2 at different enlargement ratios α1 and α2 (α1> α2) to obtain three-dimensional enlarged binarized data A3 and reduced binarized data A4. Generate. Next, the subtraction processing unit detects a heart chamber inner wall by subtraction processing of the enlarged binarized data A3 and the reduced binarized data A4, and generates three-dimensional inner wall contour data A5 based on the detection result.

  The inner wall contour data A5 described above may be generated by subtraction processing between the enlarged binarized data A3 or the reduced binarized data A4 and the binarized data A2. The generation of the inner wall contour data based on the volume data is not limited to the above-described method, and can be obtained by, for example, performing a two-dimensional differentiation process on the binarized data A2. In addition, a plurality of search vectors starting from a reference point arranged in the heart chamber of the volume data are generated in all three-dimensional directions, and these search vectors and voxels having a voxel value larger than a predetermined value, The inner wall contour data may be generated based on the intersection position.

  Returning to FIG. 1, the safety region setting unit 13 has a safety region (that is, the catheter tip is located in the right atrium of the volume data based on the inner wall contour data of each heartbeat time phase obtained by the heart chamber inner wall detection unit 12. A region that does not contact the inner wall of the heart chamber in all heartbeat time phases regardless of the heart beat) is set. Specifically, for example, the inner wall contour data for one heartbeat cycle supplied from the heart chamber inner wall detection unit 12 is superimposed, and the portion that always becomes the heart chamber region in all heartbeat time phases is the safety region for the catheter tip. Set as.

  FIG. 3 shows a method for setting a safe region. FIG. 3A shows an inner wall contour of the right atrium generated by the heart chamber inner wall detecting unit 12 in heartbeat time phases t1 to t7 constituting one heartbeat cycle. Data R1 to R7 are shown. On the other hand, FIG. 3B shows the inner wall contour data R4 of the heartbeat time phase t4 in which the right atrium extracted from the common region or the inner wall contour data R1 to R7 surrounded by the inner wall contour data R1 to R7 is the most contracted. The safety area Ro set by the safety area setting unit 13 based on this is shown. In particular, when the myocardial tissue contracts uniformly toward the center of the heart chamber as shown in FIG. 3, the region surrounded by the inner wall contour data in the systole is set as the safe region.

  Returning to FIG. 1 again, the defect hole detection unit 14 uses a heart chamber inner wall model or a computer technique created based on normal inner wall contour data or the like that does not have a defect hole collected from another patient or subject. The inner wall model of the heart chamber created by using the inner wall model storage unit (not shown) stores the heartbeat time phase as supplementary information in advance. Then, the inner wall contour data in the predetermined heartbeat time phase of the patient supplied from the heart chamber inner wall detection unit 12 is compared with the heart chamber inner wall model in the same heartbeat time phase read out from the inner wall model storage unit, so that A defect hole is detected for each heartbeat phase.

  On the other hand, the safe insertion direction setting unit 15 determines whether or not the catheter is in contact with the defect hole based on the position and shape of the defect hole detected by the defect hole detection unit 14 and the position coordinates of the catheter tip supplied from the position information conversion unit 19. The range of the insertion direction (safe insertion direction) in which the tip can be safely inserted is set.

  FIG. 4 shows the safe insertion direction set three-dimensionally by the safe insertion direction setting unit 15. That is, the region Cx shown in the inner chamber Ca of the right atrium (RA) is the inner cavity contour data supplied from the inner chamber detector 12 by the defect hole detector 14 and the inner chamber model memory read from the inner chamber model storage unit. The defect hole detected by comparison with the inner wall model is shown, and the reference point Po is the position of the catheter tip that has been coordinate-converted from the coordinate system of the X-ray image data to the coordinate system of the volume data by the position information converter 19 described later. Show. In this case, the safe insertion direction setting unit 15 sets the safe insertion direction Qx as shown by the hatched portion by connecting the catheter tip (reference point) Po and the end of the defect hole Cx.

  Next, the safe insertion period setting unit 16 shown in FIG. 1 safely inserts a heartbeat period in which the above-mentioned defect hole is fixed for a long time in the heartbeat period of the patient or a heartbeat period in which the movement range is extremely small. Set as period. FIG. 5 is a diagram for explaining a method of setting the safe insertion period. Here, for the sake of simplicity, the safe insertion period is set based on the amount of movement of the cross section of the defect hole on the same plane. Although the case will be described, in practice, the safe insertion period is set based on the three-dimensional movement information of the defect hole.

  The vertical axis in FIG. 5 represents the heartbeat time phase (time), and the horizontal axis represents the movement direction and movement amount of the defect hole. The safe insertion period setting unit 16 receives, for example, a detection result of a defect hole in one heartbeat cycle [τ0−τ3] supplied from the defect hole detection unit 14, and detects a movement amount of the defect hole in each heartbeat time phase. . Next, a period [τ1-τ2] in which the detected movement amount is within a predetermined range for a long time is set as the safe insertion period. With such a setting of the safe insertion period, when the catheter tip is inserted into the defect hole that performs pulsatile movement together with the myocardial tissue, the period [τ1-τ2] set as the safe insertion period is shown in FIG. By moving the catheter tip in the direction of safe insertion indicated by the oblique lines, it is possible to reliably insert the catheter tip into the defect hole.

  Next, the tip position information detection unit 17 shown in FIG. 1 uses a separately installed X-ray diagnostic apparatus and performs real-time X-ray imaging on the heart region of the patient in which the catheter tip is inserted into the right atrium. Two-dimensional X-ray image data collected in time series and heart rate information of the patient are received. Next, by setting a predetermined threshold value for the pixel value of the obtained X-ray image data, the position information (the position and direction of the catheter tip) arranged in the right atrium is obtained for each heartbeat time phase. To detect.

  On the other hand, the positional deviation detection unit 18 has a function of detecting positional deviation between the volume data supplied from the volume data storage unit 11 and the above-described X-ray image data supplied from the X-ray diagnostic apparatus. That is, the positional deviation detection unit 18 sequentially receives the two-dimensional X-ray image data supplied from the X-ray diagnostic apparatus in substantially real time, and the heartbeat time phase added to each of these X-ray image data as incidental information. The volume data collected at the same heartbeat time phase is read from the volume data storage unit 11. Next, a positional shift between the image data is detected based on the X-ray image data and the volume data collected in the same heartbeat time phase.

  Specifically, the cross correlation coefficient between the volume data or the MIP (Maximum Intensity Projection) image data generated by projecting the volume data in the same direction as the X-ray image data imaging direction and the X-ray image data is calculated. By calculating, a difference in position, direction and magnification between data is detected. Note that a method for aligning volume data and X-ray image data in a short time is described in Patent Document 1 and the like, and thus detailed description thereof is omitted.

  The position information conversion unit 19 receives the position information of the catheter tip supplied from the tip position information detection unit 17 and the position shift information between the X-ray image data and the volume data supplied from the position shift detection unit 18, Based on this positional deviation information, the position information of the catheter tip in the coordinate system of the X-ray image data is converted into position information corresponding to the coordinate system of the volume data.

  Next, the safety determination unit 20 includes the safety region set in the safety region setting unit 13, the safe insertion direction set in the safe insertion direction setting unit 15, and the safe insertion period set in the safe insertion period setting unit 16. As shown in FIG. 6, the tip position determination unit 201, the insertion direction determination unit 202, and the insertion time determination unit have a function of determining safety when the catheter tip is inserted toward the defect hole based on the information. 203.

  The tip position determination unit 201 receives the position information (position) in the volume data of the catheter tip supplied from the position information conversion unit 19 and the information on the safety region in the right atrium of the catheter tip supplied from the safety region setting unit 13. The safety with respect to the position of the catheter tip disposed in the right atrium is determined based on whether or not the catheter tip is within the safety region.

  On the other hand, the insertion direction determination unit 202 corresponds to the position information (position and direction) in the volume data of the catheter tip supplied from the position information conversion unit 19 and the defect hole in the catheter tip supplied from the safe insertion direction setting unit 15. The safety insertion direction information is received, and the safety with respect to the insertion direction of the catheter tip is determined based on whether or not the insertion direction of the catheter tip is within the range of the safe insertion direction.

  FIG. 7 is a diagram for explaining a safety determination method by the insertion direction determination unit 202. In FIG. 7, a center line Co that connects the catheter tip portion Po and the center of the defect hole Cx, and the catheter tip A line segment L1 passing through the end of the part Po and the defect hole Cx and having an angle β1 with respect to the center line Co, and an arrow L2 indicating the direction of the catheter distal end Po having an angle β2 with respect to the center line Co are shown. ing. In this case, the insertion direction determination unit 202 compares the angle β1 of the line segment L1 with respect to the center line Co and the angle β2 of the arrow L2, and if β2 <β1, the insertion direction of the catheter distal end portion Po indicated by the arrow L2 Is determined to be safe.

  In addition, the insertion time determination unit 203 of the safety determination unit 20 includes the heartbeat time phase of the X-ray image data supplied via the position information conversion unit 19 and the loss of the catheter tip supplied from the safe insertion period setting unit 16. The information on the safe insertion period for the hole is received, and the insertion time for the defect hole at the catheter tip (that is, the heartbeat time phase of the X-ray image data displayed in real time when the catheter tip is inserted) is included in the safe insertion period. The safety with respect to the insertion time (insertion timing) of the distal end portion of the catheter is determined depending on whether or not it is.

  Next, the safe area guide generation unit 21 shown in FIG. 1 sets the volume set in the safe area setting unit 13 based on the coordinate conversion information between the volume data and the X-ray image data supplied from the position information conversion unit 19. A three-dimensional safe area corresponding to the data is subjected to coordinate transformation to generate a two-dimensional safe area guide corresponding to the X-ray image data.

  Similarly, the safe insertion guide generation unit 22 performs coordinate conversion of the three-dimensional safe insertion direction corresponding to the volume data set in the safe insertion direction setting unit 15 based on the above-described coordinate conversion information, and generates X-ray image data. Two-dimensional safe insertion direction data corresponding to is generated. Next, based on the safety insertion direction data and the determination result of the safety with respect to the position, insertion direction, and insertion time of the catheter tip supplied from the safety judgment unit 20, the insertion direction suitable for insertion of the catheter tip and A safe insertion guide indicating the insertion time (insertion timing) is generated.

  A specific example of the navigation data generated by the navigation data generation unit 1 will be described with reference to FIG. The navigation data shown in FIG. 8 includes a safety region guide GRo indicating the safety region of the catheter tip corresponding to the X-ray image data, and a safety insertion guide GQx indicating the safe insertion direction of the catheter tip corresponding to the X-ray image data. Furthermore, inner wall contour data GCa corresponding to the X-ray image data, tip marker GPo indicating the catheter tip, defect hole data GCx indicating the defect hole, and the like are added as necessary.

  In this case, the safety insertion guide GQx is normally generated when all of the safety with respect to the position of the catheter tip portion Po, the insertion direction, and the insertion time is confirmed by the safety determination unit 20, but is not limited thereto. For example, the safety insertion guide GQx may be generated even when the catheter tip portion Po is disposed outside the safety region.

  Returning to FIG. 1, the navigation image data generation unit 2 synthesizes navigation data of the same heartbeat time phase generated by the navigation data generation unit 1 with X-ray image data of a predetermined heartbeat time phase supplied from the X-ray diagnostic apparatus. Navigation image data effective for catheter treatment is generated by (superimposing).

  Next, the display unit 3 has a function of displaying time-series navigation image data generated by the navigation image data generation unit 2, and includes, for example, a display data generation unit, a conversion processing unit, and a monitor (not shown). Yes. The display data generation unit generates display data by adding incidental information such as patient information and a heartbeat time phase to the navigation image data supplied from the navigation image data generation unit 2, and the conversion processing unit generates the display data. The display data generated by the generation unit is subjected to conversion processing such as D / A conversion and television format conversion and displayed on the monitor.

  On the other hand, the input unit 4 includes various input devices and display panels such as a keyboard, switches, selection buttons, and mice (not shown), and sets threshold values necessary for inputting patient information, detecting the inner wall of the heart chamber, and detecting the distal end of the catheter. The navigation data generation conditions are set and various instruction signals are input. An interactive interface is formed by combining the input unit 4 and the display unit 3 described above. The navigation data generation condition includes a safety determination result necessary for generating the safety insertion guide.

  The system control unit 5 includes a CPU and a storage unit (not shown), and various information input or set in the input unit 4 is stored in the storage unit. Then, the CPU comprehensively controls each unit of the medical image processing apparatus 100 based on these pieces of information, and safety with respect to the position, insertion direction, and insertion time of the distal end of the catheter inserted into the defect hole of the atrial septum The determination of sex and generation and display of navigation image data based on the determination result are executed.

(Navigation image data generation / display procedure)
Next, a procedure for generating / displaying navigation image data in the present embodiment will be described with reference to the flowchart of FIG.

  Prior to the generation of navigation image data, time-series volume data supplied from a separately installed medical image diagnostic apparatus via a network or the like generates navigation data included in the medical image processing apparatus 100 with the heartbeat time phase as supplementary information. The data is stored in the volume data storage unit 11 of the unit 1 (step S1 in FIG. 9). Next, after inputting patient information, setting various threshold values, setting navigation data generation conditions, and the like in the input unit 4, a generation start instruction signal for navigation image data is input. At this time, information input or set in the above-described initial setting is stored in the storage unit of the system control unit 5.

  The heart chamber inner wall detection unit 12 of the navigation data generation unit 1 that has received the above instruction signal via the system control unit 5 performs binary processing on the volume data sequentially read from the volume data storage unit 11 along the heartbeat time phase. Processing, enlargement / reduction processing, and subtraction processing are performed to detect the inner chamber wall of the right atrium, and three-dimensional inner wall contour data is generated based on the detection result (step S2 in FIG. 9). Next, the safety region setting unit 13 superimposes, for example, inner wall contour data for one heartbeat period detected by the heart chamber inner wall detection unit 12, and sets the region that becomes the heart chamber region in all heartbeat time phases to the distal end portion of the catheter. Is set as a safety area (step S3 in FIG. 9).

  On the other hand, the defect hole detection unit 14 includes the inner wall contour data in the predetermined heartbeat time phase of the patient supplied from the heart chamber inner wall detection unit 12 and the heart chamber inner wall model of the same heartbeat time phase read from the own inner wall model storage unit. Are detected for each heartbeat time phase (step S4 in FIG. 9), and the safe insertion period setting unit 16 detects that the above-mentioned defect hole is extended over a long period of time in the heartbeat cycle of the patient. A fixed heartbeat period or a heartbeat period whose movement range is extremely small is set as a safe insertion period (step S5 in FIG. 9).

  On the other hand, the tip position information detection unit 17 receives the two-dimensional X-ray image data in the heart region of the patient and the heart rate information of the patient generated in a separately installed X-ray diagnostic apparatus in substantially real time ( Step S6 in FIG. Next, by setting a predetermined threshold value for the pixel value of the obtained X-ray image data, position information (position and direction) of the distal end of the catheter disposed in the right atrium is detected (step S7 in FIG. 9). .

  Next, the positional deviation detection unit 18 receives the two-dimensional X-ray image data in the first heartbeat time phase supplied from the X-ray diagnostic apparatus in substantially real time, and is added to the X-ray image data as incidental information. Volume data collected at the same heartbeat time phase as the current heartbeat time phase is read from the volume data storage unit 11. Then, predetermined data processing is performed on the X-ray image data and volume data collected in the same heartbeat time phase to detect a positional shift between the data (step S8 in FIG. 9).

  If the positional deviation between the X-ray image data and the volume data is detected, the positional information conversion unit 19 supplies the positional information on the catheter tip supplied from the distal tip position information detector 17 and the positional deviation detector 18. The positional deviation information between the received data is received, and based on the positional deviation information, the position information of the catheter tip in the coordinate system of the X-ray image data is converted into the positional information corresponding to the coordinate system of the volume data (FIG. 9). Step S9).

  Next, the safe insertion direction setting unit 15 is based on the position and size of the defect hole detected by the defect hole detection unit 14 in the above-described step S4 and the position information of the catheter distal end coordinate-converted by the position information conversion unit 19. An insertion direction range (safe insertion direction) in which the catheter tip can be safely inserted into the defect hole is set (step S10 in FIG. 9).

  When the setting of the safety region, the safe insertion period, and the safe insertion direction for the catheter tip is completed, the tip position determination unit 201 of the safety determination unit 20 receives the volume data of the catheter tip supplied from the position information conversion unit 19. The safety with respect to the position of the catheter tip disposed in the right atrium is determined based on the position information (position) and the safety region information in the right atrium of the catheter tip supplied from the safety region setting unit 13; The insertion direction determination unit 202 of the safety determination unit 20 includes position information (position and direction) in the volume data of the catheter tip supplied from the position information conversion unit 19 and the catheter tip supplied from the safety insertion direction setting unit 15. The safety in the insertion direction of the catheter tip is determined based on the information on the safe insertion direction with respect to the defect hole.

  In addition, the insertion time determination unit 203 of the safety determination unit 20 includes the heartbeat time phase of the X-ray image data supplied via the position information conversion unit 19 and the loss of the catheter tip supplied from the safe insertion period setting unit 16. The safety with respect to the insertion time (insertion timing) of the distal end portion of the catheter is determined based on the information on the safe insertion period for the hole (step S11 in FIG. 9).

  Next, the safe area guide generation unit 21 corresponds to the volume data set in the safe area setting unit 13 based on the coordinate conversion information between the volume data and the X-ray image data supplied from the position information conversion unit 19. A two-dimensional safe area guide corresponding to the X-ray image data is generated by coordinate transformation of the three-dimensional safe area.

  Similarly, the safe insertion guide generation unit 22 performs coordinate conversion of the three-dimensional safe insertion direction corresponding to the volume data set in the safe insertion direction setting unit 15 based on the above-described coordinate conversion information, and generates X-ray image data. Two-dimensional safe insertion direction data corresponding to is generated. Next, based on the safety insertion direction data and the determination result of the safety with respect to the position, insertion direction, and insertion time of the catheter tip supplied from the safety judgment unit 20, the insertion direction suitable for insertion of the catheter tip and A safe insertion guide indicating the insertion timing is generated (step S12 in FIG. 9).

  Next, the navigation image data generation unit 2 converts the X-ray image data of the predetermined heartbeat time phase supplied from the X-ray diagnostic apparatus into the navigation data of the same heartbeat time phase generated by the navigation data generation unit 1 (that is, the safety region guide). In addition, the navigation image data effective for the catheter treatment is generated by superimposing the safety insertion guide), and the obtained navigation image data is displayed on the monitor of the display unit 3 (step S13 in FIG. 9).

  Next, the above-described steps S6 to S13 are repeated for the X-ray image data sequentially supplied from the X-ray diagnostic apparatus following the above-mentioned X-ray image data, whereby the time-series navigation image data is updated. Generation and display are performed (steps S6 to S13 in FIG. 9).

  According to the embodiment of the present disclosure described above, it is possible to easily obtain highly accurate navigation image data capable of safely and accurately performing treatment of an atrial septal defect hole with a catheter inserted into the right atrium. it can.

  In particular, by indicating in the navigation image data the safety region for the catheter tip inserted into the heart chamber, the frequency of collision between the beating heart chamber inner wall and the catheter tip can be greatly reduced. In addition, the navigation image data shows a safe insertion guide indicating the safe insertion direction and safe insertion timing of the catheter tip with respect to the atrial septal defect hole so that the catheter tip can be inserted into the defect hole in a short time and accurately. It is possible to prevent damage or perforation to the inner wall of the heart chamber near the defect hole.

  In addition, since the safety insertion guide in the navigation image data is shown based on the safety judgment result with respect to the position, insertion direction, and insertion time of the catheter tip, predetermined safety is ensured for insertion of the catheter tip. The insertion timing can be easily grasped.

  Furthermore, since the setting of the safe insertion direction with respect to the catheter tip is performed based on the position information of the catheter tip converted from the coordinate system of the X-ray image data to the coordinate system of the volume data, the safe insertion direction with high accuracy. Can be set.

  As mentioned above, although embodiment of this indication has been described, this indication is not limited to the above-mentioned embodiment, and it can change and carry out. For example, in the above-described embodiment, it is inserted into a defect hole of the atrial septum using volume data supplied via a network or a storage medium from a medical image diagnostic apparatus such as an X-ray CT apparatus or MRI apparatus installed separately. The medical image processing apparatus 100 for determining the safety of the catheter tip position, the insertion direction, and the insertion time has been described. However, the volume data described above may be directly supplied from the medical image diagnostic apparatus. The diagnostic apparatus may be a part of an X-ray diagnostic apparatus or a medical image diagnostic apparatus.

  In the above-described embodiment, the case where a treatment catheter is inserted into the right atrium for the purpose of treating an atrial septal defect has been described, but the treatment target site is not limited to an atrial septal defect, For example, it may be another lesioned part or diseased part such as a ventricular septal defect. Furthermore, although the catheter for the purpose of treating a defect hole has been described, a catheter for the purpose of other treatment or diagnosis may be used.

  Further, the detection of the inner wall of the heart chamber is automatically performed by processing the volume data. However, the three-dimensional image data or MPR (Multi Planar Reconstruction) image obtained by rendering the volume data is described. You may carry out by the manual setting using the input device of the input part 4 under observation of data.

  In addition, although the case where the position information of the catheter tip is detected by binarization processing for X-ray image data has been described, it may be detected based on the output signal of the position information detector provided at the catheter tip or the like. Good.

  On the other hand, the navigation data generation unit 1 in the above-described embodiment generates a safety region guide indicating the safety region of the catheter tip and a safety insertion guide indicating the safe insertion direction and safety insertion time of the catheter tip as navigation data. As described above, navigation data may be generated using either the safety area guide or the safety insertion guide.

  In the above-described embodiment, when the insertion time of the catheter tip is not included in the safe insertion period, the navigation data generation unit 1 is described as not generating the safe insertion guide. However, the navigation data generation unit 1 is not included in the safe insertion period. Even in such a case, a safety insertion guide may be generated, and the brightness or color tone of the safety insertion guide may be set / updated in accordance with the safety determination result for the insertion time. Further, instead of setting / updating the luminance or color tone of the safety insertion guide based on the safety judgment result, for example, a safety insertion time notifying unit as shown in FIG. The luminance or color tone of the notification unit may be set / updated based on the safety determination result.

  Further, as shown in FIG. 11, a safety insertion guide GQx to which a direction vector GA indicating the direction of the catheter tip is added is generated, and the luminance or color tone of the direction vector GA is determined based on the safety determination result with respect to the insertion time. It may be set / updated.

  In the above-described embodiment, the navigation data including the safe area guide and the safe insertion guide generated by the navigation data generation unit 1 is superimposed on the X-ray image data to generate the navigation image data. As shown in FIG. 12, the viewpoint and line-of-sight direction corresponding to the position and direction of the catheter tip are set in the volume data described above, and the virtual endoscope generated by the volume data rendering process based on the viewpoint and line-of-sight direction is generated. The navigation image data may be generated by adding the mirror image data Im.

  Note that a part of the medical image processing apparatus 100 according to the present embodiment can also be realized by using a computer as hardware, for example. For example, the system control unit 5 and the like can realize various functions by causing a processor such as a CPU mounted on the above-described computer to execute a predetermined control program. In this case, the system control unit 5 may install the above-described control program in advance in the computer, or store the control program in a computer-readable storage medium or distribute the control program distributed over the network to the computer. It does not matter if it is an installation.

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

DESCRIPTION OF SYMBOLS 1 ... Navigation data generation part 11 ... Volume data storage part 12 ... Heart chamber inner wall detection part 13 ... Safe area | region setting part 14 ... Defect hole detection part 15 ... Safe insertion direction setting part 16 ... Safe insertion period setting part 17 ... Tip part position Information detection unit 18 ... Position deviation detection unit 19 ... Position information conversion unit 20 ... Safety determination unit 201 ... Tip position determination unit 202 ... Insertion direction determination unit 203 ... Insertion time determination unit 21 ... Safety region guide generation unit 22 ... Safe insertion Guide generation unit 2 ... navigation image data generation unit 3 ... display unit 4 ... input unit 5 ... system control unit 100 ... medical image processing apparatus

Claims (14)

Based on the volume data collected in advance from the patient, at least one of a safety region for the catheter tip inserted into the heart chamber, a suitable insertion direction or insertion timing of the catheter tip with respect to the defect hole in the heart chamber wall Navigation data generating means for generating navigation data;
Navigation image data generating means for generating navigation image data by superimposing the navigation data on X-ray image data collected by X-ray imaging for the patient into which the catheter tip is inserted;
A medical image processing apparatus comprising: display means for displaying the navigation image data.   The navigation data generating means includes a heart chamber inner wall detecting means for detecting a heart chamber inner wall for each of the volume data in a plurality of heartbeat time phases collected in time series from the heart region of the patient, and the heart chamber inner wall. A safe region setting means for setting a safe region for the catheter tip based on the detection result of the above, and a safety corresponding to the coordinate system of the X-ray image data based on the safe region corresponding to the coordinate system of the volume data The medical image processing apparatus according to claim 1, wherein an area guide is generated.   The navigation data generating means includes a defect hole detecting means for detecting a defect hole in the inner wall of the heart chamber based on the volume data in a plurality of heartbeat time phases collected in time series from the heart region of the patient, and a plurality of heartbeat times Safe insertion period setting means for setting a safe insertion period for the defect hole of the catheter tip based on the position information of the defect hole detected in each of the phases, position information of the defect hole, and the position of the catheter tip Safe insertion direction setting means for setting a safe insertion direction of the catheter tip portion with respect to the defect hole based on position information, and the catheter tip portion with respect to the defect hole based on the safe insertion direction and the safe insertion period. Safety judging means for judging insertion safety is provided, and a safety insertion guide is generated based on the judgment result of the insertion safety. The medical image processing apparatus according to claim 1, characterized in that.   The navigation data generating means includes a heart chamber inner wall detecting means for detecting a heart chamber inner wall for each of the volume data in a plurality of heartbeat time phases collected in time series from the heart region of the patient, and the heart chamber inner wall. The medical image processing apparatus according to claim 3, further comprising a safety area setting unit that sets a safety area for the catheter tip based on the detection result of the catheter.   The said safe area | region setting means sets the common heart cavity area | region detected based on the inner wall outline data of the said several heartbeat phases produced | generated by the said heart chamber inner wall detection means as said safety area | region. A medical image processing apparatus according to claim 2 or 4. A heart chamber inner wall detecting means for detecting a heart chamber inner wall for each of the volume data in a plurality of heartbeat time phases collected in time series from the heart region of the patient,
The defect hole detecting means detects the defect hole by comparing the outline data of the inner wall of the heart chamber detected by the inner wall detection means and a previously created inner wall model of a normal heart. 3. The medical image processing apparatus according to 3.   The said safe insertion period setting means sets the longest period in which the movement amount of the said defect hole detected in each of the said several heartbeat time phases is in a predetermined range as said safe insertion period. The medical image processing apparatus described. Position information detection means for detecting the distal end portion of the catheter in the X-ray image data, and position information in the coordinate system of the X-ray image data of the detected catheter distal end portion is converted into position information in the coordinate system of the volume data. Position information converting means for converting into a defect hole, and the safe insertion direction setting means is based on the position of the catheter tip in the volume data and the position and shape of the defect hole detected by the defect hole detection means. The medical image processing apparatus according to claim 3 , wherein a range in an insertion direction in which a catheter tip can be safely inserted is set as the safe insertion direction.   Position information detection means for detecting the distal end portion of the catheter in the X-ray image data, and position information in the coordinate system of the X-ray image data of the detected catheter distal end portion is converted into position information in the coordinate system of the volume data. Position information conversion means for converting into the safety information, the safety determination means based on at least one of the safety area, the safe insertion direction or the safe insertion period and the position information in the volume data of the catheter tip The medical image processing apparatus according to claim 3 or 4, wherein insertion safety of the distal end portion of the catheter with respect to the defect hole is determined.   A positional deviation detecting means for detecting a positional deviation between the volume data and the X-ray image data, wherein the positional information converting means is based on the detection result of the positional deviation in the X-ray image data of the catheter tip portion; The medical image processing apparatus according to claim 9, wherein the position information is converted into position information corresponding to the volume data.   The said navigation data production | generation means produces | generates the said safe insertion guide by superimposing the direction vector which shows the insertion direction of a catheter front-end | tip part on the safe insertion direction data corresponding to the said safe insertion direction. Medical image processing apparatus.   Virtual endoscope image data generating means for generating virtual endoscope image data based on the volume data and the position information of the catheter tip set in the volume data, the navigation image data generating means, The medical image processing apparatus according to claim 1, wherein the navigation image data is generated by adding the virtual endoscopic image data to the X-ray image data on which the navigation data is superimposed. For a medical image processing apparatus that generates navigation image data for treatment of a defect hole based on volume data collected in advance by the medical image diagnostic apparatus and X-ray image data collected by the X-ray diagnostic apparatus,
A heart chamber inner wall detection function for detecting a heart chamber inner wall with respect to the volume data of a plurality of heartbeat phases collected from a patient;
A safety region setting function for setting a safety region for the catheter tip inserted into the heart chamber based on the detection result of the inner wall of the heart chamber;
A navigation data generation function for generating a safety area guide indicating the safety area as navigation data;
A navigation image data generation function for generating navigation image data by superimposing the navigation data on the X-ray image data;
A control program for executing a display function for displaying the navigation image data. For a medical image processing apparatus that generates navigation image data for treatment of a defect hole based on volume data collected in advance by the medical image diagnostic apparatus and X-ray image data collected by the X-ray diagnostic apparatus,
A defect hole detection function for detecting a defect hole in the inner wall of the heart chamber based on the volume data of a plurality of heartbeat phases collected from a patient;
A safe insertion period setting function for setting a safe insertion period for the defect hole at the distal end portion of the catheter inserted into the heart chamber based on positional information of the defect hole detected in each of the plurality of heartbeat time phases;
A safe insertion direction setting function for setting a safe insertion direction for the defect hole of the catheter tip based on the position information of the defect hole and the position information of the catheter tip;
A safety determination function for determining insertion safety for the defect hole of the catheter tip based on the safe insertion direction and the safe insertion period;
A navigation data generation function for generating, as navigation data, a safe insertion guide indicating a suitable insertion direction and insertion timing of the catheter tip with respect to the defect hole based on the determination result of the insertion safety;
A navigation image data generation function for generating navigation image data by superimposing the navigation data on the X-ray image data;
A control program for executing a display function for displaying the navigation image data.

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