JP5766773B2 - Endoscope system and method for operating endoscope system - Google Patents

Description

  The present invention relates to an endoscope system for acquiring information on oxygen saturation of hemoglobin in blood vessels existing in a living tissue, and an operating method of the endoscope system.

  Various biometric information is acquired in the medical field. A typical example is an examination using an endoscope. As is well known, the endoscope irradiates the observation site of the subject with illumination light from the tip of the insertion portion to be inserted into the subject, and captures an image of the observation site.

  Conventionally, a white light source such as a xenon lamp or a metal halide lamp has been used as the light source of the illumination light. However, in order to easily find a lesion, light of a narrow wavelength band (narrow band light) is irradiated to the observation site. The technique of imaging and observing the reflected light is in the spotlight (see Patent Document 1).

  A method for acquiring information on the oxygen saturation of hemoglobin in a blood vessel based on an imaging signal obtained by irradiating narrow-band light has also been intensively studied (see Patent Document 2). In Patent Document 2, narrowband light of a plurality of wavelength sets is irradiated in each wavelength band such as 300 to 400 nm, near 400 nm, 400 to 500 nm, 500 to 600 nm, and 450 to 850 nm. The wavelength set is a combination of a wavelength at which the absorbance changes due to the oxygen saturation of hemoglobin and a wavelength with little change.

Japanese Patent No. 3583731 Japanese Patent Laid-Open No. 06-315477

  When obtaining oxygen saturation information as in Patent Document 2, a function or a data table using the ratio of pixel values of the obtained image as a parameter is prepared in advance, and the obtained parameter is substituted into the function or data Search the table.

  Reference information such as these functions and data tables are created based on typical living tissue, but in actuality the reference information depends on the properties of the site to be observed, such as the structure, thickness, and blood vessel density of the mucosal layer. Change. There is no guarantee that a typical biological tissue will be the subject of observation because there are individual differences among patients and differences in each part of the digestive tract in the properties of the observed site. The calculation result of the saturation level becomes unreliable.

  Patent Document 2 does not mention the problem that the reliability of the calculation result of the oxygen saturation is lowered when observing a biological tissue that deviates from a typical example, and naturally no solution is presented.

  The present invention has been made in view of the above-described problems, and provides an endoscope system and an operation method of the endoscope system that can acquire highly reliable oxygen saturation information that contributes to diagnosis. With the goal.

  In order to achieve the above object, the endoscope system of the present invention irradiates an observation site of a subject with first measurement light for measuring oxygen saturation of hemoglobin in a blood vessel existing in a living tissue. Means for imaging reflected light from the site to be observed of the first measurement light and outputting a first pixel value, and a memory for storing reference information defining a correlation between the first pixel value and the oxygen saturation Means, calculating means for calculating the oxygen saturation according to the first pixel value based on the reference information, and setting changing means for changing the reference information according to the property of the site to be observed.

  Based on the first pixel value corresponding to the first measurement light irradiated to the normal observation site where there is no lesion and the default reference information, pre-imaging to obtain the actual measured value of oxygen saturation of the normal observation site It has a mode to execute. The setting change unit changes the default reference information in accordance with a difference between an actual value of oxygen saturation obtained by pre-imaging and a preset reference value of oxygen saturation. After the pre-photographing is completed, the process shifts to the main photographing where the calculating means calculates the oxygen saturation based on the reference information changed by the setting changing means.

  In the pre-photographing, a plurality of frames of images are photographed, and the average value of the oxygen saturation of the images for a plurality of frames is used as an actual measurement value.

  As the reference value for the oxygen saturation, one value may be set regardless of the anatomical site, or a plurality of values may be set according to the anatomical site.

  In the latter case, the operation input means for inputting the anatomical part of the observed part, or the part detecting means for detecting the anatomical part of the observed part based on the pixel value output from the imaging device, The setting change unit changes the setting of the reference value according to the operation input signal from the operation input unit or the detection result of the part detection unit. The site detection means identifies an anatomical site of the site to be observed based on the blood volume. Site detection may be performed by well-known image recognition. The anatomical site specifically includes the esophagus, stomach, large intestine, and the like.

  The calculation means calculates oxygen saturation for the entire region of the image obtained by pre-imaging. Alternatively, the oxygen saturation may be calculated for a limited region of an image obtained by pre-imaging.

  In the latter case, it is preferable that the calculation unit includes a region selection unit that selects a region of an image in which oxygen saturation is calculated by pre-photographing based on the pixel value output from the image sensor. The region selecting means selects a region other than an extremely bright region or an extremely dark region in the image as a region for calculating the oxygen saturation. An area where the blood volume is larger than the threshold and an area where the blood vessel density is lower than the threshold may be selected as the area for calculating the oxygen saturation. The area selected by the area selecting means is preferably displayed on the display means.

  After displaying on the display means a message that prompts the normal observation site to be positioned in the entire field of view of the image sensor and performing pre-imaging, pre-imaging is started in response to an operation input instructing the start of pre-imaging. Alternatively, pre-photographing may be started without displaying a message.

  In the latter case, it is preferable to include determination means for determining whether or not the actual measured value of oxygen saturation obtained by pre-imaging is within an allowable range. If the measured value of the oxygen saturation is within the allowable range, the process of changing the reference information is continued. If not, the normal observation site is positioned in the entire field of view of the image sensor. A message prompting the user to perform shooting is displayed on the display means.

  Normal observation mode in which a white light in a broad wavelength band is continuously irradiated to the site to be observed and the image is displayed on the display means almost the same as when observed with the naked eye; And a function information observation mode for displaying the result on the display means, and each mode is preferably switchable. It is preferable to start pre-shooting when the function information observation mode is selected.

  The first measurement light is light including a wavelength band in which a difference occurs in the extinction coefficient between oxyhemoglobin and reduced hemoglobin in the absorption spectrum of hemoglobin. More preferably, it is narrowband light having a wavelength band of 470 nm ± 10 nm.

  The irradiation means irradiates the site to be observed with second measurement light for measuring the blood volume in the blood vessel in addition to the first measurement light, and the imaging element reflects the second measurement light from the site to be observed. The light is imaged and a second pixel value is output. The reference information defines the correlation between the second pixel value and the blood volume in addition to the correlation between the first pixel value and the oxygen saturation. The calculation means calculates both oxygen saturation and blood volume according to the first pixel value and the second pixel value based on the reference information. In this case, the second measurement light is light including a red wavelength band.

  In addition to the first and second measurement light, the irradiating means irradiates the observation site with the reference light, and the imaging device images the reflected light from the observation site of the reference light to obtain a third pixel value. Is output. The calculation means calculates oxygen saturation and blood volume based on the first, second, and third pixel values.

  More specifically, the calculation means includes a first signal ratio that is a ratio between a first pixel value and a third pixel value that are dependent on both oxygen saturation and blood volume, and a second signal that is dependent on blood volume. A second signal ratio that is a ratio of the pixel value and the third pixel value is obtained. The reference information defines the correlation between the oxygen saturation and the first and second signal ratios, and the correlation between the blood volume and the second signal ratio. The calculation means obtains the blood volume corresponding to the second signal ratio from the reference information and obtains the oxygen saturation corresponding to the first and second signal ratios.

  An operation method of the endoscope system according to the present invention is an operation method of an endoscope system including an irradiation unit, an imaging device, a storage unit, a calculation unit, and a setting change unit, Imaging the reflected light from the observation site of the first measurement light by the measurement light generation step for generating the first measurement light for measuring the oxygen saturation of hemoglobin in the blood vessel existing in the living tissue and the imaging device In accordance with the first pixel value by the calculating means based on the imaging step of outputting the first pixel value and the reference information that defines the correlation between the first pixel value and the oxygen saturation stored in the storage means A calculation step for calculating the oxygen saturation, and a setting change step for changing the reference information in accordance with the property of the site to be observed by the setting changing means.

  According to the present invention, since the reference information for calculating the oxygen saturation level of hemoglobin in the blood vessel existing in the living tissue is changed according to the property of the site to be observed, the oxygen saturation level that contributes to diagnosis is highly reliable. Information can be acquired.

It is an external view which shows the structure of an electronic endoscope system. It is a block diagram which shows the structure of an electronic endoscope system. It is a top view which shows the structure of the front-end | tip of an electronic endoscope. It is a figure which shows the color filter of a Bayer arrangement. It is a graph which shows the spectral sensitivity characteristic of each RGB pixel of CCD. It is a graph showing the emission spectrum of excitation light, narrowband light, and fluorescence. It is a timing chart which shows operation | movement of CCD and a 1st, 2nd semiconductor light source. It is a figure which shows the structure of an image process part. It is a graph which shows the example of reference information. It is a graph which shows the light absorption characteristic of oxygenated hemoglobin and reduced hemoglobin. It is a block diagram which shows the production | generation procedure of a blood volume image and an oxygen saturation image. It is a figure which shows the color map for producing | generating a blood volume image and an oxygen saturation image. It is a figure which shows the message window which urges implementation of pre imaging | photography. It is a figure for demonstrating the mode of the change of the reference information by a setting change part. It is a flowchart which shows the process sequence of function information observation mode. It is a flowchart which shows the example which implements pre imaging | photography simultaneously with the switch to function information observation mode. It is a figure which shows the example of a display of the area | region which calculates the actual value of oxygen saturation. It is a figure which shows a rotary filter.

  In FIG. 1, the electronic endoscope system 2 includes an electronic endoscope 10, a processor device 11, and a light source device 12. As is well known, the electronic endoscope 10 includes a flexible insertion portion 13 to be inserted into a subject (patient), an operation portion 14 connected to a proximal end portion of the insertion portion 13, and a processor device 11. And a connector 15 connected to the light source device 12, an operation unit 14, and a universal cord 16 that connects the connectors 15.

  The operation unit 14 includes an angle knob for bending the distal end 17 of the insertion unit 13 in the vertical and horizontal directions, an air supply / water supply button for ejecting air and water from the air supply / water supply nozzle, and an observation image. An operation member such as a release button for recording a still image is provided.

  Further, a forceps port through which a treatment tool such as an electric knife is inserted is provided on the distal end side of the operation unit 14. The forceps port communicates with a forceps outlet 40 (see FIG. 3) provided at the distal end 17 through a forceps channel in the insertion portion 13.

  The processor device 11 is electrically connected to the light source device 12 and comprehensively controls the operation of the electronic endoscope system 2. The processor device 11 supplies power to the electronic endoscope 10 via the universal cord 16 and a transmission cable inserted into the insertion portion 13, and controls the drive of the CCD 33 (see FIG. 2) mounted on the distal end 17. In addition, the processor device 11 receives the imaging signal output from the CCD 33 via the transmission cable, and performs various processes on the received imaging signal to generate image data. Image data generated by the processor device 11 is displayed as an observation image on a monitor 18 connected to the processor device 11 by a cable.

  The electronic endoscope system 2 has a normal observation mode in which the observation site of the subject is irradiated with white light and is observed, and the observation site is irradiated with white light and narrowband light in the blood vessel of the living tissue. A function information observation mode for calculating the oxygen saturation of hemoglobin and the blood volume is prepared. Each mode is switched by operating the mode switch 19 of the operation unit 14. The normal observation mode is automatically selected immediately after the electronic endoscope system 2 is turned on.

  2 and 3, the distal end 17 is provided with one observation window 30 disposed substantially at the center and four illumination windows 31a, 31b, 31c, and 31d disposed on both sides thereof. In the back of the observation window 30, a CCD 33 for in-subject imaging is arranged via an objective optical system 32 including a lens group and a prism.

  The illumination windows 31a to 31d are illuminations from the light source device 12 guided by the light guides 34a, 34b, 34c, and 34d disposed in the universal cord 16 and the insertion portion 13 and the illumination lenses 35a, 35b, 35c, and 35d. Light is irradiated to the site to be observed. The illumination windows 31a and 31d are for white light irradiation, and the illumination windows 31b and 31c are for narrow-band light irradiation. The illumination windows 31a to 31d are narrow band for white light irradiation so that a straight line a1 connecting the centers of the illumination windows 31a and 31d and a straight line a2 passing through the centers of the illumination windows 31b and 31c intersect at the center of the observation window 30. Light irradiation is arranged alternately. With such an arrangement, it is possible to prevent uneven illumination. In FIG. 2, the illumination systems for white light irradiation and narrow band light irradiation are drawn together, but in reality, there are two systems for white light irradiation and narrow band light irradiation, for a total of four systems. It is arranged. A two-lamp type may be used in which one illumination system is used for each of white light irradiation and narrow-band light irradiation, and two illumination windows are provided.

  The CCD 33 is arranged so that an image of the observation site in the subject via the observation window 30 and the objective optical system 32 is incident on the imaging surface. On the imaging surface, a color filter composed of a plurality of color segments, for example, a primary color filter 36 having a Bayer arrangement (R-red, G-green, B-blue) shown in FIG. 4 is formed. Depending on the spectral transmittance of the primary color filter 36 and the spectral sensitivity of the pixel itself, the spectral sensitivity characteristics of the RGB pixels of the CCD 33 are as shown in FIG. The R pixel is sensitive to light having a wavelength near 650 nm, the G pixel is sensitive to light having a wavelength near 550 nm, and the B pixel is sensitive to light having a wavelength near 450 nm. The sensitivity of each RGB pixel overlaps in several wavelength bands. For example, both the B pixel and the G pixel have sensitivity in a wavelength band of 450 nm to 530 nm.

  In FIG. 2, an analog signal processing circuit (hereinafter abbreviated as AFE) 37 includes a correlated double sampling circuit (hereinafter abbreviated as CDS), an automatic gain control circuit (hereinafter abbreviated as AGC), and an analog / digital converter ( Hereinafter, this is abbreviated as A / D). The CDS performs correlated double sampling processing on the imaging signal output from the CCD 33, and removes reset noise and amplifier noise generated in the CCD 33. The AGC amplifies the image signal from which noise has been removed by CDS with a gain (amplification factor) specified by the processor device 11. The A / D converts the imaging signal amplified by the AGC into a digital signal having a predetermined number of bits. The imaging signal digitized by A / D is input to the image processing circuit 49 of the processor device 11 through a transmission cable.

  The CCD driving circuit 38 generates a driving pulse (vertical / horizontal scanning pulse, electronic shutter pulse, readout pulse, reset pulse, etc.) for the CCD 33 and a synchronization pulse for the AFE 37. The CCD 33 performs an imaging operation in accordance with the driving pulse from the CCD driving circuit 38 and outputs an imaging signal. Each part of the AFE 37 operates based on a synchronization pulse from the CCD drive circuit 38.

  After the electronic endoscope 10 and the processor device 11 are connected, the CPU 39 drives the CCD drive circuit 38 based on an operation start instruction from the CPU 45 of the processor device 11, and the AFE 37 via the CCD drive circuit 38. Adjust the gain of AGC.

  The CPU 45 controls the overall operation of the processor device 11. The CPU 45 is connected to each unit via a data bus, an address bus, and a control line (not shown). The ROM 46 stores various programs (OS, application programs, etc.) and data (graphic data, etc.) for controlling the operation of the processor device 11. The CPU 45 reads necessary programs and data from the ROM 46, develops them in the RAM 47, which is a working memory, and sequentially processes the read programs. Further, the CPU 45 obtains information that changes for each examination, such as examination date and time, character information such as patient and surgeon information, from the operation panel of the processor device 11 or a network such as a LAN (Local Area Network) and stores the information in the RAM 47. .

  The operation unit 48 is an operation panel provided on the housing of the processor device 11 or a known input device such as a mouse or a keyboard. The CPU 45 operates each unit in response to operation input signals from the operation unit 48 and the release button, the mode change switch 19, and the like in the operation unit 14 of the electronic endoscope 10.

  The image processing circuit 49 performs various kinds of image processing such as color interpolation, white balance adjustment, gamma correction, image enhancement, image noise reduction, color conversion, and the like on the imaging signal input from the electronic endoscope 10. The blood volume and oxygen saturation described later are calculated.

  The display control circuit 50 receives graphic data in the ROM 46 and RAM 47 from the CPU 45. The graphic data includes a display mask that hides the invalid pixel area of the observation image and displays only the effective pixel area, examination date and time, character information such as the patient, the operator, and the currently selected observation mode, a graphical user interface ( GUI; Graphical User Interface). The display control circuit 50 performs various display control processes such as a display mask, character information, GUI superimposition processing, and drawing processing on the display screen of the monitor 18 on the image from the image processing circuit 49.

  The display control circuit 50 has a frame memory that temporarily stores the image from the image processing circuit 49. The display control circuit 50 reads an image from the frame memory and converts the read image into a video signal (component signal, composite signal, etc.) corresponding to the display format of the monitor 18. Thereby, an observation image is displayed on the monitor 18.

  In addition to the above, the processor device 11 includes a compression processing circuit for compressing an image in a predetermined compression format (for example, JPEG format), and the compressed image is stored in a CF card, a magneto-optical disk (MO), a CD- A media I / F for recording on removable media such as R, and a network I / F for controlling transmission of various data with a network such as a LAN are provided. These are connected to the CPU 45 via a data bus or the like.

  The light source device 12 includes a first semiconductor laser light source 55 and a second semiconductor laser light source 56. Each of the light sources 55 and 56 is a broad area type InGaN-based, InGaNAs-based, or GaNAs-based semiconductor laser diode. As shown in FIG. 6, the first semiconductor laser light source 55 is excitation light for exciting the wavelength conversion member 41 disposed at the emission ends of the light guides 34a and 34d, for example, blue excitation light L1 having a center wavelength of 445 nm. To emit. On the other hand, the second semiconductor laser light source 56 is a narrowband light for calculating the oxygen saturation of hemoglobin in the blood vessel, for example, a narrowband light L2 (first measurement) whose wavelength band is limited to 470 ± 10 nm, preferably 473 nm. Light).

  The light sources 55 and 56 are driven by light source drivers 57 and 58, respectively. The condensing lenses 59 and 60 collect the light emitted from the light sources 55 and 56 and guide the light to the two light guides 61 and 62 arranged on the emission end side of the light sources 55 and 56. . The light guides 61 and 62 are connected to a combiner 63 that is a multiplexer, and the combiner 63 is connected to a coupler 64 that is a duplexer. Light from the light guides 61 and 62 is demultiplexed into four light guides 34 a to 34 d via a combiner 63 and a coupler 64. Between the condensing lenses 59 and 60 and the light guides 61 and 62, there are provided movable diaphragms 65 and 66 for adjusting the amount of light incident on the incident ends of the light guides 61 and 62. Instead of providing the combiner 63 and the coupler 64, the light from each of the light sources 55 and 56 may be directly incident on the light guides 34a to 34d.

The wavelength conversion member 41 disposed between the light guides 34a and 34d and the illumination lenses 35a and 35d absorbs part of the blue excitation light L1 from the first semiconductor laser light source 55 and emits light in the green to yellow excitation. It is a glass in which a plurality of types of phosphors are dispersedly arranged or coated on the surface. The green to yellow fluorescence (indicated by L3 in FIG. 6) excited by the wavelength conversion member 41 and the blue excitation light L1 that does not contribute to the excitation light emission of the phosphor are combined to generate white light, and the illumination window The region to be observed is irradiated through 31a and 31d. The white light in the red wavelength band is used as the second measurement light for determining the blood volume, and the green wavelength band light is used as the reference light. As the phosphor, for example, YAG fluorescent substance, or a fluorescent substance such as BAM _(BaMgAl 10 _{O 17)} is used, also called a micro-white (trademark) (Micro White (MW)) under the trade name .

  From the spectral sensitivity characteristics of FIG. 5, only the B pixel is sensitive to the reflected light of the excitation light L1 having the center wavelength of 445 nm. The B pixel and the G pixel are sensitive to the reflected light of the narrowband light L2 having the center wavelength of 473 nm. Since the fluorescence L3 is broad light of approximately 450 nm to 700 nm, all pixels of RGB are sensitive.

  The CPU 67 of the light source device 12 communicates with the CPU 45 of the processor device 11, and turns on / off the laser light of each light source 55, 56 and controls the light amount by the movable diaphragms 65, 66 via the light source drivers 57, 58. , 56 and each movable diaphragm 65, 66.

  When the normal observation mode is selected, the CPU 45 controls the driving of the light source driver 57 via the CPU 67 and turns on only the first semiconductor laser light source 55. The illumination light applied to the site to be observed is only white light in which excitation light L1 having a central wavelength of 445 nm from the first semiconductor laser light source 55 and fluorescence L3 from the wavelength conversion member 41 are mixed.

  When the function information observation mode is selected, the CPU 45 controls the driving of the light source drivers 57 and 58 via the CPU 67 to turn on the light sources 55 and 56 as shown in FIG. That is, when one of the light sources 55 and 56 is turned on, the other is turned off. The lighting / light-out operation is repeated for each accumulation / reading period of the CCD 33. The illumination light applied to the site to be observed is white light L1 + L3 or narrowband light L2. Note that one of the light sources 55 and 56 may be turned on only during the accumulation period of the CCD 33, and the light source may be turned off from the subsequent readout period to the next accumulation period.

  In FIG. 8, the image processing circuit 49 is provided with a blood information calculation unit 70. The blood information calculation unit 70 irradiates the observation site with white light and narrowband light alternately in the function information observation mode, and images two reflected images P1 and P2 (see FIG. 7, P1 = Based on the first image, P2 = second image), the oxygen saturation and blood volume of hemoglobin in the blood vessel are calculated.

  The blood information calculation unit 70 is a frame memory (not shown) that temporarily stores two successive images P1 and P2 obtained by irradiating the observation site with white light and narrowband light in the function information observation mode. ). The blood information calculation unit 70 reads the images P1 and P2 from the frame memory and takes various calculations using the pixel values of the images P1 and P2, for example, the ratio of the pixel values between the images P1 and P2. Note that the ratio may be calculated only for the blood vessel region in each of the images P1 and P2 instead of the entire images P1 and P2. In this case, the image input from the AFE 37 is analyzed in the preceding stage of the blood information calculation unit 70, and the region where the blood vessel is projected is identified by referring to, for example, the difference in luminance value between the blood vessel portion and the other portion. The blood vessel region information is output to the blood information calculation unit 70 together with the image.

  When calculating the oxygen saturation and the blood volume using the ratio of the pixel values of the first image P1 obtained by irradiating the white light and the second image P2 obtained by subsequently irradiating the narrow band light, The blood information calculation unit 70 has a ratio b2 / g1 (first pixel value) of the B pixel value b2 (first pixel value) of the second image P2 and the G pixel value g1 (third pixel value) of the first image P1 at the same position. Signal ratio), and the ratio r1 / g1 (second signal ratio) of the R pixel value r1 (second pixel value) and the G pixel value g1 (third pixel value) of the first image P1 at the same position, Based on the reference information 71, the oxygen saturation and the blood volume are calculated.

  The reference information 71 is stored in advance in the memory of the ROM 46 or the image processing circuit 49, for example, and has a correlation between each signal ratio, oxygen saturation and blood volume as shown in FIG. 9 in the form of a function or a data table. . The relationship between each signal ratio, oxygen saturation, and blood volume is obtained in advance by experiments or the like. The blood volume is correlated with the second signal ratio r1 / g1 (log scale), and the larger the ratio r1 / g1, the greater the blood volume. On the other hand, the oxygen saturation is represented by a plurality of contour lines stretched over a two-dimensional space having the first signal ratio b2 / g1 and the second signal ratio r1 / g1 as vertical and horizontal axes. The contour line becomes wider as the ratio r1 / g1, that is, the blood volume increases.

The correlation between each signal ratio, oxygen saturation, and blood volume is closely related to the light absorption characteristics and light scattering characteristics of oxygenated hemoglobin HbO ₂ and reduced hemoglobin Hb shown in FIG. Information on oxygen saturation is easily obtained from a signal obtained by irradiating light having a wavelength with a large difference in extinction coefficient between oxygenated hemoglobin HbO ₂ and reduced hemoglobin Hb, such as 473 nm which is the wavelength band of the narrowband light L2. However, the signal is highly dependent not only on oxygen saturation but also on blood volume.

The following two things can be said from FIG.
In the vicinity of the wavelength of 470 nm (for example, the blue wavelength band of the central wavelength of 470 nm ± 10 nm), the extinction coefficient changes greatly according to the change in the oxygen saturation.
-In the red wavelength band of 590 to 700 nm, it seems that the extinction coefficient changes greatly depending on the oxygen saturation, but the extinction coefficient itself is very small, so that it is hardly affected by the oxygen saturation.

  Based on such knowledge, in the functional information observation mode, the narrow band light L2 in the blue wavelength band is used as the first measurement light, the B pixel value b2 of the second image P2 corresponding to the narrow band light L2 is acquired, and white Of the light, the light in the red wavelength band that changes mainly depending on the blood volume is used as the second measurement light, and the R pixel value r1 of the first image P1 corresponding to the light in the red wavelength band is acquired. Then, using the two signal ratios of the first signal ratio b2 / g1 showing dependence on both oxygen saturation and blood volume and the second signal ratio r1 / g1 showing dependence only on blood volume, The oxygen saturation without the influence is accurately obtained.

  The blood information calculation unit 70 calculates the oxygen saturation and blood volume corresponding to the signal ratio from the reference information 71 by substituting the calculated signal ratios into functions and performing calculations or searching a data table. Regarding the blood volume, the calculated ratio r1 * / g1 * is directly used as the blood volume. As the oxygen saturation, a value of a contour line (60% in this example) intersecting with the point P corresponding to the calculated ratio b2 * / g1 * and ratio r1 * / g1 * is adopted. When the point corresponding to the ratio b2 * / g1 * and the ratio r1 * / g1 * is located above the lower limit line lmin of the oxygen saturation = 0% limit (point P ′), the oxygen saturation is set to 0%. When the oxygen saturation is located below the upper limit line lmax of the 100% limit (point P ″), the oxygen saturation is set to 100%. Alternatively, in any case, the oxygen saturation of the pixel is not calculated. The blood information calculation unit 70 outputs the blood volume and oxygen saturation calculation results to the image generation unit 72.

  The image generation unit 72 generates a blood volume image and an oxygen saturation image reflecting the calculation result based on a color map 73 for displaying the calculation result of the blood information calculation unit 70 in a pseudo color display.

  As shown in FIG. 11, the video signal output to the monitor 18 includes a luminance signal Y and color difference signals Cb and Cr. The blood volume image is generated by assigning the G pixel value g1 of the first image P1 to the luminance signal Y and the calculated blood volume to the color difference signals Cb and Cr. The G pixel value g1 of the first image P1 corresponds to reflected light in a wavelength band that is somewhat strongly absorbed by hemoglobin, so that mucous membrane irregularities and blood vessels can be visually recognized from the image based on the pixel value. Therefore, by assigning the G pixel value g1 to the luminance signal Y, the overall brightness of the blood volume image can be defined.

  The color difference signals Cb and Cr are assigned signal values according to the blood volume according to the color map 73a shown in FIG. The color map 73a is defined such that the signal value decreases as the blood volume increases with respect to the color difference signal Cb, and the signal value increases as the blood volume increases with respect to the color difference signal Cr. Accordingly, in the blood volume image, the redness increases when the blood volume is large, and the saturation of the redness decreases as the blood volume decreases, and approaches to monochrome.

  In FIG. 11, the oxygen saturation image is generated by assigning the G pixel value g1 to the luminance signal Y and the calculated oxygen saturation to the color difference signals Cb and Cr, similarly to the blood volume image.

  The color difference signals Cb and Cr are assigned signal values according to the oxygen saturation according to the color map 73b shown in FIG. The color map 73b is defined such that the signal value of the color difference signal Cr is positive and the signal value of the color difference signal Cb is negative under high oxygen saturation, and conversely the signal value of the color difference signal Cr under low oxygen saturation. Is negative, and the signal value of the color difference signal Cb is defined to be positive. Then, it is defined so that the magnitude relationship between the signal value of the color difference signal Cr and the signal value of the color difference signal Cb is reversed under the middle oxygen saturation. Accordingly, the color changes from blue to light blue to green to yellow to orange to red as the oxygen saturation level increases from the lower level. In addition to this, specific numerical values such as blood volume and oxygen saturation may be superimposed on the image as character information.

  The display control circuit 50 displays the blood volume image and the oxygen saturation image generated by the image generation unit 72 on the monitor 18 alone or side by side. These single display and parallel display may be automatically switched by the operator's operation or at regular intervals. The comparison of each image becomes easy, the diagnostic ability for a lesioned part such as undifferentiated early gastric cancer having characteristics in both oxygen saturation and blood volume can be improved, and the diagnosis can proceed smoothly.

  When the normal observation mode is switched to the function information observation mode, the CPU 45 displays a message window 80 shown in FIG. In the message window 80, for example, “please perform pre-imaging at a normal observation site”, oxygen in a state where the normal observation site without a lesion is located in the entire visual field of the electronic endoscope 10. A message prompting execution of pre-shooting for calculating the saturation is displayed.

  In response to the message window 80 being displayed, the surgeon observes the image displayed on the monitor 18 and moves the field of view of the electronic endoscope 10 to a location that is considered to be a normal observed site. Thereafter, the operation unit 48 is operated to instruct the start of pre-shooting. The illumination light remains white until the start of pre-shooting is instructed. It should be noted that a normal site to be observed is searched for in an organ having a lesion for which blood volume and oxygen saturation are to be calculated.

  The illumination light is switched from white light to narrow band light only after the start of pre-shooting is instructed, and the white light and the reflected light of the narrow band light are continuously imaged by the CCD 33 as shown in FIG. The blood information calculation unit 70 uses the default reference information 71 shown in FIG. 9 to calculate the oxygen saturation of images for a plurality of frames after the start of pre-imaging, and outputs the information to the setting change unit 74.

Based on the information sent from the blood information calculation unit 70, the setting change unit 74 obtains an average value of oxygen saturation of each frame, adds the obtained average value, and divides the result by the number of frames to obtain oxygen for all the frames. An average value STO _ave of saturation is obtained. Then, a difference Δ between the average value STO _ave and a preset reference value STO _st is obtained. The reference value STO _st is a typical value (70%) of oxygen saturation exhibited by the normal mucosa of the digestive tract from the mouth to the anus.

When the difference Δ between the average value STO _ave and the reference value STO _st is 0 (STO _ave = STO _st ), the setting changing unit 74 does nothing.

When the difference Δ between the average value STO _ave and the reference value STO _st is negative (STO _ave −STO _st <0, that is, STO _ave <STO _st ), as shown by a one-dot chain line in FIG. 14, the average value STO _ave and the reference value The default reference information 71 indicated by a thin line is translated upward along the vertical axis so that the deviation of the value STO _st is eliminated and STO _ave = STO _st . When the difference Δ between the average value STO _ave and the reference value STO _st is positive (STO _ave −STO _st > 0, that is, STO _ave > STO _st ), the average value STO _{ave is} similarly shown as indicated by a two-dot chain line. The default reference information 71 is translated downward along the vertical axis so that the deviation of the reference value STO _st is eliminated. The amount of translation is adjusted according to the difference Δ between the average value STO _ave and the reference value STO _st on the reference information 71 when the blood volume is fixed to a certain value (for example, an intermediate value) (see FIG. 9). ). Of course, the greater the difference, the greater the amount of translation. The setting changing unit 74 stores the changed reference information 71 separately from the default reference information 71.

In addition, the blood volume and its average value may be calculated together with the oxygen saturation, and the difference between the average value STO _ave and the reference value STO _st on the reference information 71 when the blood volume is the average value may be obtained. Since the contour line of the oxygen saturation of the reference information 71 becomes wider or narrower depending on the blood volume, it is preferable that the difference is obtained with the blood volume taken into account.

In the function information observation mode, after the above-described processing is executed by the setting changing unit 74 in the pre-photographing, the process shifts to the main photographing. When the difference Δ between the average value STO _ave and the reference value STO _st is 0 (STO _ave = STO _st ), the blood information calculation unit 70 continues to use the default reference information 71 shown in FIG. And calculate blood volume. In other cases, the oxygen saturation and the blood volume are calculated using the reference information 71 changed by the setting changing unit 74 instead of the default reference information 71.

  Next, the operation of the electronic endoscope system 2 configured as described above will be described. When observing the inside of the subject with the electronic endoscope 10, the surgeon operates the operation unit 48 to input information on the subject and instruct to start the examination. After instructing the start of the examination, the surgeon inserts the insertion portion 13 of the electronic endoscope 10 into the subject, and illuminates the subject with illumination light from the light source device 12, while the inside of the subject by the CCD 33 is used. The observation image is observed on the monitor 18.

  The imaging signal output from the CCD 33 is subjected to various processing in each part of the AFE 37 and then input to the image processing circuit 49. The image processing circuit 49 performs various types of image processing on the input image pickup signal to generate an image. The image processed by the image processing circuit 49 is input to the display control circuit 50. In the display control circuit 50, various display control processes are executed according to the graphic data. As a result, the observation image is displayed on the monitor 18.

  When an inspection is performed by the electronic endoscope system 2, the observation mode is switched according to the observation target. When inserting the insertion portion 13 of the electronic endoscope 10 into the subject, the normal observation mode is selected, and the insertion operation is performed while observing the image obtained by irradiating the white light to ensure a wide field of view. Do. When a lesion that requires detailed observation is discovered and the oxygen saturation or blood volume of the lesion is acquired, the function information observation mode is activated, and the lesion is alternately illuminated with white light and narrowband light. The obtained blood volume image and oxygen saturation image are observed. Then, if necessary, a release button provided on the electronic endoscope 10 is operated to acquire a still image, or when treatment is required for a lesion, various treatment tools are inserted into the forceps channel of the electronic endoscope 10. Then, treatment such as excision of lesions and medication is performed.

  In the normal observation mode, under the instruction of the CPU 45, the first semiconductor laser light source 55 is turned on by the CPU 67, and white light is irradiated from the illumination windows 31a and 31d to the observation site.

  On the other hand, as shown in step 10 (S10) of FIG. 15, when the mode changeover switch 19 is operated and the function information observation mode is selected, a message window 80 prompting the display control circuit 50 to execute pre-shooting is displayed on the monitor 18. (S11). The surgeon moves the visual field of the electronic endoscope 10 to a normal site to be observed and instructs the start of pre-imaging (YES in S12). When an instruction to start pre-photographing is given, when one of the light sources 55 and 56 is lit, the other is turned on, and the CPU 67 causes the light sources 55 and 56 to be repeated for each accumulation / reading period of the CCD 33. Is driven and controlled. The CCD 33 images the reflected light of the white light L1 + L3 or the narrow band light L2, and the first image P1 or the second image P2 is alternately output (S13).

  In the image processing circuit 49, the blood information calculation unit 70 calculates the ratio of the pixel values of the first and second images P1 and P2, and calculates the oxygen saturation based on the default reference information 71 (S14). The imaging in S13 and the calculation of oxygen saturation in S14 are repeated for a plurality of frames (NO in S15).

The calculation result of the oxygen saturation is output from the blood information calculation unit 70 to the setting change unit 74. Then, the setting change unit 74 calculates the average value STO _ave of the oxygen saturation of the entire plurality of frames (S16), and further obtains the difference Δ between the average value STO _ave and the reference value STO _st (S17). When the difference Δ between the average value STO _ave and the reference value STO _st is 0 (STO _ave = STO _st , YES in S18), the blood information calculation unit 70 in the subsequent main imaging uses the default reference information 71 to determine the oxygen saturation level. A blood volume is calculated (S19). On the other hand, when the difference Δ between the average value STO _ave and the reference value STO _st is not 0 (STO _ave <STO _st or STO _ave > STO _st , NO in S18), the setting change unit 74 causes the average value STO _ave and the reference value STO _{st to be different.} The reference information 71 is changed by the setting changing unit 74 so that the deviation is eliminated (S20). In the actual photographing, the oxygen saturation and the blood volume are calculated using the changed reference information 71 (S21).

  The calculation result of the oxygen saturation and the blood volume is converted into an oxygen saturation image and a blood volume image by the image generator 72 and displayed on the monitor 18 (S22). The series of processing of S19 or S21, S22 is continued until the function information observation mode is terminated (YES in S23), for example, by operating the mode switch 19 to select the normal observation mode.

As described above, according to the present invention, the oxygen saturation average value STO _ave of the normal site to be observed is obtained, and the reference information 71 is changed so that the deviation is eliminated when this value does not match the reference value STO _st. In addition, since the oxygen saturation is calculated using the changed reference information 71, it is possible to always obtain accurate and reproducible information on the oxygen saturation without being affected by individual differences among patients. For this reason, the reliability of the diagnosis based on the oxygen saturation image increases, and it can contribute to medical progress such as early detection of cancer tissue.

In the above embodiment, the reference value STO _st is a single value, but the reference value STO _st may be set and stored for each part of the digestive tract such as the esophagus and stomach. Rather than setting the reference value STO _st as one value, the reliability of the oxygen saturation calculation result can be further improved by setting the reference value STO _st finely for each part. In this case, when instructing the start of pre-imaging, the operator is made to input the part currently being observed via the operation unit 48 or the like, and the reference value STO _st is switched according to the operation input signal. Alternatively, as described below, in order to save the trouble of inputting a part, the anatomical part of the observed part may be automatically detected, and the reference value STO _st may be switched according to the result.

As a method for automatically detecting the anatomical part of the observed part, there is a method by comparing the ratio r1 / g1 between the R pixel value r1 and the G pixel value g1 of the first image P1, which is an index of blood volume, and a threshold value. is there. The blood volume in each part of the gastrointestinal tract is, for example, relatively small in the esophagus, relatively large in the stomach, and the large intestine has an intermediate value between them. The setting changing unit 74 specifies the currently observed region based on the ratio r1 / g1 sent from the blood information calculating unit 70 and the comparison result of the threshold value set in advance to distinguish each region. Then, after switching to the reference value STO _st corresponding to the identified part, the difference from the average value STO _ave is calculated. That is, in this case, the setting change unit 74 functions as a part detection unit.

  As another method, a known image recognition technique may be used. For image recognition, for example, it is possible to recognize the cardia with a unique shape at the joint between the esophagus and the stomach, or the area of the dark part displayed in the image is small from the esophagus and large when entering the stomach A method of comparing the area of the dark part with the threshold value is used. A method for identifying the site to be observed, such as detecting the position of the tip 17 of the electronic endoscope 10 in the body by CT imaging of the subject under examination or recognizing the site by a pH difference by providing a pH sensor at the tip 17 If so, methods other than those listed above may be adopted.

  In the above-described embodiment, the operator performs pre-imaging when the function information observation mode is selected. However, it is optional according to the operator's instruction via the operation unit 48 regardless of the normal observation mode and the function information observation mode. The pre-photographing may be started at the timing.

Further, it may be automated instead of instructing the operator to start pre-imaging. In this case, for example, as shown in FIG. 16, when the function information observation mode is selected as in the above embodiment (S30), pre-imaging is automatically started without waiting for the operator's instruction, An average value STO _ave of oxygen saturation is obtained (YES in S31, S32, S33, S34).

Then, the setting change unit 74 determines whether or not the average value STO _ave is within a preset threshold range (S35). That is, in this case, the setting change unit 74 functions as a determination unit. The threshold range is, for example, 50% to 90% oxygen saturation. If the average value STO _ave is within the threshold range (YES in S35), it is determined that a normal site to be observed without a lesion is located in the entire visual field of the electronic endoscope 10, and The processing after S17 is continued.

On the other hand, when the average value STO _ave is outside the range of the threshold value (NO in S35), it is determined that the lesioned part is reflected. In this case, as in the above embodiment, the message window 80 is displayed on the monitor 18 (S36), prompting the operator to position a normal site to be observed in the entire visual field of the electronic endoscope 10, and pre-imaging from the operator. If a start instruction is issued (YES in S37), the process returns to S31 and pre-photographing is performed again. When the average value STO _ave is within the threshold range, it is possible to save the operator from instructing the start of pre-imaging.

  Various methods other than the above-described oxygen saturation can be considered as a method for determining whether or not the site is a normal observation site. For example, determination is made by analyzing a blood vessel emphasized image (visible image of blood vessel running) of the mucosal surface layer obtained by irradiating narrow band light in the blue wavelength band (such as narrow band light L2 having a center wavelength of 473 nm in the above embodiment). May be. Specifically, the density of the blood vessels is determined from the number of branches of the blood vessels on the surface of the mucosa, and if the density is relatively high, it is judged that the new blood vessels around the cancer tissue are reflected, and if the density is relatively low, it is normal. It is judged that the site to be observed is reflected.

In the above embodiment, the average value STO _ave of the oxygen saturation of the entire region of the image frame obtained by the pre-shooting is calculated, but the region where the average value STO _ave is calculated may be limited. For example, in the blood information calculation unit 70, an extremely bright region or an extremely dark region in the image is determined to be inappropriate as a region for calculating the average value STO _ave , and oxygen saturation other than the excluded region is excluded. Is output to the setting change unit 74. When the gradation of the pixel value is expressed by 10 bits, the pixel value other than the range of 30 to 700 is excluded.

Alternatively, the average value STO _ave is calculated only for a region where the ratio r1 / g1 between the R pixel value r1 and the G pixel value g1 of the first image P1, which is an index of blood volume, is larger than a certain threshold value and the blood volume is relatively large. It may be an area. As is well known, cancer tissue lacks blood flow, so if a region with a relatively large blood volume is selected, the possibility of being a normal site to be observed increases. For this reason, it is determined that the area where the ratio r1 / g1 is equal to or less than the threshold is not a normal observed site, and is excluded from the area where the average value STO _ave is calculated.

Alternatively, only the area where the ratio b2 / g1 of the B pixel value b2 of the second image P2 and the G pixel value g1 of the first image P1 is larger than a certain threshold may be used as the area for calculating the average value STO _ave . When the new blood vessels around the cancer tissue are reflected, the density of the blood vessels is relatively high, and the ratio b2 / g1 is relatively small. For this reason, it is determined that the region where the ratio b2 / g1 is equal to or less than the threshold is high in the probability that a new blood vessel around the cancer tissue is reflected, and is excluded from the region where the average value STO _ave is calculated. In any method, the processing can be speeded up compared with the case of calculating the average value STO _ave of the oxygen saturation of the entire region, and the time from the pre-photographing to the main photographing can be shortened. it can.

As shown in FIG. 17, the area for calculating the average value STO _ave selected as described above may be displayed in an identifiable manner by surrounding it with a shaded area on the oxygen saturation image. It is possible to visually confirm whether the selected area is appropriate. Further, the operator may specify a region for calculating the average value STO _ave , and for example, a region for calculating the average value STO _ave may be fixed in the center portion of the image.

For verification after inspection, information obtained by pre-photographing and information on the calculated oxygen saturation and the area for calculating the selected average value STO _ave may be stored.

In the above embodiment, the default reference information is changed each time. In addition to the default reference information, a plurality of reference information obtained by changing the default reference information is prepared in advance, and the average value STO _ave and the reference value STO _st are changed. Depending on the calculation result of the difference Δ, a plurality of prepared ones may be selected.

The average value STO _ave may be stored and managed for each patient or for each patient organ. In this way, even if pre-photographing is not performed, the average value STO _ave obtained in the past most recent examination can be read from the storage destination and used, and the same processing as in the above embodiment can be performed. The time taken for pre-photographing can be saved.

  It should be noted that the endoscope system according to the present invention is not limited to the above-described embodiment, and various configurations can be adopted without departing from the gist of the present invention. For example, a CMOS image sensor may be used as the image sensor instead of the CCD 33.

  In the above embodiment, the blood volume is calculated in addition to the oxygen saturation, but the present invention is not limited to this. Of course, the present invention can be applied to a system that calculates only the oxygen saturation as disclosed in Patent Document 2 (Japanese Patent Laid-Open No. 06-315477). The present invention can also be applied to a system that simultaneously obtains information on blood vessel depth as well as information on oxygen saturation, as disclosed in Japanese Patent Application Laid-Open No. 2011-092690. In short, if the system calculates oxygen saturation based on some reference information, the same effect as the above embodiment can be obtained.

  In addition to calculating oxygen saturation, irradiate narrow-band light with central wavelengths of 405 nm, 450 nm, 550 nm, 780 nm, etc. to obtain blood vessel-enhanced images of the mucosal surface layer, middle layer, and deep layer, or add fluorescent substances to living tissue It is good also as a structure which can perform the special light observation function which inject | pours and irradiates excitation light and observes the fluorescence from a to-be-observed site | part, and also observes the self-fluorescence of a biological tissue.

  An oxygenated hemoglobin index obtained from blood volume × oxygen saturation (%), a reduced hemoglobin index obtained from blood volume × (100−oxygen saturation) (%), and the like may be calculated.

  In the above embodiment, the first and second semiconductor laser light sources 55 and 56 for white light and narrow band light are used, but the present invention is not limited to this. For example, a white light source such as a xenon lamp, a halogen lamp, or a white LED (light emitting diode) that generates white light having a broad wavelength from 400 to 800 nm in a blue to red wavelength, and a specific wavelength band of incident light. May be combined with a wavelength tunable element that can selectively transmit the light and change the wavelength band of the transmitted light.

  The wavelength variable element is an etalon that controls the wavelength band of transmitted light by driving an actuator such as a piezoelectric element to change the surface distance of the substrate composed of two highly reflective optical filters, or between polarizing filters. A liquid crystal tunable filter is used that sandwiches a birefringent filter and a nematic liquid crystal cell and controls the wavelength band of transmitted light by changing the voltage applied to the liquid crystal cell. In this case, a wavelength variable element is provided between the incident end of the light guide that guides the white light source and the white light to the tip of the electronic endoscope, or on the emission end side of the light guide. Alternatively, instead of the illumination optical system, an objective optical system that captures an image of a site to be observed, for example, a wavelength variable element is disposed behind the observation window or on the imaging surface of the CCD.

  Alternatively, a monochrome imaging element, a white light source, and a rotary filter that is arranged in the optical path of white light and that combines a plurality of interference filters (bandpass filters) may be used. For example, a rotary filter 90 shown in FIG. 18 is used. The rotary filter 90 has a double circular structure divided into an outer peripheral portion 90a and an inner peripheral portion 90b. The outer peripheral portion 90a is an R, G, B filter that transmits red, green, and blue wavelength bands of white light. The inner peripheral portion 90b is the same as the outer peripheral portion 90a, the R and G filter portions are the same as the outer peripheral portion 90a, and the same fan-shaped region as the B filter portion of the outer peripheral portion 90a is light of 470 nm ± 10 nm of white light (in the above embodiment) The filter portion transmits the narrow-band light L2).

  The rotary filter 90 can selectively arrange the outer peripheral portion 90a and the inner peripheral portion 90b on the optical path of white light by a shift mechanism (not shown). In the normal observation mode, the outer peripheral portion 90a is arranged on the optical path of white light, and each RGB light is sequentially irradiated to the observation site by each RGB filter unit. Then, the reflected light is imaged by the monochrome image sensor, and one normal observation image is generated from the three images obtained by irradiating the RGB lights. In the function information observation mode, the inner peripheral portion 90b is disposed on the optical path of white light, and the RG light and the narrowband light L2 are sequentially irradiated by the filter portions of the RG and the filter portion of the narrowband light L2. In this case, the R light is the second measurement light, the G light is the reference light, and the pixel values of the respective images obtained by irradiating the narrowband light L2, R light, and G light output from the monochrome image sensor are the first values. ~ Third pixel value. The rotary filter may have a structure in which a plurality of fan-shaped filter portions are arranged instead of a double circular structure, or two or more rotary filters may be prepared and switched by a shift mechanism.

  In the above embodiment, the filter part of the CCD color filter or the rotary filter is an RGB primary color system, but a filter of a complementary color system of Y (yellow), M (magenta), or C (cyan) may be used.

  In the above embodiment, an electronic endoscope is exemplified. However, the present invention is not limited to this, and other devices such as a fiberscope using an image guide, an ultrasonic endoscope in which an imaging element and an ultrasonic transducer are built in the tip, and the like. The present invention can also be applied to an endoscope of this form.

2 Electronic Endoscope System 10 Electronic Endoscope 11 Processor Unit 12 Light Source Unit 18 Monitor 19 Mode Change Switch 33 CCD
34a-34d Light guide 39, 45, 67 CPU
41 Wavelength conversion member 49 Image processing circuit 50 Display control circuit 55, 56 First and second semiconductor laser light sources 70 Blood information calculation unit 71 Reference information 74 Setting change unit 80 Message window

Claims (25)

An irradiation means for irradiating a site to be observed of a patient with a first measurement light for measuring oxygen saturation of hemoglobin in a blood vessel existing in a biological tissue;
An imaging device for imaging the reflected light from the site to be observed of the first measurement light and outputting a first pixel value;
Storage means for storing reference information defining a correlation between the first pixel value and oxygen saturation;
Calculating means for calculating oxygen saturation according to the first pixel value based on the reference information;
A setting changing means for changing the reference information according to the patient ;
Based on the first pixel value corresponding to the first measurement light irradiated to the normal observation site where no lesion exists and the default reference information, the actual value of oxygen saturation of the normal observation site is obtained. Storage / management means for storing / managing for each patient or each anatomical part of the patient,
The setting changing unit reads an actual value of oxygen saturation corresponding to the patient to be observed or an anatomical part of the patient to be observed from the storage / management unit, and is preset with the read actual value of oxygen saturation. An endoscope system , wherein default reference information is changed according to a difference from a reference value of oxygen saturation . 2. The method according to claim 1 , wherein when obtaining an actual measurement value of oxygen saturation of a normal site to be observed, a plurality of frames of images are taken, and an average value of oxygen saturation of images for a plurality of frames is used as the actual measurement value. The endoscope system described. The endoscope system according to claim 1 or 2 , wherein the reference value of oxygen saturation is set to one value. The endoscope system according to claim 1 or 2 , wherein a plurality of values corresponding to anatomical sites are set as the reference value of oxygen saturation. Provided with operation input means for inputting the anatomical part of the observed part,
The endoscope system according to claim 4 , wherein the setting change unit changes a setting of a reference value in accordance with an operation input signal from the operation input unit. Based on the pixel value output from the image sensor, comprising site detection means for detecting the anatomical site of the site to be observed,
The endoscope system according to claim 4 , wherein the setting changing unit changes a setting of a reference value according to a detection result of the part detection unit. The endoscope system according to claim 6 , wherein the part detection unit specifies an anatomical part of the observed part based on a blood volume. Said calculation means according to any one of claims 1 to 7, characterized in that to calculate the oxygen saturation for the entire region of an image when obtaining the measured value of the oxygen saturation of the normal target site Endoscope system. The calculating means, claims 1 to 7 any one of and calculates the oxygen saturation for a limited area of an image when obtaining the measured value of the oxygen saturation of the normal target site The endoscope system described in 1. Based on the pixel value output from the image sensor, the calculation means includes an area selection means for selecting an image area for calculating the oxygen saturation when obtaining an actual measurement value of the oxygen saturation of a normal site to be observed. The endoscope system according to claim 9 . The endoscope system according to claim 10 , wherein the region selection unit selects a region other than an extremely bright region or an extremely dark region in the image as a region for calculating oxygen saturation. The endoscope system according to claim 10 , wherein the region selecting unit selects a region having a blood volume greater than a threshold value as a region for calculating oxygen saturation. The endoscope system according to claim 10 , wherein the region selecting unit selects a region where the density of blood vessels is lower than a threshold value as a region for calculating oxygen saturation. The endoscope system according to any one of claims 10 to 13 , wherein the region selected by the region selecting unit is displayed on a display unit. When obtaining an actual measurement value of the oxygen saturation of a normal site to be observed, a message is displayed on the display means for prompting to carry out imaging by positioning the normal site to be observed over the entire field of view of the image sensor, and then imaging. The endoscope system according to any one of claims 1 to 14 , wherein imaging is started in response to an operation input instructing to start the operation. A determination means for determining whether or not the actual measurement value of the oxygen saturation is within an allowable range;
If the measured value of oxygen saturation is within the allowable range, continue the process of changing the reference information,
Any one of claims 1 to 14 if not fall and displaying on the display unit a message prompting the user to implement the shooting positions the normal object of interest to the entire field of view of the imaging device The endoscope system described in 1. A normal observation mode in which an image substantially equivalent to that observed with the naked eye by continuously irradiating white light in a broad wavelength band to the site to be observed is displayed on the display means;
A function information observation mode for irradiating the first measurement light to calculate information on oxygen saturation and displaying the result on the display means;
The endoscope system according to any one of claims 1 to 16 , wherein each mode is configured to be switchable. 18. The endoscope system according to claim 17 , wherein when the function information observation mode is selected, an operation for imaging to obtain an actual measurement value of oxygen saturation at a normal site to be observed is automatically started. 19. The endoscope according to any one of claims 1 to 18 , wherein the first measurement light is light including a wavelength band in which a difference occurs in an extinction coefficient between oxyhemoglobin and reduced hemoglobin in an absorption spectrum of hemoglobin. Mirror system. The endoscope system according to claim 19 , wherein the first measurement light is narrowband light having a wavelength band of 470 nm ± 10 nm. The irradiation means irradiates the site to be observed with the second measurement light for measuring the blood volume in the blood vessel in addition to the first measurement light,
The imaging element captures reflected light from the observed site of the second measurement light and outputs a second pixel value;
The reference information defines the correlation between the second pixel value and the blood volume in addition to the correlation between the first pixel value and oxygen saturation,
It said calculation means according to any one of claims 1 to 20, characterized in that calculating the first pixel value based on the reference information and both the second oxygen saturation according to the pixel values and the blood volume Endoscope system. The endoscope system according to claim 21 , wherein the second measurement light is light including a red wavelength band. The irradiation means irradiates the site to be observed with reference light in addition to the first and second measurement lights,
The imaging device captures reflected light from the observation site of reference light and outputs a third pixel value;
The endoscope system according to claim 21 or 22 , wherein the calculating means calculates oxygen saturation and blood volume based on the first, second, and third pixel values. The calculating means includes a first signal ratio that is a ratio between a first pixel value and a third pixel value that depend on both oxygen saturation and a blood volume, a second pixel value that depends on a blood volume, and a first pixel value. Obtain the second signal ratio, which is the ratio of the three pixel values,
The reference information defines the correlation between the oxygen saturation and the first and second signal ratios, and the correlation between the blood volume and the second signal ratios,
The endoscopy according to claim 23 , wherein the calculating means obtains a blood volume corresponding to the second signal ratio from the reference information and obtains an oxygen saturation corresponding to the first and second signal ratios. Mirror system. An operation method of an endoscope system including an irradiation unit, an imaging device, a storage unit, a calculation unit, a setting change unit, and a storage / management unit ,
A measurement light generation step for generating a first measurement light for measuring the oxygen saturation of hemoglobin in blood vessels existing in the living tissue by the irradiation means;
An imaging step of imaging the reflected light from the site to be observed of the first measurement light and outputting a first pixel value by the imaging element;
A calculation step of calculating an oxygen saturation corresponding to the first pixel value by the calculation means based on reference information defining a correlation between the first pixel value and the oxygen saturation stored in the storage means;
A setting change step for changing reference information according to the patient by the setting change means ;
Based on the first pixel value corresponding to the first measurement light irradiated to the normal observation site where no lesion exists and the default reference information, the actual value of oxygen saturation of the normal observation site is obtained. A storage / management step for storing / managing in the storage / management means for each patient or each patient's anatomical part,
In the setting change step, the actual measurement value of the oxygen saturation corresponding to the observation target patient or the anatomical part of the observation target patient is read from the storage / management means, and the read actual measurement value of the oxygen saturation is preset. A method for operating an endoscope system, wherein default reference information is changed according to a difference from a reference value of oxygen saturation .