JP5784082B2 - Diagnosis support apparatus and diagnosis support method - Google Patents

Description

The present invention is a diagnostic support apparatus for supporting a diagnosis using the schema (schema background), diagnosis support method, and diagnosis support system, and relates to a program for causing a computer to function as each means of the diagnosis support device. In particular, the present invention is suitable for use in a diagnosis support apparatus that creates medical documents such as medical records (diagnosis records) and image diagnosis reports.

  Before medical documents such as medical records and diagnostic imaging reports were digitized, doctors handwritten medical documents made of paper and used the so-called schema background diagram (specifically, the positional relationship between the human body structure and the diseased part). The schematic diagram shown) was drawn.

  In recent years, as medical information systems such as hospital information systems (HIS) and image archiving and communication systems (PACS) have become widespread, the digitization of medical documents has also progressed gradually. . That is, a diagnostic support apparatus capable of electronically creating and displaying medical documents such as medical charts and diagnostic imaging reports conventionally created by a doctor by hand using an information device, and further communicating with other medical information systems Is starting to be used.

  When creating a medical document electronically, a character string can be input relatively easily using, for example, a keyboard. On the other hand, in order to draw a figure having an arbitrary shape, for example, an input device such as a mouse or a tablet can be skillfully moved, and a locus drawn by the input device can be input as line drawing information. However, in creating a schema background diagram, it is necessary to draw a human body structure having a complicated shape, so that the drawing method using the mouse or tablet described above cannot easily draw a figure.

  Therefore, conventionally, the following Patent Document 1 discloses a technique for obtaining a lung field outline from a chest X-ray image by image processing. By using this contour line, it is possible to easily create a schema background diagram.

  In Patent Document 2 below, a number of schema background diagram templates (hereinafter referred to as “basic schema background diagrams”) are stored in advance in the apparatus, and the doctor selects a desired basic schema background diagram. Technology is disclosed. By using this technique, a doctor can easily create a desired schema background diagram by selecting a basic schema background diagram and then drawing a simple graphic showing a diseased part on the basic schema background diagram.

  Patent Document 3 below discloses a technique for holding various schema background diagrams in the apparatus in advance and presenting a schema background diagram corresponding to the site name by a doctor inputting the site name. Has been. By using this technique, a doctor can attach a desired schema background diagram to a medical document without performing a selection operation of the schema background diagram.

  In addition, as a technology related to the present invention, standardization of a communication protocol dedicated to medical image data that enables interconnection of image diagnostic apparatuses and medical information servers manufactured by different manufacturers as well as medical information viewers has been performed. Yes. As an example thereof, for example, DICOM (Digital Imaging and Communications in Medicine) standard has been established. In this DICOM standard, the contents and data structure of medical information such as image information and patient information, procedures for communicating medical information, that is, procedures and interfaces for requesting services such as image storage, retrieval, printing, and inquiry Is defined in detail. The DICOM standard is becoming an international standard in the field of medical images today. For example, Patent Document 4 below discloses a technique related to an image communication method and apparatus compliant with the DICOM standard.

  In addition, as a technique related to the present invention, research on segmentation and recognition of organs copied as medical images has been performed. The types of medical images include simple X-ray images (X-ray images), X-ray CT (Computed Tomography) images, MRI (Magnetic Resonance Imaging) images, and the like. Furthermore, as a kind of medical image, there are a PET (Positron Emission Tomography) image, a SPECT (Single Photon Emission Computed Tomography) image, an ultrasonic image, and the like. For example, the following Non-Patent Document 1 proposes a technique for organ segmentation based on a probability atlas in a statistical atlas and a statistical shape model.

  Studies have also been reported to detect abnormalities in segmented organs. Non-Patent Document 2 below proposes a technique for acquiring an image feature amount from a medical image such as an X-ray CT image and detecting a lesion candidate from the image feature.

Japanese Patent Laid-Open No. 63-240832 JP 2006-318154 A Japanese Patent Laid-Open No. 11-312202 JP 2000-287013 A

Shimizu and Sato, “Statistical Atlas Construction of Abdominal Organs and Application to Multiple Organ Segmentation”, Medical Imaging Technology, Vol. 24, no. 3, pp. 153-160, May 2006 Kawada, Niki and Omatsu, “Analysis of internal structure using 3D curvature of small lung masses by 3D chest CT images”, IEICE Transactions, D-II, Vol. J83-D-II, no. 1, pp. 209-218, January 2000

  However, in the technique described in Patent Document 1, when calculating the contour line of an image, a contour line other than the target region is drawn, the contour of the target region is missing due to noise in the image, or extra drawing is performed. There is a problem.

  In addition, the technique described in Patent Document 2 has an effect of making it easy for the user to select a suitable schema background diagram by hierarchically holding a plurality of stored schema background diagrams. However, in the technique described in Patent Document 2, when a large number of schema background diagrams are held, a suitable schema background diagram is selected from among them, and the doctor has to perform a complicated operation.

  In the technique described in Patent Document 3, a doctor does not perform a schema background diagram selection operation, but it is necessary to input the name of a part in detail.

  In other words, the conventional technique has a problem that it is difficult to efficiently select a suitable schema background diagram from among a plurality of schema background diagrams when creating a medical text.

The present invention has been made in view of such problems, and allows a suitable schema ( schema background diagram ) to be efficiently selected from a plurality of schemas ( schema background diagram ) when creating medical text. The purpose is to do.

The diagnosis support apparatus of the present invention corresponds to an acquisition unit that acquires a medical image to be examined, an analysis unit that analyzes the acquired medical image, and a plurality of human body parts that are obtained by the analysis. And output means for outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the order of execution.
Another aspect of the diagnosis support apparatus according to the present invention includes an acquisition unit that acquires a medical image to be examined, an analysis unit that analyzes the acquired medical image, and different types of the examination target obtained by the analysis. A plurality of different human body parts, wherein a plurality of schemas corresponding to the respective human body parts of the plurality of human body parts are determined from the plurality of schemas stored in the storage means, and the analysis is performed. a plurality of abnormalities obtained by said plurality of based on the plurality of abnormalities size and shape consisting of abnormal sites in each of the body parts of a human body site, said plurality of abnormality to the plurality of schema determining means for determining the site of size and shape, based on the size and shape of said determined respective abnormalities of the plurality of abnormalities is added Shi Having output means for outputting a plurality of different types of schemata consisting chromatography Ma, a.

The diagnosis support method of the present invention corresponds to an acquisition step of acquiring a medical image to be examined, an analysis step of analyzing the acquired medical image, and a plurality of human body parts of the inspection target obtained by the analysis And an output step of outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the ranking.
Another aspect of the diagnosis support method of the present invention includes an acquisition step of acquiring a medical image to be examined, an analysis step of analyzing the acquired medical image, and different types of the inspection target obtained by the analysis A plurality of different human body parts, wherein a plurality of schemas corresponding to the respective human body parts of the plurality of human body parts are determined from the plurality of schemas stored in the storage means, and the analysis is performed. a plurality of abnormalities obtained by said plurality of based on the plurality of abnormalities size and shape consisting of abnormal sites in each of the body parts of a human body site, said plurality of abnormality to the plurality of schema a determination step of determining a region of size and shape, based on the size and shape of said determined respective abnormalities of the plurality of abnormal sites Having an output step of outputting a plurality of different types of schemata consisting pressurized been schema, the.

The diagnosis support system according to the present invention corresponds to an acquisition unit that acquires a medical image to be examined, an analysis unit that analyzes the acquired medical image, and a plurality of human body parts that are obtained by the analysis. And output means for outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the order of execution.
Another aspect of the diagnosis support system according to the present invention includes an acquisition unit that acquires a medical image to be examined, an analysis unit that analyzes the acquired medical image, and different types of the inspection target obtained by the analysis. A plurality of different human body parts, wherein a plurality of schemas corresponding to the respective human body parts of the plurality of human body parts are determined from the plurality of schemas stored in the storage means, and the analysis is performed. a plurality of abnormalities obtained by said plurality of based on the plurality of abnormalities size and shape consisting of abnormal sites in each of the body parts of a human body site, said plurality of abnormality to the plurality of schema determining means for determining the site of size and shape, based on the size and shape of said determined respective abnormalities of the plurality of abnormalities is added It has a different type of output means for outputting a plurality of schemata consisting schema, the.

  The program of the present invention is for causing a computer to function as each means of the diagnosis support apparatus.

According to the present invention, it is possible to efficiently select a suitable schema ( schema background diagram ) from among a plurality of schemas ( schema background diagram ) at the time of medical text creation.

It is a schematic diagram which shows an example of schematic structure of the diagnosis assistance system which concerns on the 1st Embodiment of this invention. It is a flowchart which shows an example of the process sequence in the control method of the diagnosis assistance apparatus which concerns on the 1st Embodiment of this invention. It is a schematic diagram which shows an example of the medical document displayed in the window of the monitor shown in FIG. It is a schematic diagram which shows an example of the medical image displayed in the window of the monitor shown in FIG. It is a schematic diagram which shows the 1st Embodiment of this invention and shows an example of the presentation example of the schema background figure candidate relevant to an attention image. It is a schematic diagram which shows an example of the medical document with which the schema background figure added was displayed in the window of the monitor shown in FIG. 3 is a flowchart illustrating an example of a detailed processing procedure of attention image analysis processing in step S105 of FIG. 2. It is a flowchart which shows an example of the process sequence in the control method of the diagnostic assistance apparatus which concerns on the 2nd Embodiment of this invention. It is a schematic diagram which shows the 2nd Embodiment of this invention and shows an example of the schema background figure to which abnormality information was added.

  The best mode (embodiment) for carrying out the present invention will be described below with reference to the drawings. The embodiment described below is only an example, and the present invention is not limited to the illustrated configuration.

(First embodiment)
First, a first embodiment of the present invention will be described.
FIG. 1 is a schematic diagram illustrating an example of a schematic configuration of a diagnosis support system according to the first embodiment of the present invention.

  As shown in FIG. 1, the diagnosis support system according to the present embodiment includes a diagnosis support apparatus 100, a medical document database 200, a medical image database 300, and a local area network (LAN) 400. . That is, the diagnosis support system shown in FIG. 1 is configured such that the diagnosis support apparatus 100 is connected to the medical document database 200 and the medical image database 300 via the LAN 400.

  The diagnosis support apparatus 100 is an apparatus that supports diagnosis using a schema background diagram, and includes a control unit 110, a monitor 120, a mouse 130, and a keyboard 140.

  The control unit 110 controls the operation of the diagnosis support apparatus 100, and includes a central processing unit (CPU) 111, a main memory 112, a magnetic disk 113, a display memory 114, and a bus 115. ing. Then, when the CPU 111 executes a program stored in the main memory 112, for example, communication with the medical document database 200 and the medical image database 300 and various controls of overall operation control of the diagnosis support apparatus 100 are executed.

  The CPU 111 mainly controls the operation of each component of the diagnosis support apparatus 100 and controls the operation of the diagnosis support apparatus 100 in an integrated manner.

  The main memory 112 stores a control program executed by the CPU 111 and provides a work area when the CPU 111 executes the program.

  The magnetic disk 113 stores (stores) image data (basic schema image data) 1131 related to a plurality of basic schema background diagrams in addition to an operating system (OS), device drivers of peripheral devices, and various application software. Here, the basic schema image data 1131 is typically created in advance with a plurality of details for each part of the human body structure, for example, and is registered in association with each part. Specifically, basic schema image data 1131a, 1131b, 1131c,... Are stored and registered in the magnetic disk 113. In addition, the magnetic disk 113 also stores part space existence probability information (probability atlas information) 1132 and part feature amount information 1133 acquired at the time of an attention image analysis process described later.

  The display memory 114 temporarily stores display data to be displayed on the monitor 120.

  The bus 115 connects the components of the diagnosis support apparatus 100 so that they can communicate with each other, and also connects the diagnosis support apparatus 100 and the LAN 400 so that they can communicate with each other.

  The monitor 120 is composed of, for example, a CRT monitor or a liquid crystal monitor, and displays an image or the like based on display data in the display memory 114 under the control of the CPU 111.

  The mouse 130 and the keyboard 140 are used for a pointing input and a character input by the user, respectively.

  The diagnosis support apparatus 100 according to the present embodiment can read medical document data such as an electronic medical record and an image diagnosis report from the medical document database 200 via the LAN 400. Further, the diagnosis support apparatus 100 can read medical image data, which is various types of medical examination data, from the medical image database 300 via the LAN 400.

  Note that an external storage device such as an FDD, HDD, CD drive, DVD drive, MO drive, ZIP drive or the like is connected to the diagnosis support apparatus 100, and medical document data and / or medical image data is read from these drives. Also good. The types of medical images at this time include simple X-ray images (X-ray images), X-ray CT images, MRI images, PET images, SPECT images, ultrasound images, and the like.

  The medical document database 200 stores medical document data such as an electronic medical record and an image diagnosis report created by the diagnosis support apparatus 100, medical document data from other apparatuses connected to the LAN 400, and the like.

  In the medical image database 300, for example, medical image data transmitted from each modality connected to the LAN 400 is stored.

  The LAN 400 connects the diagnosis support apparatus 100 to the medical document database 200 and the medical image database 300 so that they can communicate with each other.

  Next, a processing procedure in the control method of the diagnosis support apparatus 100 according to the first embodiment will be described.

  FIG. 2 is a flowchart illustrating an example of a processing procedure in the control method of the diagnosis support apparatus 100 according to the first embodiment of the present invention. Specifically, the flowchart shown in FIG. 2 is realized by the CPU 111 executing a program stored in the main memory 112.

  In the following processing, a doctor who is a user operates the mouse 130 and the keyboard 140 to input various commands (instructions / commands) to the diagnosis support apparatus 100. In the following processing, the execution status and execution result of the program executed by the CPU 111 are displayed on the monitor 120. Then, the doctor gives an instruction while viewing the information displayed on the monitor 120.

  First, in step S101 of FIG. 2, the CPU 111 selects one medical document data created in the past and reads it into the main memory 112 in accordance with a doctor's command input, or loads new medical document data on the main memory 112. To create. In this way, the CPU 111 acquires medical document data.

  Thereafter, the CPU 111 creates display data in the display memory 114 based on the medical document data acquired in the main memory 112, and displays the display data in one window displayed on the monitor 120. As a result, a medical document based on the medical document data is displayed on the monitor 120.

  FIG. 3 is a schematic diagram showing an example of a medical document displayed in the window 301 of the monitor 120 shown in FIG. Here, the medical document shown in FIG. 3 does not show information unnecessary for explaining the present embodiment. In the window 301 shown in FIG. 3, a date column 302 is configured on the left side, a patient information column 303 is configured on the upper side, and a finding description column 304 in which a doctor describes a finding or the like is provided below the patient information column 303. It is configured. The format of the window 301 is not particularly limited to that shown in FIG.

  Here, the selection processing of medical document data in step S101 can be realized by the CPU 111 communicating with the medical document database 200 via the bus 115 and the LAN 400 and receiving desired medical document data from the medical document database 200. Alternatively, the CPU 111 can be realized by reading desired medical document data from an external storage device (not shown) connected to the diagnosis support apparatus 100. At this time, for example, a doctor designates medical document data to be selected by inputting a patient ID, and based on this designation, the CPU 111 selects medical document data instructed from the medical document database 200 (or an external storage device). The form of receiving can be taken.

  Subsequently, in step S102, the CPU 111 inputs medical examination data to be examined into the main memory 112 in accordance with a doctor's command input, creates display data in the display memory 114 based on the medical examination data, and generates an image based on the data. Etc. are displayed on the monitor 120. Here, the medical examination data input to the main memory 112 is examination target data related to a basic schema background diagram (basic schema image data 1131) stored in advance on the magnetic disk 113. At this time, the CPU 111 displays the display data based on the medical examination data in a window different from the display data based on the medical document data. Here, in this embodiment, medical image data is applied as an example of medical examination data.

  FIG. 4 is a schematic diagram showing an example of a medical image displayed in the window 401 of the monitor 120 shown in FIG. In the window 401 shown in FIG. 4, four X-ray images (402, 403, 404, 405) are displayed as medical images. FIG. 4 shows a window 401 for displaying four medical images. However, in the present embodiment, the present invention is not limited to this. For example, in the case of more sheets, a known method is used. You may make it switch and display.

  Here, the medical examination data input process (that is, the medical image data reading process) in step S102 is realized by the CPU 111 receiving desired medical image data from the medical image database 300 via the bus 115 and the LAN 400. it can. Alternatively, the CPU 111 can be realized by reading new medical image data from an external storage device connected to the diagnosis support apparatus 100. At this time, for example, the medical image data stored in the main memory 112 and associated with the patient ID or examination number of the designated medical document is received from the medical image database 300 (or external storage device). Can do.

  In the present embodiment, it is assumed that the medical examination data (medical image data) read in step S102 is recorded / supplied according to the DICOM standard, and the reading of the medical image data is executed in accordance with a doctor's command input. However, related medical image data may be automatically read in conjunction with the medical document data read in step S101.

  After that, when a doctor (user) selects and inputs an image (one or a plurality of images) of interest from among the medical images displayed on the monitor 120, the CPU 111 subsequently selects the selected input in step S103. The image of interest based on the selection is selected. Specifically, the CPU 111 selects one or a plurality of target image data based on the image selected and input by the doctor (user) from the medical image data input in step S102. At this time, for example, a doctor who is a user designates a medical image displayed on the monitor 120 and showing a feature suspected of having a disease by using the mouse 130 or the keyboard 140 to select and input a target image. Can be realized.

  Furthermore, the doctor may enlarge and display a part of the medical image in order to observe the medical image displayed on the monitor 120 in more detail and to select and input the target image. In this case, it is necessary to convert the coordinates on the screen designated by the user doctor on the enlarged medical image into corresponding coordinates on the original image. The conversion process in this case can be performed based on, for example, information on the enlargement center and enlargement magnification when the medical image is enlarged. In addition, when a doctor selects and inputs a target image for a medical image including three-dimensional information such as an X-ray CT image, the doctor displays the three-dimensional information as a slice image cut out on a certain plane for observation. There is a case. In this case, the three-dimensional position on the original image pointed to by the target image designated by the doctor as the user can be obtained based on the type of cross section and the cross section position of the displayed image.

  Further, as described above, the attention image specified by the user is not limited to one for the medical image, and a plurality of designations can be input. For example, there may be a case where a part that is considered to be a primary disease of a certain disease and a part that is suspected to be metastasized are designated as an attention image. In this case, it is configured such that a process for sequentially storing a plurality of designated images of interest is performed so that the user can input a command to end selection input of the images of interest. Further, in the present embodiment, the doctor (user) who observed the medical image does not perform selection input of the target image and terminates the process of step S103 on the assumption that there is no abnormality candidate or information to be noted in the medical image. It is also possible to make it.

  Subsequently, in step S104, the CPU 111 determines whether or not there is an attention image selected in step S103. If the result of this determination is that there is no image of interest selected in step S103 (S104 / NO), the processing of the flowchart shown in FIG.

On the other hand, if the result of determination in step S104 is that there is an image of interest selected in step S103 (S104 / YES), processing proceeds to step S105.
In step S105, the CPU 111 performs an analysis process on the target image selected in step S103. Specifically, the CPU 111 performs an analysis process for determining and specifying the human body part of the subject to be imaged indicated by the target image selected in step S103. Here, the part (human body part) of the subject is, for example, an organ name such as “stomach”, “lung”, “liver”, “heart”, “right lung”, “left ventricle”, etc. The detailed position within the organ is also included. Further, the part is not limited to the organ-related part, and may be a rough position such as “chest”, “abdomen”, or the like.

  Therefore, if the target image selected in step S103 is a part of the right lung, it is also a part of the lung and similarly a part of the chest. That is, the information on the part specified in step S105 for a certain target image is not limited to one, and a plurality of hierarchical parts such as “upper body-chest-lung-right lung” as in the example described above. It will be specified as information. Furthermore, in step S105, the number of parts to be identified is not limited to one, and when a plurality of human body parts are included in the target image, each part information is identified.

  Note that the processing (operation) performed by the doctor on the target image, for example, instructions such as image enlargement, area designation, and gradation conversion are sequentially stored in the main memory 112 and used when analyzing the image. . That is, the image analysis is performed only on the enlarged medical image or only on the designated area.

  Subsequently, in step S106, the CPU 111 creates a part candidate list according to the human body part determined in step S105. Here, in the present embodiment, the order of the part candidate list is set corresponding to the size of the area of each part in the target image selected in step S103. At this time, the area of the part in the target image will be described as a pixel unit of the target image, but a value close to the actual area of the part may be calculated using the pixel size information mounted in DICOM_header. it can. If the medical image data, which is medical examination data, is volume data such as 3D CT, the size of the region area of the 2D image as well as the size of the region volume of the 3D image determines the order of the region candidate list. Sometimes available. Here, the site candidate list is created in the order of site size, giving priority to the larger site in the image of interest.

  In the present embodiment, the information used when determining the order of the part candidate list is not limited to the size of the part. For example, information such as a ratio of the part in the attention image or a percentage partially displayed with respect to the whole part may be used. Furthermore, in the above-described example, the order of the part candidate list is determined in the order of the part size. However, in order to explicitly focus on the part that is small and difficult to find, A form of creating a candidate list is also applicable.

  Furthermore, as another method for determining the ranking of the part candidate list, there is an example in which the information of the determination certainty obtained by the determination process of the human body part in step S105 is used. Here, since the determination process of the human body part may be erroneously determined, a form in which the order of the part candidate list is determined in accordance with the part determination certainty factor is also applicable.

  As described above, a part candidate list corresponding to the human body part determined in step S105 is created. Then, the CPU 111 creates a schema background diagram candidate list in the basic schema candidate diagram corresponding to the part according to the created part candidate list. That is, the CPU 111 performs a schema background diagram candidate list creation process based on the analysis result of the target image (medical image) in step S105.

  Subsequently, in step S107, the CPU 111 determines the basic schema background of the part entered in the part candidate list in step S106 from the plurality of basic schema background diagrams (basic schema image data 1131) stored in the magnetic disk 113. Load the figure. The basic schema background diagram (basic schema image data 1131) read here is treated as a basic schema background diagram candidate that is a candidate that can be added to the medical document acquired in step S101.

  In the present embodiment, as described above, the magnetic disk 113 stores a plurality of basic schema background diagrams (basic schema image data) as a schema background diagram storage device (schema DB). In addition, the magnetic disk 113 includes information such as the human organ targeted by the schema background diagram, the size of the range, and the level of detail of the structure represented by the schema background diagram, and the corresponding schema background diagram. Assume that they are stored in association. As for the recording / management of the schema background diagram, for example, as disclosed in Patent Document 2, a method of recording / managing for each level represented by the schema background diagram can be used.

  Subsequently, in step S108, the CPU 111 displays (outputs) the basic schema background map candidate read in step S107 as a separate window on the monitor 120 and presents it to the doctor. At that time, basic schema background map candidates are presented in the order of the part candidate list determined in step S106. By doing so, it is possible to present first a basic schema background diagram that is considered to be most demanded by doctors.

FIG. 5 is a schematic diagram illustrating an example of presentation of a schema background diagram candidate related to the image of interest according to the first embodiment of this invention.
In the window 501 shown in FIG. 5, a plurality of basic schema background diagram candidate images are displayed and presented. If the basic schema background map desired by the doctor is not in the displayed schema background map candidates, the doctor presses the “other” button 502 to request presentation (output) of the schema background map image of a different part. be able to. Based on this request, the CPU 111 displays the next schema background diagram candidate image in the window 501.

  For example, if the image of interest is a medical image of the chest and the image contains lungs, bronchi, and heart, as shown in FIG. 5, the entire chest and only the lungs (coronal image) are used as schema background diagram candidates. Display lungs and bronchi, lungs (axial images), lungs (sagittal images), heart, etc. In addition, regarding the axial image and the sagittal image, if the direction in which the part is reflected can be specified at the part determination stage in step S105, the information can be displayed.

  Subsequently, in step S109, the CPU 111 accepts a selection input of a basic schema background diagram from a doctor, and based on the selection input, a basic schema to be added to a medical document from the basic schema background diagram candidates presented in step S108. Select a schema background view. At this time, for example, the doctor uses the mouse 130 to select and input the desired basic schema background map from the images of the basic schema background map candidates displayed on the monitor 120. In this embodiment, the present invention is not limited to this method. For example, an identification number is assigned to each schema background diagram candidate, and a doctor selects a schema background diagram to be added to a medical document by selecting and inputting the number from the keyboard 140. It may be a form to do.

  Subsequently, in step S110, the CPU 111 adds a basic schema image based on the basic schema background diagram acquired in step S109 to the medical document read in step S101, and performs superimposed display (superimposition output) or additional display (addition). Output). This state is shown in FIG.

FIG. 6 is a schematic view showing an example of a medical document displayed in the window 301 of the monitor 120 shown in FIG.
FIG. 6 is obtained by adding a basic schema image 601 and its findings etc. information 602 related to the basic schema background diagram to the finding description column 304 to the medical document shown in FIG. Further, FIG. 6 shows that the date and time information is added to the date column 302 and the patient information is added to the patient information column 303 with respect to the medical document shown in FIG.

  The doctor inputs the findings etc. information 602 by using the basic schema image 601 related to the schema background diagram displayed in the window 301. Thereafter, the CPU 111 registers the medical document data in the medical document database 200. Thereafter, the processing in the flowchart of FIG.

Next, details of the attention image analysis process in step S105 of FIG. 2 will be described.
FIG. 7 is a flowchart illustrating an example of a detailed processing procedure of the attention image analysis processing in step S105 of FIG. Specifically, FIG. 7 shows details of the process of specifying the human body part of the subject in the analysis process of the target image. In this example, an example in which an abdominal three-dimensional X-ray CT image is applied as a target image to be analyzed will be described.

  When the process of step S105 in FIG. 2 is started, first, in step S201 in FIG. 7, the CPU 111 inputs the entire medical image input in step S102 and information on the target image that the doctor is paying attention to.

  Subsequently, in step S202, the CPU 111 acquires each part space existence probability information of the abdomen. This part space existence probability information is obtained by statistically analyzing the part shape, gray value distribution, spatial arrangement, etc. of a large number of medical image data. Examples of the abdominal part include right / left kidney, spleen, pancreas, liver, gallbladder, stomach wall, and the like. Then, the CPU 111 stores the acquired part space existence probability information in the magnetic disk 113 as part space existence probability information 1132.

  Subsequently, in step S <b> 203, the CPU 111 acquires each part feature amount information of the abdomen. Different parts have different characteristics such as segmentation parameters, shape characteristics, and CT values in CT images. The site can be more accurately recognized using the feature. Then, the CPU 111 stores the acquired part feature amount information as part feature amount information 1133 in the magnetic disk 113.

  In this embodiment, the part space existence probability information and the part feature amount information are stored in the magnetic disk 113. However, for example, the part space existence probability information and the part feature amount information are stored in the medical image database 300 or an independent database server via the LAN 400. It may be.

  Subsequently, in step S204, the CPU 111 performs an abdominal space standardization process. Since the part space existence probability information 1132 is existence probability information for a predetermined index (also referred to as a landmark) of the abdomen, the corresponding point between the index defined in the part space existence probability information and the index of the target medical image is obtained. It is necessary to take.

  Here, for example, the right and left kidney apex and the spleen lowest point are well known as indices. If the corresponding index is determined, the space of the three-dimensional X-ray CT image to be processed and the part space existence probability information can be matched, that is, the space can be standardized.

  When the space standardization process is completed, subsequently, in step S205, the CPU 111 performs rough extraction of the region of each part based on the part space existence probability information 1132. Here, using the part space existence probability information 1132, the posterior probability that each part of the image (pixel (x, y, z in the case of a three-dimensional image)) is a part is calculated, and the value becomes the maximum. Assign site labels to pixels. The following equation (1) is used to calculate the posterior probability of the part.

  In the equation (1), l represents a part label, v is a feature quantity of a pixel pixel (x, y, z), p (v | l) is a probability of v for a certain part l obtained statistically, p (L) is the prior probability of the part label l obtained from the part space existence probability information.

  Subsequently, in step S206, the CPU 111 performs detailed extraction of a part region for each part. Here, if it is known in the process in step S203 that even a part of the region has a high probability, it is used as an initial region of the segmentation technique. For example, as a segmentation technique, a LevelSet method or a Snakes method well known in the image processing field can be used. Then, when executing the segmentation technique, necessary unique parameters and feature quantities are used for each part. In this embodiment, the detailed extraction of the part region in step S206 is performed by the processing of the segmentation technique.

  The segmentation processing of the above-described part is described in detail in Non-Patent Document 1, for example. Here, calculation of the part determination certainty factor for determining the order of the part candidate list after the part region of the medical image (target image) is determined will be described. In this embodiment, the average part posterior probability of the region occupied by the part is used as the part determination certainty factor. The part determination certainty factor can be expressed by, for example, the following expression (2).

In the equation (2), M represents the number of pixels occupied by the part.
Further, as another method of processing the part determination certainty factor, a method using size information of the determined part region is also conceivable. In this case, in addition to the part space existence probability information as statistical information, the average size information for each part is held, and by comparing the size of the determined part with the average size of the part, it can be used as a part determination certainty factor. is there. In addition, in this embodiment, you may utilize the calculation method of other site | part determination reliability other than having mentioned above.

  Subsequently, in step S207, the CPU 111 identifies the position of the image that the doctor is interested in in the three-dimensional X-ray CT image (medical image), and determines the portion that exists in the image of interest. When specifying the position of the image of interest, for example, an axial slide number or pixel spatial position information is used. Thereafter, the process of the flowchart of FIG. 7 ends.

  Through the processing in steps S201 to S207 in FIG. 7, the attention image analysis processing in step S105 in FIG. 2, more specifically, the region identification processing in the attention image is performed.

  According to the first embodiment, by analyzing a medical image (attention image) that is noticed by a doctor who is a user, a suitable schema background diagram can be efficiently generated from a plurality of schema background diagrams at the time of medical text creation. You can choose. Therefore, as in the prior art, it is possible to save the trouble of the doctor finding out a schema background diagram suitable for diagnosis from among a plurality of schema background diagrams when creating medical text. Furthermore, a suitable schema background diagram can be efficiently found by using operations such as enlargement and area designation performed on a medical image (attention image) focused on by the doctor.

(Second Embodiment)
Next, a second embodiment of the present invention will be described.
The second embodiment detects an abnormality (abnormality candidate) of a part in an image of interest by analysis with respect to the processing procedure of FIG. 2 in the first embodiment, and when the schema background diagram is selected, the abnormality is detected. A process that uses information is added.

  The internal configuration of the diagnosis support apparatus according to the second embodiment is the same as the internal configuration of the diagnosis support apparatus 100 according to the first embodiment shown in FIG.

  The processing procedure in the control method of the diagnosis support apparatus 100 according to the second embodiment will be described below.

  FIG. 8 is a flowchart illustrating an example of a processing procedure in the control method of the diagnosis support apparatus 100 according to the second embodiment of the present invention. Here, processes similar to those in the flowchart shown in FIG. 2 are given the same step numbers, and detailed descriptions thereof are omitted.

  First, in this example, the process of steps S101 to S106 in FIG. 2 is performed.

  Subsequently, in step S301, the CPU 111 detects an abnormality of a part included in the target image based on the analysis result of the target image in step S105 for the target image selected in step S103.

  For example, if the chest three-dimensional CT image is a target image to be analyzed and it is determined in step S105 that a heart is present in the target image, the abnormality detection of the heart is performed. For example, as detection of coronary artery calcification, the aorta and pulmonary artery in the mediastinum region is specified, and a heart abnormality is detected by detecting a high-concentration small region of the heart surface region where the coronary artery runs.

  Further, when it is determined that a lung exists in the same chest three-dimensional CT image, abnormality detection of the lung is also performed. In this case, for example, abnormalities of the lung are detected by using the internal structure of the tumor, the nature of the margin, the involvement of existing structures such as the pulmonary blood vessels and the bronchi for detecting and determining the lung mass (for example, non-existing) Patent Document 2).

  Subsequently, in step S302, the CPU 111 determines again the order of the part candidate list created in step S106 using the part abnormality information detected in step S301, and rearranges the part candidate list.

  For example, if it is determined in step S105 that a heart and a lung are present in the image of interest, in step S106, the heart and the lung are entered in the region candidate list. Furthermore, when coronary artery calcification is detected in the heart in step S301, the heart is set to have a higher rank than the lung in the re-determination of the position candidate list in step S302.

  After that, the CPU 111 recreates the schema background diagram candidate list in the basic schema candidate diagram corresponding to the part according to the part candidate list whose order has been redetermined and rearranged. Thus, in the above-described example, when a schema background diagram candidate is presented (FIG. 5) in step S108 of the post-process, the basic schema diagram of the heart is presented at a higher position.

Thereafter, in this example, the process of steps S107 to S110 in FIG. 2 is performed.
Through this processing, as shown in FIG. 6, the medical document with the basic schema background view added is displayed (output) in the window 301 of the monitor 120.

  Subsequently, in step S303, the CPU 111 performs a process of adding (displaying) the abnormality information of the part detected in step S501 to the schema background diagram selected and displayed in step S109. When this abnormal information is added, the size and shape of the abnormal part relative to the schema background diagram are determined based on the size of the part extracted from the image of interest, the size and shape of the abnormal part. Then, the CPU 111 adds abnormality information to the schema background diagram based on the position of the abnormality with respect to the region of the target image.

  FIG. 9 is a schematic diagram illustrating an example of a schema background diagram to which abnormality information is added according to the second embodiment of this invention. In FIG. 9, abnormal information such as the position and size of a lung mass 902 that is an abnormal part is added to a basic schema image 901 (for example, equivalent to the basic schema image 601 of FIG. 6) related to a lung schema background diagram. Yes.

  Then, when the process of step S303 ends, the process in the flowchart of FIG. 8 ends.

  In this embodiment, an example in which abnormality information is added (S303) after a schema background diagram to be added to a medical document has been selected has been described. However, the order of processing is not limited. For example, when the schema background diagram candidate is displayed (output) on the monitor 120 and presented in step S108 of FIG. 8, abnormality information may already be added to present the schema background diagram candidate. Further, the abnormality information of the plurality of parts detected in step S301 may be presented to the doctor, and the schema background diagram candidate may be presented based on the abnormality information selected by the doctor.

  According to the second embodiment, it is possible to select a schema background diagram including an abnormality by detecting the presence / absence of an abnormality in a part included in the target image, and to efficiently select a suitable schema background diagram. Can do. Furthermore, by adding abnormality information to the selected schema background diagram, for example, a doctor who is a user can easily grasp the abnormal part.

(Third embodiment)
Next, a third embodiment of the present invention will be described.
In the third embodiment, only the processes of steps S105 and S106 are changed from the process procedure of FIG. 2 in the first embodiment or the process procedure of FIG. 8 in the second embodiment.

  In step S105 of the first embodiment (and the second embodiment), it has been described that the human body part of the subject to be pointed to by the selected target image is specified. However, the embodiment of the present invention is applied to this embodiment. It is not limited.

  For example, a doctor may adjust the contrast of an image of interest in order to observe a medical image. Due to the contrast adjustment (display conditions) of the image of interest, there are parts that are easier to observe and parts that are not. Then, in the process of step S105 in the third embodiment, the CPU 111 specifies a more focused part in the target image by contrast analysis of the target image. As described above, by analyzing the attention image after the contrast adjustment, it is possible to determine a region having a good display contrast as the region of interest. For example, the image of interest after contrast adjustment is divided into a plurality of regions, and the distribution of the contrast is analyzed for each divided region to determine the region of interest. Then, as described above, it is specified which part the attention position is.

  After that, in the process of step S106 in the third embodiment, the CPU 111 increases the rank of the site of interest that is a more easily viewable site (a site with good display contrast) when creating the site candidate list.

  According to the third embodiment, by analyzing the attribute of the image of interest, it is possible to specify the part of the image of interest that the user (doctor) is more focused on. As a result, it is possible to preferentially present the part that the user is paying more attention to, and it is possible to efficiently select a suitable schema background diagram from a plurality of schema background diagrams when creating medical text.

(Other embodiments of the present invention)
2, 7 and 8 showing the control method of the diagnosis support apparatus 100 according to each embodiment of the present invention described above, the CPU (111) of the computer uses the storage medium (main memory 112). This can be realized by executing the program stored in (). This program and a computer-readable recording medium storing the program are included in the present invention.

  In addition, the present invention can be implemented as, for example, a system, apparatus, method, program, storage medium, or the like. Specifically, the present invention may be applied to a system including a plurality of devices. You may apply to the apparatus which consists of one apparatus.

  In the present invention, a software program (in the embodiment, a program corresponding to the flowcharts shown in FIGS. 2, 7, and 8) for realizing the functions of the above-described embodiments is directly or remotely supplied to the system or apparatus. Including what to do. The present invention also includes a case where the system or the computer of the apparatus is achieved by reading and executing the supplied program code.

  Accordingly, since the functions of the present invention are implemented by computer, the program code installed in the computer also implements the present invention. In other words, the present invention includes a computer program itself for realizing the functional processing of the present invention.

  In that case, as long as it has the function of a program, it may be in the form of object code, a program executed by an interpreter, script data supplied to the OS, or the like.

  Examples of the recording medium for supplying the program include a flexible disk, hard disk, optical disk, magneto-optical disk, MO, CD-ROM, CD-R, and CD-RW. In addition, there are magnetic tape, nonvolatile memory card, ROM, DVD (DVD-ROM, DVD-R), and the like.

  As another program supply method, a browser on a client computer is used to connect to an Internet home page. The computer program itself of the present invention or a compressed file including an automatic installation function can be downloaded from the homepage by downloading it to a recording medium such as a hard disk.

  It can also be realized by dividing the program code constituting the program of the present invention into a plurality of files and downloading each file from a different homepage. That is, a WWW server that allows a plurality of users to download a program file for realizing the functional processing of the present invention on a computer is also included in the present invention.

  In addition, the program of the present invention is encrypted, stored in a storage medium such as a CD-ROM, distributed to users, and key information for decryption is downloaded from a homepage via the Internet to users who have cleared predetermined conditions. Let It is also possible to execute the encrypted program by using the downloaded key information and install the program on a computer.

  Further, the functions of the above-described embodiments are realized by the computer executing the read program. In addition, based on the instructions of the program, an OS or the like running on the computer performs part or all of the actual processing, and the functions of the above-described embodiments can also be realized by the processing.

  Further, the program read from the recording medium is written in a memory provided in a function expansion board inserted into the computer or a function expansion unit connected to the computer. Thereafter, the CPU of the function expansion board or function expansion unit performs part or all of the actual processing based on the instructions of the program, and the functions of the above-described embodiments are realized by the processing.

  Note that each of the above-described embodiments is merely a specific example for carrying out the present invention, and the technical scope of the present invention should not be construed as being limited thereto. . That is, the present invention can be implemented in various forms without departing from the technical idea or the main features thereof.

100 Diagnosis support device 110 Control unit 111 CPU (Central processing unit)
112 Main memory 113 Magnetic disk 1131 Basic schema background diagram (Basic schema image data)
1132 Site space existence probability information (probability atlas information)
1133 Part feature information 114 Display memory 115 Bus 120 Monitor 130 Mouse 140 Keyboard 200 Medical document database 300 Medical image database 400 LAN (local area network)

Claims (16)

An acquisition means for acquiring a medical image to be examined;
Analyzing means for analyzing the acquired medical image;
Output means for outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the order corresponding to the plurality of human body parts to be examined obtained by the analysis When,
A diagnostic support apparatus comprising: The output means stores the storage means based on a rank corresponding to a human body part including an abnormality that is higher than a rank of a human body part not including an abnormality among the plurality of human body parts obtained by the analysis. The diagnosis support apparatus according to claim 1 , wherein information corresponding to a human body part including the abnormality selected from stored information is output as information corresponding to the plurality of human body parts. The diagnosis support apparatus according to claim 2, further comprising display control means for causing the display means to display information corresponding to the outputted human body part including the abnormality. The plurality of human body parts of different types in the examination object obtained by the analysis, and the schema corresponding to each human body part of the plurality of human body parts from among the plurality of schemas stored in the storage means Determining a plurality of different types of schemas, and a plurality of abnormal sites obtained by the analysis , the size of the plurality of abnormal sites comprising the abnormal sites in each of the human body sites and based on the shape, further comprising a determining means for determining the size and shape of the plurality of abnormalities for the plurality of schema,
And the output means, based on the size and shape of the determined different types of multiple schemata consisting schemata respective abnormal position of the plurality of abnormalities is added, corresponding to the plurality of body parts The diagnosis support apparatus according to claim 1, wherein the diagnosis support apparatus outputs the information as information. An acquisition means for acquiring a medical image to be examined;
Analyzing means for analyzing the acquired medical image;
A plurality of different types of human body parts in the test object obtained by the analysis, the schemas corresponding to the human body parts of the plurality of human body parts from among the plurality of schemas stored in the storage means Determine a plurality of different types of schema, and obtain a plurality of abnormal parts obtained by the analysis, and the size and shape of the plurality of abnormal parts composed of abnormal parts in each human body part of the plurality of human body parts based on a determination means for determining the size and shape of the plurality of abnormalities for the plurality of schema,
Based on the determined size and shape, output means for outputting a plurality of different types of schemas each consisting of a schema to which each abnormal part of the plurality of abnormal parts is added;
A diagnostic support apparatus comprising: Display control means for causing the display means to display a plurality of schemas output by the output means;
A selection input means for a user to select and input one of a plurality of schemas displayed on the display means;
The diagnosis support apparatus according to claim 4, further comprising: Based on the rank corresponding to the plurality of body parts, to create a schema candidate list by arranging a plurality of schema corresponding to said plurality of body parts that have been selected from a plurality of schema stored in the storage means It further has a creation means,
And the output means, the diagnostic support apparatus according to any one of claims 1 to 4 and outputs a schema candidate list created in the above. Based on the rank corresponding to the plurality of human body parts, a creation means for creating a region candidate list by arranging site name of said plurality of body parts,
Selection means for selecting a plurality of schemas corresponding to the plurality of human body parts from the plurality of schemas stored in the storage means based on the created part candidate list;
Further comprising
And the output means, the diagnostic support apparatus according to any one of claims 1 to 4 and outputs a plurality of schemata said selected. The creating means further creates a schema candidate list in which the plurality of selected schemas are arranged,
9. The diagnosis support apparatus according to claim 8, wherein the output unit outputs the created schema candidate list. And the output means, based on the rank corresponding to the magnitude of said plurality of body parts, to output the information corresponding to the plurality of body parts that have been selected from among the information stored in said storage means The diagnosis support apparatus according to claim 1, wherein The output means corresponds to the plurality of human body parts selected from the information stored in the storage means based on the order corresponding to the contrast of the plurality of human body parts in the medical image after contrast adjustment. The diagnosis support apparatus according to claim 1, wherein information to be output is output.   The program for functioning a computer as each means of the diagnostic assistance apparatus of any one of Claims 1 thru | or 11. An acquisition step of acquiring a medical image to be examined;
An analysis step for analyzing the acquired medical image;
An output step of outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the order corresponding to the plurality of human body parts to be examined obtained by the analysis When,
A diagnostic support method characterized by comprising: An acquisition step of acquiring a medical image to be examined;
An analysis step for analyzing the acquired medical image;
A plurality of different types of human body parts in the test object obtained by the analysis, the schemas corresponding to the human body parts of the plurality of human body parts from among the plurality of schemas stored in the storage means Determine a plurality of different types of schema, and obtain a plurality of abnormal parts obtained by the analysis, and the size and shape of the plurality of abnormal parts composed of abnormal parts in each human body part of the plurality of human body parts based on a determination step of determining the size and shape of the plurality of abnormalities for the plurality of schema,
Based on the determined size and shape, an output step of outputting a plurality of different types of schemas each consisting of a schema to which each abnormal part of the plurality of abnormal parts is added;
A diagnostic support method characterized by comprising: An acquisition means for acquiring a medical image to be examined;
Analyzing means for analyzing the acquired medical image;
Output means for outputting information corresponding to the plurality of human body parts selected from the information stored in the storage means based on the order corresponding to the plurality of human body parts to be examined obtained by the analysis When,
A diagnostic support system comprising: An acquisition means for acquiring a medical image to be examined;
Analyzing means for analyzing the acquired medical image;
A plurality of different types of human body parts in the test object obtained by the analysis, the schemas corresponding to the human body parts of the plurality of human body parts from among the plurality of schemas stored in the storage means Determine a plurality of different types of schema, and obtain a plurality of abnormal parts obtained by the analysis, and the size and shape of the plurality of abnormal parts composed of abnormal parts in each human body part of the plurality of human body parts based on a determination means for determining the size and shape of the plurality of abnormalities for the plurality of schema,
Based on the determined size and shape, output means for outputting a plurality of different types of schemas each consisting of a schema to which each abnormal part of the plurality of abnormal parts is added;
A diagnostic support system comprising:

Images