JP6019369B1 - Ultrasonic image display device, operating method thereof, and recording medium storing program - Google Patents

Abstract

Provided is an ultrasonic image display device capable of easily and surely puncturing a subject with a puncture needle. The insertion angle of the puncture needle 6 in the puncture guide attachment is determined. A first guideline 65 indicating the direction in which the puncture needle 6 advances is displayed on the first tomographic image 8, and a second guideline indicating the course at the insertion angle of the puncture needle 6 is displayed on the second tomographic image 9. 66 is displayed. Based on the insertion angle of the puncture needle 6, the depth position at which the tip 71 of the puncture needle 6 starts to be seen is predicted in the first tomographic image 8 and the second tomographic image 9, and the position is indicated to the operator. A horizontal line 67 and guide marks 68 shown in advance are displayed. Selection diagram: Fig. 3

Description

The present invention relates to an ultrasonic image display apparatus for displaying a tomographic image of a subject using an ultrasonic probe and performing puncturing while confirming the position of a puncture needle, an operating method thereof, and a recording medium storing a program Is.

  In medical practice, puncture of living tissue (subject) such as general injection, nerve block injection, blood sampling, and catheter insertion is widely performed. When performing treatments such as nerve block injection and catheter insertion, biological tissue may be damaged unless the target site is punctured accurately. In such a background, in recent years, an ultrasonic guide technique has been used in which puncture is performed while observing the state of a target region with an ultrasonic image.

  Conventionally, in an apparatus using an ultrasonic guide, one tomographic image is displayed and puncture is performed. With this apparatus, only one of a short-axis image (transverse section) and a long-axis image (longitudinal section) can be confirmed. Therefore, even when the puncture needle is not accurately punctured in the blood vessel, there is a problem that it is difficult for the operator to notice it.

  In order to solve this problem, two orthogonal cross sections (cross section and longitudinal section) are scanned simultaneously to display ultrasonic images (short axis image and long axis image) of each section, and puncture while observing these images An angiography apparatus has been proposed (see, for example, Patent Document 1).

Japanese Patent No. 5292581

  However, even when puncturing is performed using the angiography apparatus of Patent Document 1, the insertion angle of the puncture needle is adjusted while confirming two tomographic images (transverse and vertical cross-sectional images), and the target site In order to perform puncture surely, a certain amount of skill is required. For this reason, there is a demand for a technique for enabling an operator with little work experience using an angiographic apparatus to perform puncture easily and reliably without damaging a living tissue.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide an ultrasonic image display device and an ultrasonic image display method capable of easily and surely puncturing a subject with a puncture needle. It is in. Another object is to provide a recording medium storing a program for operating a computer built in the ultrasonic image display apparatus.

In order to solve the above problem, the invention according to claim 1 acquires a first tomographic image showing a transverse section of a subject and a second tomographic image showing a longitudinal section in a direction intersecting the transverse section. A probe main body in which a plurality of ultrasonic transducers for linearly scanning ultrasonic waves are arranged so as to be orthogonal to each other, and a puncture needle that is fixed to the probe main body along the longitudinal section indicated by the second tomographic image A puncture guide attachment for guiding the puncture needle to be inserted into the subject at a predetermined angle set in advance, and an angle at which the insertion angle of the puncture needle can be adjusted in multiple steps to the puncture guide attachment An ultrasonic image display device that simultaneously displays the first tomographic image and the second tomographic image on the same screen by transmitting and receiving the ultrasonic wave using an ultrasonic probe provided with an adjustment mechanism, An insertion angle determination means for determining an insertion angle of the puncture needle in the puncture guide attachment, a first guideline indicating a direction in which the puncture needle advances on the first tomographic image, and the second tomography On the image, based on the guideline display means for displaying the second guideline indicating the course at the insertion angle of the puncture needle and the insertion angle of the puncture needle determined by the insertion angle determination means, the first tomographic image And a position display means for predicting a depth position at which the tip of the puncture needle begins to be visible in the second tomographic image and displaying a horizontal line as a position display section that indicates the position to the operator in advance. The gist of the present invention is an ultrasonic image display device characterized by comprising:

Therefore, according to the first aspect of the present invention, the insertion angle determination means determines the insertion angle of the puncture needle in the puncture guide attachment. Further, the guideline display means displays the first guideline indicating the advancing direction of the puncture needle on the first tomographic image showing the transverse section of the subject, and puncturing the second tomographic image showing the longitudinal section. A second guideline indicating the course at the needle insertion angle is displayed. Furthermore, the position display means predicts the depth position at which the tip of the puncture needle begins to appear in the first tomographic image and the second tomographic image based on the insertion angle of the puncture needle, and A position display unit indicating the position in advance is displayed. In this way, the doctor (operator) can easily foresee the depth position at which the puncture needle begins to appear in the first tomographic image and the second tomographic image by checking the position display unit. As a result, it is possible to determine whether or not the moment when the puncture needle reaches the treatment portion (tissue such as a vein or nerve) of the subject can be captured by each tomographic image before the puncture starts. And when it is judged that it cannot catch, it becomes possible to reset the insertion angle of a puncture needle. In the present invention, the course of the puncture needle and the insertion angle of the puncture needle can be confirmed by each guideline. For this reason, the puncture needle can be reliably punctured into the treatment portion of the subject while reducing the psychological burden on the operator . In addition, since the position display means displays a horizontal line as a position display unit, the depth position where the puncture needle begins to appear can be determined by checking the horizontal lines displayed in the first tomographic image and the second tomographic image. Can be easily foreseen.

The present invention has been made in view of the above problems, and an object of the present invention is to provide an ultrasonic image display apparatus that can easily and reliably puncture a subject with a puncture needle and an operation method thereof. . Another object is to provide a recording medium storing a program for operating a computer built in the ultrasonic image display apparatus.

According to a second aspect of the present invention, in the first aspect of the present invention, the position display means may be arranged at an intersection position between the guide line and the horizontal line in at least one of the first tomographic image and the second tomographic image. The gist is to display a guide mark as the position display unit.

Therefore, according to the second aspect of the present invention, by confirming the guide mark displayed in the tomographic image, it is possible to easily and accurately foresee the position where the puncture needle starts to be seen.

The gist of the invention described in claim 3 is that, in claim 2 , the guide mark is a frame-like mark displaying a tomographic image in the frame at the intersection position.

Therefore, according to the third aspect of the present invention, since the tomographic image is displayed until the puncture needle begins to appear within the frame of the frame-shaped guide mark, the puncture needle is displayed without being hidden by the guideline or the horizontal line. The moment when it begins to appear can be confirmed with certainty.

The gist of the invention of claim 4 is that, in claim 3 , the guide mark has a size larger than the diameter of the image corresponding to the tip of the puncture needle.

Therefore, according to the invention described in claim 4 , since the frame-shaped guide mark having a size larger than the diameter of the image corresponding to the tip of the puncture needle is displayed, the guide mark and the image of the needle tip overlap each other. Therefore, the moment when the puncture needle begins to be visible can be confirmed more reliably.

According to a fifth aspect of the present invention, in any one of the second to fourth aspects, the position display unit includes the guide mark having the same shape and the same size in the first tomographic image and the second tomographic image. The gist is to display.

Therefore, according to the fifth aspect of the present invention, the position display means displays the guide mark having the same shape and the same size in the first tomographic image and the second tomographic image. It is easy to understand sensuously. Therefore, the position where the puncture needle begins to be visible in each tomographic image can be confirmed relatively easily.

The gist of the invention of claim 6 is that, in any one of claims 2 to 5 , the guide mark and the horizontal line are broken lines.

Therefore, according to the sixth aspect of the present invention, the guide mark and the horizontal line are broken lines, and the image is partially displayed from the gap between the broken lines, so that the guide mark and the horizontal line are displayed as solid lines. This makes it easier to grasp the subject and the surrounding structure.

The gist of a seventh aspect of the present invention is that, in any one of the first to sixth aspects, the position display means displays the horizontal line in a color different from the guideline.

Therefore, according to the seventh aspect of the invention, since the horizontal line is displayed in a color different from that of the guideline, the depth position of the puncture needle indicated by the horizontal line can be easily determined.

The gist of an eighth aspect of the present invention is that, in any one of the first to seventh aspects, the position display means displays the horizontal line with a line type different from the guideline.

Therefore, according to the invention described in claim 8 , since the horizontal line is displayed with a line type different from the guideline, the depth position of the puncture needle indicated by the horizontal line can be easily determined.

A ninth aspect of the present invention provides the method according to any one of the first to eighth aspects, further comprising position information input means for inputting position information corresponding to a set position of an insertion angle of the puncture needle in the puncture guide attachment. The gist of the insertion angle determination means is to determine the insertion angle of the puncture needle based on the position information input by the position information input means.

Therefore, according to the ninth aspect of the present invention, the position information input means inputs the position information corresponding to the set position of the insertion angle of the puncture needle at the present time, thereby determining the insertion angle of the puncture needle. Then, a second guideline indicating a course at the insertion angle is displayed on the second tomographic image. Further, based on the insertion angle of the puncture needle, a position where the tip of the puncture needle starts to be seen is predicted, and a position display unit indicating the position is displayed on each tomographic image. In this case, the operator can easily foresee the depth position at which the puncture needle starts to be seen by checking the position display unit displayed on each tomographic image, and the second guideline is displayed on the second tomographic image. The puncture needle can be reliably inserted into the subject at the insertion angle indicated by.

The invention according to claim 10 is to linearly scan ultrasonic waves so as to obtain a first tomographic image showing a transverse section of a subject and a second tomographic image showing a longitudinal section in a direction intersecting the transverse section. A plurality of ultrasonic transducers arranged so as to be orthogonal to each other, and a puncture needle fixed at a predetermined angle along the longitudinal section indicated by the second tomographic image, fixed to the probe body. A puncture guide attachment for guiding the puncture needle to be inserted into the subject, and an ultrasonic adjustment provided with an angle adjusting mechanism capable of adjusting the insertion angle of the puncture needle in a multistage manner on the puncture guide attachment In the method for simultaneously displaying the first tomographic image and the second tomographic image on the same screen by performing transmission and reception of the ultrasonic wave using a probe, in the puncture guide attachment, An insertion angle determination step for determining an insertion angle of the puncture needle, and a first guideline indicating a direction in which the puncture needle advances on the first tomographic image, and the puncture on the second tomographic image. The first tomographic image and the second tomographic image based on the guideline display step for displaying a second guideline indicating the course at the needle insertion angle, and the insertion angle of the puncture needle determined by the insertion angle determination means And a position display step of predicting a depth position at which the tip of the puncture needle begins to be visible and displaying a horizontal line as a position display section that indicates the position to the operator in advance. The gist of the method of operating the ultrasonic image display apparatus is as follows.

Therefore, according to the tenth aspect of the present invention, the insertion angle of the puncture needle in the puncture guide attachment is determined in the insertion angle determination step. Further, in the guideline display step, a first guideline indicating a direction in which the puncture needle is advanced is displayed on the first tomographic image, and a second path indicating the course at the insertion angle of the puncture needle is displayed on the second tomographic image. The guidelines are displayed. Further, in the position display step, based on the insertion angle of the puncture needle determined by the insertion angle determination means, a depth position at which the tip of the puncture needle begins to appear in the first tomographic image and the second tomographic image is predicted. Then, a position display unit showing the position in advance for the worker is displayed. In this way, the operator can easily foresee the depth position at which the puncture needle begins to appear in the first tomographic image and the second tomographic image by checking the position display unit. As a result, it is possible to determine whether or not the moment when the puncture needle reaches the treatment portion of the subject can be captured by each tomographic image before the puncture is started. And when it is judged that it cannot catch, it becomes possible to reset the insertion angle of a puncture needle. In the present invention, the course of the puncture needle and the insertion angle of the puncture needle can be confirmed by each guideline. For this reason, the puncture needle can be reliably punctured into the treatment portion of the subject while reducing the psychological burden on the operator . In addition, since the horizontal line as the position display unit is displayed in the position display step, the depth position where the puncture needle begins to appear by checking the horizontal line displayed in the first tomographic image and the second tomographic image. Can be easily foreseen.

The invention according to claim 11 is to linearly scan ultrasonic waves so as to obtain a first tomographic image showing a transverse section of a subject and a second tomographic image showing a longitudinal section in a direction intersecting the transverse section. A plurality of ultrasonic transducers arranged so as to be orthogonal to each other, and a puncture needle fixed at a predetermined angle along the longitudinal section indicated by the second tomographic image, fixed to the probe body. A puncture guide attachment for guiding the puncture needle to be inserted into the subject, and an ultrasonic adjustment provided with an angle adjusting mechanism capable of adjusting the insertion angle of the puncture needle in a multistage manner on the puncture guide attachment A computer built in an ultrasonic image display device that simultaneously displays the first tomographic image and the second tomographic image on the same screen by transmitting and receiving the ultrasonic waves using a probe is provided. An insertion angle determination means for determining an insertion angle of the puncture needle in the guide attachment, and a first guideline indicating a direction in which the puncture needle advances are displayed on the first tomographic image, and on the second tomographic image. Guide line display means for displaying a second guideline indicating a course at the insertion angle of the puncture needle, and the first tomographic image and the first tomographic image based on the insertion angle of the puncture needle determined by the insertion angle determination means. To predict the depth position at which the tip of the puncture needle begins to appear in the two tomographic images, and to operate as a position display means for displaying a horizontal line as a position display section that indicates the position to the operator in advance. The gist is a recording medium storing the program.

Therefore, according to the eleventh aspect of the present invention, the ultrasonic image display apparatus according to the first aspect can be realized by operating the computer according to the program stored in the recording medium. By using the ultrasonic image display device, it is possible to reliably puncture the treatment portion of the subject while reducing the psychological burden on the operator.

As described above in detail, according to the inventions of claims 1 to 11 , the puncture needle can be punctured easily and reliably with respect to the subject.

1 is a front view showing an angiography apparatus according to an embodiment. 1 is a block diagram showing an electrical configuration of an angiography apparatus according to an embodiment. Explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of one Embodiment. The perspective view which shows the probe main body of an ultrasonic probe. Explanatory drawing which shows the usage method of an ultrasonic probe. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image. Explanatory drawing which shows a 1st tomographic image and a 2nd tomographic image.

  Hereinafter, an embodiment in which the present invention is embodied in an angiography apparatus as an ultrasonic image display apparatus will be described in detail with reference to the drawings. FIG. 1 is a front view showing an angiographic apparatus 1 according to the present embodiment, and FIG. 2 is a block diagram showing an electrical configuration of the angiographic apparatus 1.

  As shown in FIGS. 1 and 2, the angiography apparatus 1 includes an apparatus main body 2 and an ultrasonic probe 3 connected to the apparatus main body 2. An angiography apparatus 1 according to the present embodiment is an apparatus used when, for example, a puncture needle 6 such as a catheter is inserted into a vein 5 in a living tissue 4 (subject). One tomographic image 8 (short axis image) and a second tomographic image 9 (long axis image) showing a longitudinal section of the vein 5 are simultaneously displayed on the same screen 10 (see FIG. 3).

  The ultrasonic probe 3 includes a signal cable 11, a probe main body 12 connected to the distal end of the signal cable 11, a puncture guide attachment 14 that is detachably fixed to the probe main body 12, and a base end of the signal cable 11. And a probe-side connector 15 provided on the device. A connector 16 is provided in the apparatus main body 2, and a probe-side connector 15 of the ultrasonic probe 3 is connected to the connector 16.

  The ultrasonic probe 3 is a linear probe for performing linear electronic scanning, and, for example, linearly scans ultrasonic waves of 5 MHz. A plurality of ultrasonic transducers 23 and 24 (probes) are arranged on the transducer installation surface 20 serving as the bottom surface of the probe main body 12 so that the arrangement directions are orthogonal to each other and are substantially T-shaped. Yes.

  More specifically, the probe body 12 includes a first element unit 25 that houses a plurality of first ultrasonic transducers 23 for acquiring the first tomographic image 8 and a plurality of elements for acquiring the second tomographic image 9. And a second element unit 26 that houses the second ultrasonic transducer 24. The plurality of first ultrasonic transducers 23 in the first element unit 25 are linearly arranged along the minor axis direction X corresponding to the cross section. The plurality of second ultrasonic transducers 24 in the second element unit 26 are linearly arranged along the major axis direction Y corresponding to the longitudinal section. In the present embodiment, the number of elements of the first ultrasonic transducer 23 accommodated in the first element unit 25 is, for example, 48, and the second ultrasonic transducer accommodated in the second element unit 26. The number of 24 elements is, for example, 80. Therefore, the length of the ultrasonic transducers 23 and 24 in the arrangement direction is longer in the second element unit 26 than in the first element unit 25.

  In the second element unit 26, an ultrasonic transducer array 27 in which a plurality of ultrasonic transducers 24 are arranged in the major axis direction Y is arranged along the center line L 0 of the probe body 12 on the transducer installation surface 20. Has been. That is, in the present embodiment, the extension line L0 of the ultrasonic transducer array 27 in the major axis direction Y and the center line L0 of the probe main body 12 coincide with each other on the transducer installation surface 20. Further, the ultrasonic transducer arrays 27 in the major axis direction Y are arranged so that the start ends thereof are located at substantially the center of the ultrasonic transducer array 28 in the minor axis direction X.

  In the ultrasonic probe 3 of the present embodiment, the scanning of the ultrasonic waves in the substantially T-shaped ultrasonic transducer arrays 27 and 28 is, for example, one end of the ultrasonic transducer array 28 in the short axis direction X (for example, FIG. 2). Is started from the ultrasonic transducer 23 at the start end). Then, the elements are sequentially performed one by one toward the ultrasonic transducer 23 at the other end of the ultrasonic transducer array 28 in the short axis direction X (for example, the terminal end at the left end in FIG. 2). Thereafter, the other end from the ultrasonic transducer 24 at one end of the ultrasonic transducer row 27 in the major axis direction Y located at the approximate center of the ultrasonic transducer row 28 in the minor axis direction X (the start end which is the lower end in FIG. 2). Ultrasonic scanning is performed in order for each element toward the ultrasonic transducer 24 at the upper end (the upper end in FIG. 2).

  In the ultrasonic probe 3 of the present embodiment, the transducer installation surface 20 located on the bottom surface of the probe main body 12 is a contact surface with the biological tissue 4 and serves as a transmission / reception surface for transmitting and receiving ultrasonic waves. In the transducer installation surface 20, a substantially T-shaped acoustic lens 29 is disposed via a not-shown acoustic matching layer at a portion where the ultrasonic transducer arrays 27 and 28 are disposed in a substantially T-shape. Yes. The acoustic lens 29 is made of, for example, a silicone resin, and is provided on the ultrasonic radiation surface 30 side of the ultrasonic transducers 23 and 24 in the first element unit 25 and the second element unit 26. The acoustic lens 29 is formed in a convex shape with a curved outer surface in contact with the living tissue 4, and an ultrasonic beam output in the normal direction from the ultrasonic radiation surfaces 30 of the ultrasonic transducers 23 and 24. The aperture is narrowed down and converged at a predetermined focal position.

  In the probe main body 12, the extension line of the ultrasonic transducer array 27 in the major axis direction Y (the center line L0 of the probe main body 12 on the transducer installation surface 20) and the edge of the transducer installation surface 20 (lower in FIG. 2). On the side, the left edge in FIG. 4) is provided with a positioning portion 31. The positioning portion 31 is a recess for determining the insertion position of the puncture needle 6 with respect to the living tissue 4 when the distal end side of the puncture needle 6 abuts. Furthermore, on the transducer installation surface 20 of the probe body 12 that the living tissue 4 contacts, at both ends in the minor axis direction X, convex strips 32 for avoiding compression of the observation site of the living tissue 4 are arranged in the major axis direction. It is provided along Y (see FIG. 4). By providing the pair of ridges 32 apart from each other on the transducer installation surface 20 of the probe body 12, the region between the pair of ridges 32 on the transducer installation surface 20 side is not pressed too strongly. Therefore, the vein 5 at the observation site is prevented from being crushed, and the vein 5 can be punctured with certainty.

  The puncture guide attachment 14 includes a puncture needle guide portion 34 in which a guide groove 33 for guiding the puncture needle 6 is formed, an angle adjustment mechanism 35 that can adjust the insertion angle of the puncture needle 6 in multiple steps, and a probe. And a fixing portion 36 that is fitted and fixed to the lower side of the main body 12. The puncture guide attachment 14 has the puncture needle 6 positioned at the center of the transverse section indicated by the first tomographic image 8 and the puncture needle 6 at a predetermined angle along the longitudinal section indicated by the second tomographic image 9. The puncture needle 6 is guided to be inserted into 4. The puncture guide attachment 14 of the present embodiment is a resin molded part formed using a flexible resin material.

  The lower portion of the probe main body 12 has a hammerhead type outer shape (substantially T-shaped) in which the first element unit 25 disposed on the distal end side protrudes in the lateral direction (see FIGS. 2 and 4). In the puncture guide attachment 14, the fixing portion 36 is formed in an annular shape along the hammerhead type outer shape. For example, an engagement recess (not shown) is formed on the inner peripheral side of the fixed portion 36, and the engagement recess engages with an engagement protrusion (not shown) formed on the probe main body 12. A puncture guide attachment 14 is fixed to the probe body 12.

  In the puncture guide attachment 14, an angle adjustment mechanism 35 is provided at one end of the fixing portion 36, and a puncture needle guide portion 34 is detachably attached to the angle adjustment mechanism 35. The puncture needle guide part 34 protrudes at a position spaced upward from the transducer installation surface 20. The angle adjustment mechanism 35 is an adjustment mechanism that is provided so as to move the puncture needle guide portion 34 in multiple steps in the circumferential direction around the positioning portion 31 of the probe main body 12 and to be fixed at each position. The angle adjustment mechanism 35 is provided with, for example, three stages of switching positions.

  The guide groove 33 of the puncture needle guide portion 34 is formed so as to extend along the extension line L0 of the ultrasonic transducer array 27 in a projection view from the transducer installation surface 20. The puncture needle guide portion 34 is constituted by two rod-like members 40 extending in a direction parallel to the arrangement direction of the ultrasonic transducer arrays 27 in the major axis direction Y and having base end portions connected to each other. The shape seen is substantially U-shaped. A gap provided between the two bar-shaped members 40 in the puncture needle guide portion 34 is a guide groove 33. In a state where the puncture guide attachment 14 is attached to the probe body 12, the guide groove 33 is disposed on the center line L 0 of the probe body 12. The guide groove 33 is provided with an opening 41 for introducing the puncture needle 6 and a bottom portion 42 for contacting the introduced puncture needle 6. Further, the guide groove 33 of the puncture needle guide portion 34 is provided with a puncture needle introduction portion 43 formed so that the groove width gradually increases toward the opening 41 side.

  The insertion angle of the puncture needle 6 is determined by the combination of the bottom portion 42 of the guide groove 33 and the positioning portion 31 of the probe main body 12. That is, the needle tip of the puncture needle 6 is brought into contact with the positioning portion 31 of the probe body 12 and the side surface of the puncture needle 6 is brought into contact with the bottom portion 42 of the guide groove 33, thereby inserting the puncture needle 6 into the living tissue 4. The angle is determined. Further, in the puncture guide attachment 14, the angle adjustment mechanism 35 is operated to move the puncture needle guide portion 34 to change the position of the bottom portion 42 of the guide groove 33, thereby determining the bottom portion 42 and the positioning portion 31. The insertion angle of the puncture needle 6 is adjusted in multiple steps.

  Next, the electrical configuration of the angiography apparatus 1 will be described in detail.

  As shown in FIG. 2, the apparatus main body 2 of the angiography apparatus 1 includes a controller 50, a pulse generation circuit 51, a transmission circuit 52, a reception circuit 53, a signal processing circuit 54, an image processing circuit 55, a memory 56, and a storage device 57. , An input device 58, a display device 59, and the like. The controller 50 is a computer configured to include a known central processing unit (CPU), and executes a control program using the memory 56 to control the entire apparatus in an integrated manner.

  The pulse generation circuit 51 operates in response to a control signal from the controller 50, and generates and outputs a pulse signal having a predetermined period. The transmission circuit 52 includes a plurality of delay circuits (not shown) corresponding to the number of elements of the ultrasonic transducers 23 and 24 in the ultrasonic probe 3, and based on the pulse signal output from the pulse generation circuit 51, The drive pulse delayed according to the sound wave vibrators 23 and 24 is output. The delay time of each drive pulse is set so that the ultrasonic wave output from the ultrasonic probe 3 is focused at a predetermined irradiation point.

  The reception circuit 53 includes a signal amplification circuit, a delay circuit, and a phasing addition circuit (not shown). In this receiving circuit 53, each reflected wave signal (echo signal) received by each ultrasonic transducer 23, 24 in the ultrasonic probe 3 is amplified, and the delay time considering the reception directivity is each reflected wave signal. Is added to, and then phased and added. By this addition, the phase difference between the reception signals of the ultrasonic transducers 23 and 24 is adjusted.

  The signal processing circuit 54 includes a logarithmic conversion circuit, an envelope detection circuit, an A / D conversion circuit, and the like (not shown). The logarithmic conversion circuit in the signal processing circuit 54 logarithmically converts the reflected wave signal, and the envelope detection circuit detects the envelope of the output signal of the logarithmic conversion circuit. The A / D conversion circuit converts the analog signal output from the envelope detection circuit into a digital signal.

  The image processing circuit 55 performs image processing based on the reflected wave signal output from the signal processing circuit 54 and generates image data of a B-mode ultrasound image (tomographic image). Specifically, the image processing circuit 55 generates image data with luminance corresponding to the amplitude (signal intensity) of the reflected wave signal. Image data generated by the image processing circuit 55 is sequentially stored in the memory 56. Here, image data of the first tomographic image 8 showing the transverse section of the living tissue 4 and the second tomographic image 9 showing the longitudinal section of the living tissue 4 are generated and stored in the memory 56. Based on the image data for one frame stored in the memory 56, the first tomographic image 8 and the second tomographic image 9 of the living tissue 4 are displayed on the display device 59 in black and white.

  The input device 58 includes a keyboard 61, a trackball 62, and the like, and is used for inputting requests and instructions from the user. The display device 59 is, for example, a display such as an LCD or a CRT, and is used to display a first tomographic image 8 and a second tomographic image 9 (see FIG. 3) of the living tissue 4 and an input screen for various settings. .

  As shown in FIG. 3, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the display screen 10 of the display device 59 of the present embodiment. On the first tomographic image 8, a first guideline 65 indicating the direction in which the puncture needle 6 proceeds is shown to extend linearly along the vertical direction of the screen. Further, on the second tomographic image 9, a second guideline 66 indicating a course at the insertion angle of the puncture needle 6 is displayed so as to extend linearly from the upper left of the screen toward the lower right. The guide lines 65 and 66 on the first tomographic image 8 and the second tomographic image 9 are displayed with the same line type (specifically, dotted line) and line color (specifically, yellow) in the present embodiment. .

  Furthermore, on the first tomographic image 8 and the second tomographic image 9, a position display unit is displayed that indicates in advance to the operator the depth position at which the tip of the puncture needle 6 starts to be seen. In the present embodiment, a horizontal line 67 and a guide mark 68 are displayed as the position display unit. The guide mark 68 of the present embodiment is a rectangular frame-like mark displaying a tomographic image in the frame at the intersection of the guide lines 65 and 66 and the horizontal line 67 and corresponds to the tip 71 of the puncture needle 6. It has a size larger than the diameter of the image (for example, a size that is about 1.5 to 3 times larger). Further, the guide mark 68 is displayed at the same height position, the same shape and the same size on the first tomographic image 8 and the second tomographic image 9. On the second tomographic image 9, the guide mark 68 is displayed at a position at the left end of the screen and the start end of the second guideline 66.

  The horizontal line 67 is a line horizontal to the transducer installation surface 20 in the probe main body 12. The horizontal line 67 is displayed with a different line type (specifically, a one-dot chain line) and a different line color (specifically, red) from the guide lines 65 and 66. On the other hand, the guide mark 68 is displayed in the same line type (specifically dotted line) and line color (specifically yellow) as the guide lines 65 and 66.

  The storage device 57 is a magnetic disk device, an optical disk device, or the like, and stores a control program and various data in a recording medium. The controller 50 transfers programs and data from the storage device 57 to the memory 56 in accordance with instructions from the input device 58, and sequentially executes them. The program executed by the controller 50 may be a program stored in a storage medium such as a memory card, a flexible disk, or an optical disk, or a program downloaded via a communication medium, and is installed in the storage device 57 at the time of execution. Use.

  Next, an operation example when inserting the puncture needle 6 of the catheter into the vein 5 of the living tissue 4 using the angiography apparatus 1 of the present embodiment will be described.

  Here, an operator such as a doctor first determines the insertion angle of the puncture needle 6 suitable for the treatment section of the patient. Then, the operator attaches the puncture guide attachment 14 in which the position of the puncture needle guide portion 34 is set by operating the angle adjustment mechanism 35 so as to be the insertion angle to the probe body 12. Thereafter, the operator operates the keyboard 61 of the input device 58 as position information input means, and inputs position information corresponding to the set position of the insertion angle of the puncture needle 6 set by the angle adjustment mechanism 35. At this time, the controller 50 temporarily stores the position information in the memory 56.

  Further, the operator applies an acoustic medium (sterile gel or sterilized gel) to the surface of the biological tissue 4 serving as the treatment portion (for example, the surface of the forearm 4a having the vein 5 as shown in FIG. 5). The transducer installation surface 20 of the probe main body 12 is brought into contact via an acoustic medium. Thereafter, the operator operates a scan start button (not shown) provided on the input device 58. Then, the controller 50 determines the button operation, and starts processing for displaying the tomographic images 8 and 9 of the living tissue 4.

  In this process, the controller 50 operates the pulse generation circuit 51 to start transmission / reception of ultrasonic waves by the ultrasonic probe 3. Specifically, the pulse generation circuit 51 operates in response to a control signal output from the controller 50, and a pulse signal having a predetermined cycle is supplied to the transmission circuit 52. In the transmission circuit 52, a drive pulse having a delay time corresponding to each of the ultrasonic transducers 23 and 24 is generated based on the pulse signal and supplied to the ultrasonic probe 3. Thereby, each ultrasonic transducer | vibrator 23 and 24 of the ultrasonic probe 3 vibrates, and an ultrasonic wave is irradiated toward the biological tissue 4. FIG. A part of the ultrasonic wave propagating in the living tissue 4 is reflected by a tissue boundary surface (for example, blood vessel wall) in the living tissue 4 and received by the ultrasonic probe 3. At this time, the reflected waves are converted into electric signals (reflected wave signals) by the ultrasonic transducers 23 and 24 of the ultrasonic probe 3. The reflected wave signal is amplified by the receiving circuit 53 and then input to the signal processing circuit 54.

  The signal processing circuit 54 performs signal processing such as logarithmic conversion, envelope detection, and A / D conversion, and a reflected wave signal converted into a digital signal is supplied to the image processing circuit 55. The image processing circuit 55 performs image processing for generating image data of the tomographic images 8 and 9 based on the reflected wave signal. Then, the controller 50 temporarily stores each image data generated by the image processing circuit 55 in the memory 56.

  The controller 50 reads out each image data stored in the memory 56 and generates data for one frame of the first tomographic image 8 and the second tomographic image 9. Moreover, the controller 50 as an insertion angle determination means reads the positional information memorize | stored in the memory 56, and determines the insertion angle of the puncture needle 6 based on the positional information (insertion angle determination step). And the controller 50 as a guideline display means produces | generates the display data of the guidelines 65 and 66 according to the insertion angle of the puncture needle 6 (guideline display step). Further, the controller 50 as the position display means predicts the depth position at which the tip of the puncture needle 6 starts to appear in the first tomographic image 8 and the second tomographic image 9 based on the insertion angle of the puncture needle 6. Then, display data of a position display section (horizontal line 67 and guide mark 68) indicating the depth position in advance for the operator is generated (position display step).

  Thereafter, the controller 50 outputs the data of the generated tomographic images 8 and 9 to the display device 59, and outputs the display data of the guide lines 65 and 66, the horizontal line 67 and the guide mark 68 to the display device 59. As a result, as shown in FIG. 3, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the display screen 10 of the display device 59 at the same time, and the guideline 65 is displayed on each tomographic image 8, 9. 66, a horizontal line 67 and a guide mark 68 are displayed in a superimposed manner.

  The operator confirms the first tomographic image 8 and the second tomographic image 9 displayed on the display device 59 and adjusts the position of the ultrasonic probe 3. Specifically, first, as shown in FIG. 5 and FIG. 6, the operator takes a cross section of the vein 5 on the first tomographic image 8 (short axis image) and on the first tomographic image 8. The first element unit 25 side of the ultrasonic probe 3 is moved so that the first guideline 65 is positioned at the center of the vein 5. Further, as shown in FIG. 5 and FIG. 7, the second element unit 26 side of the ultrasonic probe 3 is so photographed that a longitudinal section of the vein 5 is photographed along the second tomographic image 9 (long axis image). Is moved so that the direction (axial direction) in which the vein 5 extends and the major axis direction Y of the probe main body 12 coincide with each other. At this time, in a state where the position of the ultrasonic probe 3 on the first element unit 25 side (short axis side) is kept, the second element unit 26 side (long axis side) which is the rear side is swung left and right. Perform alignment.

  Based on the horizontal line 67 and the guide mark 68 on the first tomographic image 8 and the second tomographic image 9 and the second guideline 66 on the second tomographic image 9, the operator determines that the insertion angle of the puncture needle 6 is a vein. It is determined whether the angle is suitable for puncturing 5. As shown in FIG. 7, the horizontal line 67 and the guide mark 68 are above the treatment portion for puncturing the vein 5, and the insertion angle of the puncture needle 6 is an angle suitable for puncturing the vein 5. When it is determined that there is, the operator introduces the puncture needle 6 of the catheter through the opening 41 of the guide groove 33 in the puncture needle guide portion 34 of the puncture guide attachment 14. Then, the operator brings the needle tip of the puncture needle 6 into contact with the position of the positioning portion 31 of the probe main body 12, and after bringing the side surface of the puncture needle 6 into contact with the bottom 42 of the guide groove 33, The puncture needle 6 is inserted into the (forearm 4a). Then, as shown in FIG. 3, the puncture needle 6 is displayed in the first tomographic image 8 and the second tomographic image 9. Here, after the puncture needle 6 is displayed in the frame of the guide mark 68 in the first tomographic image 8, the puncture needle 6 is displayed in the frame of the guide mark 68 in the second tomographic image 9. The operator inserts the puncture needle 6 while confirming the insertion position of the puncture needle 6 along the second guideline 66 in the second tomographic image 9.

  When the distal end 71 of the puncture needle 6 reaches the blood vessel wall of the vein 5, the distal end 71 does not penetrate the blood vessel wall, and the blood vessel wall is recessed in a tent shape (tenting). When the operator determines that the tenting has sufficiently progressed based on the dent of the blood vessel wall, the operator moves the rear end side of the puncture needle 6 along the guide groove 33 toward the opening 41. As a result, the insertion angle of the puncture needle 6 is changed so that the puncture needle 6 extends along the direction of the vein 5, so that the distal end 71 of the puncture needle 6 easily penetrates the blood vessel wall of the vein 5. Is inserted into the blood vessel. As shown in FIG. 8, the operator confirms that the tip 71 of the puncture needle 6 has reached the vein 5 based on the second tomographic image 9 and stops the puncture operation of the puncture needle 6.

  On the other hand, as shown in FIGS. 9 and 10, when the vein 5 for puncturing is at a relatively shallow position, the horizontal line 67 and the guide mark 68 are below the treatment portion for puncturing the vein 5. There is. In this case, when the puncture needle 6 is punctured as described above, when the puncture needle 6 starts to appear in the first tomographic image 8 and the second tomographic image 9 as shown in FIG. The tip 71 penetrates the blood vessel wall, and it is difficult to stop the puncture operation of the puncture needle 6 in the vein 5.

  Therefore, when the horizontal line 67 and the guide mark 68 are below the treatment portion for puncturing the vein 5, the operator determines that there is a problem with the insertion angle of the puncture needle 6. Then, the position of the puncture needle guide 34 is reset by operating the angle adjustment mechanism 35 so as to obtain an appropriate insertion angle. Specifically, the operator adjusts the position of the puncture needle guide portion 34 by operating the angle adjustment mechanism 35 so that the inclination angle of the puncture needle 6 is reduced. Thereafter, the operator operates the keyboard 61 of the input device 58 and inputs position information corresponding to the insertion angle of the puncture needle 6 set by the angle adjustment mechanism 35 again. The controller 50 generates display data of the position display unit (the horizontal line 67 and the guide mark 68) based on the position information, and outputs the display data to the display device 59. As a result, as shown in FIG. 12, in the first tomographic image 8 and the second tomographic image 9, the horizontal line 67 and the guide mark 68 are displayed at a position above the treatment portion for puncturing the vein 5. . For this reason, it is possible to puncture the vein 5 after confirming the position of the tip 71 of the puncture needle 6 in the first tomographic image 8 and the second tomographic image 9. That is, the operator can determine from the first tomographic image 8 and the second tomographic image 9 that the tenting has sufficiently progressed, and after that, insert the puncture needle 6 into the blood vessel wall of the vein 5. To do. Then, based on the second tomographic image 9, the operator confirms that the tip 71 of the puncture needle 6 has reached the vein 5 and stops the puncture operation of the puncture needle 6.

  Thereafter, the operator operates a scan end button (not shown) provided on the input device 58. The controller 50 determines the button operation, and ends the process for displaying the tomographic images 8 and 9 of the living tissue 4. Further, the operator moves the probe main body 12 along the guide groove 33 while maintaining the puncture state of the puncture needle 6 (while leaving the puncture route). Then, the operator removes the ultrasonic probe 3 (the puncture guide attachment 14 and the probe main body 12) from the puncture needle 6 through the opening 41 of the guide groove 33. Thereafter, the operator performs a catheter operation, inserts the catheter into the vein 5 and performs a predetermined treatment.

  Therefore, according to the present embodiment, the following effects can be obtained.

  (1) In the angiography apparatus 1 of the present embodiment, the depth position at which the tip 71 of the puncture needle 6 begins to be visible in the first tomographic image 8 and the second tomographic image 9 based on the insertion angle of the puncture needle 6. Is predicted, and a horizontal line 67 and a guide mark 68 indicating the position in advance to the operator are displayed. In this way, the doctor (operator) can easily determine the depth position at which the puncture needle 6 starts to appear in the first tomographic image 8 and the second tomographic image 9 by checking the horizontal line 67 and the guide mark 68. I can foresee. As a result, it is possible to determine whether or not the moment when the puncture needle 6 reaches the treatment part (specifically, the vein 5) of the living tissue 4a can be captured by the tomographic images 8 and 9 before the puncture is started. it can. If it is determined that the puncture needle 6 cannot be captured, the insertion angle of the puncture needle 6 can be reset. In the present embodiment, the path of the puncture needle 6 and the insertion angle of the puncture needle 6 can be confirmed by the guide lines 65 and 66. For this reason, it is possible to reliably puncture the vein 5 with the puncture needle 6 while reducing the psychological burden on the operator.

  (2) In the angiography apparatus 1 of the present embodiment, the guide mark 68 is a frame-like mark that displays a tomographic image in a frame that is an intersection position between the guide lines 65 and 66 and the horizontal line 67. The guide mark 68 has a size larger than the diameter of the image corresponding to the tip 71 of the puncture needle 6. In this way, since the tomographic image is displayed until the puncture needle 6 begins to appear within the frame of the guide mark 68, the moment when the puncture needle 6 begins to appear without being hidden by the guide lines 65, 66 and the horizontal line 67. Can be confirmed more reliably. Further, since the guide marks 68 displayed on the first tomographic image 8 and the second tomographic image 9 have the same shape and the same size, the position where the puncture needle 6 starts to be seen in each of the tomographic images 8 and 9 can be confirmed relatively easily. can do.

  (3) In the angiography apparatus 1 of the present embodiment, the horizontal line 67 and the guide mark 68 are a one-dot chain line and a dotted line, and an image is partially displayed from the gap between the one-dot chain line and the dotted line. Compared with the case where the guide mark 68 is displayed with a solid line, the vein 5 and the surrounding structure can be easily grasped.

  (4) In the angiography apparatus 1 of the present embodiment, the horizontal line 67 is displayed in a color (red) different from the color of the guide lines 65 and 66 (yellow), and a line different from the line type (dotted line) of the guide line 65 A horizontal line 67 is displayed with a seed (one-dot chain line). In this way, the depth position of the puncture needle 6 indicated by the horizontal line 67 can be easily determined.

  In addition, you may change embodiment of this invention as follows.

  In the angiography apparatus 1 of the above embodiment, the horizontal line 67 is displayed as the position display unit on the first tomographic image 8 and the second tomographic image 9, but the present invention is not limited to this. . Specifically, on the first tomographic image 8 and the second tomographic image 9, an image of a region above the depth position at which the tip 71 of the puncture needle 6 begins to appear has an intensity or color different from that of the lower region. By displaying in shades, a line-shaped boundary between images in each region may be seen as a position display unit.

  In the angiography apparatus 1 of the above-described embodiment, the horizontal line 67 and the guide mark 68 as the position display unit are displayed on the first tomographic image 8 and the second tomographic image 9. It may be configured to display only. In this case, the operator can predict the position where the tip of the puncture needle 6 starts to be seen by confirming the intersection position of the guide lines 65 and 66 and the horizontal line 67 displayed in the tomographic images 8 and 9. it can. In addition, the guide mark 68 is displayed on both the first tomographic image 8 and the second tomographic image 9, but may be displayed on at least one of the images. For example, when the guide mark 68 is displayed only on the first tomographic image 8, the guide mark 68 confirms the position where the puncture needle 6 starts to appear in the first tomographic image 8 in which the puncture needle 6 is displayed first. Can do. Even if the guide mark 68 is not displayed on the second tomographic image 9, the puncture needle 6 is displayed in the second tomographic image 9 based on the puncture needle 6 displayed in the guide mark 68 of the first tomographic image 8. The depth position at which it can begin to be seen can be predicted. Further, when the guide mark 68 is displayed only on the second tomographic image 9, the depth position at which the puncture needle 6 starts to appear in the second tomographic image 9 can be reliably predicted.

  In the angiography apparatus 1 of the above-described embodiment, a selection function for setting display or non-display for the horizontal line 67 and the guide mark 68 may be provided. Specifically, the controller 50 displays a selection button for setting the horizontal line 67 and the guide mark 68 to display or non-display on the setting screen of the display device 59. Then, the controller 50 displays or deletes the horizontal line 67 and the guide mark 68 on the first tomographic image 8 and the second tomographic image 9 based on the operator's button operation. For example, a skilled worker accustomed to the operation of the angiography apparatus 1 predicts a position where the tip of the puncture needle 6 begins to be visible based on the positions of the guide lines 65 and 66 displayed in the tomographic images 8 and 9. be able to. For this reason, when a skilled worker uses the angiography apparatus 1, the puncture needle 6 may be punctured without displaying the horizontal line 67 and the guide mark 68. Further, when used by an operator who is not familiar with the operation of the angiography apparatus 1, the puncture needle 6 can be punctured reliably and securely by displaying the horizontal line 67 and the guide mark 68. .

  In the above embodiment, the guide mark 68 as the position display unit has a quadrangular frame shape, but may have a triangular or circular frame shape. Further, the guide mark 68 is not limited to the frame-shaped mark, and may be a cross-shaped mark, a dot-shaped mark, or the like as long as the position can be recognized.

  In the angiography apparatus 1 of the above-described embodiment, the insertion angle of the puncture needle 6 is determined based on position information input by operating the keyboard 61, but is not limited to this. Specifically, for example, the angle adjustment mechanism 35 is provided with position detection means (sensor or switch) for detecting the insertion angle of the puncture needle 6. The controller 50 may be configured to display the horizontal line 67 and the guide mark 68 on the tomographic images 8 and 9 based on the insertion angle of the puncture needle 6 detected by the position detection means. In this way, since the insertion angle of the puncture needle 6 according to the operation position of the angle adjustment mechanism 35 can be automatically determined, the puncture needle 6 can be punctured quickly.

  In the angiography apparatus 1 of the above embodiment, the tomographic images 8 and 9 of the vein 5 are displayed and the treatment using the catheter is performed, but the angiography apparatus is used when performing other treatment such as blood sampling. 1 may be used. Further, the present invention is not limited to the angiography apparatus 1, and the present invention may be embodied in an ultrasonic image display apparatus that displays a tomographic image of a nerve other than a blood vessel and performs other treatment such as nerve block injection. .

  Next, in addition to the technical ideas described in the claims, the technical ideas grasped by the embodiments described above are listed below.

  (1) The ultrasonic image display device according to claim 2, wherein the horizontal line is a line parallel to a transducer installation surface in the probe body.

  (2) In Claim 1, in the first tomographic image and the second tomographic image, the position display means displays an image of an area above the depth position at which the tip of the puncture needle begins to appear in the lower area. An ultrasonic image display device characterized in that a line-shaped boundary between images in each region is made visible as the position display unit by displaying the image with a luminance different from that of the image or with different shades of color.

DESCRIPTION OF SYMBOLS 1 ... Angiography apparatus as an ultrasonic image display apparatus 3 ... Ultrasonic probe 4 ... Living tissue as a subject 4a ... Forearm as a subject 5 ... Vein in a subject 6 ... Puncture needle 8 ... First tomographic image 9 ... second tomographic image 10 ... screen 12 ... probe body 14 ... puncture guide attachment 23 ... first ultrasonic transducer as an ultrasonic transducer 24 ... second ultrasonic transducer 35 as an ultrasonic transducer 35 ... Angle adjusting mechanism 50... Controller as insertion angle determination means, guideline display means and position display means 57... Storage device provided with recording medium 58... Input device as position information input means 65... First guideline 66. 67 ... Horizontal line 68 ... Guide mark 71 ... Tip of puncture needle

Claims (11)

A plurality of ultrasonic transducers for linearly scanning ultrasonic waves are orthogonal to obtain a first tomographic image showing a cross section of a subject and a second tomographic image showing a vertical cross section in a direction crossing the cross section. A probe body arranged to
A puncture guide attachment that is fixed to the probe body and guides the puncture needle so that the puncture needle is inserted into the subject at a predetermined angle along the longitudinal section indicated by the second tomographic image. An ultrasonic probe provided with an angle adjustment mechanism capable of adjusting the insertion angle of the puncture needle in a multi-step manner on the puncture guide attachment, and transmitting and receiving the ultrasonic wave, An ultrasonic image display device that simultaneously displays the second tomographic image on the same screen,
An insertion angle determination means for determining an insertion angle of the puncture needle in the puncture guide attachment;
A first guideline indicating a direction in which the puncture needle advances is displayed on the first tomographic image, and a second guideline indicating a course at the insertion angle of the puncture needle is displayed on the second tomographic image. Guideline display means to
Based on the insertion angle of the puncture needle determined by the insertion angle determination means, the depth position where the tip of the puncture needle begins to be visible is predicted in the first tomographic image and the second tomographic image, and the operator An ultrasonic image display device comprising: position display means for displaying a horizontal line as a position display unit that indicates the position in advance. The position display means displays a guide mark as the position display unit at an intersection position between the guide line and the horizontal line in at least one of the first tomographic image and the second tomographic image. The ultrasonic image display device according to claim 1 . The ultrasonic image display device according to claim 2 , wherein the guide mark is a frame-like mark in which a tomographic image is displayed in a frame that is the intersection position. The ultrasonic image display apparatus according to claim 3 , wherein the guide mark has a size larger than a diameter of an image corresponding to a tip of the puncture needle. The superposition according to any one of claims 2 to 4 , wherein the position display means displays the guide mark having the same shape and the same size in the first tomographic image and the second tomographic image. Sound image display device. The ultrasonic image display device according to claim 2, wherein the guide mark and the horizontal line are broken lines. It said position display means, an ultrasonic image display apparatus according to any one of claims 1 to 6, characterized in that displaying the horizontal line in a color different from the guideline. It said position display means, an ultrasonic image display apparatus according to any one of claims 1 to 7, wherein the displaying the horizontal line in a different line types with said guidelines. Position information input means for inputting position information according to a setting position of an insertion angle of the puncture needle in the puncture guide attachment,
The said insertion angle determination means judges the insertion angle of the said puncture needle based on the said positional information input by the said positional information input means, The any one of Claim 1 thru | or 8 characterized by the above-mentioned. Ultrasonic image display device. A plurality of ultrasonic transducers for linearly scanning ultrasonic waves are orthogonal to obtain a first tomographic image showing a cross section of a subject and a second tomographic image showing a vertical cross section in a direction crossing the cross section. A probe body arranged to
A puncture guide attachment that is fixed to the probe body and guides the puncture needle so that the puncture needle is inserted into the subject at a predetermined angle along the longitudinal section indicated by the second tomographic image. An ultrasonic probe provided with an angle adjustment mechanism capable of adjusting the insertion angle of the puncture needle in a multi-step manner on the puncture guide attachment, and transmitting and receiving the ultrasonic wave, In the method of simultaneously displaying the second tomographic image on the same screen,
An insertion angle determination step of determining an insertion angle of the puncture needle in the puncture guide attachment;
A first guideline indicating a direction in which the puncture needle advances is displayed on the first tomographic image, and a second guideline indicating a course at the insertion angle of the puncture needle is displayed on the second tomographic image. A guideline display step,
Based on the insertion angle of the puncture needle determined by the insertion angle determination means, the depth position where the tip of the puncture needle begins to be visible is predicted in the first tomographic image and the second tomographic image, and the operator ultrasonic method for operating an image display apparatus which comprises a position display step of displaying the horizontal line of the position display unit showing the position in advance with respect to. A plurality of ultrasonic transducers for linearly scanning ultrasonic waves are orthogonal to obtain a first tomographic image showing a cross section of a subject and a second tomographic image showing a vertical cross section in a direction crossing the cross section. A probe body arranged to
A puncture guide attachment that is fixed to the probe body and guides the puncture needle so that the puncture needle is inserted into the subject at a predetermined angle along the longitudinal section indicated by the second tomographic image. An ultrasonic probe provided with an angle adjustment mechanism capable of adjusting the insertion angle of the puncture needle in a multi-step manner on the puncture guide attachment, and transmitting and receiving the ultrasonic wave, A computer built in an ultrasonic image display device for simultaneously displaying the second tomographic image on the same screen;
An insertion angle determining means for determining an insertion angle of a puncture needle in the puncture guide attachment;
A first guideline indicating a direction in which the puncture needle advances is displayed on the first tomographic image, and a second guideline indicating a course at the insertion angle of the puncture needle is displayed on the second tomographic image. Guideline display means to
Based on the insertion angle of the puncture needle determined by the insertion angle determination means, the depth position where the tip of the puncture needle begins to be visible is predicted in the first tomographic image and the second tomographic image, and the operator The recording medium which stored the program for making it operate | move as a position display means to display the horizontal line as a position display part which shows the position previously.

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