JP6055565B1 - Ultrasonic diagnostic equipment - Google Patents

Abstract

An automated technique for measuring a heart by ultrasonic waves is provided. A cross section determination unit 41 determines the type of a cross section of a heart represented by a moving image by image recognition processing for a plurality of frames constituting an ultrasonic moving image selected by an image selection unit 30. The part specifying unit 42 specifies a measurement target part from candidate parts corresponding to the type of cross section. The measurement range selection unit 43 selects a plurality of frames to be measured from a plurality of frames constituting the moving image to be measured. The tracking point setting unit 44 sets a plurality of tracking points on the contour of the measurement target part within the reference frame included in the plurality of measurement target frames. The tracking processing unit 45 executes tracking processing for a plurality of tracking points. The measurement unit 46 performs measurement related to the measurement target part based on the result of the tracking process. [Selection] Figure 1

Description

  The present invention relates to an ultrasonic diagnostic apparatus, and more particularly to measurement of a heart using ultrasonic waves.

  An ultrasonic diagnostic apparatus is an apparatus that forms and displays an ultrasonic image based on reception data obtained by transmitting and receiving ultrasonic waves. Generally, an ultrasonic diagnostic apparatus has a plurality of operation modes (B mode, Doppler mode, etc.). Furthermore, an ultrasonic diagnostic apparatus having a plurality of measurement functions is also known. A suitable example of such a measurement function is a measurement function related to the heart.

  For example, Patent Document 1 describes a technique for identifying the type of an ultrasonic tomographic image as a technique for supporting measurement of the heart by ultrasonic waves. Patent Document 2 describes a technique for extracting the contour of a target part such as a heart in a medical image such as an ultrasonic image.

Japanese Patent No. 5242163 Japanese Patent No. 575794

  In the measurement of the heart by ultrasonic waves, a number of procedures such as selection of a measurement (analysis) type, selection of a measurement cross section, selection of a measurement site, and setting of the contour of the measurement site are required. In the past, it has been common to rely on operations from users such as doctors and laboratory technicians for all or most of these many procedures. Leaving complicated operations related to measurement to the user increases the burden on the user, and there is also a concern that measurement reproducibility and objectivity may be reduced due to variations in judgment according to the user's skill and experience value. .

  An object of the present invention is to provide an automated technique for measuring a heart by ultrasonic waves.

  An ultrasonic diagnostic apparatus suitable for the above object determines the type of a cross section of the heart represented by the moving image by image recognition processing for at least one of a plurality of frames constituting the ultrasonic moving image. A determination unit, a specifying unit that specifies a measurement target part from at least one candidate part corresponding to the type of the cross section, and at least a part of the plurality of frames, and subjecting the measurement target part to a trace process A processing unit that executes tracking processing of a plurality of representative locations obtained by application, and a measurement unit that executes measurement according to the type of the cross section related to the measurement target portion based on the result of the tracking processing It is characterized by that.

  In the above configuration, for example, image information inherent in each frame (each cross section) constituting the moving image is used by the image recognition process, and the type of the cross section of the heart represented by the moving image is determined. By actively using the inherent information inherent in the moving image, it is possible to reduce the operation for selecting a cross section by the user, and it is possible to make the operation unnecessary.

  In the measurement of the heart, generally, for example, one or more of the left ventricle, the right ventricle, the left atrium, and the right atrium are set as measurement target parts (parts to be measured). And the kind of desirable section according to measurement about a measurement object part and the measurement object part is defined medically.

  Therefore, when the type of the cross section is determined by the image recognition process, it is possible to narrow down a part (candidate part) that is a candidate for the measurement target part from the type of the cross section. The specifying unit having the above configuration specifies a measurement target part from at least one candidate part corresponding to the type of cross section. For example, if there is only one candidate part, that candidate part is set as a measurement target part, and if there are a plurality of candidate parts, a candidate part selected in advance (preset) is set as a measurement target part. When there are a plurality of candidate parts, the user may select a measurement target part from among the candidate parts. Even in this case, the burden on the user in selecting the measurement target part can be reduced by narrowing down the number of candidate parts according to the type of the cross section.

  Furthermore, the measurement unit configured as described above performs measurement according to the type of cross section related to the measurement target region. As described above, from the medical knowledge, the desired cross-section type corresponding to the measurement target region and the measurement related to the measurement target region is determined. Therefore, if the cross-sectional type and the measurement target part are specified, the measurement items related to the measurement target part can be specified or narrowed down. For example, the measurement unit having the above-described configuration automatically (without user operation) performs measurement according to the type of cross section related to the measurement target region.

  As described above, according to the configuration described above, in the measurement of the heart, user operations for specifying the type of cross section and specifying the measurement target part are reduced, and the user operation is desirably unnecessary. More preferably, it is possible to automatically execute measurement according to the type of cross section related to the measurement target part.

  In a preferred embodiment, the determination unit includes, as the types of cross sections, a left ventricular long axis cross section obtained by a parasternal approach, a left ventricular short axis cross section, and a four-chamber cross section and a three-chamber cross section obtained by an apex approach. And at least one cross section corresponding to the moving image is specified from a plurality of cross sections including the two-chamber cross section.

  In a preferred specific example, the specifying unit specifies at least one of a left ventricle, a right ventricle, a left atrium, a right atrium, and an aorta of the heart as the measurement target site.

  In a desirable specific example, the ultrasonic diagnostic apparatus includes a selection unit that selects a plurality of frames to be measured from a plurality of frames constituting the moving image based on preset data designating a measurement range in a time axis direction. In addition, the processing unit is characterized in that the tracking process is executed for a plurality of frames to be measured.

  In a preferred embodiment, the ultrasonic diagnostic apparatus applies the trace processing to the measurement target portion in a reference frame included in a plurality of frames selected as an analysis target from a plurality of frames constituting the moving image. Thus, it further includes a setting unit that sets a plurality of tracking points on the outline of the measurement target region as the plurality of representative locations, and the processing unit includes the tracking points over a plurality of frames to be analyzed. The tracking process is executed every time.

  In a desirable specific example, the setting unit executes the trace processing using an algorithm selected according to the type of the cross section and the measurement target region.

  In a desirable specific example, the ultrasonic diagnostic apparatus performs measurement for at least one of a plurality of measurement items determined for each analysis mode according to the type of the cross section, and according to the analysis mode. The measurement result is displayed on the display screen.

  In addition, the function corresponding to each part with which the ultrasonic diagnostic apparatus demonstrated above is provided may be implement | achieved by computer. For example, the functions of the determination unit, the identification unit, the processing unit, the measurement unit, the selection unit, and the setting unit configured as described above may be realized by a computer, and the computer may function as an ultrasonic diagnostic apparatus.

  According to the present invention, an automated technique for measuring a heart by ultrasonic waves is provided.

It is a figure which shows the specific example of a suitable ultrasonic diagnostic apparatus in implementation of this invention. It is a figure which shows the list of the algorithms utilized in each analysis mode of apex section analysis mode and short-axis section analysis mode. It is a figure which shows the list of the algorithm utilized in the apex part cross-section capacity | capacitance analysis mode. It is a figure which shows the specific example of the several measurement item defined for every analysis mode. It is a figure which shows the specific example of the preset data memorize | stored in a preset memory | storage part. It is a figure which shows the specific example of the setting screen utilized for the setting of preset data. It is a figure which shows the specific example of the analysis screen displayed on a display part. It is a flowchart which shows the specific example of a measurement process.

  FIG. 1 is a diagram showing a specific example of an ultrasonic diagnostic apparatus suitable for implementing the present invention. The ultrasonic diagnostic apparatus of FIG. 1 has a heart measurement function.

  The probe 10 is an ultrasonic probe that transmits and receives an ultrasonic wave to and from a region including a heart in a living body. The probe 10 includes a plurality of vibration elements, and the plurality of vibration elements are electronically scanned and scanned with an ultrasonic beam in a space including the heart. The probe 10 is used, for example, by being held by a user such as a doctor or a laboratory technician and contacting the body surface of the subject. Note that the probe 10 may be a probe that combines electronic scanning and mechanical scanning.

  The transmission / reception unit 12 has functions of a transmission beam former and a reception beam former. That is, the transmission / reception unit 12 forms a transmission beam by outputting a transmission signal to each of the plurality of vibration elements included in the probe 10, and further receives a plurality of reception signals obtained from the plurality of vibration elements. A reception beam is formed by performing phasing addition processing or the like. As a result, an ultrasonic beam (transmission beam and reception beam) is scanned in the scanning plane, and reception signals (reception data) corresponding to the ultrasonic beam are collected, while a plurality of frames (a plurality of scans) corresponding to a plurality of time phases are collected. Frame) is formed. In order to obtain an ultrasonic reception signal, the ultrasonic beam may be scanned three-dimensionally in the tertiary space, or a technique such as transmission aperture synthesis may be used.

  The image forming unit 20 forms an ultrasonic image (image data) based on an ultrasonic reception signal (reception data) constituting each frame obtained from the transmission / reception unit 12. For example, the image forming unit 20 forms a B-mode image of a plurality of frames by performing detection processing, filtering processing, AD conversion processing, and the like on the ultrasonic reception signal.

  The image forming unit 20 forms image data in a scanning coordinate system corresponding to ultrasonic scanning, for example, an rθ coordinate system with an r direction corresponding to the beam depth direction and a θ direction corresponding to the beam scanning direction. Image data obtained in a scanning coordinate system (for example, rθ coordinate system) is preferably subjected to coordinate conversion processing by, for example, a digital scan converter, and converted to image data in a display coordinate system (for example, xy orthogonal coordinate system). . The function of the digital scan converter is provided in the image forming unit 20 or the display processing unit 50, for example.

  The image storage unit 22 stores image files of a plurality of ultrasonic moving images. Each image file is data of a moving image composed of a plurality of frames of tomographic images (moving B-mode images) formed in the image forming unit 20. The image storage unit 22 stores, for example, a plurality of image files corresponding to a plurality of dates and times relating to the same subject's heart, a plurality of image files relating to a plurality of subject's hearts, and the like.

  In addition, it is desirable that each image file stored in the image storage unit 22 is associated with electrocardiographic waveform information. That is, it is desirable that the time phases of a plurality of frames constituting each image file and the time phases of the electrocardiographic waveform are associated with each other. Thereby, for example, it is possible to specify a frame corresponding to a characteristic time phase (for example, an R wave) in an electrocardiographic waveform among a plurality of frames constituting each image file.

  The image selection unit 30 selects each image file used for heart measurement from a plurality of image files stored in the image storage unit 22. For example, a display image (a list of thumbnail images of typical frames included in each image file) indicating the contents of a plurality of image files stored in the image storage unit 22 is displayed on the display unit 52, and a doctor or a laboratory technician By operating the operation device 60 while viewing the display image, the user designates at least one image file used for heart measurement. The image selection unit 30 selects at least one image file designated by the user.

  The measurement processing block 40 executes processing related to heart measurement based on each image file selected by the image selection unit 30. The measurement processing block 40 includes a cross-section determination unit 41, a part specifying unit 42, a measurement range selection unit 43, a tracking point setting unit 44, a tracking processing unit 45, a measurement unit 46, and a preset storage unit 47. Processing related to measurement executed in the measurement processing block 40 will be described in detail later.

  The display processing unit 50 forms a display image including a moving image related to the cross section of the heart based on the tomographic images of a plurality of frames obtained from the image forming unit 20. The display processing unit 50 also displays a moving image corresponding to each image file stored in the image storage unit 22 and a display image (for example, each image file) indicating the contents of a plurality of image files stored in the image storage unit 22. A list of thumbnail images of representative frames included). Further, the display processing unit 50 forms a display image related to the measurement of the heart based on each measurement image file selected by the image selection unit 30 and the measurement result obtained from the measurement processing block 40. The display image formed in the display processing unit 50 is displayed on the display unit 52.

  The control unit 100 generally controls the inside of the ultrasonic diagnostic apparatus in FIG. The overall control by the control unit 100 also reflects an instruction received from a user such as a doctor or a laboratory technician via the operation device 60.

  Among the configurations shown in FIG. 1 (respectively assigned parts), the transmission / reception unit 12, the image forming unit 20, the image selection unit 30, the cross-section determination unit 41, the site identification unit 42, the measurement range selection unit 43, and the tracking point setting unit 44. The tracking processing unit 45, the measurement unit 46, and the display processing unit 50 can be realized by using hardware such as an electric / electronic circuit or a processor. It may be used. Further, at least a part of the functions corresponding to the above-described units may be realized by a computer. That is, at least a part of the functions corresponding to the above-described units may be realized by cooperation between hardware such as a CPU, a processor, and a memory and software (program) that defines the operation of the CPU and the processor.

  The image storage unit 22 and the preset storage unit 47 can be realized by a storage device such as a semiconductor memory or a hard disk drive. A preferred specific example of the display unit 52 is a liquid crystal monitor or the like. The operation device 60 can be realized by at least one of a mouse, a keyboard, a trackball, a touch panel, and other switches, for example. And the control part 100 is realizable by cooperation with hardwares, such as CPU, a processor, a memory, and the software (program) which prescribes | regulates operation | movement of CPU, a processor, for example.

  The overall configuration of the ultrasonic diagnostic apparatus in FIG. 1 is as described above. Next, processing and functions related to heart measurement realized by the ultrasonic diagnostic apparatus of FIG. 1 will be described in detail. In addition, about the structure (part) shown in FIG. 1, the code | symbol of FIG. 1 is utilized in the following description.

  In ultrasonic diagnosis of the heart, various ultrasonic images are used depending on the purpose of diagnosis. For example, the left ventricular major axis and the left ventricular minor axis section obtained by the parasternal approach, the four-chamber section, the three-chamber section, and the two-chamber section obtained by the apex approach are particularly used. The four-chamber section shows the four chambers of the left ventricle, right ventricle, left atrium, and right atrium, the three-chamber section shows the left ventricle, the left atrium, and the aorta, and the two-chamber section shows the left ventricle and the left atrium. The bunch is projected. A user such as a doctor or a laboratory technician designates each image file to be used for diagnosis (measurement) from among a plurality of image files related to the moving image of the heart stored in the image storage unit 22, for example, and the image selection unit 30. Selects the image file.

  The measurement processing block 40 performs a measurement process described in detail below on each image file selected by the image selection unit 30. In the following description, processing relating to one image file (each image file) selected by the image selection unit 30 will be described in detail. When a plurality of image files are selected by the image selection unit 30, a process described in detail below may be executed for each image file.

  The cross section determination unit 41 determines the type of the cross section of the heart represented by the moving image to be measured. The slice determination unit 41 performs image recognition processing on at least one frame of a plurality of frames constituting each image file selected by the image selection unit 30, and displays the cross section of the heart represented by the image file (moving image). Determine the type. The cross-section determination unit 41 includes, as types of cross-sections, a long-axis cross section of the left ventricle obtained by the parasternal approach, a short-axis cross-section of the left ventricle, a four-chamber cross section, a three-chamber cross section, and a two-chamber cross section obtained by the apex approach. At least one cross-section corresponding to the moving image to be measured is specified from among a plurality of cross-sections including.

  The cross-section determination unit 41 may use any of various known image recognition processes. For example, a technique related to the image recognition process described in Patent Document 1 (Japanese Patent No. 5242163) is used. It is desirable to determine the type of cross section. The outline of the determination process using the technique of Patent Document 1 is as follows.

  First, a reference template (reference template) is prepared in advance for each type of cross section. For example, a reference template is prepared for each of the left ventricular long-axis cross-section, left ventricular short-axis cross-section, four-chamber cross-section, three-chamber cross-section, and two-chamber cross-section. The section determination unit 41 applies a process detailed in Patent Document 1 to at least one frame among a plurality of frames constituting each measurement target image file selected by the image selection unit 30 to form a template. To do. Then, by applying the process detailed in Patent Document 1 to the templated measurement target frame and the reference template of each cross section, which reference template the measurement target frame corresponds to (Which reference template and the difference in the matching result is equal to or less than the threshold value) are determined.

  For example, if the measurement target frame corresponds to the left ventricular long-axis cross-section reference template, it is determined that the cross-sectional type of the image file from which the measurement target frame is obtained is “long-axis cross-section”. If the measurement target frame corresponds to the left ventricular short-axis cross-section reference template, it is determined that the type of cross-section of the image file from which the measurement target frame is obtained is “short-axis cross-section”. Similarly, if the reference templates correspond to the four-chamber cross-section, the three-chamber cross-section, and the two-chamber cross-section, they are determined as “four-chamber cross-section”, “three-chamber cross-section”, or “two-chamber cross-section”, respectively. Further, if there is no corresponding reference template (the difference between the matching results is equal to or less than the threshold value), it is determined that the cross-sectional type is “other”.

  The “short-axis cross section” is further detailed according to the position of the cross-section, for example, mitral valve level left ventricular short axis image, apex level left ventricular short axis image, papillary muscle level left ventricular short axis image, etc. The types of cross sections may be classified.

  It is desirable that the measurement target frame and the reference template for each cross section correspond to the same heartbeat time phase. For example, it is desirable that both the measurement target frame and the reference template for each cross section correspond to the time phase of the R wave in the electrocardiogram waveform. In addition, multiple measurement target frames obtained from the same image file (same moving image) are templated and collated with multiple reference templates prepared for each cross section. The accuracy of the determination may be improved by determining a typical cross section.

  The part specifying unit 42 specifies a measurement target part from at least one candidate part corresponding to the type of cross section. The part specifying unit 42 specifies at least one of the left ventricle, right ventricle, left atrium, and right atrium of the heart as a measurement target part. For example, if the type of cross section of each image file to be measured is “long axis cross section” or “short axis cross section”, the candidate site is only the left ventricle and the measurement target site is the left ventricle.

  On the other hand, if the cross-section type of each image file to be measured is “four-chamber cross-section”, the candidate sites are the four chambers of the left ventricle, right ventricle, left atrium, and right atrium. A measurement target part is specified. In this case, the part specifying unit 42 specifies the measurement target part in accordance with, for example, preset data stored in the preset storage unit 47 or according to an instruction from the user. For example, when the cross-section type is “four-chamber cross section”, if the left ventricle is preset as the measurement target part, the left ventricle is set as the measurement target part, and if the right ventricle is preset, the right ventricle is set as the measurement target part. It is said. For example, when the user designates the left atrium or the right atrium using the operation device 60, the left atrium or the right atrium designated by the user is set as the measurement target region.

  Similarly, if the cross-sectional type of each image file to be measured is “three-chamber cross-section”, the three-chamber cross-section includes the left ventricle, left atrium, and aorta, so the candidate sites are the left ventricle, left The region specifying unit 42 specifies the left ventricle, the left atrium, or the aorta as a measurement target region in accordance with, for example, preset data stored in the preset storage unit 47 or according to an instruction from the user. Even when the cross-sectional type of each image file to be measured is “two-chamber cross-section”, the candidate sites are the left ventricle and the left atrium, and the site specifying unit 42, for example, according to preset data stored in the preset storage unit 47 Alternatively, the left ventricle or the left atrium is specified as the measurement target part in accordance with an instruction from the user.

  When the type of cross section is “four-chamber cross section” or “two-chamber cross section”, the apex section analysis mode or the apex section capacity analysis mode is selected as the analysis mode described later. Since the apex section analysis mode is an analysis mainly for the left ventricle, in the apex section analysis mode, the left ventricle is specified as a measurement target part. Note that a part other than the left ventricle (for example, the right ventricle or the right atrium) may be set as a measurement target part in accordance with preset data or an instruction from the user. In addition, when the cross-section type is “short-axis cross-section”, the short-axis cross-section analysis mode is selected as the analysis mode described later. When the cross-section type is “long-axis cross-section”, the analysis mode described later is selected. The free analysis mode is selected. In the free analysis mode, the measurement target part is specified in accordance with an instruction from the user.

  The measurement range selection unit 43 selects a plurality of frames to be measured from a plurality of frames constituting each image file (moving image) to be measured. The measurement range selection unit 43 selects a plurality of frames based on preset data that specifies a measurement range in the time axis direction. As preset data for designating the measurement range in the time axis direction, for example, the selected heart rate and the starting heart rate position are stored in the preset storage unit 47.

  The selected heart rate is data indicating a heart rate (heart rate section) selected as a measurement target. For example, if “ALL (select all)” is preset as the selected heart rate, all the frames constituting the image file that is the measurement target are selected as the measurement target. If “numerical value” is preset as the selected heart rate, multiple frames corresponding to the heart rate interval indicated by the numerical value are selected as the measurement target from among the multiple frames constituting the image file that is the measurement target. The

  If the numerical value set as the selected heart rate is larger than the heart rate (total heart rate) corresponding to all the frames constituting the measurement target image file, the plurality of frames constituting the measurement target image file Of these, a range from a starting heartbeat position to a final frame described later is selected as a measurement target.

  The start heartbeat position is data indicating the position (time phase) of the first frame selected as the measurement target. For example, “numerical value” is preset as the start heartbeat position. Then, the frame corresponding to the heart rate after the heart rate indicated by the numerical value from the start frames of the plurality of frames constituting the image file to be measured is set as the first frame of the measurement target. For example, if “2” is preset as the start heartbeat position, the frame corresponding to the second R wave counted from the start frame of the plurality of frames constituting the image file to be measured is the first frame to be measured. Is done.

  When the selected heart rate is “ALL”, the preset setting of the start heart rate position is ignored (invalidated). In addition, if the value of the starting heartbeat position is larger than the heart rate corresponding to all the frames constituting the image file to be measured (total heart rate), the final heart rate of all the frames constituting the image file is determined. The corresponding frame is the first frame to be measured. For example, if the total heart rate of the image file to be measured is 2, but the start heart rate position is set to 4, the number is counted from the start frame of the plurality of frames constituting the image file to be measured. The frame corresponding to the R-th wave is the first frame to be measured.

  Tracking is performed when a measurement target part is specified by the part specification unit 42 and a plurality of frames to be measured are selected from a plurality of frames constituting each image file (moving image) that is a measurement target by the measurement range selection unit 43. The point setting unit 44 applies the trace process to the measurement target part for at least a part of the plurality of frames selected as the analysis target.

  The tracking point setting unit 44 applies a plurality of traces on the contour of the measurement target part as a plurality of representative parts by applying a trace process to the measurement target part in the reference frame included in the plurality of frames selected as the analysis target. Set a point. Thereby, an ROI (region of interest) composed of a plurality of tracking points is set. ROI settings include manual setting (manual setting), semi-auto setting (multiple point designation), and full auto setting (full automatic tracing).

  In the manual setting, all of the plurality of tracking points are set by the user. For example, a user such as a doctor or a laboratory technician operates the operation device 60 while confirming a display image displayed on the display unit 52 to determine a reference frame from a plurality of frames to be analyzed. The position of each tracking point in the image is designated, and a plurality of tracking points are set on the contour of the measurement target part. For example, if the measurement target site is the left ventricle, a plurality of tracking points are set on the boundary of the intima of the left ventricle. For example, when it is desired to measure the outer membrane of the left ventricle, a plurality of tracking points are set on the boundary of the outer membrane of the left ventricle. Of course, a plurality of tracking points may be set on the boundary between both the intima and the adventitia and used for measurement related to the myocardial thickness in the left ventricle.

  In the semi-auto setting, at least one representative point of the plurality of tracking points is set by the user, and the tracking point setting unit 44 sets the remaining plurality of tracking points based on the at least one representative point set by the user. . For example, a user such as a doctor or a laboratory technician operates the operation device 60 while confirming a display image displayed on the display unit 52 to determine a reference frame from a plurality of frames to be analyzed. By specifying the position of each representative point in the image, at least one representative point is set on the contour of the measurement target part. For example, if the measurement target region is the left ventricle, three representative points corresponding to three locations of two annulus portions and one apex portion are set.

  In the semi-auto setting, the tracking point setting unit 44 sets the remaining (other) tracking points based on at least one representative point set by the user. The tracking point setting unit 44 may use any of various known processes. For example, the tracking point setting unit 44 uses a technique for extracting a contour of a target part described in Patent Document 2 (Japanese Patent No. 575794). Thus, it is desirable to extract the contour of the measurement target part where a plurality of tracking points are set. The outline of the contour extraction process using the technique of Patent Document 2 is as follows.

  Contour model data corresponding to a measurement target region (for example, left ventricle) is read from a database or the like, and the position and inclination of the contour model data based on at least one representative point (for example, two annulus portions and one apex portion). And the size is adjusted, thereby generating a first initial contour. Further, for example, by using a contour model that dynamically deforms such as an active contour model (ACM), a dynamic shape model (ASM), a dynamic appearance model (AAM), etc. Approximate the initial contour. Thus, the contour of the measurement target part (for example, the contour of the left ventricle) is extracted, and a plurality of (for example, about one hundred) tracking points are set on the contour. For example, if the measurement target site is the left ventricle, a plurality of tracking points are set on the boundary of the intima of the left ventricle. For example, when it is desired to measure the outer membrane of the left ventricle, a plurality of tracking points are set on the boundary of the outer membrane of the left ventricle. Of course, a plurality of tracking points may be set on the boundary between both the intima and the adventitia and used for measurement related to the myocardial thickness in the left ventricle.

  In the full auto setting, the tracking point setting unit 44 sets all of the plurality of tracking points. The tracking point setting unit 44 first determines a reference frame from a plurality of frames to be analyzed. For example, the first frame (the frame with the earliest time phase) among the plurality of frames to be analyzed is set as the reference frame. Of course, a frame corresponding to the end systole or end diastole determined from the electrocardiogram waveform information or a time phase frame designated by the user may be used as the reference frame.

  In the full auto setting, the tracking point setting unit 44 analyzes the image in the cross section of the reference frame to extract the contour of the measurement target part included in the image (cross section). For example, pattern matching, an active contour model (ACM), a dynamic shape model (ASM) using machine learning, or a dynamic appearance model (AAM) can be applied to the contour extraction. In the contour extraction, for example, an annulus that has a relatively high brightness in the image is extracted as a representative point, and then measured based on the extracted representative point using, for example, the technique of Patent Document 2. The contour of the target part (for example, the left ventricle) may be extracted. Of course, for example, a learning method such as the AdaBoost method may be used for extracting the representative points.

  In the full auto setting, for example, if the measurement target region is the left ventricle, a plurality of tracking points are set on the boundary of the intima of the left ventricle. For example, when it is desired to measure the outer membrane of the left ventricle, a plurality of tracking points are set on the boundary of the outer membrane of the left ventricle. Of course, a plurality of tracking points may be set on the boundary between both the intima and the adventitia and used for measurement related to the myocardial thickness in the left ventricle.

  In the full auto setting, the tracking point setting unit 44 uses a plurality of algorithms selected according to the type of the cross section of the heart represented by the moving image to be measured and the measurement target site in the cross section. Execute trace processing to set the tracking point.

  2 and 3 are diagrams showing specific examples of algorithms used for the trace processing. 2 and 3 show a list of algorithms used in each analysis mode of the apex section analysis mode, the short-axis section analysis mode, and the apex section capacity analysis mode that require the trace processing.

  The tracking point setting unit 44 selects an algorithm for trace processing according to the type of the cross section of the heart represented by the moving image to be measured and the measurement target site in the cross section. In the specific examples of FIGS. 2 and 3, an algorithm corresponding to the time phase of the reference frame to be traced is selected. For example, when the reference frame is in the vicinity of the R wave of the electrocardiogram waveform (for example, a period of 50 ms before and after the R wave), that is, when the reference frame is an R wave period frame, the end diastole algorithm (ED algorithm) is selected. If the reference frame is in another time phase (for example, a time phase other than the period of 50 ms before and after the R wave), that is, if it is another period frame, the systolic algorithm (ES algorithm) is selected.

  FIG. 2 shows a list of algorithms used in each analysis mode of the apex section analysis mode and the short-axis section analysis mode.

  In the apex section analysis mode, the measurement target site is the left ventricle, and an algorithm is selected according to the type of section and the time phase of the reference frame. For example, if the type of cross section is a four-chamber cross section and the reference frame is an R wave period frame, the ED algorithm 4 is selected. Even if the cross-section type is a four-chamber cross section and the reference frame is an R wave period frame, the ED algorithm 4I is selected when the front and back of the four-chamber cross section are reversed. Further, for example, if the type of the cross section is a two-chamber cross section and the reference frame is a frame of another period, the ES algorithm 2 is selected. Even if the type of the cross section is a two-chamber cross section and the reference frame is a frame of another period, the ED algorithm 2I is selected when the front and back of the two-chamber cross section are reversed.

In the short-axis cross-section analysis mode, the measurement target site is the left ventricle, and an algorithm is selected according to the type of cross-section and the time phase of the reference frame. For example, if the cross-sectional type is a mitral valve level left ventricular short-axis image and the reference frame is an R-wave period frame, the ED algorithm BS is selected. For example, if the cross-sectional type is a papillary muscle level left ventricular short-axis image and the reference frame is a frame of another period, the ES algorithm MS is selected.

  FIG. 3 shows a list of algorithms used in the apex section capacitance analysis mode.

  In the apex section capacity analysis mode, an algorithm is selected according to the type of section, the measurement target region, and the time phase of the reference frame. For example, if the type of cross section is a four-chamber cross section, the measurement target site is the left ventricle (LV), and the reference frame is an R wave period frame, the ED algorithm 4LV is selected. Note that even if the cross-section type is a four-chamber cross section, the measurement target site is the left ventricle (LV), and the reference frame is an R-wave period frame, if the front and back of the four-chamber cross section are reversed (back), the ED algorithm 4LVI Is selected.

  For example, if the cross-sectional type is a two-chamber cross section, the measurement target site is the left ventricle (LV), and the reference frame is a frame of another period, the ES algorithm 2LV is selected. Even if the cross-section type is a two-chamber cross section, the measurement target part is the left ventricle (LV), and the reference frame is a frame of another period, the ED algorithm 2LVI is selected when the front and back of the two-chamber cross section are reversed (back) The

  In the full auto setting, the tracking point setting unit 44 executes a tracing process for setting a plurality of tracking points using an algorithm selected from the list shown in FIGS.

  When a plurality of tracking points are set on the contour of the measurement target part by the tracing process of the tracking point setting unit 44, the tracking processing unit 45 executes a tracking process for the plurality of tracking points. The tracking point setting unit 44 sets a plurality of tracking points in the reference frame included in the plurality of frames selected as the analysis target. The tracking processing unit 45 performs tracking processing over a plurality of frames by pattern matching processing between frames for each tracking point. Thereby, the movement destinations of a plurality of tracking points are tracked (tracked) over a plurality of frames to be analyzed. In addition, for example, for each frame, an ROI (region of interest) that connects a plurality of tracking points in the frame is formed, so that a change in the shape of the measurement target part can be detected from a change in the shape of the ROI over a plurality of frames. Can be confirmed.

  Based on the result of the tracking process performed by the tracking processing unit 45, the measurement unit 46 performs measurement related to the measurement target region. The measurement unit 46 performs measurement on at least one of a plurality of measurement items determined for each analysis mode according to the type of cross section related to the measurement target region.

  FIG. 4 is a diagram illustrating a specific example of a plurality of measurement items defined for each analysis mode. FIG. 4 shows specific examples of a plurality of measurement items corresponding to the analysis modes of the free analysis mode, the short-axis cross-section analysis mode, the apex section analysis mode, and the apex section capacity analysis mode.

  In the specific example of FIG. 4, a plurality of measurement items such as volume, EF (Ejection Faction), and area change rate are associated with the free analysis mode. In the free analysis mode, the measurement unit 46 performs, for example, measurement for at least one of a plurality of measurement items illustrated in FIG. 4, preferably measurement for all measurement items.

  Similarly, in the short-axis cross-section analysis mode, the apex section analysis mode, and the apex section capacity analysis mode, the measurement unit 46 measures at least one of a plurality of measurement items corresponding to each analysis mode. Desirably, measurement for all measurement items is executed.

  In addition, when the user specifies a measurement item from a plurality of measurement items corresponding to each analysis mode of the free analysis mode, the short-axis cross-sectional analysis mode, the apex section analysis mode, and the apex section capacity analysis mode, Measurement only for the measurement item specified by the user may be executed.

  FIG. 5 is a diagram showing a specific example of preset data stored in the preset storage unit 47. FIG. 5 shows a specific example of preset items stored as preset data and the preset setting contents.

  For example, the preset heart rate and the starting heart rate of the preset items are preset data used for selecting a plurality of frames to be measured by the measurement range selection unit 43. As already described, either “ALL” or “numerical value (1 to 10)” as the selected heart rate and “numerical value (1 to 4)” as the start heart rate position are stored as preset data as preset data. Stored in the unit 47.

  In addition to the selected heart rate and the starting heart rate, the preset storage unit 47 stores, for example, preset data regarding a plurality of preset items shown in FIG. Further, it is desirable that the user can set (change) the setting contents of the preset data.

  FIG. 6 is a diagram showing a specific example of a setting screen used for setting preset data. The setting screen is composed of, for example, GUI (graphic user interface) parts related to a plurality of preset items. FIG. 6 illustrates a specific example of a setting screen regarding a plurality of preset items such as a start method, apex image analysis selection, a selected heart rate, and a start heart position that are a part of the preset data stored in the preset storage unit 47. Has been. A preset data setting screen is displayed on the display unit 52.

  For example, when the user wants to change the preset of the start method, the user operates the operation device 60 such as a mouse, a trackball, or a touch panel, and selects the start method in the selection menu or text field corresponding to the start method. "Or" User selection (non-automatic) ". Also, for example, if the user wants to change the apex image analysis selection preset, the user operates the operation device 60 to select the apex image analysis selection in the selection menu or text field corresponding to the apex image analysis selection. Set to “apex section” or “apex section capacity”.

  Note that the setting screen shown in FIG. 6 is a specific example of a one-page setting screen displayed on the display unit 52 at a time. For example, a setting screen of a plurality of pages that can be selected using a plurality of tabs is configured. May be. In addition to the selection menu and text field, various known components such as buttons, check boxes, scrolling lists, and scroll bars can be used as GUI components used for the setting screen.

  FIG. 7 is a diagram illustrating a specific example of an analysis screen displayed on the display unit 52. In the specific example illustrated in FIG. 7, the analysis screen includes an ultrasound image, a measurement result, an electrocardiogram waveform, and a menu display area. It is desirable to use an analysis screen corresponding to each analysis mode for each of the free analysis mode, the short-axis cross-section analysis mode, the apex section analysis mode, and the apex section capacity analysis mode.

  In the ultrasonic image display area, an ultrasonic image corresponding to each image file to be measured is displayed. For example, an ultrasonic image to be measured is displayed as a moving image. When setting the ROI by the tracking point setting unit 44, it is desirable to display a still image of a reference frame used for setting the ROI, and to display an ROI including a plurality of tracking points on the still image. In displaying the measurement result, a moving image of a plurality of frames to be measured is displayed. For example, it is desirable to perform loop reproduction in which a plurality of frames of moving images to be measured are repeatedly displayed.

  In the measurement result display area, measurement results relating to the heart for each image file to be measured are displayed. Since a plurality of measurement items are to be measured for each analysis mode (see FIG. 4), the measurement results are displayed in the measurement result display area for each measurement item, for example, as a graph or a numerical value. It is desirable that each measurement item to be displayed can be selected by the user using, for example, a measurement item selection button displayed in the menu display area.

  In the display area of the electrocardiogram waveform, an electrocardiogram waveform formed based on the electrocardiogram waveform information associated with each image file to be measured is displayed. It is desirable to display a time phase cursor indicating the time phase of the ultrasound image displayed in the ultrasound image display area in the electrocardiogram waveform.

  In the menu display area, a plurality of setting items capable of user operation (setting and selection) are displayed. For example, any of the free analysis, short-axis cross-sectional analysis, apex cross-section analysis, and apex cross-section volume analysis shown in FIG. 7 is operated (such as a mouse click operation for each button or a touch operation using a touch panel). Then, the analysis mode corresponding to the button is switched to the analysis screen corresponding to the analysis mode.

  In the specific example of FIG. 7, a selection menu (or a text field) for setting the type and part of the cross section, and buttons for deleting the ROI and starting measurement are also prepared. In addition, by operating a button corresponding to each item (item A to item C in the example of FIG. 7) indicated by the measurement item (such as a mouse click operation or a touch operation using a touch panel for each button) The measurement result of the associated measurement item is displayed in the measurement result display area.

  FIG. 8 is a flowchart showing a specific example of measurement processing by the ultrasonic diagnostic apparatus of FIG. First, when each image file selected by the image selection unit 30 in accordance with an instruction from the user is read into the measurement processing block 40 (S800), a preset “start method (FIG. 5)” is confirmed (S802). ).

  If the “starting method” is set to automatic (S802), the cross section determination unit 41 determines the type of the cross section of the heart represented by each image file (moving image) (S804), and according to the type of the cross section The analysis mode is selected by branching (S806).

  For example, if the section type is “long-axis section” or “others”, the free analysis mode is selected (S810), and if the section type is “three-chamber section”, the apex section analysis mode is selected (S816). ), The short-axis cross-section analysis mode is selected if the cross-section type is “short-axis cross-section” (S818). When the type of the cross section is “two-chamber cross section” or “four-chamber cross section”, the preset “apex image analysis selection (FIG. 5)” is confirmed (S812), and the apex cross section capacity is set. For example, the apex section capacity analysis mode is selected (S814). If the apex section is set, the apex section analysis mode is selected (S816).

  On the other hand, if the “starting method” is not set to automatic (S802), the analysis mode is selected by the user (S808), and the analysis mode selected by the user is entered.

  In the case of the apex section volume analysis mode (S814), apex section analysis mode (S816) or short axis section analysis mode (S818), the preset “section automatic selection (FIG. 5)” and “time phase automatic selection” (FIG. 5) ”is confirmed (S820, S824). If automatic cross section selection is set (if ON), the type of cross section determined by the cross section determination unit 41 is used as it is. If automatic cross section selection is not set (if OFF), the user selects it. The type of cross section is selected (S822).

  If automatic time phase selection is set (if ON), the measurement range selection unit 43 selects a plurality of frames to be measured from a plurality of frames constituting an image file (moving image) that is a measurement target. Is done. If automatic time phase selection is not set (if OFF), the user selects a plurality of frames to be measured (S826).

  Further, the preset “ROI setting (FIG. 5)” is confirmed (S828), and manual, semi-auto, or full-auto is selected according to “ROI setting”.

  In the manual, a plurality of tracking points are set by the user (S830). In the semi-auto, representative points are set by the user (S832), and a plurality of tracking points are set by the tracking point setting unit 44 based on the representative points set by the user (S834).

  In the case of full auto, it is confirmed whether or not the retrace is performed (S836), and in the case of retrace, that is, the re-execution of the trace, the tracking point setting unit 44 receives the operation of clicking the image (S838) from the user. Thus, a representative point and a plurality of tracking points are set (S840, S842). If it is not retrace, the operation of clicking the image from the user is omitted, and the representative point and a plurality of tracking points are set by the tracking point setting unit 44 (S840, S842).

  Further, in the case of full auto, the preset “automatic measurement start (FIG. 5)” is confirmed (S844), and when the automatic measurement start is set (if ON), the tracking processing unit 45 The tracking process by and the measurement process by the measurement unit 46 are executed (S852). When the automatic measurement start is not set (if OFF), the user confirms a plurality of tracking points (ROI) (S846).

  In addition, when the ROI setting is manual (S830) and semi-automatic (S832, S834), the user confirms a plurality of tracking points (ROI) (S846), and also in the free analysis mode (S810), the user After setting a plurality of tracking points (S811), the user confirms a plurality of tracking points (ROI) (whether or not the setting of S811 is completed) (S846).

  If the confirmation result of the user in S846 is OK (Yes), the tracking processing by the tracking processing unit 45 and the measurement processing by the measuring unit 46 are executed after receiving the measurement start operation (S850) from the user (S852). ). If the confirmation result of the user in S846 is NG (No), the user corrects a plurality of tracking points (ROI) (S848), and when the measurement start operation (S850) is performed by the user, the tracking processing unit 45 The tracking process by and the measurement process by the measurement unit 46 are executed (S852).

  When the tracking process and the measurement process (S852) are completed, the image file (moving image) to be measured is loop reproduced (repeatedly reproduced) on the display unit 52, and the measurement result is displayed on the display unit 52 (S854).

  Then, the operations of cross-sectional correction (S856), ROI deletion (S858), and analysis mode (analysis type) correction (S862) from the user are confirmed, and if these operations are not present, the analysis ends (S864). If there is a user operation for correcting the cross section (S856), the type of the cross section is selected by the user (S822), and the processes after S824 are executed. If there is an instruction to delete the ROI from the user (S858), after the user operation for executing the ROI deletion (S860), the processes after S820 are executed. If there is a user operation for correcting the analysis mode (analysis type) (S862), after the analysis mode is selected by the user (S808), the processes after S806 are executed.

  As mentioned above, although preferred embodiment of this invention was described, embodiment mentioned above is only a mere illustration in all the points, and does not limit the scope of the present invention. The present invention includes various modifications without departing from the essence thereof.

  DESCRIPTION OF SYMBOLS 10 Probe, 12 Transmission / reception part, 20 Image formation part, 22 Image storage part, 30 Image selection part, 41 Section determination part, 42 Site identification part, 43 Measurement range selection part, 44 Tracking point setting part, 45 Tracking processing part, 46 Measurement unit, 47 preset storage unit, 50 display processing unit, 52 display unit, 60 operation device, 100 control unit.

Claims (7)

A determination unit for determining a type of a cross section of the heart represented by the moving image by image recognition processing for at least one of the plurality of frames constituting the ultrasonic moving image;
A specifying unit that specifies a measurement target part from at least one candidate part according to the type of the cross section;
A processing unit that performs at least a part of the plurality of frames and performs tracking processing of a plurality of representative portions obtained by applying trace processing to the measurement target portion;
Based on the result of the tracking process, a measurement unit that performs measurement according to the type of the cross section related to the measurement target part;
Having
An ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus according to claim 1,
The determination unit, as the type of the cross section, the left ventricular long axis section and the left ventricular short axis section obtained by the parasternal approach, the four-chamber section, the three-chamber section, and the two-chamber section obtained by the apex approach Identifying at least one cross-section corresponding to the moving image from a plurality of cross-sections including
An ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus according to claim 1 or 2,
The specifying unit specifies at least one of a left ventricle, a right ventricle, a left atrium, a right atrium, and an aorta of the heart as the measurement target part;
An ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus according to any one of claims 1 to 3,
Based on preset data that designates a measurement range in the time axis direction, further includes a selection unit that selects a plurality of frames to be measured from a plurality of frames constituting the moving image,
The processing unit executes the tracking process for a plurality of frames to be measured.
An ultrasonic diagnostic apparatus. In the ultrasonic diagnostic apparatus according to any one of claims 1 to 4,
By applying the trace processing to the measurement target part in a reference frame included in a plurality of frames selected as an analysis target from a plurality of frames constituting the moving image, the measurement target as the plurality of representative locations. It further has a setting unit for setting a plurality of tracking points on the contour of the part,
The processing unit executes the tracking process for each tracking point over a plurality of frames to be analyzed.
An ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus according to any one of claims 1 to 5,
The setting unit performs the trace process using an algorithm selected according to the type of the cross section and the measurement target part,
An ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus according to any one of claims 1 to 6,
Performing measurement for at least one of a plurality of measurement items determined for each analysis mode according to the type of the cross section, and displaying a measurement result in a display screen according to the analysis mode;
An ultrasonic diagnostic apparatus.

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