JP6073558B2 - Medical diagnostic imaging equipment - Google Patents

Description

  Embodiments described herein relate generally to a medical image diagnostic apparatus.

  A medical image diagnostic apparatus is an apparatus that acquires an image representing the inside of a subject. As medical image diagnostic apparatuses, X-ray CT (Computed Tomography) apparatuses and X-ray imaging apparatuses are known.

  An X-ray CT apparatus is an apparatus that scans a subject with X-rays, collects data, and processes the collected data with a computer, thereby imaging the inside of the subject. Specifically, the X-ray CT apparatus emits X-rays to a subject a plurality of times from different directions, detects X-rays transmitted through the subject with an X-ray detector, and generates a plurality of detection data. collect. The collected detection data is A / D converted by the data collection unit and then transmitted to the data processing system. The data processing system forms projection data by pre-processing the detection data. Subsequently, the data processing system executes a reconstruction process based on the projection data to form tomographic image data.

  The data processing system forms volume data based on a plurality of tomographic image data as further reconstruction processing. The volume data is a data set representing a three-dimensional distribution of CT values corresponding to a three-dimensional region of the subject. When acquiring volume data, volume scanning using a multi-row X-ray detector is applied. Also, by repeatedly performing the volume scan, a plurality of volume data having different time phases can be acquired (4D scan).

  The X-ray CT apparatus can perform MPR (Multi Planar Reconstruction) display by rendering volume data in an arbitrary direction. The cross-sectional image (MPR image) displayed in MPR includes an orthogonal three-axis image and an oblique image. An orthogonal triaxial image is an axial image showing a cross section orthogonal to the body axis, a sagittal image showing a cross section of the subject along the body axis, and a coronal showing a cross section of the subject along the body axis. Show the image. The oblique image is an image showing a cross section other than the orthogonal three-axis image. Further, the X-ray CT apparatus renders volume data by setting an arbitrary line of sight, thereby forming a pseudo 3D image when the 3D region of the subject is viewed from this line of sight.

  The X-ray imaging apparatus is an apparatus that images the inside of the subject by irradiating the subject with X-rays and detecting the transmitted X-rays with a two-dimensional X-ray detector. Imaging methods using an X-ray imaging apparatus include normal imaging for obtaining a still image by single X-ray irradiation and fluoroscopic imaging for obtaining a moving image by irradiating X-rays continuously or intermittently.

JP 2010-259653 A JP 2011-4966 A

  Volume scanning and 4D scanning of the X-ray CT apparatus and fluoroscopic imaging of the X-ray imaging apparatus are used for observing the motion state of the joint. In particular, 4D scanning and fluoroscopic imaging are used for continuous imaging while operating a joint. In such joint examinations, it is desired to grasp the relationship between the operation state of the joint and the timing at which the patient feels pain. That is, it is desired to grasp how pain is generated in a state where the joint is bent.

  In other medical fields as well, it is desired to grasp the relationship between the action state of the body and the occurrence timing of a biological reaction (life reaction). For example, there is a case where it is desired to grasp a change in the pain state according to the body position. However, such information cannot be obtained by the conventional medical image diagnostic apparatus.

  The problem to be solved by the present invention is to provide a medical image diagnostic apparatus capable of obtaining the relationship between the motion state of the body and the generation timing of the biological reaction.

The medical image diagnostic apparatus according to the first embodiment includes an in-vivo image acquiring unit that acquires a plurality of in-vivo images having different time phases by continuously or intermittently irradiating a predetermined part of a subject with X-rays, An input unit that inputs generation information representing the occurrence of a biological reaction in a specific state of the subject, and an appearance image acquisition unit that acquires an appearance image by imaging the predetermined part at least at an imaging timing corresponding to the input of the generation information A first part shape information representing the shape of the predetermined part by analyzing an appearance image at the imaging timing, and a second part representing the shape of the predetermined part by analyzing the plurality of in-vivo images A specifying unit that acquires shape information and specifies an in-vivo image corresponding to second shape information that substantially matches the first part shape information among the plurality of second part shape information acquired; Memory part and specific A control unit that associates the stored in-vivo image with the appearance image acquired at the photographing timing and stores it in the storage unit, receives an instruction to display the image, and causes the display unit to display the identified in-vivo image; Have
Further, the medical image diagnostic apparatus according to the second embodiment includes an in-vivo image acquiring unit that acquires a plurality of in-vivo images having different time phases by continuously or intermittently irradiating a predetermined part of a subject with X-rays. An input unit that inputs generation information indicating the occurrence of a biological reaction in a specific state of the subject, and at least at the imaging timing corresponding to the input of the generation information, the direction from which the in-vivo image is acquired is substantially the same as An appearance image acquisition unit that captures a predetermined part to acquire an appearance image, and a specification that identifies the in-vivo image acquired substantially simultaneously with the generation information input while the in-vivo image acquisition unit acquires the in-vivo image And the storage unit, the identified in-vivo image and the appearance image acquired at the photographing timing are associated with each other and stored in the storage unit, and in response to an instruction to display the image, Has a control unit for displaying on the display unit the appearance image or both those obtained by the photographing timing.

It is a block diagram showing the structure of the medical image diagnostic apparatus (X-ray CT apparatus) which concerns on embodiment. It is a block diagram showing the structure of the medical image diagnostic apparatus (X-ray CT apparatus) which concerns on embodiment. It is the schematic for demonstrating the process which the medical image diagnostic apparatus (X-ray CT apparatus) which concerns on embodiment performs. It is a flowchart showing the operation example of the medical image diagnostic apparatus (X-ray CT apparatus) which concerns on embodiment. It is a flowchart showing the operation example of the medical image diagnostic apparatus (X-ray CT apparatus) which concerns on embodiment. It is a block diagram showing the structure of the medical image diagnostic apparatus which concerns on a modification. It is a flowchart showing operation | movement of the medical image diagnostic apparatus which concerns on a modification. It is a flowchart showing operation | movement of the medical image diagnostic apparatus which concerns on a modification. It is a block diagram showing the structure of the medical image diagnostic apparatus which concerns on a modification. It is the schematic showing the display mode by the medical image diagnostic apparatus which concerns on a modification. It is a block diagram showing the structure of the medical image diagnostic apparatus which concerns on a modification. It is the schematic showing the display mode by the medical image diagnostic apparatus which concerns on a modification.

  A medical image diagnostic apparatus according to an embodiment will be described with reference to the drawings. Hereinafter, examples of the X-ray CT and the X-ray imaging apparatus will be described.

[Constitution]
With reference to FIG.1 and FIG.2, the structural example of the X-ray CT apparatus 1 which concerns on embodiment is demonstrated. Note that “image” and “image data” may be identified with each other.

  FIG. 1 shows the overall configuration of the X-ray CT apparatus 1. In FIG. 2, the parts related to the acquisition of the CT image are collectively represented as the in-vivo image acquisition unit 100. The in-vivo image acquisition unit 100 includes the gantry device 10, the couch device 30, the scan control unit 42, the preprocessing unit 431, and the reconstruction processing unit 432 in FIG. 1. When the reconstruction processing unit 432 forms volume data, the in-vivo image acquisition unit 100 also includes a rendering processing unit 433.

  As shown in FIG. 1, the X-ray CT apparatus 1 includes a gantry device 10, a bed device 30, a console device 40, and an appearance image acquisition unit 50.

(Mounting device)
The gantry device 10 is an apparatus that irradiates the subject E with X-rays and collects X-ray detection data transmitted through the subject E. The gantry device 10 includes an X-ray generator 11, an X-ray detector 12, a rotating body 13, a high voltage generator 14, a gantry driver 15, an X-ray diaphragm 16, a diaphragm driver 17, And a data collection unit 18.

  The X-ray generator 11 includes an X-ray tube that generates X-rays (for example, a vacuum tube that generates a cone-shaped or pyramid-shaped beam (not shown)). The generated X-rays are exposed to the subject E.

  The X-ray detection unit 12 includes a plurality of X-ray detection elements (not shown). The X-ray detection unit 12 detects X-ray intensity distribution data (hereinafter sometimes referred to as “detection data”) indicating the intensity distribution of X-rays transmitted through the subject E with an X-ray detection element, and the detection data is Output as a current signal.

  As the X-ray detection unit 12, for example, a two-dimensional X-ray detector (surface detector) in which a plurality of detection elements are arranged in two directions (slice direction and channel direction) orthogonal to each other is used. The plurality of X-ray detection elements are provided, for example, in 320 rows along the slice direction. By using a multi-row X-ray detector in this way, a three-dimensional region having a width in the slice direction can be imaged with one scan (volume scan). The slice direction corresponds to the body axis direction of the subject E, and the channel direction corresponds to the rotation direction of the X-ray generation unit 11.

  The rotating body 13 is a member that supports the X-ray generation unit 11 and the X-ray detection unit 12 at positions facing each other with the subject E interposed therebetween. The rotating body 13 has an opening that penetrates in the slice direction. A top plate on which the subject E is placed is inserted into the opening. The rotating body 13 is rotated along a circular orbit centered on the subject E by the gantry driving unit 15.

  The high voltage generator 14 applies a high voltage to the X-ray generator 11. The X-ray generator 11 generates X-rays based on this high voltage. The X-ray diaphragm unit 16 forms a slit (opening), and changes the size and shape of the slit so that the X-ray fan angle (divergence angle in the channel direction) output from the X-ray generation unit 11 and the X-rays are changed. Adjust the cone angle (spreading angle in the slice direction). The diaphragm drive unit 17 drives the X-ray diaphragm unit 16 to change the size and shape of the slit.

  A data collection unit 18 (DAS: Data Acquisition System) collects detection data from the X-ray detection unit 12 (each X-ray detection element). Further, the data collection unit 18 converts the collected detection data (current signal) into a voltage signal, periodically integrates and amplifies the voltage signal, and converts it into a digital signal. Then, the data collecting unit 18 transmits the detection data converted into the digital signal to the console device 40.

(Bed apparatus)
A subject E is placed on a top plate (not shown) of the bed apparatus 30. The couch device 30 moves the subject E placed on the top plate in the body axis direction. Moreover, the couch device 30 moves the top plate in the vertical direction.

(Console device)
The console device 40 is used for operation input to the X-ray CT apparatus 1. Further, the console device 40 reconstructs CT image data (tomographic image data and volume data) representing the internal form of the subject E from the detection data input from the gantry device 10. The console device 40 includes a control unit 41, a scan control unit 42, a processing unit 43, a storage unit 44, a display unit 45, and an operation unit 46.

  The control unit 41, the scan control unit 42, and the processing unit 43 include, for example, a processing device and a storage device. As the processing apparatus, for example, a CPU (Central Processing Unit), a GPU (Graphic Processing Unit), or an ASIC (Application Specific Integrated Circuit) is used. The storage device is configured to include, for example, a ROM (Read Only Memory), a RAM (Random Access Memory), and an HDD (Hard Disc Drive).

  The storage device stores a computer program for executing the function of each unit of the X-ray CT apparatus 1. The processing device implements the above functions by executing these computer programs. The control unit 41 controls each unit of the apparatus.

  The scan control unit 42 integrally controls operations related to X-ray scanning. This integrated control includes control of the high voltage generation unit 14, control of the gantry driving unit 15, control of the aperture driving unit 17, and control of the bed apparatus 30.

  The control of the high voltage generator 14 is to control the high voltage generator 14 so that a predetermined high voltage is applied to the X-ray generator 11 at a predetermined timing. The control of the gantry driving unit 15 controls the gantry driving unit 15 so as to rotationally drive the rotating body 13 at a predetermined timing and a predetermined speed. The control of the diaphragm control unit 17 controls the diaphragm driving unit 17 so that the X-ray diaphragm unit 16 forms a slit having a predetermined size and shape. The control of the couch device 30 is to control the couch device 30 so that the top plate is moved to a predetermined position at a predetermined timing.

  In the volume scan, the scan is executed with the position of the top plate fixed. In the helical scan, the scan is executed while moving the top plate.

  The processing unit 43 performs various processes on the data input from the gantry device 10 (data collection unit 18) and the data input from the appearance image acquisition unit 50. The processing unit 42 includes a preprocessing unit 431, a reconstruction processing unit 432, a rendering processing unit 433, and an image specifying unit 434.

  The preprocessing unit 431 performs preprocessing including logarithmic conversion processing, offset correction, sensitivity correction, beam hardening correction, and the like on the detection data from the gantry device 10 to generate projection data.

  The reconstruction processing unit 432 generates CT image data (tomographic image data or volume data) based on the projection data generated by the preprocessing unit 431. As the reconstruction processing of the tomographic image data, for example, any method such as a two-dimensional Fourier transform method or a convolution / back projection method can be applied.

  The volume data is generated by interpolating a plurality of reconstructed tomographic image data. As volume data reconstruction processing, for example, an arbitrary method such as a cone beam reconstruction method, a multi-slice reconstruction method, an enlargement reconstruction method, or the like can be applied. In the volume scan using the multi-row X-ray detector described above, a wide range of volume data can be reconstructed.

  The rendering processing unit 433 can execute, for example, MPR processing and volume rendering. The MPR process is an image process for generating MPR image data representing a section by setting an arbitrary section to the volume data generated by the reconstruction processing unit 432 and performing a rendering process. Volume rendering generates pseudo three-dimensional image data representing the three-dimensional region of the subject E by sampling volume data along an arbitrary line of sight (ray) and adding the values (CT values). Image processing.

(Image identification part)
First, the premise of the process executed by the image specifying unit 434 will be described. An image (CT image) formed by the reconstruction processing unit 432 is called an in-vivo image, and an image acquired by the appearance image acquisition unit 50 is called an appearance image. The in-vivo image is an image depicting the inside of the subject E. The appearance image is an image depicting the appearance of the subject E.

  The in-vivo image acquisition unit 100 acquires a plurality of in-vivo images by irradiating a predetermined part of the subject E with X-rays continuously or intermittently. This predetermined part is, for example, a joint part. As a plurality of in-vivo images, a plurality of volume data along a time series obtained by 4D scanning, a plurality of tomographic images or pseudo three-dimensional images along a time series obtained by rendering these volume data, and a predetermined cross section are repetitive. There are a plurality of tomographic images along the time series obtained by scanning.

  The operation unit 46 is used to input generation information indicating the occurrence of a biological reaction of the subject E. Some of these biological reactions occur with pain. Examples of biological reactions that occur with pain include pain recognition, vocalization, facial expression changes, respiratory changes, sweating changes, electrocardiographic changes, blood pressure changes, electromyogram changes, brain wave changes, pupil diameter changes There are changes.

  The operator of the operation unit 46 operates the operation unit 46 in response to the occurrence of such a biological reaction. Upon receiving the operation, the operation unit 46 inputs a signal as generation information to the control unit 41. The operator is the subject E (patient) or another person (doctor, nurse, radiographer, etc.).

  The appearance image acquisition unit 50 acquires an appearance image by imaging a predetermined part of the subject E at least at the imaging timing corresponding to the input of the occurrence information. This shooting may be a still image shooting or a moving image shooting. Details of the appearance image acquisition unit 50 will be described later.

  With the above preparation, the image specifying unit 434 will be described. The image specifying unit 434 specifies the in-vivo image acquired substantially simultaneously with the input of the generation information among the plurality of in-vivo images acquired by the in-vivo image acquiring unit 100. The control unit 41 associates the identified in-vivo image with the appearance image acquired at the imaging timing corresponding to the input of the biological reaction occurrence information, and causes the storage unit 44 to store the associated in-vivo image.

  In addition, when the appearance image acquisition unit 50 performs moving image shooting, or when performing multiple times of still image shooting, the image specifying unit 434 specifies the in-vivo images described above, and among the appearance images sequentially acquired by moving image shooting, The appearance image acquired substantially simultaneously with the input of the biological reaction occurrence information is specified. The appearance image specifying process can be executed in the same manner as the in-vivo image specifying process. The control unit 41 stores the identified in-vivo image and appearance image in the storage unit 44 in association with each other.

  “Substantially simultaneous” means that not only the case of completely simultaneous but also a predetermined error is allowed. This error is determined according to, for example, the acquisition interval of the in-vivo image and / or the appearance image. An example of processing executed by the image specifying unit 434 will be described. In the following example, the examination target is a predetermined joint part of the subject E. The in-vivo image and the appearance image are obtained by photographing the range including the joint part.

  When the first processing example is applied, the image specifying unit 434 includes an analysis unit 435 (see FIG. 2). The analysis unit 435 acquires first shape information indicating the shape of the joint part by analyzing the appearance image acquired by the appearance image acquisition unit 50. Furthermore, the analysis unit 435 analyzes each of the plurality of in-vivo images acquired by the in-vivo image acquisition unit 100, thereby acquiring second shape information indicating the shape of the joint part drawn in the in-vivo image. .

  Here, the in-vivo image and the appearance image are obtained by drawing joint portions from (almost) the same direction. As a method for realizing this, the appearance image drawing direction can be adjusted according to the drawing direction of the in-vivo image, and vice versa. The former is applied when an X-ray imaging apparatus is used, and can be realized, for example, by providing an imaging apparatus for appearance images in the vicinity of an X-ray tube or an X-ray detector.

  The latter is applied, for example, when forming volume data, and can be realized by rendering a tomographic image of a cross section corresponding to the drawing direction of the appearance image from the volume data. As an example of the method of specifying the cross section, a data range corresponding to the joint part in the volume data is specified, and the shape of the two-dimensional region corresponding to the joint part in the appearance image is substantially (of the three-dimensional data range) (almost). The matching two-dimensional data range can be specified by using image processing such as pattern matching, and the direction of the two-dimensional data range in the coordinate system defined in the volume data can be set as the target cross-sectional direction.

  Each shape information represents, for example, the shape of the contour of the body surface in the range including the joint part. In this case, the analysis unit 435, for example, a predetermined color (skin color) or a predetermined shape (the shape of the joint part and its peripheral part) based on the pixel value (luminance value, RGB value, CT value, etc.) of each image. ) Is specified. Further, the analysis unit 435 specifies an image region (contour region) corresponding to the contour of the image region. As an example of this case, an outline region Ga in the CT image G is shown in FIG. The contour region itself or its shape (including the approximate shape) is the first and second shape information.

  The shape information is not limited to the contour shape, and may be any information that represents the shape of the joint part. For example, the contour shape and the core wire shape of the bone can be used as the shape information. As an example of these cases, FIG. 3 shows a bone outline region Gb and a core region Gc in the CT image G. In addition, when using a core wire shape, it is also possible to obtain an angle formed by two or more bone core wires located at a joint site and use this angle information as shape information. Even when the contour shape is used, the directions of two parts that contact each other at the joint part (for example, the upper arm and the forearm in the elbow joint) are specified based on the contour shape, and an angle formed by these two directions is obtained. The information can be shape information.

  The analysis unit 435 performs the above process on each of the plurality of in-vivo images acquired by the in-vivo image acquisition unit 100. Thereby, a plurality of pieces of second shape information are obtained. The image specifying unit 434 specifies an in-vivo image corresponding to the second shape information that substantially matches the first shape information based on the appearance image among the obtained plurality of second shape information. This processing can be performed using image processing such as pattern matching for both pieces of shape information, for example. The in-vivo image thus identified is used as the in-vivo image acquired substantially simultaneously with the input of the biological reaction occurrence information.

  A second processing example will be described. Even when this processing example is applied, the image specifying unit 434 includes an analysis unit 435 (see FIG. 2). The analysis unit 435 analyzes the appearance image acquired by the appearance image acquisition unit 50, thereby acquiring first feature position information indicating the position of a predetermined feature region in the appearance image. Further, the analysis unit 435 analyzes each of the plurality of in-vivo images acquired by the in-vivo image acquisition unit 100, thereby acquiring second feature position information indicating the position of the feature region in the in-vivo image.

  This feature region is an image region corresponding to a predetermined part of the human body or an image region corresponding to an artificial object photographed together with the subject E. Examples of the former include a predetermined bone or a predetermined part thereof, a predetermined organ or a predetermined part thereof. Examples of the latter include a marker affixed to the subject E, an insert (such as a catheter) inserted into the subject E, and an artifact (such as an osteosynthesis bolt) provided in the body of the subject E. .

  The process of specifying the feature region can be performed based on, for example, pattern matching based on the shape of the feature region, or pixel values (luminance value, RGB value, CT value, etc.) unique to the feature region. Further, the number of specified characteristic regions is one or more arbitrary numbers. When two or more feature areas are specified, information indicating the positional relationship (distance, orientation, etc.) of these feature areas can be used as the feature position information.

  Each feature region may be one point (one pixel) or an image region composed of a plurality of pixels. In the latter case, information indicating the size and shape of the image area can be used as the feature position information.

  The analysis unit 435 performs the above process on each of the plurality of in-vivo images acquired by the in-vivo image acquisition unit 100. Thereby, a plurality of pieces of second feature position information are obtained. The image specifying unit 434 acquires the body reaction occurrence information substantially simultaneously with the input of the biological reaction occurrence information based on the obtained second feature position information and the first feature position information based on the appearance image. Identify the image.

  This processing is performed by, for example, comparing the first feature position information with the second feature position information, the positional relationship between two or more feature areas indicated in the first feature position information, or the size or shape of the feature areas, etc. And (substantially) the second feature position information indicating the same feature region can be selected. The in-vivo image corresponding to the selected second feature position information is used as the in-vivo image acquired substantially simultaneously with the input of the biological reaction occurrence information.

  A third processing example will be described. When this processing example is applied, it is not necessary to provide the analysis unit 435 in the image specifying unit 434 (see FIG. 1). When performing this processing example, the image specifying unit 434 includes first timing information indicating the input timing of the biological reaction occurrence information by the operation unit 46, and second timing indicating the in-vivo image acquisition timing by the in-vivo image acquisition unit 100. Receive with timing information. Then, the image specifying unit 434 specifies the in-vivo image corresponding to the second timing information received substantially simultaneously with the first timing information.

  The first timing information is sent from the control unit 41 to the image specifying unit 434 in response to input of a signal from the operation unit 46 to the control unit 41. The second timing information is input to the image specifying unit 434 each time an in-vivo image at each time phase is formed or each time phase scan is performed.

  When the time required for the pre-processing and reconstruction processing is sufficiently short, the reconstruction processing unit 432, the rendering processing unit 433, the control unit 41, and the gantry device 10 can be used at any timing of image formation or scanning. Second timing information is input to the image specifying unit 434. On the other hand, in other cases, the second timing information is input from the control unit 41 or the gantry device 10 to the image specifying unit 434 at the timing when the scan is performed.

  The image specifying unit 434 receives the second timing information sequentially. The image specifying unit 434 that has received the input of the first timing information corresponding to the operation of the operation unit 46 specifies, for example, the second timing information input at the timing closest to the input timing of the first timing information. . Then, the image specifying unit 434 sets the in-vivo image corresponding to the specified second timing information as the in-vivo image acquired substantially simultaneously with the input of the biological reaction occurrence information.

(Storage unit, display unit, operation unit)
The storage unit 44 stores detection data, projection data, image data after reconstruction processing, and the like. The display unit 45 is configured by a display device such as an LCD (Liquid Crystal Display). The operation unit 46 is used for inputting various instructions and information to the X-ray CT apparatus 1. The operation unit 46 includes, for example, a keyboard, a mouse, a trackball, a joystick, and the like. The operation unit 46 may include a GUI (Graphical User Interface) displayed on the display unit 45.

  As described above, the operation unit 46 is used to input generation information indicating the occurrence of a biological reaction of the subject E. That is, the operation unit 46 inputs a signal as biological reaction occurrence information in response to an operation by the operator. Such an operation unit 46 functions as an “input unit”.

(Appearance image acquisition unit)
The appearance image acquisition unit 50 acquires an appearance image by imaging a predetermined part (joint part or the like) of the subject E at least at an imaging timing corresponding to input of occurrence information of a biological reaction. This shooting may be a still image shooting or a moving image shooting. The appearance image acquisition unit 50 is configured to include a digital camera and / or a digital video camera according to the shooting mode.

  In the case of still image shooting, it can be configured to execute shooting in response to input of generated information from the operation unit 46. For example, the control unit 41 that has received the generated information can be configured to control the appearance image acquisition unit 50 to perform shooting.

  It is also possible to configure so that the control unit 41 that receives the generated information performs control to output the notification information, and an operator who recognizes the notification information inputs an external image shooting trigger. The notification information is, for example, display information by the display unit 45 or audio information output by an audio output unit (not shown).

  The appearance image obtained by still image shooting corresponds to the appearance image acquired at the shooting timing corresponding to the input of the occurrence information of the biological reaction.

  One or more arbitrary number of appearance images can be obtained by such still image shooting. When acquiring two or more appearance images, one or more appearance images including those first photographed are selected as the appearance images obtained at the photographing timing corresponding to the input of the biological reaction occurrence information. It is possible. This selection process includes, for example, a process of extracting an appearance image acquired during a predetermined time or a process of extracting a predetermined number of appearance images. In addition, it is also possible to use an appearance image that has been captured between the start of still image shooting and the request for stopping shooting as the appearance image acquired at the shooting timing.

  In the case of moving image shooting, the appearance image acquisition unit 50 sequentially inputs video signals obtained by repeatedly shooting to the console device 40. Each frame obtained by this moving image shooting corresponds to an appearance image. Thereby, a plurality of appearance images along the time series are obtained.

[Operation]
The operation of the X-ray CT apparatus 1 according to this embodiment will be described. Hereinafter, first and second operation examples will be described. The first operation example corresponds to a case where the appearance image acquisition unit 50 performs still image shooting. The second operation example corresponds to the case where the appearance image acquisition unit 50 performs moving image shooting.

[First operation example: FIG. 4]
(S1: Acquisition of in-vivo images)
Start acquisition of multiple in-vivo images with different time phases. The acquisition of the in-vivo image is continued at least until the input of biological reaction occurrence information (S3). The process of acquiring the in-vivo image is performed as follows, for example.

  First, the subject E is placed on the top plate of the bed apparatus 30 and inserted into the opening of the gantry apparatus 10. When a predetermined scan start operation is performed, the control unit 41 sends a control signal to the scan control unit 42. Upon receiving this control signal, the scan control unit 42 controls the high voltage generation unit 14, the gantry drive unit 15, and the aperture drive unit 17 to scan a range including a predetermined part of the subject E with X-rays. The X-ray detection unit 12 detects X-rays that have passed through the subject E. The data collection unit 18 collects detection data sequentially generated from the X-ray detector 12 along with the scan. The data collection unit 18 sends the collected detection data to the preprocessing unit 431. The preprocessing unit 431 performs the above-described preprocessing on the detection data from the data collection unit 18 to generate projection data. The reconstruction processing unit 432 forms a plurality of in-vivo images having different time phases by performing a reconstruction process based on a preset reconstruction condition on the projection data.

(S2, S3: Input of biological reaction occurrence information)
When the operator recognizes the occurrence of a predetermined biological reaction (S2: YES), the operator operates the operation unit 46. Upon receiving the operation, the operation unit 46 inputs a signal as biological reaction occurrence information to the control unit 41 (S3).

(S4: Acquisition of appearance image)
Upon receiving the biological reaction occurrence information, the control unit 41 controls the appearance image acquisition unit 50 to image a predetermined part of the subject E. Or the control part 41 which received the generation | occurrence | production information of biological reaction outputs predetermined alerting | reporting information. The operator who has recognized the notification information operates the operation unit 46 to instruct acquisition of an appearance image. In response to this instruction, the appearance image acquisition unit 50 performs photographing. Thereby, an appearance image is obtained.

(S5: Identification of in-vivo images)
The image specifying unit 434 executes any one of the processes described above, so that among the plurality of in-vivo images acquired in step 1, the in-vivo body acquired substantially simultaneously with the input of biological reaction occurrence information (S 3). Identify the image.

(S6: Association and storage of in-vivo image and appearance image)
The control unit 41 associates the in-vivo image specified in step 5 with the appearance image acquired in step 4 and stores the image in the storage unit 44. This is the end of the operation according to the first operation example.

[Second operation example: FIG. 5]
(S11: Acquisition of in-vivo image)
Similar to the first operation example, acquisition of a plurality of in-vivo images having different time phases is started.

(S12: Acquisition of appearance image)
The appearance image acquisition unit 50 starts moving image shooting of a predetermined part of the subject E. Thereby, a plurality of appearance images along the time series are obtained. The acquisition of the appearance image is continued until at least the input of occurrence information of biological reaction (S14).

(S13, S14: Input of biological reaction occurrence information)
When the operator recognizes the occurrence of a predetermined biological reaction (S13: YES), the operator operates the operation unit 46. Upon receiving the operation, the operation unit 46 inputs a signal as biological reaction occurrence information to the control unit 41 (S14).

(S15: Identification of in-vivo image)
The image specifying unit 434 specifies an in-vivo image acquired substantially simultaneously with the input of biological reaction occurrence information (S14) among the plurality of in-vivo images acquired in step 11.

(S16: Identification of appearance image)
Furthermore, the image specifying unit 434 specifies the appearance image acquired substantially simultaneously with the input of the biological reaction occurrence information (S14) among the plurality of appearance images acquired in Step 12. The in-vivo image specifying process and the appearance image specifying process may be performed first or both in parallel.

(S17: Association and storage of in-vivo image and appearance image)
The control unit 41 associates the in-vivo image specified in step 15 with the appearance image specified in step 16 and stores the image in the storage unit 44. This is the end of the operation according to the second operation example.

[Display mode]
A method for displaying the in-vivo image and the appearance image stored as described above will be described.

[First display example]
This display example relates to a case where both an in-vivo image and an appearance image are displayed.

  In response to receiving a predetermined trigger, the control unit 41 reads in-vivo images and appearance images associated with each other from the storage unit 44 and causes the display unit 45 to display them. As the display mode, only one of the read in-vivo image and appearance image may be displayed, or both may be displayed. The latter includes a case where both images are displayed side by side and a case where the other image is displayed superimposed on one image.

  According to the first display example, both images associated with each other can be browsed easily.

[Second display example]
This display example relates to a case where a display request for one of the in-vivo image and the appearance image is made. When this display example is applied, an instruction unit for instructing display of one of the in-vivo image and the appearance image associated with each other is provided. The instruction unit includes an operation unit 46.

  The control unit 41 causes the display unit 45 to display a screen for designating an image. On this screen, for example, at least one information of patient identification information (patient ID, patient name, etc.), shooting date and time, and a reduced image (thumbnail) of the shot image is presented. The operator designates desired information among the presented information using the operation unit 46.

  The control unit 41 recognizes the designation result as an instruction to display the one image, and displays the designated image and an image associated therewith (corresponding to the other image) corresponding to the instruction. 46 is displayed.

  According to the second display example, it is possible to facilitate the browsing operation of both associated images.

[Third display example]
This display example relates to a case where an in-vivo image is displayed as a moving image (including a slide show display).

  The control unit 41 causes the storage unit 44 to store a plurality of in-vivo images acquired by the in-vivo image acquisition unit 100. And the control part 41 performs a moving image display by switching and displaying these in-vivo images on the display part 45 at predetermined time intervals in order of a time series.

  When such a moving image display is performed, the control unit 41 generates a biological reaction at the timing when the in-vivo image (one or more frames: referred to as a specific frame) specified by the image specifying unit 434 is displayed. Information to be displayed is displayed on the display unit 45. This information is called occurrence timing information. Examples of the generation timing information include character string information or image information indicating the occurrence of a biological reaction, and numerical information indicating the generation timing and generation period (continuation period) of the biological reaction.

  The timing to display the occurrence timing information is the same timing as the display of a specific frame (the first one), the same timing as the display of one of a plurality of specific frames, or the specific frame (the first one) There are timings before the display. When displaying before a specific frame, the information which counts down arrival of the display timing of a specific frame (the first of them) can be displayed. Moreover, you may make it display the information counted up by the generation | occurrence | production start of biological reaction as a trigger, or the information counted down until the completion | finish of biological reaction.

  According to the third display example, it is possible to easily grasp in what state the body is in the living body information.

[Action / Effect]
The operation and effect of the X-ray CT apparatus 1 according to this embodiment will be described.

  The X-ray CT apparatus 1 includes an in-vivo image acquisition unit 100, an operation unit 46, an appearance image acquisition unit 50, a storage unit 44, an image specification unit 434, and a control unit 41. The in-vivo image acquisition unit 100 irradiates a predetermined part of the subject E with X-rays continuously or intermittently, and acquires a plurality of in-vivo images having different time phases. The operation unit 46 (input unit) inputs generation information indicating the occurrence of a predetermined biological reaction of the subject E. The appearance image acquisition unit 50 acquires an appearance image by imaging a predetermined part at least at an imaging timing corresponding to the input of occurrence information. The image specifying unit 434 (specifying unit) specifies an in-vivo image acquired substantially simultaneously with input of generation information among a plurality of in-vivo images. The control unit 41 stores the identified in-vivo image and the appearance image acquired at the above photographing timing in the storage unit 44 in association with each other.

  Thus, the X-ray CT apparatus 1 is configured to store both the in-vivo image and the appearance image obtained at the timing corresponding to the occurrence of the biological reaction in association with each other. Therefore, the image viewer can recognize that this in-vivo image (and appearance image) is obtained at the timing of occurrence of a biological reaction. Further, the viewer can grasp the internal state at the generation timing of the biological reaction, that is, the operation state of the body from the in-vivo image. Therefore, according to the X-ray CT apparatus 1, it is possible to grasp the relationship between the motion state of the body and the generation timing of the biological reaction. For example, when examining a joint part, the viewer can grasp the state of pain when the bone in the joint is in a state.

<Modification>
A modification of the medical image diagnostic apparatus according to the embodiment will be described. Any content described in the above embodiment can be combined with each modification. Moreover, it is also possible to combine modifications. Hereinafter, the same components as those in the above embodiment will be described with the same reference numerals.

[First Modification]
In the above embodiment, the operator inputs that a biological reaction has occurred by using the operation unit 46. On the other hand, in this modification, the state of the subject E is monitored and the occurrence of a biological reaction is automatically detected. A configuration example of a medical image diagnostic apparatus according to this modification is shown in FIG. A medical image diagnostic apparatus according to this modification is obtained by adding a detection unit 200 to, for example, the X-ray CT apparatus 1 of the above embodiment. In FIG. 6, the display unit 45 and the operation unit 46 are omitted.

  The detection unit 200 monitors the state of the subject E and detects the occurrence of a biological reaction, thereby inputting a signal as generation information of biological information. Biometric information to be targeted includes vocalization, facial expression, breathing, sweating, electrocardiogram, blood pressure, electromyogram, brain wave, pupil diameter, and the like. The biological reaction to be detected is, for example, a change in biological information accompanying pain. Such biological reactions are known.

  The utterance can be detected using a microphone. The detected content at this time includes the content of the utterance, the voice volume, and the like.

  The content of the utterance can be detected by, for example, a microprocessor (not shown) provided in the detection unit 200 executing a known voice recognition technique. This microprocessor determines whether or not the contents stored in advance have been uttered by analyzing the electrical signal output from the microphone. When it is determined that the content has been generated, the microprocessor inputs a generation signal to the control unit 41.

  The detection of the voice volume can be performed by, for example, a microprocessor (not shown) provided in the detection unit 200 analyzing an electrical signal output from the microphone. The microprocessor determines whether the volume is equal to or higher than a predetermined threshold based on the electrical signal. When it is determined that the volume is equal to or higher than the threshold, the microprocessor inputs a generated signal to the control unit 41.

  The facial expression and pupil diameter can be detected by photographing the patient's face and eyes and analyzing the photographed image.

  In the detection of a facial expression, a microprocessor (not shown) provided in the detection unit 200 analyzes a photographed image and expresses a characteristic point of a facial expression stored in advance (for example, a characteristic change of facial muscles accompanying the occurrence of pain). Point) and determining whether the positional relationship between these feature points matches the positional relationship corresponding to the biological reaction. When it is determined that the positional relationship corresponding to the biological reaction is satisfied, the microprocessor inputs a generation signal to the control unit 41.

  In the detection of the pupil diameter, a microprocessor (not shown) provided in the detection unit 200 analyzes the captured image to extract an image region (eye region) corresponding to the eye, and analyzes the eye region to analyze the pupil. This can be done by specifying an image region (pupil region) corresponding to and calculating the diameter of the pupil region. The microprocessor determines whether the pupil diameter is within a predetermined tolerance. When it is determined that the pupil diameter is outside the allowable range, the microprocessor inputs a generation signal to the control unit 41.

  Respiration, sweating, electrocardiogram, blood pressure, electromyogram, and electroencephalogram can be detected by using a known respiratory monitor device, sweat monitor device, electrocardiograph, blood pressure measuring device, electromyograph, and electroencephalograph, respectively. An electric signal indicating a detection result by these devices is input to a microprocessor (not shown) provided in the detection unit 200. The microprocessor determines whether a biological reaction has occurred by comparing the detection result with a predetermined threshold value. When it is determined that a biological reaction has occurred, the microprocessor inputs a generation signal to the control unit 41.

  The operation of the medical image diagnostic apparatus according to this modification will be described. An example of the operation is shown in FIG.

(S21: Start of monitoring of biological reaction)
The monitoring (monitoring) of the biological reaction by the detection unit 200 is started.

(S22: Acquisition of in-vivo image)
Similar to the above embodiment, acquisition of a plurality of in-vivo images having different time phases is started.

(S23, S24: Input of occurrence information of biological reaction)
When detecting the occurrence of a predetermined biological reaction (S23: YES), the detection unit 200 inputs a signal as biological reaction occurrence information to the control unit 41 (S24).

(S25: Acquisition of appearance image)
Upon receiving the biological reaction occurrence information, the control unit 41 controls the appearance image acquisition unit 50 to image a predetermined part of the subject E. Or the control part 41 which received the generation | occurrence | production information of biological reaction outputs predetermined alerting | reporting information. The operator who has recognized the notification information operates the operation unit 46 to instruct acquisition of an appearance image. In response to this instruction, the appearance image acquisition unit 50 performs photographing. Thereby, an appearance image is obtained.

(S26: Identification of in-vivo image)
The image specifying unit 434 executes any one of the processes described above, so that among the plurality of in-vivo images acquired in Step 22, the in-vivo body acquired substantially simultaneously with the input of the occurrence information of biological reaction (S24). Identify the image.

(S27: Association and storage of in-vivo image and appearance image)
The control unit 41 associates the in-vivo image specified in step 26 with the appearance image acquired in step 25 and stores it in the storage unit 44. This is the end of the operation according to this operation example.

  Another operation example will be described with reference to FIG.

(S31: Start of monitoring of biological reaction)
The monitoring (monitoring) of the biological reaction by the detection unit 200 is started.

(S32: Acquisition of in-vivo image)
Similar to the above embodiment, acquisition of a plurality of in-vivo images having different time phases is started.

(S33: Acquisition of appearance image)
The appearance image acquisition unit 50 starts moving image shooting of a predetermined part of the subject E. Thereby, a plurality of appearance images along the time series are obtained. The acquisition of the appearance image is continued until at least the input of occurrence information of biological reaction (S14).

(S34, S35: Input of occurrence information of biological reaction)
When the detection unit 200 detects the occurrence of a predetermined biological reaction (S34: YES), the detection unit 200 inputs a signal as generation information of the biological reaction to the control unit 41 (S35).

(S36: Identification of in-vivo image)
The image specifying unit 434 specifies an in-vivo image acquired substantially simultaneously with the input of biological reaction occurrence information (S35) among the plurality of in-vivo images acquired in step 32.

(S37: Identification of appearance image)
Further, the image specifying unit 434 specifies the appearance image acquired substantially simultaneously with the input of the biological reaction occurrence information (S35) among the plurality of appearance images acquired in step 33. The in-vivo image specifying process and the appearance image specifying process may be performed first or both in parallel.

(S38: Association and storage of in-vivo image and appearance image)
The control unit 41 associates the in-vivo image specified in step 36 with the appearance image specified in step 37 and stores it in the storage unit 44. This is the end of the operation according to this operation example.

  According to the medical image diagnostic apparatus according to this modification, as in the above-described embodiment, it is possible to grasp the relationship between the action state of the body and the generation timing of the biological reaction. Furthermore, since the occurrence of a biological reaction can be automatically detected, the user's hand is not bothered for that purpose.

[Second Modification]
In this modification, a function for estimating and presenting a site causing pain will be described. A configuration example of a medical image diagnostic apparatus according to this modification is shown in FIG. In the medical image diagnostic apparatus according to this modification, for example, a cause area estimation unit 436 is added to the processing unit 43 of the X-ray CT apparatus 1 of the above-described embodiment.

  The cause region estimation unit 436 analyzes one or more in-vivo images including the in-vivo image specified by the image specifying unit 434 and estimates a pain cause region. In addition, the cause area estimation unit 436 may be configured to analyze the in-vivo area and estimate the degree of pain. The cause area estimation unit 436 is an example of an “estimation unit”.

  An example of examination of a joint part will be described. The cause region estimation unit 436 analyzes the in-vivo image as shown in FIG. 3 and specifies an image region (bone region) corresponding to the bone located at the joint part. Further, the causal area estimation unit 436 analyzes the identified bone area and estimates the pain causal area based on the shape and pixel value (luminance value, CT value, etc.). At this time, you may consider the result of the other test | inspection performed beforehand. Moreover, you may refer the information which matched the shape and / or pixel value, and the cause area | region created beforehand based on clinical data. As an area causing pain, there is an image area corresponding to a diseased part such as cartilage wear, fracture, or tumor.

  In addition, the cause area estimation unit 436 analyzes the in-vivo image centering on the estimated cause area, and estimates the degree of pain based on the shape and pixel value (luminance value, CT value, etc.). At this time, you may consider the result of the other test | inspection performed beforehand. In addition, information that is created in advance based on clinical data and that associates the shape, size, and / or pixel value of the causative region with the degree of pain may be referred to.

  When the control unit 41 displays the in-vivo image on the display unit 45, the control unit 41 changes the display mode of the cause area and the display mode of the other image areas. As specific examples, the cause area may be displayed with a color, or the cause area may be surrounded by a frame. Moreover, the control part 41 can display a cause area | region with the display mode according to the estimated grade of the pain. As a specific example, the display color can be changed according to the degree of pain, and the display color of the frame and the line form (solid line, broken line, etc.) can be changed.

  An example of the in-vivo image display mode according to this modification is shown in FIG. In the in-vivo image H, a frame Ha indicating a pain cause region estimated by the cause region estimation unit 436 is displayed by a broken line. Further, a frame Hb indicating a region in which the level of pain is estimated to be particularly large in the cause region is displayed with a solid line.

  According to such a modified example, in addition to the effects of the embodiment and the modified example, it is possible to easily grasp the site causing the pain and the degree of the pain.

[Third Modification]
In this modification, a function for estimating and presenting the cause of pain will be described. A configuration example of a medical image diagnostic apparatus according to this modification is shown in FIG. In the medical image diagnostic apparatus according to this modification, for example, a cause estimation unit 437 is added to the processing unit 43 of the X-ray CT apparatus 1 of the above embodiment. This modification can be used in combination with the second modification.

  The cause estimating unit 437 analyzes one or more in-vivo images including the in-vivo image specified by the image specifying unit 434 to estimate the cause of pain. The cause estimation unit 437 is an example of an “estimation unit”.

  An example of examination of a joint part will be described. In this case, causes of pain include cartilage wear, fractures, tumors, and the like. The cause estimating unit 437 analyzes the in-vivo image as shown in FIG. 3 and specifies an image region (bone region) corresponding to the bone located at the joint site. Further, the cause estimating unit 437 analyzes the identified bone region and estimates the cause of pain based on the shape and pixel value (luminance value, CT value, etc.). At this time, you may consider the result of the other test | inspection performed beforehand. Moreover, you may refer the information which matched the shape and / or pixel value, and the cause area | region created beforehand based on clinical data.

  The control unit 41 causes the display unit 45 to display information indicating the cause of pain estimated by the cause estimation unit 437. This information is, for example, text information (“cartilage wear”, “fracture”, “tumor”, etc.) indicating the cause of pain. A specific example is shown in FIG. The display unit 45 is provided with a pain cause display unit 45a. The control unit 41 causes the pain cause display unit 45a to display text information “wear of cartilage” indicating the cause of pain estimated by the cause estimation unit 437.

  According to this modification, in addition to the effects of the embodiment and the modification, it is possible to easily grasp the cause of pain.

[Other variations]
A medical image diagnostic apparatus (first medical image diagnostic apparatus) according to an embodiment or a modified example uses a biological reaction generation information (information indicating generation timing), an in-vivo image, and / or an appearance image as another medical image diagnostic apparatus. (This second medical image diagnostic apparatus) can be transmitted.

  The second medical image diagnostic apparatus includes an X-ray CT apparatus, an X-ray imaging apparatus, an MRI (magnetic resonance imaging) apparatus, a PET (positron tomography) apparatus, a SPECT (single photon emission tomography) apparatus, and an ultrasonic diagnosis. It can be any type of modality, such as a device.

  The second medical image diagnostic apparatus acquires the generation timing of the biological reaction based on the information received from the first medical image diagnostic apparatus, and performs imaging based on the generation timing. Thereby, also in other medical image diagnostic apparatuses, imaging can be performed at a timing corresponding to the occurrence of a biological reaction. In addition, it is possible to grasp the relationship between the movement state of the body and the generation timing of the biological reaction.

  The second medical image diagnostic apparatus superimposes the in-vivo image and / or appearance image obtained by the first medical image diagnostic apparatus and the image acquired by the second medical image diagnostic apparatus, thereby A fusion image can be displayed. A well-known method can be used for the fusion image display process including the image alignment process.

  The occurrence information, in-vivo image and / or appearance image of the biological reaction acquired by the medical image diagnostic apparatus according to the embodiment or the modified example can be used for medical actions other than medical image diagnosis. Examples of application targets include artificial joint design, rehabilitation, and informed consent.

  In designing an artificial joint, it is possible to refer to the timing at which pain occurs or to refer to the movable range of a joint that can be grasped based on a plurality of in-vivo images. In rehabilitation, this can be accomplished while knowing how much the joint is bent and how much pain has occurred. With informed consent, it is possible to easily explain the relationship between the state of movement of the body and the timing of occurrence of a biological reaction.

  In the above embodiments and modifications, the example of the X-ray CT apparatus has been described in detail, but the same configuration can be applied to the X-ray imaging apparatus. An X-ray imaging apparatus acquires an in-vivo image by outputting X-rays from an X-ray tube, and detecting and visualizing X-rays transmitted through a subject with an X-ray detector (imaging plate). In addition to forming an image on a plane orthogonal to the direction connecting the X-ray tube and the X-ray detector, the X-ray imaging apparatus can also reconstruct a three-dimensional image from a plurality of images taken from different directions. is there. The X-ray imaging apparatus is used as an “in-vivo image acquisition unit”.

  A medical image diagnostic apparatus according to another embodiment will be described. This embodiment includes an in-vivo image acquisition unit, an appearance image acquisition unit, a storage unit, and a control unit. The in-vivo image acquisition unit acquires a plurality of in-vivo images having different time phases by continuously or intermittently irradiating a predetermined part of the subject with X-rays. The appearance image acquisition unit acquires the appearance image by imaging the predetermined part at least at the imaging timing corresponding to the occurrence of the predetermined biological reaction of the subject. The control unit stores a plurality of in-vivo images and appearance images in association with each other in the storage unit. Here, the in-vivo image and the appearance image stored in the storage unit do not have to be all of those acquired above.

  An example of this medical image diagnostic apparatus will be described. The in-vivo image acquisition operation by the in-vivo image acquisition unit and the appearance image acquisition operation by the appearance image acquisition unit are synchronized. As an example of this synchronization, both image acquisition operations can be started simultaneously. It is also possible to start the other image acquisition operation after starting one image acquisition operation. In these examples, the timing of both image acquisition operations can be grasped on the same time axis. For example, both image acquisition operations (for example, timing for starting image acquisition) can be recorded as coordinates on the same time axis. It is also possible to record the time difference between the image acquisition operations of both (for example, the time difference of the timing to start image acquisition, including zero time difference). Such time-related processing can be performed using, for example, a time measuring function of the control unit (microprocessor).

  The control unit performs such synchronization control, and stores the in-vivo image and the appearance image acquired thereby in the storage unit in association with each other. At this time, the control unit can store information related to time such as the coordinate values and the time difference on the time axis in the storage unit in association with the in-vivo image and the appearance image. Further, when both image acquisition operations are always performed with the same time difference, it is not necessary to store information regarding the time.

  When browsing both images, it is possible to control the display timing of both images in consideration of stored time information or a predetermined time difference. That is, the display timing of both images can be performed by performing the same synchronous control as the acquisition timing of these images. Thereby, the time axes of both display images can be matched (that is, both images can be displayed along the same time axis).

  According to such an embodiment, for example, it is possible to grasp the body reaction state from one image and grasp the occurrence timing of the biological reaction from the other image. Therefore, it is possible to obtain the relationship between the body motion state and the occurrence timing of the biological reaction.

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

DESCRIPTION OF SYMBOLS 1 X-ray CT apparatus 10 Base apparatus 11 X-ray generation part 12 X-ray detection part 13 Rotating body 14 High voltage generation part 15 Base drive part 16 X-ray aperture part 17 Aperture drive part 18 Data collection part 30 Bed apparatus 40 Console apparatus 41 Control unit 42 Scan control unit 43 Processing unit 431 Preprocessing unit 432 Reconstruction processing unit 433 Rendering processing unit 434 Image specifying unit 435 Analysis unit 436 Cause region estimation unit 437 Cause estimation unit 44 Storage unit 45 Display unit 46 Operation unit

Claims (14)

An in-vivo image acquisition unit that continuously or intermittently irradiates a predetermined part of the subject to acquire a plurality of in-vivo images having different time phases;
An input unit for inputting occurrence information representing occurrence of a biological reaction in a specific state of the subject;
An appearance image acquisition unit that acquires an appearance image by imaging the predetermined portion at least at an imaging timing corresponding to the input of the occurrence information;
First part shape information representing the shape of the predetermined part is obtained by analyzing an appearance image at the imaging timing, and second part shape information representing the shape of the predetermined part by analyzing the plurality of in-vivo images A specifying unit for specifying an in-vivo image corresponding to the second part shape information substantially matching the first part shape information among the plurality of second part shape information acquired;
A storage unit;
A controller that associates the identified in-vivo image with the appearance image acquired at the photographing timing and stores the associated in-vivo image in the storage unit; And a medical image diagnostic apparatus.   The medical image diagnosis apparatus according to claim 1, wherein the control unit causes the display unit to display an appearance image acquired at the imaging timing in addition to the identified in-vivo image.   The medical image diagnostic apparatus according to claim 1, wherein the first part shape information and the second part shape information include contour information indicating a contour shape of a body surface at the predetermined part. . The predetermined part is a joint part;
The medical image diagnosis according to claim 1 or 2, wherein the first part shape information and the second part shape information include angle information indicating an angle formed by a bone and a bone in the joint part. apparatus.   Each of the first part shape information and the second part shape information includes feature position information representing a position or shape of an image region corresponding to the predetermined part, and the first part shape information includes the first part shape information The medical image diagnosis apparatus according to claim 1, wherein the feature position information and the second part shape information include second feature position information.   6. The first feature position information and the second feature position information include marker position information indicating a position of an image region representing a marker attached to the body surface of the subject. The medical image diagnostic apparatus described. The appearance image acquisition unit sequentially acquires appearance images by repeatedly photographing the predetermined part,
The specifying unit specifies an appearance image acquired substantially simultaneously with the input of the occurrence information among the sequentially acquired appearance images;
The said control part links | relates the said in-vivo image each identified by the said specific part, and the said external appearance image, It memorize | stores in the said memory | storage part. Medical diagnostic imaging device.   The medical image diagnostic apparatus according to claim 1, wherein the input unit includes an operation unit that inputs a signal as the generation information in response to an operation by an operator. .   The input unit includes a detection unit that monitors the state of the subject, detects the occurrence of the biological reaction, and inputs a signal as the generation information. The medical image diagnostic apparatus according to claim 1. The specific state of the subject is a state where pain has occurred, and the occurrence information is information indicating that the pain has become apparent,
The medical image diagnostic apparatus according to claim 9, wherein the detection unit detects a change in biological information associated with pain as the biological reaction. The specific state of the subject is a state where pain has occurred, and the occurrence information is information indicating that the pain has become apparent,
An estimation unit that analyzes one or more in-vivo images including the in-vivo image specified by the specifying unit and estimates a pain-causing region;
A display unit, and
The said control part displays an in-vivo image on the said display part by making the display aspect of the said cause area of the said pain different from the display aspect of another image area | region. The medical image diagnostic apparatus according to any one of the above. The estimation unit analyzes the one or more internal regions to estimate the degree of pain;
The medical image diagnostic apparatus according to claim 11, wherein the control unit displays the pain cause area in a display mode according to the estimated degree of pain. The specific state of the subject is a state where pain has occurred, and the occurrence information is information indicating that the pain has become apparent,
An estimation unit that analyzes one or more in-vivo images including the in-vivo image specified by the specifying unit and estimates the cause of pain;
A display unit, and
The medical image diagnostic apparatus according to any one of claims 1 to 11, wherein the control unit displays information indicating the estimated cause of the pain on the display unit. The in-vivo image acquisition unit
X-ray CT apparatus that repeatedly scans the subject with X-rays to collect data, and reconstructs the collected data to form the plurality of in-vivo images, or
The subject is irradiated with X-rays continuously or intermittently, X-rays transmitted through the subject are detected, and the plurality of in-vivo images are formed along a plane substantially orthogonal to the X-ray irradiation direction. It is an X-ray imaging apparatus. The medical image diagnostic apparatus as described in any one of Claims 1-12 characterized by the above-mentioned.

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