JP6104529B2 - Ultrasonic diagnostic apparatus, image generation apparatus, and image display apparatus - Google Patents

Ultrasonic diagnostic apparatus, image generation apparatus, and image display apparatus Download PDF

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JP6104529B2
JP6104529B2 JP2012152728A JP2012152728A JP6104529B2 JP 6104529 B2 JP6104529 B2 JP 6104529B2 JP 2012152728 A JP2012152728 A JP 2012152728A JP 2012152728 A JP2012152728 A JP 2012152728A JP 6104529 B2 JP6104529 B2 JP 6104529B2
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ultrasonic
image
storage
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JP2014014446A (en
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敏江 丸山
敏江 丸山
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東芝メディカルシステムズ株式会社
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Description

  Embodiments described herein relate generally to an ultrasonic diagnostic apparatus, an image generation apparatus, and an image display apparatus.

  An ultrasonic diagnostic apparatus is an apparatus that acquires and displays an ultrasonic image of in-vivo information, and is less expensive and less exposed than other diagnostic imaging apparatuses such as an X-ray diagnostic apparatus and an X-ray CT (Computer Tomography) apparatus. It is used as a useful device for observing the inside of a subject in real time.

  The ultrasonic diagnostic apparatus is also used for mass examination of breasts and the like. In mass screening, doctors have to check many subjects in a short time. Therefore, in recent years, group examinations are generally divided into primary examinations and secondary examinations in order to improve examination efficiency.

  In the primary examination, for example, an engineer operates an ultrasound diagnostic apparatus to display an ultrasound image of the examination site of the subject on the monitor, while an ultrasound image of the place where the subject complains of symptoms, An ultrasonic image at a location where it is determined that image storage is necessary is stored in a database, or measurement processing is performed on the ultrasonic image.

  In the secondary examination, for example, a doctor performs diagnosis by viewing the ultrasonic images of each subject stored in the primary examination and the results of measurement processing one by one.

  In such a secondary examination, it is determined to which subject the ultrasonic image stored in the primary examination and the result of the measurement process correspond, and also to which position in the examination site of the subject. There is a need to. In a mass screening for a large number of subjects, the time required for this determination is enormous.

JP 2008-206747 A

  The problem to be solved by the present invention is to improve the efficiency of diagnosis using an ultrasonic image generated and stored using an ultrasonic diagnostic apparatus.

An ultrasonic diagnostic apparatus according to an embodiment includes a position detection unit, an ultrasonic image generation unit, a display unit, a reference image generation unit, and a storage processing unit. The position detection unit detects the position of an ultrasonic probe that transmits and receives ultrasonic waves to and from the subject. The ultrasonic image generation unit generates an ultrasonic image based on a signal obtained by transmission / reception of ultrasonic waves by the ultrasonic probe. The display unit displays the ultrasonic image. The reference image generation unit, when performing transmission / reception of the ultrasonic wave while moving the ultrasonic probe, stores the ultrasonic image sequentially displayed on the display unit as the ultrasonic probe moves. Are input at a desired timing, a moving path of the ultrasonic probe, and a storage position mark indicating a position detected by the position detection unit when the storage instruction is input, A reference image superimposed on a body mark representing an examination site is generated. The storage processing unit stores, in the storage unit, the ultrasonic image and the reference image for which the storage instruction has been made in association with the subject information.





The block diagram which shows the principal part structure of the ultrasonic diagnosing device which concerns on one Embodiment. The flowchart of the process which an ultrasonic diagnosing device performs by the primary test | inspection in the embodiment. The figure for demonstrating the measurement process in the embodiment. The figure which shows an example of the test | inspection information pictorial chart in the embodiment. The figure which shows the data structure example of the database in the embodiment. The flowchart of the process which an ultrasonic diagnosing device performs by the secondary test | inspection in the embodiment. The figure which shows an example of the browsing screen displayed by the secondary test | inspection in the embodiment. The figure which shows an example of the diagnostic screen displayed by the secondary test | inspection in the embodiment. 5 is a flowchart of processing executed by the ultrasonic diagnostic apparatus in the diagnostic processing according to the embodiment. The figure which shows an example of the diagnostic screen displayed by the secondary test | inspection in the embodiment. The figure which shows an example of the diagnostic screen displayed by the secondary test | inspection in the embodiment.

An embodiment will be described with reference to the drawings.
In the present embodiment, a case will be described in which a breast mass screening is performed by an ultrasonic diagnostic apparatus. Furthermore, in this group examination, a doctor interprets the ultrasound image stored in the primary examination and the primary examination in which the technician scans the breasts of each subject with an ultrasound probe and stores the necessary ultrasound images. It shall be conducted separately from the secondary inspection.

[Ultrasonic diagnostic equipment]
FIG. 1 is a block diagram showing a main configuration of an ultrasonic diagnostic apparatus 1 according to the present embodiment. The ultrasonic diagnostic apparatus 1 also functions as an image generation apparatus and an image display apparatus according to this embodiment.

  As shown in FIG. 1, an ultrasonic diagnostic apparatus 1 includes an ultrasonic probe 2, an apparatus main body 3, an input apparatus 4 (input section), a monitor 5 (display section), a position information acquisition apparatus 6, a transmitter 7, and a magnetic sensor. 8 etc.

  The ultrasonic probe 2 includes a plurality of piezoelectric vibrators, a matching layer provided in each piezoelectric vibrator, a backing material that prevents propagation of ultrasonic waves from each piezoelectric vibrator to the rear, and the like. Each piezoelectric vibrator generates an ultrasonic wave based on a drive signal supplied from the apparatus main body 3, and further receives a reflected wave from the subject P and converts it into an electric signal. The ultrasonic probe 2 may be any kind of probe such as a sector type, a linear type, or a convex type.

  When ultrasonic waves are transmitted from the ultrasonic probe 2 to the subject P, the transmitted ultrasonic waves are reflected one after another at the discontinuous surface of the acoustic impedance in the body tissue of the subject P, and the ultrasonic probe as a reflected wave signal 2 is received by a plurality of piezoelectric vibrators. The amplitude of the received reflected wave signal depends on the difference in acoustic impedance at the discontinuous surface where the ultrasonic wave is reflected. The reflected wave signal when the transmitted ultrasonic pulse is reflected by the moving blood flow or the surface of the heart wall depends on the velocity component of the moving body in the ultrasonic transmission direction due to the Doppler effect. Subject to frequency shift.

  The input device 4 includes a mouse, a trackball, a keyboard, a touch panel, and the like for taking various instructions from the operator, a region of interest (ROI) setting instruction, and various image quality condition setting instructions into the apparatus body 3. .

  The monitor 5 displays a GUI (Graphical User Interface) for the operator of the ultrasonic diagnostic apparatus 1 to input various instructions using the input device 4 or an ultrasonic image based on image data generated in the apparatus main body 3. Is displayed.

  The transmitter 7 forms a magnetic field having a predetermined intensity around the own device.

  The magnetic sensor 8 is attached to the ultrasonic probe 2. The magnetic sensor 8 detects the intensity and direction of the magnetic field formed by the transmitter 7, generates a signal corresponding to the detection result, and outputs the signal to the position information acquisition device 6.

  The position information acquisition device 6 is based on a signal received from the magnetic sensor 8, for example, in a three-dimensional coordinate space (X, Y, Z) defined by the X axis, the Y axis, and the Z axis with the transmitter 7 as the origin. The position (x, y, z) and orientation (θx, θy, θz) of the ultrasonic probe 2 are calculated. Here, θx is the rotation angle of the ultrasound probe 2 around the X axis, θy is the rotation angle of the ultrasound probe 2 around the Y axis, and θz is the ultrasound probe around the Z axis. The rotation angle is 2.

  The position information acquisition device 6, the transmitter 7, and the magnetic sensor 8 constitute a position detection unit that detects the position of the ultrasonic probe 2.

  The apparatus main body 3 includes a transmission / reception unit 10, a B-mode processing unit 11, a Doppler processing unit 12, an image generation unit 13 (ultrasonic image generation unit), an image memory 14, an internal storage unit 15, an interface unit 16, a control unit 17, and the like. Is provided.

  The transmission / reception unit 10 includes a trigger generation circuit, a delay circuit, a pulsar circuit, and the like as a transmission system circuit. The pulsar circuit repeatedly generates rate pulses for forming transmission ultrasonic waves at a predetermined rate frequency. The delay circuit gives a delay time for each piezoelectric vibrator necessary for determining the transmission directivity to each ultrasonic pulse generated by the ultrasonic probe 2 for each rate pulse generated by the pulsar circuit. . The trigger generation circuit supplies a drive signal (drive pulse) to the ultrasonic probe 2 at a timing based on the rate pulse. In other words, the delay circuit arbitrarily adjusts the transmission direction from the piezoelectric vibrator surface by changing the delay time given to each rate pulse.

  The transmission / reception unit 10 includes an amplifier circuit, an A / D converter, an adder, and the like as a reception system circuit. The amplifier circuit performs gain correction processing by amplifying the reflected wave signal received by the ultrasonic probe 2 for each channel. The A / D converter provides a delay time necessary for A / D converting the gain-corrected reflected wave signal to determine the reception directivity. The adder performs an addition process of the reflected wave signal processed by the A / D converter to generate reflected wave data. By the addition processing of the adder, the reflection component from the direction corresponding to the reception directivity of the reflected wave signal is emphasized.

  The B-mode processing unit 11 receives reflected wave data from the transmission / reception unit 10 and performs logarithmic amplification, envelope detection processing, etc. on the received reflected wave data, and data in which the signal intensity is expressed by brightness brightness (B-mode data) is generated.

  The Doppler processing unit 12 performs frequency analysis on velocity information from the reflected wave data received from the transmission / reception unit 10, extracts blood flow, tissue, or contrast agent echo components due to the Doppler effect, and calculates average velocity, dispersion, power, and the like. Data (Doppler data) obtained by extracting moving body information for multiple points is generated.

  The image generation unit 13 generates image data of an ultrasound image from the B mode data generated by the B mode processing unit 11 and the Doppler data generated by the Doppler processing unit 12. Specifically, the image generation unit 13 converts (scan converts) a scanning line signal sequence of ultrasonic scanning into a scanning line signal sequence of a video format typified by a television or the like, so that B mode data or Doppler data is obtained. Image data for display (B-mode image data or Doppler image data) is generated from the image data.

  The image memory 14 stores the image data generated by the image generation unit 13. Further, the image memory 14 stores an output signal (RF: Radio Frequency) immediately after passing through the transmission / reception unit 10, an image luminance signal, various raw data, image data acquired via a network, and the like as necessary. . Even if the data format of the image data stored in the image memory 14 is the data format after the video format conversion displayed on the monitor 5, the coordinates that are the raw data generated by the B-mode processing unit 11 and the Doppler processing unit 12 The data format before conversion may be used.

  The internal storage unit 15 stores various data such as a diagnostic protocol and a database 150 for storing data related to breast mass screening. Furthermore, the internal storage unit 15 is also used for storing image data stored in the image memory 14 as necessary.

  The interface unit 16 controls transmission / reception of various types of information between the input device 4, the position information acquisition device 6, the network, and the device body 3.

  The control unit 17 includes a central processing unit (CPU), a read only memory (ROM), a random access memory (RAM), and the like, and comprehensively controls the ultrasonic diagnostic apparatus 1. Specifically, the control unit 17 is based on various setting requests input by the operator via the input device 4, various control programs and various setting information read from the internal storage unit 15 or the ROM, etc. The operation of the B-mode processing unit 11, the Doppler processing unit 12 and the image generation unit 13 is controlled, and the image data stored in the image memory 14 is displayed on the monitor 5.

  In the breast mass screening, the control unit 17 includes a main processing unit 100, a measurement processing unit 101, a reference image generation unit 102, a storage processing unit 103, a first display processing unit 104, and a second display processing unit 105. Realize the function. The operation of each part will be clarified in the following description.

  Next, the operation of the ultrasonic diagnostic apparatus 1 in breast mass screening will be described.

[Primary inspection]
First, the operation of the ultrasonic diagnostic apparatus 1 in the primary examination described above will be described. FIG. 2 is a flowchart showing a flow of processing executed by the ultrasonic diagnostic apparatus 1 for one subject in the primary examination. The processing shown in this flowchart is mainly executed by the main processing unit 100, the measurement processing unit 101, the reference image generation unit 102, and the storage processing unit 103.

  First, the main processing unit 100 receives input of subject information such as information (Premenopausal / Postmenopausal) on the subject's ID, name, age, weight, height, and menopause (step S101). The subject information may be input, for example, by operating the input device 4 by an operator such as a doctor or engineer, or input to the ultrasonic diagnostic apparatus 1 via a recording medium such as a CD-ROM or USB memory. May be. In addition, the subject information may be input to the ultrasonic diagnostic apparatus 1 from an external apparatus via a network.

  After the subject information is input, for example, a primary examination for the subject related to the subject information is performed in the order of an examination for the right breast and an examination for the left breast. .

  First, the main processing unit 100 performs reference coordinate acquisition processing (step S102). This process is a process for defining the positional relationship between the breast and the ultrasonic probe 2 in the magnetic field generated by the transmitter 7. In the present embodiment, the positions (x, y, z) of the ultrasonic probe 2 at two points of the armpit and the nipple are determined as reference coordinates.

  For example, when performing an examination on the right breast, the operator sequentially arranges the ultrasonic probe 2 on the right armpit and right nipple of the subject, and at the positions, the reference coordinates are set via the input device 4. Enter acquisition instructions. The main processing unit 100 sets the position (x, y, z) of the ultrasonic probe 2 calculated by the position information acquisition device 6 when these acquisition instructions are input, to the right armpit position and the right nipple position, respectively. Is temporarily stored in the RAM of the control unit 17.

  When the reference position acquisition process is completed, the main processing unit 100 starts recording the position (x, y, z) of the ultrasonic probe 2 calculated by the position information acquisition device 6 (step S103). Thereafter, the main processing unit 100 acquires the position (x, y, z) calculated by the position information acquisition device 6 at a predetermined period, and in time series in the position recording work area formed in the RAM of the control unit 17. Write.

  After step S103, the main processing unit 100 starts generating image data of the ultrasound image and displaying an ultrasound image based on the generated image data (step S104). Specifically, the main processing unit 100 issues commands to the transmission / reception unit 10, the B-mode processing unit 11, and the image generation unit 13 to transmit / receive ultrasonic waves by the ultrasonic probe 2 and an ultrasonic image (B in this embodiment). Mode image) is started, and an ultrasonic image based on the generated image data is displayed on the monitor 5.

  After step S104, the storage processing unit 103 determines whether an ultrasonic image storage instruction has been input by the operator (step S105). The save instruction is input, for example, when the operator operates a store button provided on the input device 4.

  If it is determined that a storage instruction has been input (Yes in step S105), the storage processing unit 103 calculates the ultrasonic probe 2 calculated by the position information acquisition device 6 from the image data of the ultrasonic image currently displayed on the monitor 5. Are associated with the current position (x, y, z) and temporarily stored in the RAM of the control unit 17 (step S106).

  After step S106, the measurement processing unit 101 determines whether a measurement instruction is input by the operator (step S107). The measurement instruction is input by, for example, an operator operating a measurement button provided on the input device 4.

  If it is determined that a measurement instruction has been input (Yes in step S107), the measurement processing unit 101 displays an ultrasonic image based on the image data stored in step S106 on the monitor 5, and performs a measurement process on the image. (Step S108).

  Here, an example of the measurement process will be described. FIG. 3 is an example of a diagnostic screen 50 displayed on the monitor 5 during the measurement process. On the diagnostic screen 50, an ultrasonic image U based on the image data stored in step S106 and a display area 51 for measurement results are arranged. The measurement processing unit 101 arranges, for example, one or more pairs of calipers indicated by “+” on the ultrasonic image U, and sets the distance between these calipers (between A-A and B-B in FIG. 3). measure. The distance measured here is, for example, a value obtained by converting an arbitrary unit distance between calipers on the ultrasonic image U into an actual distance (mm). Further, the measurement processing unit 101 displays the distance as a measurement result in the display area 51 like “Dist A 31.3 mm” or “Dist B 21.3 mm”.

  After step S108, the measurement processing unit 101 adds measurement data that is a result of the measurement process to the image data stored in step S106 (step S109). The measurement data is data including, for example, information regarding the caliper placement position on the ultrasonic image U, information indicating the distance between the calipers, and the like.

  After step S109, or when the storage processing unit 103 determines that no storage instruction is input in step S105 (No in step S105), or if no measurement instruction is input in step S107, the measurement processing unit 101 Is determined (No in step S107), the main processing unit 100 determines whether or not an instruction to end the examination is input (step S110). The end instruction is input, for example, when the operator operates the input device 4. In addition, the main processing unit 100 may automatically recognize the end of the inspection without an operator's operation. In this case, for example, a contact-type sensor is provided in the vicinity of the ultrasonic transmission / reception surface of the ultrasonic probe 2, and when it is detected by this sensor that the ultrasonic probe 2 is separated from the body surface of the subject, the main processing is performed. A configuration or the like that causes the unit 100 to determine that the inspection is complete may be employed.

  If the main processing unit 100 determines that the end instruction has not been input (No in step S110), the process returns to step S104.

  On the other hand, if it is determined that an end instruction has been input (Yes in step S110), the main processing unit 100 stops recording the position (x, y, z) of the ultrasonic probe 2 (step S111). Furthermore, the main processing unit 100 determines whether or not the inspection for the left and right breasts has been completed (step S112).

  The main processing unit 100 determines that the examination for the left and right breasts has not been completed when step S112 is executed for the first time after the processing shown in the flowchart is started, for example. It is determined that the examination for the breast has been completed. Note that an engineer who is an operator may select via the input device 4 whether or not the examination for the left and right breasts has been completed.

  If the main processing unit 100 determines that the examination for the left and right breasts has not been completed (No in step S112), the process returns to step S102, and the processes in steps S102 to S111 are performed on breasts that have not been examined. Executed.

  On the other hand, when the main processing unit 100 determines that the examination for the left and right breasts has been completed (Yes in step S112), the reference image generation unit 102 serves as a reference image in the secondary examination. Image data is generated (step S113).

  An example of the inspection information picture F is shown in FIG. The illustrated examination information picture F includes body marks BML and BMR imitating the shapes of the left and right breasts, movement path marks TML and TMR indicating the movement path of the ultrasound probe 2 when scanning the left and right breasts, and ultrasonic waves. The probe width marks WML and WMR representing the width of the piezoelectric vibrator surface of the probe 2 and the storage position mark SM indicating the position where the image data of the ultrasonic image is stored are superimposed.

  The body marks BML and BMR according to the present embodiment have a shape in which a cone is attached to a triple concentric circle. Body marks BML and BMR may use a predetermined shape in common for all subjects, or based on subject information (age, height, weight, etc.) input in step S101. The shape may be changed for each subject.

  The movement path mark TMR arranged on the body mark BMR of the right breast is a curve representing the locus of coordinates written in the above-described position recording work area at the time of examining the right breast. The movement path mark TML arranged on the left breast body mark BML is a curve representing a locus of coordinates written in the position recording work area at the time of examination of the left breast.

  In the present embodiment, for simplification of explanation, the X axis of the above-described three-dimensional coordinate space (X, Y, Z) is substantially parallel to the body axis of the subject, and the Y axis is the body width of the subject. The movement path marks TML and TMR are assumed to be substantially parallel to a direction (a direction along a straight line connecting both shoulders), and the locus (x, y) of the position (x, y) in the XY plane defined by the X axis and the Y axis. And

  When the movement path marks TML, TMR are arranged on the body marks BML, BMR, the reference coordinates stored in the RAM of the control unit 17 in step S102 are used. That is, the reference image generation unit 102 determines the base arm position (for example, the apex of the cone portion) and the nipple position (for example, the center of the concentric circle) that are predetermined in the body mark BMR, and the reference in step S102 when examining the right breast. The scale of the movement path mark TMR is adjusted so that the armpit and the nipple position (x, y) acquired as coordinates coincide with each other, and then the movement path mark TMR is arranged on the body mark BMR. In addition, the reference image generation unit 102 determines the position of the armpit (for example, the apex of the cone portion) and the position of the nipple (for example, the center of the concentric circle) predetermined in the body mark BML and the left breast at step S102. The scale of the movement path mark TML is adjusted so that the armpit and the nipple position (x, y) acquired as the reference coordinates coincide with each other, and then the movement path mark TML is arranged on the body mark BML.

  In addition, when the path | route which moves the ultrasonic probe 2 in a primary test is predetermined, the movement path | route marks TML and TMR of the shape showing the path | route are predetermined, and this movement path | route mark TML and TMR are set to a body. You may arrange | position on the mark BML and BMR.

  The probe width mark WMR is a curve connecting a position away from the movement path mark TMR by a specified distance corresponding to the length of the piezoelectric transducer surface of the ultrasonic probe 2, and the probe width mark WML is from the movement path mark TML. It is a curve connecting positions separated by a specified distance. The specified distance may be switched according to the type of the ultrasonic probe 2 used. The reference image generation unit 102 also adjusts the specified distance in accordance with the adjustment of the scale of the movement path mark TML.

  The storage position mark SM is obtained by adding a unique number to a symbol having a predetermined shape. In the example of FIG. 4, the symbol of the storage position mark SM has a cross shape. However, the symbol of the storage position mark SM corresponding to the image data of the ultrasonic image to which the measurement data is added in step S109 is made different in shape, pattern, or color from the other storage position marks SM. In the following description, the shape, pattern or color of the storage position mark SM corresponding to the image data of the ultrasonic image to which the measurement data is added is referred to as a measured notation. In FIG. 4, the storage position mark SM with the measured notation is a double cross shape.

  The number of each storage position mark SM is assigned in ascending order from 1 in the order in which the image data of the corresponding ultrasonic image is stored in step S106, for example. The reference image generation unit 102 arranges the storage position mark SM at a position on the movement path marks TML, TMR corresponding to the position (x, y) stored in association with the image data in step S106. When step S106 is executed a plurality of times, the reference image generation unit 102 arranges a plurality of storage position marks SM corresponding to each time.

  After the inspection information picture F is generated in step S113, the storage processing unit 103 receives the subject information input in step S101, the image data of the inspection information picture F, and the super information stored in step S106. A record including the image data of the sonic image and the inspection date (current date) is generated and stored in the database 150 (step S114). The storage processing unit 103 attaches the number included in the corresponding storage position mark SM to the image data of the ultrasonic image in this record. With step S114, the primary inspection for one subject is completed.

  When the processing shown in the flowchart of FIG. 2 is performed on a plurality of subjects, the database 150 stores subject information, image data D1 of examination information picture F, and image data of ultrasonic images as shown in FIG. A plurality of records including D2 and the like are stored. Each image data D2 is given a number (No.) as described above. In addition, the image data D2 of the ultrasonic image is not included in the record of the subject who has completed the primary examination without passing through step S106. Further, measurement data is added to the image data D2 of the ultrasonic image that has undergone the measurement processing in step S108, as in the image data D2 with the number “3” in FIG.

[Secondary inspection]
Next, the operation of the ultrasonic diagnostic apparatus 1 in the above-described secondary examination will be described. FIG. 6 is a flowchart showing a flow of processing executed by the ultrasonic diagnostic apparatus 1 in the secondary examination. The processing shown in this flowchart is mainly executed by the measurement processing unit 101, the storage processing unit 103, the first display processing unit 104, and the second display processing unit 105.

  First, the first display processing unit 104 displays the browsing screen 200 including the subject list 210 on the monitor 5 as shown in FIG. 7 (step S201). One row included in the subject list 210 corresponds to one record in the database 150. Each row of the subject list 210 includes subject information such as the subject ID and name included in the corresponding record, examination date (Exam Date), and image data D1 contained in the record. The thumbnail (Thumbnail) etc. of the inspection information picture F based on it are included. The hatched line indicates the currently selected line S. The selected row S can be sequentially switched in the vertical direction by operating the input device 4. Although FIG. 7 shows a state in which only a part of the subject list 210 is displayed, the rows displayed in the subject list 210 are sequentially switched according to the movement of the selected row S, for example.

  On the browsing screen 200, an image display area 220 is arranged below the subject list 210. In the image display area 220, an inspection information picture F based on the image data D1 included in the record corresponding to the selected row S of the database 150, an ultrasonic image U based on the image data D2 included in the record, and the like are arranged. . The examination information picture F arranged in the image display area 220 is an enlargement of the thumbnail included in the subject list 210.

  After step S201, the first display processing unit 104 determines whether or not a secondary inspection end instruction has been input (step S202). This end instruction is input, for example, when the operator operates the input device 4. When it is determined that the end instruction has not been input (No in step S202), the first display processing unit 104 determines whether or not a subject has been selected from the subject list 210 (step S203). For example, when the operator operates the input device 4 to input a diagnosis execution instruction, the subject corresponding to the currently selected row S is selected. In addition, when the operator operates a thumbnail included in the subject list 210 via the input device 4, the subject corresponding to the row including the thumbnail may be selected.

  When the first display processing unit 104 determines that the subject has not been selected (No in step S203), the process returns to step S201. On the other hand, when the first display processing unit 104 determines that the subject has been selected (Yes in step S203), the second display processing unit 105 causes the monitor 5 to display a diagnostic screen relating to the subject (step S204). . Further, the second display processing unit 105 or the like executes a diagnosis process using the diagnosis screen (step S205).

  An example of the diagnostic screen displayed in step S204 is shown in FIG. The illustrated diagnosis screen 300 includes an examination information picture F based on the image data D1 included in the selected subject record and an ultrasonic image U based on the image data D2 corresponding to the number “1” included in the record. Including. When no image data D2 is included in the record, the ultrasound image U is not arranged on the diagnosis screen 300.

  In such a diagnostic screen 300, the second display processing unit 105 makes the shape, pattern or color of the storage position mark SM corresponding to the ultrasonic image U being displayed different from the storage position mark SM not displayed. In the following description, the shape, pattern or color of the storage position mark SM being displayed is referred to as “displaying notation”, and the shape, pattern or color of the undisplayed storage position mark SM is referred to as “undisplayed notation”. In FIG. 8, the storage position mark SM (number “2”, “3”) not shown is added to the pattern or color of the storage position mark SM (displayed with the number “1”). Example).

While interpreting the ultrasonic image U displayed on such a diagnostic screen 300, a doctor who is an operator of the ultrasonic diagnostic apparatus 1 diagnoses the subject.
A flowchart of the diagnostic process in step S205 is shown in FIG.
In the diagnosis process, first, the second display processing unit 105 waits for an operation input by the operator (step S301). The operation input received here is, for example, a measurement instruction for the displayed ultrasound image U, an operation of the storage position mark SM included in the displayed examination information picture F, and a subject corresponding to the diagnosis screen 300. This is an input of an instruction to end the diagnosis process.

  When any operation input is made via the input device 4 (No in step S301), the second display processing unit 105 determines that the operation input is an input of a measurement instruction, an operation of the storage position mark SM, and the end of the diagnosis process. It is determined which of the instructions is input (step S302).

  When it is determined that the operation input is an operation of the storage position mark SM (“mark operation” in step S302), the second display processing unit 105 displays the currently displayed ultrasonic image U as the operated storage position mark. Replacement with an ultrasonic image based on the image data D2 corresponding to SM (step S303).

  After step S303, the second display processing unit 105 changes the operated storage position mark SM to display notation (step S304). Further, the second display processing unit 105 displays the shape, pattern or color of the storage position mark SM corresponding to the ultrasonic image U displayed before the replacement in step S303, a shape different from the displayed notation and the undisplayed notation, The pattern or color is changed (step S305). In the following description, the shape, pattern, or color of the storage position mark SM after the change is referred to as a displayed notation.

  FIG. 10 illustrates the diagnosis screen 300 after the storage position mark SM with the number “2” is operated from the state shown in FIG. In this case, in step S303, the ultrasonic image U is replaced with an ultrasonic image based on the image data D2 corresponding to the storage position mark SM with the number “2”. In step S304, the storage position mark SM with the number “2” is displayed, and in step S305, the number “1” corresponding to the ultrasonic image U displayed before the replacement is added. The storage position mark SM is displayed. In FIG. 10, the pattern or color of the displayed storage position mark SM (with the number “1”) is displayed as the storage position mark SM (with the number “2”) displayed. An example is shown in which the storage position mark SM (noted with the number “3”) is changed from an undisplayed notation.

  After step S305, the process returns to step S301, and the second display processing unit 105 waits for the next operation input by the operator.

  Note that, when the storage position mark SM of the measured notation becomes a notation being displayed, the second display processing unit 105 reflects the measurement data on the diagnosis screen 300. FIG. 11 illustrates a diagnostic screen 300 after the storage position mark SM with the number “3” is operated from the state shown in FIG. The storage position mark SM to which the number “3” is attached corresponds to the image data D2 to which the measurement data is added, and has been measured. The second display processing unit 105 places a caliper such as “+” at a position on the ultrasonic image U indicated by the measurement data. Further, the second display processing unit 105 arranges a display area 301 on the diagnosis screen 300, and sets the distance between the calipers indicated by the measurement data in the display area 301 to “Dist A 30.6 mm” or “Dist B 24.5 mm”. Is displayed.

  If it is determined in step S302 that the operation input made via the input device 4 is an input of a measurement instruction (“measurement instruction” in step S302), the measurement processing unit 101 performs a measurement process (step S306). In this measurement process, the measurement processing unit 101 arranges one or a plurality of calipers as shown in FIG. 11 on the ultrasonic image U according to the operation of the input device 4 and measures the distance between these calipers. Further, the second display processing unit 105 arranges a display area 301 as shown in FIG. 11 on the diagnosis screen 300, and displays the distance between the calipers indicated by the measurement data in this display area 301. When a measurement instruction is input in a state where the diagnostic screen 300 in which the measurement data is reflected is displayed as shown in FIG. 11, the measurement processing unit 101 moves or deletes the arranged calipers in step S306. May be accepted.

  After step S306, the second display processing unit 105 changes the storage position mark SM to the measured notation by making the storage position mark SM corresponding to the ultrasonic image U being displayed into a double cross shape ( Step S307).

  Further, the storage processing unit 103 adds the measurement data in step S306 to the image data D2 corresponding to the ultrasonic image U being displayed on the diagnostic screen 300, and steps to the image data D1 corresponding to the examination information picture F being displayed. The database 150 is updated by reflecting the change of the storage position mark SM in S307 (step S308).

  After step S308, the process returns to step S301, and the second display processing unit 105 waits for the next operation input by the operator.

  In step S302, when it is determined that the operation input made via the input device 4 is an input of an end instruction (“end instruction” in step S302), the storage processing unit 103 displays examination information being displayed on the diagnostic screen 300 It is determined whether or not the state of the storage position mark SM shown in the picture F (non-displayed notation and displayed notation state) should be maintained (step S309). Whether or not the state of the storage position mark SM should be retained may be determined, for example, according to an operation input by the operator via the input device 4, or setting information that determines whether or not the state of the storage position mark SM should be retained. May be stored in advance in the internal storage unit 15 or the like and determined based on the setting information.

  When it is determined that the state of the storage position mark SM shown in the currently displayed inspection information picture F should be maintained (Yes in step S309), the storage processing unit 103 stores the inspection information picture F stored in the database 150. The database 150 is updated by reflecting the current state of the storage position mark SM in the image data D1 (step S310). Specifically, the storage processing unit 103 displays all of the storage position marks SM included in the image data D1 that are displayed or displayed in the displayed inspection information picture F. Change to the notation.

  With the step S310, the diagnosis process shown in the flowchart of FIG. 9 is completed. If the storage processing unit 103 determines that the state of the storage position mark SM should not be maintained (No in step S309), the diagnostic process is terminated without passing through step S310.

  After the diagnosis process is thus completed, the process returns to step S201 in the flowchart of FIG. In step S201 executed at this time, the first display processing unit 104 displays the subject list 210 based on the database 150 after being updated in step S308 or step S310 on the monitor 5. That is, when the image data D1 of any record is updated in step S308 or step S310, thumbnails corresponding to the updated image data D1 are displayed in the subject list 210. In this thumbnail, all the storage position marks SM corresponding to the ultrasonic images displayed in the diagnostic process are displayed.

  When the diagnostic process is completed without passing through step S310, the storage position mark SM in the thumbnail of the examination information picture F of the subject is displayed in the diagnostic process in the subject list 210 displayed thereafter. Even the one corresponding to the displayed ultrasonic image is not displayed.

  When the doctor who is an operator finishes the diagnosis process for all the subjects included in the subject list 210, he / she inputs an instruction to end the secondary examination via the input device 4. At this time, the first display processing unit 104 determines that an end instruction has been input (Yes in step S202), and the process illustrated in the flowchart of FIG. 6 ends. This completes the main processing executed by the ultrasound diagnostic apparatus 1 in the secondary examination.

The operation of the present embodiment as described above will be described.
The ultrasonic diagnostic apparatus 1 according to the present embodiment generates an examination information picture F in which the movement path marks TML, TMR and the storage position mark SM are superimposed on the body marks BML, BMR for the subject who has finished the primary examination. The image data D1 of the examination information picture F and the image data D2 of the ultrasonic image instructed to be stored are stored in the database 150 in association with the subject information. If such inspection information picture F is browsed in a secondary inspection or the like, it becomes extremely easy to recognize the scan status of the subject's test site and the storage status of the ultrasound image. As a result, the efficiency of diagnosis using ultrasonic images is improved.

  Further, if the storage position of the ultrasonic image can be recognized by the storage position mark SM, the ultrasonic image can be confirmed smoothly in consideration of a subtle difference in the breast structure.

  In addition, since the storage position mark SM corresponding to the ultrasonic image to which the measurement data is added becomes a measured notation, the measurement processing execution state for the ultrasonic image stored in the primary inspection and the secondary inspection can be easily recognized. it can.

  Further, the ultrasonic diagnostic apparatus 1 displays a subject list 210 including thumbnails of examination information picture F of each subject at the time of the secondary examination. The doctor can grasp the outline of the primary examination for each subject in a broad frame by browsing such a subject list 210.

  Further, in the diagnosis screen 300, the storage position mark SM corresponding to the browsed ultrasonic image is changed to the displayed notation, so that browsing of the ultrasonic image can be prevented.

Furthermore, if the state of the storage position mark SM in the displayed notation is maintained (Yes in step S309), the subject whose ultrasound image has been browsed based on the thumbnail of the subject list 210 or the like is displayed. A person can be easily distinguished from a subject who is not. Therefore, omission of diagnosis for the subject can be prevented.
In addition to these, various suitable actions can be obtained from the configuration disclosed in the present embodiment.

[Modification]
The configuration disclosed in the above embodiment can be variously modified.
For example, the image data of the examination information picture F may be generated by an image generation apparatus such as a workstation separate from the ultrasonic diagnostic apparatus 1 and stored in the database 150. In this case, for example, the subject information input in step S101, the position of the ultrasonic probe 2 recorded in the position recording work area, the ultrasonic image for which a storage instruction is given, the storage position thereof, and the like are ultrasonically diagnosed. The image is transmitted from the device 1 to the image generation device. Then, the image generation device is provided with the functions of the reference image generation unit 102 and the storage processing unit 103, and the image generation device generates image data of the inspection information picture F, and the image data and the image of the ultrasonic image. Records in which data is associated with subject information are stored in the database 150.

  Further, the processing related to the secondary examination may be performed by an image display device such as a workstation separate from the ultrasonic diagnostic apparatus 1. In this case, the image display device has functions such as the first display processing unit 104 and the second display processing unit 105, and the subject list 210 corresponding to each record stored in the database 150 in the image display device. And the diagnostic screen 300 is displayed.

  In addition, the shapes of the body marks BML and BMR, the movement path marks TML and TMR, the probe width marks WML and WMR, and the storage position mark SM can be modified in various ways within a range that does not impair their functions. For example, in the above embodiment, the storage position mark SM is a cross-shaped symbol, but the storage position mark SM corresponding to the ultrasonic image to which no measurement data is added is “I”, and the ultrasonic wave to which the measurement data is added. The storage position mark SM corresponding to the image can be expressed by letters such as alphabets, such as “M”.

  Further, the ultrasonic image stored by the storage instruction is not limited to the B-mode image. In addition, it is possible to input a save instruction for a Doppler image or a 3D image and save it in the database 150. In this case, for example, the storage position mark SM corresponding to the B-mode image is “I”, the storage position mark SM corresponding to the Doppler image is “D”, and the storage position mark SM corresponding to the 3D image is “V”. The shape, pattern or color of the storage position mark SM may be varied depending on the image type.

  In the above embodiment, the X axis of the three-dimensional coordinate space (X, Y, Z) is substantially parallel to the body axis of the subject, and the Y axis is the body width direction of the subject (a straight line connecting both shoulders). It is assumed that the movement path marks TML, TMR and the storage position mark SM are arranged on the body marks BML, BMR under this precondition. If the precondition is not satisfied, the position (x, y, z) of the ultrasonic probe 2 acquired by the position information acquisition device 6 is converted into coordinates in the plane corresponding to the body marks BML, BMR, The movement path marks TML, TMR and the storage position mark SM may be arranged on the body marks BML, BMR using the coordinates after conversion.

  The configuration disclosed in the above embodiment can also be applied to scenes other than breast mass screening, for example, abdominal examinations in health examinations, conferences in close examinations using an ultrasonic diagnostic apparatus, remote diagnosis, and the like. When a part other than the breast is to be examined, the shape of the body mark may be changed to a shape corresponding to the part.

  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 novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

  DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic apparatus, 2 ... Ultrasonic probe, 4 ... Input device, 5 ... Monitor, 6 ... Position information acquisition apparatus, 7 ... Transmitter, 8 ... Magnetic sensor, 13 ... Image generation part, 17 ... Control part, 100 DESCRIPTION OF SYMBOLS ... Main processing part, 101 ... Measurement processing part, 102 ... Reference image generation part, 103 ... Storage processing part, 104 ... Display processing part, 105 ... Display processing part, 150 ... Database, 210 ... Subject list, F ... Examination Information picture, BML, BMR ... body mark, TML, TMR ... movement path mark, WML, WMR ... probe width mark, SM ... storage position mark, BMR ... body mark.

Claims (10)

  1. A position detection unit that detects the position of an ultrasonic probe that transmits and receives ultrasonic waves to the subject; and
    An ultrasonic image generation unit that generates an ultrasonic image based on a signal obtained by transmission and reception of ultrasonic waves by the ultrasonic probe;
    A display unit for displaying the ultrasonic image;
    When transmitting / receiving the ultrasonic wave while moving the ultrasonic probe, an instruction to save the ultrasonic image sequentially displayed on the display unit as the ultrasonic probe moves is input at a desired timing. An input unit for
    A reference image is generated by superimposing a movement position of the ultrasonic probe and a storage position mark representing a position detected by the position detection unit upon input of the storage instruction on a body mark representing an examination site of the subject. A reference image generation unit;
    In association with the subject information, a storage processing unit that stores the ultrasound image and the reference image in which the storage instruction is made in a storage unit,
    An ultrasonic diagnostic apparatus comprising:
  2.   The ultrasonic diagnostic apparatus according to claim 1, wherein the movement path is a predetermined shape or a locus of a position detected by the position detection unit.
  3. A measurement processing unit that performs a predetermined measurement process on the ultrasonic image;
    When the measurement processing is performed on the ultrasonic image for which the storage instruction has been given, the storage processing unit adds measurement data indicating a result of the meter-side processing to the ultrasonic image and stores the measurement data in the storage unit. ,
    The reference image generation unit includes a shape, a pattern, or a color of the storage position mark corresponding to the ultrasonic image on which the measurement process has been performed, and the storage position mark corresponding to an ultrasonic image on which the measurement process has not been performed. The ultrasonic diagnostic apparatus according to claim 1, wherein a shape, a pattern, or a color is different.
  4. A storage position that represents the position of the ultrasonic probe when inputting a storage path of an ultrasonic image obtained by transmitting and receiving an ultrasonic wave by the ultrasonic probe and a moving path of the ultrasonic probe that transmits and receives an ultrasonic wave to the subject A reference image generation unit that generates a reference image in which a mark is superimposed on a body mark representing an examination site of a subject;
    In association with the subject information, a storage processing unit that stores the ultrasound image and the reference image in which the storage instruction is made in a storage unit,
    An image generation apparatus comprising:
  5.   The image generation apparatus according to claim 4, wherein the movement path is a predetermined shape or a locus of a position detected by a position detection unit that detects a position of the ultrasonic probe.
  6. The storage processing unit adds measurement data indicating a result of the meter-side processing to the ultrasonic image and stores it in the storage unit when the storage instruction is given for the ultrasonic image subjected to predetermined measurement processing. And
    The reference image generation unit includes a shape, a pattern, or a color of the storage position mark corresponding to the ultrasonic image on which the measurement process has been performed, and the storage position mark corresponding to an ultrasonic image on which the measurement process has not been performed. The image generating apparatus according to claim 4, wherein the shape, the pattern, or the color is different.
  7. When performing transmission / reception of an ultrasonic wave while moving the ultrasonic probe, an ultrasonic image at the time when an instruction to save an ultrasonic image sequentially displayed on the display unit according to the movement of the ultrasonic probe is input, A reference image in which a storage position mark indicating the position of the ultrasonic probe on the moving path of the ultrasonic probe at the time when the storage instruction is input is superimposed on a body mark indicating an examination site of the subject, A storage unit stored in association with the person information;
    A first display processing unit for displaying on the display unit a subject list including the subject information stored in the storage unit and a thumbnail of the reference image associated with each subject information;
    In response to selection of the subject from the subject list, the display unit displays the ultrasound image and the reference image stored in the storage unit in association with the subject information corresponding to the subject. A second display processing unit to be displayed on
    An image display device comprising:
  8.   When the storage position mark of the reference image displayed on the display unit is operated, the second display processing unit stores the ultrasonic image displayed on the display unit stored in the storage unit. The image display device according to claim 7, wherein the image display device is switched to an ultrasonic image corresponding to the stored storage position mark.
  9.   The second display processing unit makes the shape, pattern or color of the storage position mark corresponding to the ultrasonic image being displayed on the display unit different from the shape, pattern or color of the other storage position mark. 9. The image display device according to claim 8, wherein
  10.   The second display processing unit corresponds to the shape, pattern or color of the storage position mark corresponding to the ultrasonic image that has been displayed on the display unit, and the ultrasonic image not yet displayed on the display unit. The image display device according to claim 8, wherein the storage position mark has a different shape, pattern, or color.
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