JP6162391B2 - X-ray diagnostic equipment - Google Patents

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus.

  Conventionally, endovascular treatment is performed under an image guide using an X-ray diagnostic apparatus. For example, in a procedure for opening a completely occluded blood vessel, an X-ray image is taken in a state where a guide wire is inserted into the blood vessel and a contrast medium is flowed on the opposite side across the occluded site. The doctor refers to the photographed X-ray image and grasps the three-dimensional state between the distal end of the guide wire and the end of the opposite blood vessel across the occlusion site, and then operates the guide wire to occlude it. Open the site.

  Here, it is desirable for the doctor to operate the guide wire while grasping in real time the three-dimensional state between the distal end of the guide wire and the end of the blood vessel on the opposite side across the obstruction site. However, since the X-ray image displayed on the monitor is a two-dimensional image to the last, for example, when a doctor who advances a guide wire observes the monitor, although the two-dimensional information can be grasped, information in the depth direction I can't figure out. Therefore, the doctor needs to operate the X-ray diagnostic apparatus or the like, which is an operation other than the guide wire operation, in order to confirm the three-dimensional running condition of the blood vessel. This leads to a delay in the operation of the guide wire, leading to an increase in the X-ray exposure dose of the subject and the doctor due to the extension of the procedure time.

  Therefore, in recent years, a technique has been known that makes it easy to grasp the three-dimensional state of an imaging target by capturing an X-ray image while sliding the C-arm of the X-ray diagnostic apparatus and displaying it on a monitor. Yes. However, in the above-described conventional technology, there is a certain limit in grasping the three-dimensional state of the photographing target.

JP 2011-72655 A

  The problem to be solved by the present invention is to provide an X-ray diagnostic apparatus that makes it possible to grasp the three-dimensional state of an imaging target with higher accuracy.

The X-ray diagnostic apparatus according to the embodiment includes an X-ray tube device, an X-ray detector, a swing mechanism, an image generation unit, and a display control unit. The X-ray tube apparatus irradiates a subject with X-rays. The X-ray detector detects X-rays irradiated from the X-ray tube device and passed through the subject. The swing mechanism swings the irradiation direction of the X-rays irradiated to the subject by the X-ray tube device. The image generating means generates an X-ray image using information on X-rays that are irradiated onto the subject while the irradiation direction is being swung by the swinging mechanism and that has passed through the subject. The display control unit controls the X-ray image generated by the image generation unit to be displayed on a predetermined display unit. The peristaltic mechanism starts peristalsis from a predetermined irradiation direction in the X-ray irradiation direction, and perturbs the X-ray irradiation direction so as to return to the predetermined irradiation direction through a path different from the path that has passed through. Let

FIG. 1 is a diagram illustrating an example of the configuration of the X-ray diagnostic apparatus according to the first embodiment. FIG. 2 is a diagram for explaining an example of a problem related to the related art. FIG. 3 is a diagram illustrating an example of the configuration of the system control unit according to the first embodiment. FIG. 4 is a diagram for explaining the swinging in the X-ray irradiation direction by the swinging mechanism control unit according to the first embodiment. FIG. 5A is a diagram illustrating an example of rocking by the rocking mechanism control unit according to the first embodiment. FIG. 5B is a diagram illustrating an example of rocking by the rocking mechanism control unit according to the first embodiment. FIG. 5C is a diagram illustrating an example of rocking by the rocking mechanism control unit according to the first embodiment. FIG. 5D is a diagram illustrating an example of rocking by the rocking mechanism control unit according to the first embodiment. FIG. 6 is a diagram illustrating an example of an X-ray image displayed under the control of the display control unit according to the first embodiment. FIG. 7 is a flowchart illustrating a processing procedure performed by the X-ray diagnostic apparatus according to the first embodiment. FIG. 8 is a diagram illustrating an example of the configuration of the X-ray diagnostic apparatus according to the second embodiment. FIG. 9 is a diagram illustrating a modification of the configuration of the X-ray diagnostic apparatus according to the second embodiment. FIG. 10 is a diagram illustrating a change example of the focus of the X-ray controlled by the swing mechanism control unit according to the third embodiment. FIG. 11 is a diagram for explaining an application example according to the fourth embodiment.

(First embodiment)
FIG. 1 is a diagram illustrating an example of a configuration of an X-ray diagnostic apparatus 100 according to the first embodiment. As shown in FIG. 1, the X-ray diagnostic apparatus 100 according to the first embodiment includes a high voltage generator 11, an X-ray tube 12, an X-ray diaphragm device 13, a top plate 14, and a C arm 15. And an X-ray detector 16. In addition, the X-ray diagnostic apparatus 100 according to the first embodiment includes a C-arm rotation / movement mechanism 17, a top board movement mechanism 18, a C-arm / top board mechanism control section 19, an aperture control section 20, and a system. A control unit 21, an input unit 22, and a display unit 23 are provided. The X-ray diagnostic apparatus 100 according to the first embodiment includes an image data generation unit 24, an image data storage unit 25, and an image processing unit 26. In addition, the X-ray diagnostic apparatus 100 is connected to the injector 30.

  The injector 30 is a device for injecting a contrast medium from a catheter inserted into the subject P. Here, the contrast medium injection from the injector 30 is executed according to the injection instruction received via the system control unit 21 described later. Specifically, the injector 30 executes a contrast medium injection according to a contrast medium injection condition including a contrast medium injection start instruction, an injection stop instruction, and an injection speed received from the system control unit 21 described later. . The injector 30 can also start and stop injection according to an injection instruction directly input to the injector 30 by the operator.

  The high voltage generator 11 generates a high voltage under the control of the system control unit 21 and supplies the generated high voltage to the X-ray tube 12. The X-ray tube 12 generates X-rays using the high voltage supplied from the high voltage generator 11.

  The X-ray diaphragm 13 narrows the X-rays generated by the X-ray tube 12 under the control of the diaphragm controller 20 so that the region of interest of the subject P is selectively irradiated. For example, the X-ray diaphragm device 13 has four slidable diaphragm blades. The X-ray diaphragm 13 narrows down the X-rays generated by the X-ray tube 12 and irradiates the subject P by sliding these diaphragm blades under the control of the diaphragm controller 20. The X-ray tube 12 and the X-ray diaphragm device 13 are collectively referred to as an X-ray tube device. The top 14 is a bed on which the subject P is placed, and is placed on a bed (not shown). The subject P is not included in the X-ray diagnostic apparatus 100.

  The X-ray detector 16 detects X-rays that have passed through the subject P. For example, the X-ray detector 16 has detection elements arranged in a matrix. Each detection element converts the X-rays that have passed through the subject P into electrical signals and accumulates them, and transmits the accumulated electrical signals to the image data generation unit 24.

  The C arm 15 holds the X-ray tube 12, the X-ray diaphragm device 13, and the X-ray detector 16. The X-ray tube 12 and the X-ray diaphragm 13 and the X-ray detector 16 are arranged so as to face each other with the subject P sandwiched by the C arm 15.

  The C-arm rotating / moving mechanism 17 is a mechanism for rotating and moving the C-arm 15, and the top board moving mechanism 18 is a mechanism for moving the top board 14. The C arm / top plate mechanism control unit 19 controls the C arm rotation / movement mechanism 17 and the top plate movement mechanism 18 under the control of the system control unit 21, thereby rotating and moving the C arm 15 and the top plate 14. Adjust the movement. The aperture control unit 20 controls the irradiation range of the X-rays irradiated to the subject P by adjusting the aperture of the aperture blades of the X-ray aperture device 13 under the control of the system control unit 21. .

  The image data generation unit 24 generates image data using the electrical signal converted from the X-rays by the X-ray detector 16, and stores the generated image data in the image data storage unit 25. For example, the image data generation unit 24 performs current / voltage conversion, A (Analog) / D (Digital) conversion, and parallel / serial conversion on the electrical signal received from the X-ray detector 16 to generate image data. To do.

  Here, under the control of the system control unit 21, which will be described later, the image data generation unit 24 sets the subject P to which a guide wire is inserted and a contrast medium is administered, for example, in order to treat a completely occluded blood vessel. A plurality of X-ray images photographed automatically are generated. Then, the image data generation unit 24 stores the generated X-ray image in the image data storage unit 25.

  The image data storage unit 25 stores the image data generated by the image data generation unit 24. For example, the image data storage unit 25 stores image data in which a predetermined region of the subject P into which a guide wire is inserted and a contrast medium is administered is photographed in time series.

  The image processing unit 26 performs various image processing on the image data stored in the image data storage unit 25. For example, the image processing unit 26 generates a moving image by processing a plurality of X-ray images along the time series stored in the image data storage unit 25.

  The input unit 22 receives various instructions from an operator such as a doctor or engineer who operates the X-ray diagnostic apparatus 100. For example, the input unit 22 includes a mouse, a keyboard, a button, a trackball, a joystick, and the like. The input unit 22 transfers the instruction received from the operator to the system control unit 21. For example, the input unit 22 receives a designation instruction for designating an arbitrary region in the X-ray image. For example, the input unit 22 receives an input operation for swinging the X-ray irradiation direction. Note that the swing in the X-ray irradiation direction will be described in detail later.

  The display unit 23 displays a GUI (Graphical User Interface) for receiving an instruction from the operator, image data stored in the image data storage unit 25, and the like. For example, the display unit 23 includes a monitor. The display unit 23 may include a plurality of monitors.

  The system control unit 21 controls the operation of the entire X-ray diagnostic apparatus 100. For example, the system control unit 21 controls the high voltage generator 11 in accordance with an operator instruction transferred from the input unit 22 and adjusts the voltage supplied to the X-ray tube 12, thereby irradiating the subject P. Controls X-ray dose and ON / OFF. Further, for example, the system control unit 21 controls the C arm / top plate mechanism control unit 19 in accordance with an instruction from the operator, and adjusts the rotation and movement of the C arm 15 and the movement of the top plate 14. Further, for example, the system control unit 21 controls the aperture control unit 20 in accordance with an instruction from the operator, and adjusts the aperture of the aperture blades of the X-ray aperture device 13 to irradiate the subject P. The X-ray irradiation range is controlled.

  Further, the system control unit 21 controls image data generation processing by the image data generation unit 24, image processing by the image processing unit 26, analysis processing, and the like according to an instruction from the operator. Further, the system control unit 21 performs control so that a GUI for receiving an instruction from the operator, an image stored in the image data storage unit 25, and the like are displayed on the monitor of the display unit 23. Further, the system control unit 21 controls the injection of the contrast agent by transmitting signals of the start and end of the contrast agent injection to the injector 30.

  Here, the X-ray diagnostic apparatus 100 according to the present embodiment makes it possible to grasp the three-dimensional state of the imaging target with higher accuracy. Specifically, the X-ray diagnostic apparatus 100 captures and displays an X-ray image by swinging the irradiation direction of the X-rays irradiated to the imaging target by the processing of the system control unit 21 described in detail below. As a result, the three-dimensional state of the object to be imaged is grasped with higher accuracy.

  FIG. 2 is a diagram for explaining an example of a problem related to the related art. Here, FIG. 2 shows an X-ray image for performing open treatment of a stenosis site in the coronary artery of the heart. For example, in the opening treatment of the stenosis site in the coronary artery of the heart, as shown in FIG. 2, a guide wire is inserted into the stenosis site and the blood vessel on the opposite side across the stenosis site (the opposite blood vessel in the figure) ) To grasp the blood vessel travel and open the stenotic site.

  Here, the X-ray image used for the opening treatment is a two-dimensional image as shown in FIG. Therefore, for example, when the running of the blood vessel is finely changed, particularly when the blood vessel is bent in the depth direction of the X-ray image, the three-dimensional state of the blood vessel cannot be grasped. Therefore, in recent years, there has been disclosed a technique for taking an X-ray image while sliding the C-arm and sliding it on a monitor. However, in the conventional technique, the C-arm is merely moved on one axis. Therefore, it is difficult to cope with a case where the blood vessel travels finely, and there is a certain limit in grasping the three-dimensional state of the imaging target.

  Therefore, the X-ray diagnostic apparatus 100 according to the present application captures and displays an X-ray image by swinging the irradiation direction of the X-rays irradiated to the imaging target, thereby increasing the three-dimensional state of the imaging target. Let the accuracy grasp. FIG. 3 is a diagram illustrating an example of the configuration of the system control unit 21 according to the first embodiment. As illustrated in FIG. 3, the system control unit 21 according to the first embodiment includes a determination unit 211, a swing mechanism control unit 212, an image generation control unit 213, and a display control unit 214.

  The determination unit 211 determines whether or not the travel of the linear structure included in the X-ray image generated by the image data generation unit 24 under the control of the image generation control unit 213 described later is unknown. Specifically, the determination unit 211 detects the movement of the medical device based on the position of the medical device inserted into the linear structure included in the X-ray image, and the movement of the medical device is detected. When it stops, it determines with driving | running | working of a linear structure being unknown. For example, the determination unit 211 detects the movement of the guide wire based on the position of the guide wire inserted into the blood vessel included in the X-ray image, and the blood vessel travels when the movement of the guide wire stops. Judged as unknown.

  For example, the determination unit 211 extracts the position (coordinates) of the tip of the guide wire in each of a plurality of X-ray images along the time series generated by the image data generation unit 24 based on the pixel value. To do. Then, the determination unit 211 detects the movement of the guide wire by determining whether or not the coordinates of the tip of the guide wire extracted from each X-ray image have moved. Here, the determination unit 211 determines that the movement of the guide wire has stopped when the coordinates of the tip of the guide wire have not moved from the predetermined region for a predetermined time. When the determination unit 211 determines that the movement of the guide wire has stopped, the determination unit 211 notifies the swing mechanism control unit 212 of the determination result. Note that the predetermined time and the predetermined region used for the determination can be arbitrarily set by the operator.

  The swing mechanism control unit 212 swings the X-ray irradiation direction irradiated to the subject P by the X-ray tube apparatus. Specifically, the swing mechanism control unit 212 according to the first embodiment includes a support unit (C arm) that supports the X-ray tube device (X-ray tube 12 and X-ray diaphragm device 13) and the X-ray detector 16. 15) is moved freely in the three-dimensional space to swing the X-ray irradiation direction.

  Here, the swing mechanism control unit 212 swings the X-ray irradiation direction when the determination unit 211 determines that the travel of the linear structure is unknown. For example, when the determination unit 211 determines that the movement of the guide wire has stopped and the determination result is notified, the swing mechanism control unit 212 controls the C arm / top plate mechanism control unit 19 to control the C arm 15. The X-ray irradiation direction is swung by freely moving in a three-dimensional space.

  FIG. 4 is a diagram for explaining the swing in the X-ray irradiation direction by the swing mechanism control unit 212 according to the first embodiment. For example, as shown in FIG. 4A, the swing mechanism control unit 212 slides and rotates the floor-mounted C-arm 15 provided in an arc shape with respect to the top plate 14 on which the subject P is placed. By rotating or turning, the X-ray irradiation direction is freely swung in the three-dimensional space.

  That is, as shown in FIG. 4B, the swing mechanism control unit 212 moves the C arm 15 to RAO (first oblique, right forward oblique), LAO (second oblique, left forward oblique). The X-ray irradiation direction can be freely oscillated in a three-dimensional space by angling with the position: left antenna obliqué), CRA (head direction: cranial), and CAU (tail direction: caudal).

  Here, as described above, the swinging mechanism control unit 212 swings the X-ray irradiation direction by changing the angle of the C arm 15 according to the determination result of the determination unit 211. That is, the operator first moves (slides and turns) the C-arm 15 to a desired position via the input unit 22. Then, the operator performs, for example, open treatment of a stenosis site while observing an X-ray image taken at a desired position. At this time, if the determination unit 211 determines that the movement of the guide wire has stopped, the swing mechanism control unit 212 swings the X-ray irradiation direction by changing the angle of the C arm 15.

  Here, an example of rocking in the X-ray irradiation direction by the rocking mechanism control unit 212 will be described with reference to FIGS. 5A to 5D. 5A to 5D are diagrams illustrating an example of swinging by the swinging mechanism control unit 212 according to the first embodiment. Here, FIGS. 5A to 5D show the trajectory of the C-arm 15 under the control of the swing mechanism control unit 212. For example, as shown in FIG. 5A, the swing mechanism control unit 212 moves the C arm so as to reciprocate between RAO and LAO. Here, the swinging mechanism control unit 212 angulates the C arm 15 at an angle at which the operator can obtain a stereoscopic effect by dynamic parallax. For example, the swing mechanism control unit 212 performs an angle of ± 1 to 5 degrees with respect to the C arm 15 from the initial position.

  That is, the swinging mechanism control unit 212 moves the C arm 15 so as to make an angle of ± 1 to 5 degrees from the position of the C arm 15 where the X-ray image is first taken, thereby obtaining an imaging target ( For example, X-rays are irradiated at an angle shifted by ± 1 to 5 degrees with respect to guide wires and contrasted blood vessels located on both sides of the stenosis site. As a result, the swing mechanism control unit 212 can display an X-ray image when the imaging target is observed from an angle shifted by ± 1 to 5 degrees compared to the first X-ray image to the operator. it can.

  The swing in the X-ray irradiation direction by the swing mechanism control unit 212 is not limited to the example shown in FIG. 5A, and various other swings are possible. For example, as shown in FIG. 5B, the swing mechanism control unit 212 controls the C arm 15 to draw a predetermined locus. Further, for example, as shown in FIG. 5C, the swing mechanism control unit 212 performs control so that the C arm draws a circular (ellipse) locus. Further, for example, the swinging mechanism control unit 212 can control the C-arm 15 to draw a random trajectory as shown in FIG. 5D.

  As shown in FIGS. 5A to 5D, the swing mechanism control unit 212 controls the C arm 15 so as to draw an arbitrary trajectory. In any case, the C arm 15 is moved ± 1 to ± 1 from the initial position. It is desirable to control the angle to be 5 degrees.

  Returning to FIG. 3, the image generation control unit 213 uses the information of the X-rays irradiated to the subject P while the irradiation direction is swung by the swinging mechanism control unit 212 and passed through the subject P. An X-ray image is generated. Specifically, the image generation control unit 213 uses X-ray information detected while the C-arm 15 is controlled to be angled ± 1 to 5 degrees from the initial position by the swing mechanism control unit 212. Then, the image data generation unit 24 is controlled so as to generate an X-ray image. For example, the image generation control unit 213 controls the image data generation unit 24 to generate an X-ray image at a frame rate of 15 frame / sec.

  The display control unit 214 performs control so that the X-ray image generated by the control of the image generation control unit 213 is displayed on the display unit 23. For example, the display control unit 214 causes the display unit 23 to display an X-ray image generated at a frame rate of 15 frames / sec.

  Hereinafter, an example of a procedure using the swinging in the X-ray irradiation direction according to the above-described embodiment will be described. Here, the opening treatment of the stenosis site will be described as an example. First, the operator operates so as to image a region where he / she wants to see the X-ray diagnostic apparatus 100 in the same manner as in a normal usage method. Here, the operator operates the X-ray diagnostic apparatus 100 so that the part to be viewed is located near the center of the image. At this time, the position of the guide wire is detected by automatically turning on the oscillation mode, which is the mode for executing the oscillation in the X-ray irradiation direction, to automatically determine whether or not the movement has stopped. Thus, swinging in the X-ray irradiation direction can be automatically executed.

  Subsequently, the operator inserts a guide wire into the blood vessel, injects a contrast medium into the blood vessel on the opposite side across the stenosis site, and advances the guide wire while visually confirming the target arrival position (stenosis site). . Here, when the progress of the guide wire stops, the swinging mechanism control unit 212 controls the C arm 15 to be angled by ± 1 to 5 degrees from the initial position.

  For example, the swinging mechanism control unit 212 tilts the C-arm 15 by 2 degrees in the LAO direction, and then tilts by 2 degrees in the RAO direction. The swing mechanism control unit 212 controls the C arm 15 so as to repeatedly execute this. The image generation control unit 213 generates an X-ray image from X-ray information collected while the C arm 15 is angled. The display control unit 214 causes the display unit 23 to display the generated X-ray image in real time.

  FIG. 6 is a diagram illustrating an example of an X-ray image displayed under the control of the display control unit 214 according to the first embodiment. For example, as shown in FIG. 6A, it is assumed that open treatment of a stenosis site is performed while an X-ray image depicting a guide wire and an opposite blood vessel is observed. In this case, if it is determined that the movement of the tip of the guide wire has stopped, an X-ray image is generated and displayed while the angle of the C arm 15 is changed by the control of the swing mechanism control unit 212. That is, as shown in FIGS. 6B and 6C, the display control unit 214 displays an X-ray image in the case where the distal end of the guide wire and the opposite blood vessel are observed from the side surface as a moving image.

  By observing these images (moving images), the operator can grasp the three-dimensional state of the object to be imaged (guidewire, blood vessel, etc.), and clearly know where the blood vessel to be reached is. It becomes like this.

  In the above-described example, the case where the movement of the guide wire is determined from the X-ray image and the swing in the X-ray irradiation direction is automatically performed has been described. However, the X-ray diagnostic apparatus 100 according to the first embodiment is It is also possible to perform swinging in the X-ray irradiation direction upon receiving an instruction from the operator. In such a case, for example, the input unit 22 receives a swing operation that is an input operation for performing swing in the X-ray irradiation direction. Then, when the input unit 22 accepts the swing operation, the swing mechanism control unit 212 performs swing in the X-ray irradiation direction (angle setting of the C arm 15).

  For example, the operator presses the switch when the three-dimensional state of the imaging target cannot be grasped from the X-ray image (desired depth information is desired). As a result, the swing mechanism control unit 212 starts angling the C-arm 15 and a moving image is displayed. Meanwhile, the operator advances the guide wire while injecting the contrast medium. While the switch is pressed, the C arm 15 continues to perform a predetermined angle.

  Here, when the operator confirms the three-dimensional state of the photographing target once, the positional relationship remains in the head, and there is a case where the operator does not have to confirm it many times. In such a case, if the C-arm 15 continues to move even after confirmation of the three-dimensional state of the subject to be imaged, the movement may become troublesome. Therefore, in the X-ray diagnostic apparatus 100 according to the present embodiment, it is possible to perform control so that the C arm 15 is moved by one cycle for each input operation by the operator.

  For example, when the operator operates the joystick provided in the input unit 22 once (for example, tilts forward once), the swing mechanism control unit 212 moves in the direction of RAO to LAO with respect to the C arm 15. One round-trip angle is executed. At this time, the C arm 15 returns to its original position and stops after performing one reciprocating angle. As a result, the operator grasps the three-dimensional state of the object to be imaged, and does not feel bothered by the continuous movement of the C-arm 15, and the X-ray at the original position where the image was originally captured is obtained. You can continue to observe the image.

  The angle at which the X-ray irradiation direction is swung (the angle at which the C-arm 15 is moved) can be arbitrarily determined by the operator. For example, a GUI for inputting the angle at which the display unit 23 is swung is used. It can also be displayed.

  Next, processing of the X-ray diagnostic apparatus 100 according to the first embodiment will be described with reference to FIG. FIG. 7 is a flowchart illustrating a processing procedure performed by the X-ray diagnostic apparatus 100 according to the first embodiment. Here, FIG. 7 shows a process in the case where the movement of the guide wire is automatically determined and the swing in the X-ray irradiation direction is automatically executed.

  As shown in FIG. 7, in the X-ray diagnostic apparatus 100 according to the first embodiment, when the swing mode is ON (Yes at Step S101), it is determined whether or not the input unit 22 has received a swing operation. (Step S102). When the swing operation is accepted (Yes at Step S102), the swing mechanism control unit 212 swings the X-ray irradiation direction by causing the C arm 15 to be angled (Step S106). ).

  On the other hand, when the swing operation has not been accepted (No at Step S102), the determination unit 211 acquires a plurality of X-ray images taken with time (Step S103), and guides the X-ray images. The position of each wire is detected (step S104). Then, the determination unit 211 determines whether or not a predetermined time has elapsed since the movement of the guide wire is stopped from the position of the guide wire for each detected X-ray image (step S105).

  If it is determined that the movement of the guide wire has stopped and the predetermined time has not elapsed (No at Step S105), the process returns to Step S102, and whether or not the input unit 22 has accepted the swing operation. Determine whether. On the other hand, when it is determined that the movement of the guide wire has stopped and a predetermined time has elapsed (Yes at step S105), the swing mechanism control unit 212 causes the C arm 15 to be angled. The X-ray irradiation direction is swung (step S106).

  Then, the X-ray diagnostic apparatus 100 according to the first embodiment determines whether or not a manipulation end operation has been executed by the operator (step S107). If it is determined that the procedure has not been completed (No at Step S107), the process returns to Step S102 to determine whether or not the input unit 22 has accepted the swing operation. On the other hand, when it is determined that the procedure has been completed (Yes at Step S107), the X-ray diagnostic apparatus 100 ends the process.

  As described above, according to the first embodiment, the X-ray tube device (the X-ray tube 12 and the X-ray diaphragm device 13) irradiates the subject with X-rays. The X-ray detector 16 detects X-rays irradiated from the X-ray tube device and passed through the subject. The swing mechanism control unit 212 swings the irradiation direction of the X-rays irradiated to the subject by the X-ray tube device. The image generation control unit 213 irradiates the subject while the irradiation direction is swung by the swinging mechanism control unit 212, and generates an X-ray image using information on the X-rays that have passed through the subject. The display control unit 214 controls the display unit 23 to display the X-ray image generated by the image generation control unit 213. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can cause the operator to observe X-ray images depicting the imaging target from various directions, and grasps the three-dimensional state of the imaging target in detail. Make it possible. That is, the X-ray diagnostic apparatus 100 according to the first embodiment swings the X-ray irradiation direction in a circle / ellipse / random locus to move, for example, a blood vessel or the like that travels within the subject. It is possible to make the operator grasp the three-dimensional state more preferably. As a result, the operator can perform the guide wire operation more smoothly, so that the operation time can be expected to be shortened, and the X-ray exposure dose of the subject and the operator can be reduced.

  As described above, the X-ray diagnostic apparatus 100 according to the first embodiment can freely swing the X-ray irradiation direction in the three-dimensional space. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can cope with, for example, a case where the travel of the blood vessel changes finely and grasps the three-dimensional state of the imaging target in more detail. Make it possible.

  Further, according to the first embodiment, the swinging mechanism control unit 212 moves the C-arm 15 that supports the X-ray tube device and the X-ray detector freely in the three-dimensional space, thereby irradiating X-rays. Swing direction. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can grasp the three-dimensional state of the imaging target in detail without using the biplane apparatus, and suppresses the enlargement of the X-ray diagnostic apparatus. Thus, the operating room space can be used effectively.

  Further, according to the first embodiment, the determination unit 211 determines whether or not the travel of the blood vessel included in the X-ray image generated by the image generation control unit 213 is unknown. The swinging mechanism control unit 212 swings the X-ray irradiation direction when the determination unit 211 determines that the blood vessel travel is unknown. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can automatically swing in the X-ray irradiation direction, and even when the operator cannot use both hands due to the technique, It makes it possible to perform oscillation in the irradiation direction of the line.

  Further, according to the first embodiment, the determination unit 211 detects the movement of the guide wire based on the position of the guide wire inserted into the blood vessel included in the X-ray image, and the movement of the guide wire is detected. When stopped, it is determined that the blood vessel travel is unknown. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment determines in real time whether or not the blood vessel travel is unknown, and reflects the determination result in the fluctuation of the immediate X-ray irradiation direction. to enable.

  Further, according to the first embodiment, the input unit 22 receives an input operation for swinging the X-ray irradiation direction. The swing mechanism control unit 212 swings the X-ray irradiation direction by one cycle when the input unit 22 receives a predetermined input operation. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment first grasps the three-dimensional state of the imaging target and does not feel bothered by the continuous movement of the C-arm 15. It is possible to continue to observe the X-ray image at the original position taken.

(Second Embodiment)
In the above-described first embodiment, the case where the X-ray irradiation direction is swung by sliding and rotating the C-arm 15 has been described. In the second embodiment, an example in which the X-ray irradiation direction is swung by swinging the X-ray tube device (X-ray tube and X-ray diaphragm device) will be described. FIG. 8 is a diagram illustrating an example of the configuration of the X-ray diagnostic apparatus 200 according to the second embodiment.

  As shown in FIG. 8, the X-ray diagnostic apparatus 200 according to the second embodiment includes a top board 14, an X-ray tube 12, an X-ray diaphragm device 13, an X-ray detector 16, and a tube holding unit. 201 and a stand 202, and X-ray images are taken. Although not shown in FIG. 8, the X-ray diagnostic apparatus 200 further includes a console operated by the operator, operates by receiving various instructions from the operator via the console, and an X-ray image. Take a photo of Examples of the X-ray diagnostic apparatus 200 according to the second embodiment include an X-ray TV apparatus.

  Hereinafter, in the same configuration as the X-ray diagnostic apparatus 100 according to the first embodiment, the same reference numerals are given and the description thereof is omitted. Note that the X-ray diagnostic apparatus 200 according to the second embodiment includes a control unit (not shown) similar to the system control unit 21 shown in FIG. 3, and the system control unit 21 performs overall control. .

  The tube holding unit 201 holds the X-ray tube 12, and the stand 202 connects the tube holding unit 201 and the top plate 14. Thereby, as shown in FIG. 8, the X-ray tube 12 and the X-ray detector 16 are arranged to face each other with the top plate 14 interposed therebetween.

  The swinging mechanism control unit 212 according to the second embodiment swings the X-ray irradiation direction by changing the X-ray irradiation direction by the X-ray tube device (the X-ray tube 12 and the X-ray diaphragm device 13). Move. Specifically, the swinging mechanism control unit 212 according to the second embodiment controls an swinging device (not shown) provided in the tube holding unit 201 to thereby obtain an X-ray tube device (X-ray tube). 12 and the X-ray irradiation device 13) change the X-ray irradiation direction. The oscillating device is a device that can arbitrarily change the direction of the X-ray tube device with respect to the top plate 14 by, for example, a motor. For example, the swing mechanism control unit 212 swings the X-ray irradiation direction by controlling the swing device to change the direction of the X-ray tube device.

  Furthermore, the X-ray diagnostic apparatus 200 according to the second embodiment can remove the annoyance given to the operator when the movable part is exposed to the outside by installing a cover on the movable part. FIG. 9 is a diagram illustrating a modification of the configuration of the X-ray diagnostic apparatus 200 according to the second embodiment. For example, as shown in FIG. 9, the X-ray diagnostic apparatus 200 includes a cover 203 so as to cover the X-ray tube 12, the X-ray diaphragm device 13, and the tube holder 201. As a result, even if the orientation of the X-ray tube device is changed by controlling the swing device, there is no apparently moving part, giving the operator troublesomeness that interferes with the treatment procedure. It is possible to deter.

  As described above, according to the second embodiment, the swinging mechanism control unit 212 swings the X-ray irradiation direction by changing the X-ray irradiation direction by the X-ray tube apparatus. Therefore, the X-ray diagnostic apparatus 200 according to the second embodiment can make it possible to grasp in detail the three-dimensional state of an imaging target even in an apparatus such as an X-ray TV apparatus that does not have a C-arm. To do.

(Third embodiment)
In the first and second embodiments described above, the case where the X-ray irradiation direction is swung by moving the C-arm 15 or the X-ray tube apparatus has been described. In the third embodiment, a case where the X-ray irradiation direction is swung by changing the focus of X-rays generated from the X-ray tube will be described.

  Such a technique can be applied to both the X-ray diagnostic apparatus 100 shown in FIG. 1 and the X-ray diagnostic apparatus 200 shown in FIG. That is, the swinging mechanism control unit 212 according to the third embodiment swings the X-ray irradiation direction by changing the X-ray irradiation direction by the X-ray tube included in the X-ray tube apparatus. For example, the swinging mechanism control unit 212 according to the third embodiment swings the X-ray irradiation direction by changing the focal point of the X-rays generated from the X-ray tube by the Flying Focal Spot function.

  FIG. 10 is a diagram illustrating an example of a change in the focus of the X-ray controlled by the swing mechanism control unit 212 according to the third embodiment. For example, the X-ray tube 12 according to the third embodiment is an X-ray tube that can move the X-ray focal point electromagnetically. Then, the swinging mechanism control unit 212 changes the magnetic force applied to the X-ray tube 12 to shift the X-ray focal point from the position 12a to the position 12b as shown in FIG. Thereby, it is possible to irradiate X-rays from different angles with respect to an imaging target (for example, a guide wire or a contrasted blood vessel). That is, it is possible to generate and display an X-ray image depicting the imaging target from different angles, and to allow the operator to observe the side surface of the imaging target.

  As described above, according to the third embodiment, the swinging mechanism control unit 212 changes the X-ray irradiation direction by the X-ray tube 12 included in the X-ray tube device, so that the X-ray irradiation direction is changed. Oscillate. Therefore, the X-ray diagnostic apparatus according to the third embodiment makes it possible to grasp the three-dimensional state of the imaging target with higher accuracy without involving extensive control of the apparatus.

(Fourth embodiment)
The first, second and third embodiments have been described so far, but may be implemented in various different forms other than the first, second and third embodiments described above. .

  In the above-described first, second, and third embodiments, the case where the technique according to the present application is used for open treatment of a stenosis site has been described. However, the embodiment is not limited to this, and the present invention can be applied to any technique as long as it grasps the three-dimensional state of an imaging target in an X-ray image. FIG. 11 is a diagram for explaining an application example according to the fourth embodiment. For example, as shown in FIG. 11, the technology according to the present application can be used to grasp the positional relationship between the stent and the guide wire.

  In the above-described second embodiment, the X-ray TV apparatus has been described as an example of swinging the X-ray tube apparatus. However, the embodiment is not limited to this. For example, the X-ray tube apparatus of the X-ray diagnostic apparatus having the C-arm as shown in FIG. 1 may be swung.

  In the above-described first, second, and third embodiments, the case of imaging a blood vessel has been described as an example. However, the embodiment is not limited to this. For example, any embodiment may be applied as long as the imaging is performed on a linear structure (such as a long thin organ or tissue) such as the digestive tract. be able to.

  In the first, second, and third embodiments described above, the case where a guide wire is used as a medical device has been described as an example. However, the embodiment is not limited to this, and can be applied to any device as long as an elongated medical device such as a catheter is used.

  As described above, according to the first, second, third, and fourth embodiments, the X-ray diagnostic apparatus according to the present embodiment makes it possible to grasp the three-dimensional state of the imaging target with higher accuracy. to enable.

  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 21 System control part 22 Input part 23 Display part 24 Image data generation part 100,200 X-ray diagnostic apparatus 211 Judgment part 212 Oscillation mechanism control part 213 Image generation control part 214 Display control part

Claims (7)

An X-ray tube device for irradiating the subject with X-rays;
An X-ray detector that detects X-rays irradiated from the X-ray tube device and passed through the subject;
A rocking mechanism for rocking the irradiation direction of X-rays irradiated to the subject by the X-ray tube device;
Image generating means for generating an X-ray image using information of X-rays that are irradiated to the subject while the irradiation direction is swung by the swing mechanism and passed through the subject;
Display control means for controlling the X-ray image generated by the image generation means to be displayed on a predetermined display unit;
Equipped with a,
The peristaltic mechanism starts peristalsis from a predetermined irradiation direction in the X-ray irradiation direction, and perturbs the X-ray irradiation direction so as to return to the predetermined irradiation direction through a path different from the path that has passed through. X-ray diagnostic apparatus characterized by causing.   The swing mechanism swings the X-ray irradiation direction by freely moving a support portion supporting the X-ray tube device and the X-ray detector in a three-dimensional space. Item 2. The X-ray diagnostic apparatus according to Item 1.   The X-ray diagnostic apparatus according to claim 1, wherein the swinging mechanism swings the X-ray irradiation direction by changing an X-ray irradiation direction by the X-ray tube apparatus.   The said rocking | fluctuation mechanism rocks | swivels the said X-ray irradiation direction by changing the X-ray irradiation direction by the X-ray tube contained in the said X-ray tube apparatus. X-ray diagnostic equipment. A determination unit for determining whether or not the travel of the linear structure included in the X-ray image generated by the image generation unit is unknown;
The said rocking | fluctuation mechanism rock | fluctuates the irradiation direction of the said X-ray, when it determines with driving | running | working of the said linear structure being unclear by the said determination means. The X-ray diagnostic apparatus as described in any one.   The determination unit detects the movement of the medical device based on the position of the medical device inserted into the linear structure included in the X-ray image, and the movement of the medical device is stopped. The X-ray diagnostic apparatus according to claim 5, wherein it is determined that travel of the linear structure is unknown. A receiving means for receiving an input operation for swinging the X-ray irradiation direction;
The swing mechanism swings the X-ray irradiation direction by one period when the receiving unit receives a predetermined input operation. X-ray diagnostic equipment.

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