JP6224341B2 - Fixing device and ultrasonic diagnostic apparatus - Google Patents

Description

  The present invention relates to a fixture attached to an upper limb or a lower limb of a subject and an ultrasonic diagnostic apparatus.

  In the ultrasonic diagnostic apparatus, ultrasonic waves are transmitted from the ultrasonic probe into the subject, and echo signals reflected from the subject are received by the ultrasonic probe. Then, an ultrasonic image such as a B-mode image is created and displayed based on the received echo signal.

  In such an ultrasonic diagnostic apparatus, for example, Patent Document 1 discloses a real-time ultrasonic image of the same cross section in a subject, a reference medical image such as an X-ray CT (Computed Tomography) image and an MRI (Magnetic Resonance Imaging) image. An ultrasonic diagnostic apparatus that displays an image is disclosed. In this ultrasonic diagnostic apparatus, after the position correspondence information between the coordinates in the ultrasonic image and the coordinates in the reference medical image is set, the operator moves the ultrasonic probe to cross-section the real-time ultrasonic image Even if changes, the reference medical image having the same cross section as that cross section is displayed.

  An example of setting the position correspondence information will be described. First, the operator displays a real-time ultrasonic image and a reference medical image that are considered to be the same cross section in the subject. Next, position correspondence information is specified by an operator designating a place that seems to be the same in two images. For example, the operator designates a part having a structural feature such as a branch part of a blood vessel as a part that seems to be the same.

International Publication No. WO2004-098414 Pamphlet

  Incidentally, in recent years, along with the fact that a high-quality ultrasonic image near the body surface can be obtained with a high-frequency ultrasonic probe, an ultrasonic diagnostic apparatus has come to be used also in the field of shaping. Yes. Therefore, in the field of shaping, there is a demand for performing diagnosis by displaying a real-time ultrasonic image and a reference medical image for the same cross section of the subject.

  However, for example, an ultrasonic image of an arm or the like is poor in a portion having a structural feature as compared with ultrasonic images of other parts, and setting of position correspondence information is difficult.

  One aspect of the invention made to solve the above-described problem is a fixture that is attached to an upper limb or a lower limb of a subject and fixes the upper limb or the lower limb in a state of being bent at a joint. Alternatively, a holding unit that holds an ultrasonic probe that transmits and receives ultrasonic waves to and from the lower limb in a predetermined position, and the holding unit has at least an ultrasonic wave transmitting / receiving surface of the ultrasonic probe at a bending portion of the joint. The fixture is provided at a position for holding the ultrasonic probe so as to be in contact with the apex.

  The invention according to another aspect includes a display image control unit that displays on the display unit an ultrasonic image based on an echo signal obtained by transmitting and receiving ultrasonic waves by the ultrasonic probe held by the holding unit of the fixture. This is an ultrasonic diagnostic apparatus.

  According to the invention of the above aspect, the ultrasonic probe is held by the fixture so that the joint of the upper limb or the lower limb is bent and the transmitting / receiving surface is in contact with at least the apex of the bent portion of the joint. Therefore, an ultrasonic image including the apex of the bent portion can be displayed. Therefore, it is possible to easily set the position correspondence information between the ultrasonic image and the reference medical image on the basis of the vertex of the bent portion.

It is a block diagram which shows an example of schematic structure of embodiment of the ultrasonic diagnosing device which concerns on this invention. It is a block diagram which shows the structure of the display control part in the ultrasonic diagnosing device shown by FIG. It is a perspective view which shows the fixing tool in embodiment of this invention. It is an enlarged view which shows the holding | maintenance part of the fixing tool shown by FIG. It is a perspective view which shows a holding member. It is a front view which shows the fixing tool attached to the upper limb. It is an enlarged view near an angle adjustment knob. It is a figure explaining rotation of a frame. It is a flowchart which shows the effect | action of embodiment of the ultrasonic diagnosing device which concerns on this invention. It is a figure explaining that the ultrasonic probe hold | maintained by the holding member of the fixing tool contact | abuts to the vertex vicinity of an elbow. It is a flowchart which shows the detail of the process of FIG.9 S4. It is a figure which shows the display part on which the real-time ultrasonic image and the reference medical image were displayed. It is a figure which shows the transmission / reception surface of the ultrasonic wave in the upper limb of a subject. It is an enlarged view of an ultrasonic image on which an indicator is displayed. It is a figure which shows the ultrasonic image and reference medical image in which the marker was set to the vertex of the elbow. It is an enlarged view of an ultrasonic image in which a marker is set at the intersection of the end of the transmission area indicator and the contour of the upper limb indicator. It is a figure explaining the display area of the ultrasonic image in the upper limb of a subject. FIG. 17 is a diagram illustrating a reference medical image and an ultrasound image in which a marker is set at a position corresponding to the marker set in FIGS. 15 and 16. It is an enlarged view which shows the holding | maintenance part in the modification of embodiment. It is a figure which shows the state by which the ultrasonic probe was hold | maintained at the holding member in which the mark was shown in the holding | maintenance part in the modification of embodiment. It is a figure which shows the state by which the ultrasonic probe was hold | maintained at the holding member in which the mark was shown in the holding | maintenance part in the modification of embodiment. It is a figure which shows the state by which the ultrasonic probe was hold | maintained at the holding member in which the mark was shown in the holding | maintenance part in the modification of embodiment. In the modification of embodiment, it is a figure which shows the state by which the marker was set to the ultrasonic image when an ultrasonic probe is hold | maintained in the position of FIG. FIG. 24 is a diagram showing a state in which markers are set at corresponding positions in the reference medical image and the marker positions set in the ultrasonic image shown in FIG. 23 in the modification of the embodiment. In the modification of embodiment, it is a figure which shows the state by which the marker was set to the ultrasonic image when an ultrasonic probe is hold | maintained in the position of FIG. In the modification of embodiment, it is a figure which shows the state by which the marker was set to the position corresponding to the position of the marker set to the ultrasonic image shown by FIG. 25, and a reference medical image. In the modification of embodiment, it is a figure which shows the state by which the marker was set to the ultrasonic image when an ultrasonic probe is hold | maintained in the position of FIG. In the modification of embodiment, it is a figure which shows the state in which the marker was set to the position corresponding to the position of the marker set to the ultrasonic image shown in FIG. 27, and a reference medical image. In the modification of embodiment, it is a figure which shows the other example of the state by which the marker was set to the ultrasonic image when an ultrasonic probe is hold | maintained in the position of FIG. FIG. 30 is a diagram showing a state in which markers are set at positions corresponding to positions of markers set in the ultrasound image shown in FIG. 29 and a reference medical image in a modification of the embodiment. In the modification of embodiment, it is a figure which shows the other example of the state by which the marker was set to the ultrasonic image when an ultrasonic probe is hold | maintained in the position of FIG. FIG. 32 is a diagram showing a state in which markers are set at positions corresponding to positions of markers set in the ultrasound image shown in FIG. 31 and reference medical images in a modification of the embodiment. It is a perspective view which shows the other examples of the fixing tool in embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described. First, an example of an embodiment of an ultrasonic diagnostic apparatus according to the present invention will be described. An ultrasonic diagnostic apparatus 1 shown in FIG. 1 includes an ultrasonic probe 2, a transmission / reception beam former 3, an echo data processing unit 4, a display control unit 5, a display unit 6, an operation unit 7, a control unit 8, and a storage unit 9.

  The ultrasonic probe 2 includes a plurality of ultrasonic transducers (not shown) arranged in an array, and transmits ultrasonic waves to the subject through the ultrasonic transducers, and echo signals thereof. Receive.

  The ultrasonic probe 2 is provided with the magnetic sensor 10 composed of, for example, a Hall element. The magnetic sensor 10 detects the magnetism generated from the magnetic generator 11 composed of, for example, a magnetic generating coil. A detection signal in the magnetic sensor 10 is input to the display control unit 5. A detection signal in the magnetic sensor 10 may be input to the display control unit 5 via a cable (not shown), or may be input to the display control unit 5 wirelessly. The magnetism generator 11 and the magnetic sensor 10 are provided to detect the position and inclination of the ultrasonic probe 2 as will be described later.

  The transmission / reception beam former 3 supplies an electrical signal for transmitting an ultrasonic wave from the ultrasonic probe 2 under a predetermined scanning condition to the ultrasonic probe 2 based on a control signal from the control unit 8. The transmission / reception beamformer 3 performs signal processing such as A / D conversion and phasing addition processing on the echo signal received by the ultrasonic probe 2, and the echo data after the signal processing is sent to the echo data processing unit 4. Output to.

  The echo data processing unit 4 performs processing for creating an ultrasound image on the echo data output from the transmission / reception beamformer 3. For example, the echo data processing unit 4 performs B mode processing such as logarithmic compression processing and envelope detection processing to create B mode data.

  As shown in FIG. 2, the display control unit 5 includes a position calculation unit 51, an ultrasonic image data creation unit 52, a display image control unit 53, a position correspondence relationship specifying unit 54, and an indicator display control unit 55. Based on the magnetic detection signal from the magnetic sensor 10, the position calculation unit 51 is information (hereinafter referred to as the position and inclination) of the ultrasonic probe 2 in a coordinate system with the magnetic generation unit 11 as an origin in a three-dimensional space. , “Probe position information”). Further, the position calculation unit 51 calculates position information (position information of the ultrasonic wave transmission / reception surface) of the echo signal in the coordinate system based on the probe position information. Accordingly, the position calculation unit 51 calculates the position of the cross section of the ultrasonic image. The position calculation unit 51 and the magnetic sensor 10 are an example of an embodiment of a position detection unit in the present invention.

  The ultrasonic image data creation unit 52 scans the data input from the echo data processing unit 4 using a scan converter to create ultrasonic image data.

  The display image control unit 53 causes the display unit 6 to display an ultrasonic image based on the ultrasonic image data. As will be described later, the ultrasound image is an image of the upper limb of the subject in the three-dimensional space. The display image control unit 53 causes the display unit 6 to display a reference medical image for the upper limb of the subject. The display image control unit 53 is an example of an embodiment of a display image control unit in the present invention.

  The reference medical image is a medical image acquired in advance by a medical image apparatus 90 other than the ultrasonic diagnostic apparatus 1 for the same subject as the ultrasonic transmission / reception target. For example, the medical imaging apparatus 90 is an X-ray CT apparatus or an MRI apparatus, and the reference medical image is an X-ray CT image acquired by the X-ray CT apparatus or an MRI image acquired by the MRI apparatus. is there.

  The position correspondence specifying unit 54 specifies a position correspondence between coordinates in the ultrasound image and coordinates in the reference medical image. Details will be described later. The position correspondence specifying unit 54 is an example of an embodiment of a position correspondence specifying unit in the present invention.

  The indicator display control unit 55 displays an indicator In (see FIG. 14 and the like described later) indicating the upper limb fixed in a state bent at a predetermined angle at a joint on the display unit 6 by a fixture described later. And displayed on the ultrasonic image UI. The indicator display control unit 55 is an example of an embodiment of an indicator display control unit in the present invention.

  The display unit 6 is an LCD (Liquid Crystal Display), a CRT (Cathode Ray Tube), or the like. The operation unit 7 includes a keyboard and a pointing device (not shown) for an operator to input instructions and information. The operation unit 7 is an example of an embodiment of an input unit in the present invention.

  The control unit 8 includes a CPU (Central Processing Unit) (not shown). The control unit 8 reads the control program stored in the storage unit 9 and executes functions in each unit of the ultrasonic diagnostic apparatus 1.

  The storage unit 9 is an HDD (Hard Disk Drive), a semiconductor memory such as a RAM (Random Access Memory) and a ROM (Read Only Memory). The storage unit 9 may store raw data such as B-mode data obtained by the echo data processing unit 4 in addition to the control program. The storage unit 9 may store ultrasonic image data obtained by the ultrasonic image data creation unit 52. The raw data and the ultrasonic image data stored in the storage unit 9 are stored in the storage unit 9 together with the position information obtained by the position calculation unit 51.

  Further, the storage unit 9 stores volume data of a reference medical image acquired by the medical image device 90.

  Next, an example of the embodiment of the fixture according to the present invention will be described with reference to FIG. 3 is attached to the upper limb (arm) of the subject. The fixture 100 includes a fixture main body 104 configured to have frame bodies 101, 102, and 103, and a holding member 105 that is detachably attached to the fixture main body 104. The frame body 101 includes a pair of frame bodies 101a and 101b, the frame body 102 includes a pair of frame bodies 102a and 102b, and the frame body 103 includes a pair of frame bodies 103a and 103b.

  The fixture 100 includes a holding portion 106 including the frame body 101 and the holding member 105, and an arm fixing portion 107 configured to include the frame bodies 102 and 103. First, the holding unit 106 will be described. The holding unit 106 holds the ultrasonic probe 2. As shown in FIG. 4, the holding member 105 is provided between the frame bodies 101a and 101b. Therefore, the frame bodies 101 a and 101 b have a length required for providing the holding member 105.

  The holding member 105 is formed of an elastic material such as sponge, for example, and is elastically fitted between the frame bodies 101a and 101b and is held between the frame bodies 101a and 101b. FIG. 5 is a perspective view of the holding member 105. The holding member 105 is provided with protrusions 108 and 108 at positions facing each other. The holding member 105 is elastically fitted to the frame body 101 at the protrusions 108 and 108.

  The holding member 105 is provided with a probe holding hole 109. The ultrasonic probe 2 is detachably fitted and held in the probe holding hole 109 by the elasticity of the holding member 105. When the fixture 100 is attached to the upper limb of the subject, the ultrasonic probe 2 is held by the holding member 105 in a state where the ultrasonic transmission / reception surface 2a is in contact with the elbow.

  The ultrasonic probe 2 is fitted in the probe holding hole 109 in a close contact state. Therefore, when the ultrasonic probe 2 is held by the holding member 5, the position of the ultrasonic wave transmitting / receiving surface of the ultrasonic probe 2 on the fixture 100 is always the same position.

  Next, the arm fixing portion 107 will be described. The arm fixing portion 107 includes a first arm fixing member 110 configured to include the frame body 102 and a second arm fixing member 111 configured to include the frame body 103. The first arm fixing member 110 is provided on one end side of the holding portion 106, and the second arm fixing member 111 is provided on the other end side of the holding portion 106.

  As shown in FIG. 6, the first arm fixing member 110 is attached to one side of the upper limb (arm) X of the subject with respect to the elbow, that is, to the forearm X1 in FIG. The second arm fixing member 111 is attached to the other side of the elbow, that is, the upper arm X2 in FIG. In this state, the elbow of the subject is positioned on the holding unit 106. The first arm fixing member 110 is an example of an embodiment of a first member in the present invention, and the second arm fixing member 111 is an example of an embodiment of a second member in the present invention.

  However, although not particularly illustrated, the first arm fixing member 110 may be attached to the upper arm and the second arm fixing member 111 may be attached to the forearm.

  Between the frame bodies 102a and 102b constituting the first arm fixing member 110, belt-like support bodies 112 and 112 that abut against and support the forearm X1 (or the upper arm X2) are provided. The support body 112 is provided on the opposing surfaces of the frame bodies 102a and 102b. Also, between the frame bodies 103a and 103b constituting the second arm fixing member 111, belt-like support bodies 113 and 113 for contacting and supporting the upper arm X2 (or forearm X1) are provided. The support body 113 is provided on the opposing surface of the frame bodies 103a and 103b.

  The frame bodies 102a and 102b are provided with attachment belts 114a and 114b. The attaching belts 114a and 114b are provided with a hook-and-loop fastener portion 115 (only the hook-and-loop fastener portion of the attaching belt 114a is shown). The attachment belts 114a and 114b are wound around the forearm X1 (or the upper arm X2) and fastened by the hook-and-loop fastener portion 115. Thereby, the first arm fixing member 110 is attached to the forearm X1 (or the upper arm X2).

  The frame bodies 103a and 103b are provided with mounting belts 116a and 116b. The attachment belts 116a and 116b are also provided with a hook-and-loop fastener portion 117 (only the hook-and-loop fastener portion of the attachment belt 116b is shown). The attachment belts 116a and 116b are wound around the upper arm X2 (or the forearm X1) and fastened by the hook-and-loop fastener portion. Thereby, the 2nd arm fixing member 111 is attached to the upper arm X2 (or forearm X1).

  The frame bodies 102a and 102b and the frame bodies 103a and 103b are provided so as to be rotatable with respect to the frame bodies 101a and 101b. Therefore, the angle formed by the first arm fixing member 110 and the second arm fixing member 111 can be changed, and the bending angle of the upper limb fixed by the fixing device 100 can be changed.

  The frame bodies 102a and 102b and the frame bodies 103a and 103b are pivotally supported by the frame bodies 101a and 101b so as to maintain a predetermined angle with respect to the frame bodies 101a and 101b. The frame body 102a is pivotally supported on the frame body 101a by an angle adjustment knob 118. The frame body 103a is pivotally supported on the frame body 101a by an angle adjustment knob 119. The angle adjusting knobs 118 and 119 rotate as the frame bodies 102a and 103a rotate.

  On the angle adjusting knobs 118 and 119, an arrow A indicating the angles of the frame bodies 102a and 102b and the frame bodies 103 and 103b with respect to the frame bodies 101a and 101b is drawn. FIG. 7 shows an arrow A of the angle adjustment knob 118. In addition, on the frame body 102a, numbers from 0 ° to 90 ° and a scale S are drawn every 10 ° around the angle adjustment knobs 118 and 119 (in FIG. 7, in the angle adjustment knob, Only 118 is shown). However, in FIG. 7, only the numbers “0 °” and “90 °” are shown. The scale S indicated by the arrow A indicates the angles of the frame bodies 102a and 102b and the frame bodies 103a and 103b with respect to the frame bodies 101a and 101b. The arrow A, the scale S, and the numbers indicating the angles are an example of an embodiment of the angle determination unit in the present invention.

  For example, as shown in FIG. 8, the operator can rotate the frame body 102 a by rotating the angle adjustment knob 118.

  Now, the operation of this example will be described. The ultrasonic diagnostic apparatus 1 of this example displays a reference medical image having the same cross section as that of the ultrasonic image while displaying a real-time ultrasonic image of the upper limb of the subject. This will be specifically described based on the flowchart of FIG.

  First, in step S1, the medical image device 90 acquires volume data of a reference medical image for the upper limb X of the subject P. When the volume data is acquired, the fixture 100 is attached to the upper limb X (see FIG. 6). The upper limb X to which the fixing device 100 is attached is fixed in a state of being bent at the elbow.

  The operator adjusts the angle between the first arm fixing member 110 and the second arm fixing member 111 so that the upper limb X is fixed by the fixing tool 100 at a desired angle.

  Next, in step S2, the volume data acquired by the medical image apparatus 90 in step S1 is taken into the ultrasonic diagnostic apparatus 1. The volume data is stored in the storage unit 9.

  Next, in step S3, the fixture 100 is attached again to the upper limb X of the subject P, and transmission / reception of ultrasonic waves by the ultrasonic probe 2 is started. The transmission / reception of ultrasonic waves in step S3 and the acquisition of volume data in step S1 are different in place (examination room) and date / time. Accordingly, when the acquisition of the volume data in step S1 is completed, the fixture 100 is removed from the upper limb X of the subject P, and therefore the fixture 100 is mounted again in step S3.

  Also in this step S3, the fixing tool 100 fixes the upper limb X of the subject P in a bent state at the same angle as the angle of step S1. The angle between the first arm fixing member 110 and the second arm fixing member 111 can be grasped by the scale S indicated by the arrow A of the angle adjusting knobs 118 and 119. Therefore, the operator refers to the arrow A and the scale S, and makes the angles of the first arm fixing member 110 and the second arm fixing member 111 the same as in step S1.

  In this step S <b> 3, the ultrasonic probe 2 is attached to the probe holding hole 109 provided in the holding member 105 of the fixture 100. Thereby, as shown in FIG. 10, the ultrasonic probe 2 comes into contact with the vicinity of the vertex of the elbow of the subject P (the fixture 100 is not shown in FIG. 10). The ultrasonic probe 2 has a direction such that the azimuth direction (the arrangement direction of the ultrasonic transducers) is the X-axis direction in FIG. 10, that is, the direction in which the upper limb extends (the axial direction of the upper limb). It is held by the holding member 105. In this state, transmission / reception of ultrasonic waves is performed.

  Incidentally, since the ultrasonic probe 2 is not used in step S1, it is not necessary to attach the ultrasonic probe 2 to the holding member 105 when acquiring volume data by the medical imaging apparatus 90 in step S1. .

  Next, in step S4, alignment processing is performed to specify position correspondence information in the coordinate system of the ultrasonic image in real time and the coordinate system of the reference medical image 2. In this alignment process, a coordinate conversion formula that can specify corresponding coordinates in the coordinate system of the ultrasonic image and the coordinate system of the reference medical image is calculated. The alignment process is performed by the position correspondence specifying unit 54.

  The process of step S4 will be described based on the flowchart of FIG. First, in step S41, as shown in FIG. 12, when the operator inputs the operation unit 7, the display image control unit 53 displays the reference medical image MI along with the real-time ultrasonic image UI on the display unit. 6 to display. The reference medical image MI is a two-dimensional image based on the volume data stored in the storage unit 9.

  As shown in FIG. 13, the display image control unit 53 is a reference medical image having the same cross section on the ultrasound transmission / reception surface SP by the ultrasound probe 2 held by the holding member 105 and the upper limb X of the subject P. Display MI. Incidentally, the transmission / reception surface SP is a cross section in the direction in which the upper limb extends (X-axis direction).

  The display image control unit 53 displays a reference medical image MI having a preset cross section based on the volume data. Here, the holding portion 106 of the fixture 100 is positioned at the center portion of the upper limb X in the direction (Y-axis direction) orthogonal to the direction (X-axis direction) in which the upper limb X extends. Thus, the ultrasonic probe 2 is held. Therefore, the display image control unit 53 displays the reference medical image MI of the cross section located at the central portion of the upper limb X in the Y-axis direction based on the volume data.

  Next, in step S42, the operator sets a marker MK at a position considered to be the same position on the upper limb X of the subject P in the ultrasonic image UI and the reference medical image MI. When the marker MK is set, the indicator display control unit 55 causes the indicator In to be displayed on the ultrasonic image UI displayed on the display unit 6 as shown in FIG. In FIG. 14, only the ultrasound image UI is shown enlarged, but the reference medical image MI is displayed on the display unit 6 along with the ultrasound image UI on which the indicator In is displayed. Yes.

  The indicator In includes an upper limb indicator In1 indicating an upper limb, an angle indicator In2 indicating an angle, a probe indicator In3 indicating the ultrasonic probe 2, and a transmission region indicator In4 indicating an ultrasonic transmission region by the ultrasonic probe 2. have. The indicator display control unit 55 may display the indicator In when there is an input from the operation unit 7 by an operator.

  The upper limb indicator In1 indicates the outline of the upper limb with a broken line. This upper limb indicator In1 is a standard upper limb size. The upper limb indicator In1 may be displayed in a size according to gender, height, weight, and the like.

  The angle indicator In2 includes a first angle indicator In2a indicating the angle of the angle adjustment knob 118 and a second angle indicator In2b indicating the angle of the angle adjustment knob 119. The first angle indicator In2a and the second angle indicator In2b have an arrow image a corresponding to the arrow A of the angle adjustment knobs 118 and 119 and a scale image s corresponding to the scale S.

  When the angle of the scale S indicated by the arrow A is input in the operation unit 7, the indicator display control unit 55 displays an arrow image a indicating the scale image s of the input angle. The angle input in the operation unit 7 is performed with respect to each of the angle adjustment knobs 118 and 119. The indicator display control unit 55 displays the arrow image a of the first angle indicator In2a based on the angle θ1 input with respect to the angle adjustment knob 118. The indicator display control unit 55 displays the arrow image a of the second angle indicator In2b based on the angle θ2 input with respect to the angle adjustment knob 119.

  The indicator display control unit 55 sets the angle of the upper limb indicator In1 displayed on the display unit 6 based on the angles θ1 and θ2 input in the operation unit 7. More specifically, the upper limb indicator In1 indicates a standard upper limb contour in the human body, and includes a forearm portion x1 corresponding to the forearm and an upper arm portion x2 corresponding to the upper arm. Since the angle between the forearm and the upper arm is specified based on the angles θ1 and θ2, the indicator display control unit 55 determines that the angle between the forearm portion x1 and the upper arm portion x2 is based on the angles θ1 and θ2. The upper limb indicator In1 is displayed so that the angle is specified.

  As shown in FIG. 15, the operator sets markers MK1u and MK1m at the vertices of the elbows in each of the ultrasonic image UI and the reference medical image MI. In the ultrasonic image UI, the operator may identify the vertex of the elbow with reference to the upper limb indicator In1 (not shown in FIG. 15) and set the marker MK1u. The indicator display control unit 55 sets the markers MK1u and MK1m based on the input from the operation unit 7. Further, as shown in FIG. 16, the indicator display control unit 55 sets markers MK2u and MK3u at the intersections between the end of the transmission region indicator In4 and the contour of the upper limb indicator In1 in the ultrasonic image UI. To do.

  Incidentally, the ultrasonic probe 2 can receive an echo signal from the subject only at a portion in contact with the subject. Therefore, as shown in FIG. 17, in the ultrasonic wave transmitting / receiving surface 2a of the ultrasonic probe 2, it is only a part that comes into contact with the bent elbow. Only the ultrasonic image UI of the upper limb X is displayed. Accordingly, since only a part of the elbow of the upper limb X is displayed in the ultrasonic image UI, as described above, the markers MK2u and MK3u are set based on the transmission area indicator In4 and the upper limb indicator In1. Is called. Incidentally, in FIG. 17, the upper limb X is virtually indicated by a two-dot chain line.

  When the markers MK2u and MK3u are set in the ultrasonic image UI, the indicator display control unit 55 sets the markers MK2m and MK3m at the corresponding positions of the reference medical image MI as shown in FIG. Specifically, the indicator display control unit 55 first calculates a distance d1 between the marker MK1u and the marker MK2u and a distance d2 between the marker MK1u and the marker MK3u in the ultrasonic image UI. Next, the indicator display control unit 55 sets the markers MK2m and MK3m in the reference medical image MI based on the distances d1 and d2 with the marker MK1m as a reference. For example, the indicator display control unit 55 sets the marker MK2m at a distance d1 from the marker MK1m on the contour of the upper limb X of the reference medical image MI. Further, the indicator display control unit 55 sets the marker MK3m at a distance d2 from the marker MK1m on the contour of the upper limb X of the reference medical image MI. Here, it is assumed that the upper limbs X are displayed in the same size in the ultrasonic image UI and the reference medical image MI.

  In this way, when the same position of the subject in the ultrasonic image UI and the reference medical image MI is identified by the markers MK1u to MK3u and the markers MK1m to MK3m in step S42, step S43 is performed. Move on to processing. In step S43, the position correspondence specifying unit 54 obtains a coordinate conversion formula between the coordinate system of the ultrasonic image UI and the coordinate system of the reference medical image MI, and specifies the position correspondence. More specifically, position information of the ultrasonic transmission / reception surface SP (cross section of the ultrasonic image UI) by the ultrasonic probe 2 is obtained by the position calculation unit 51. The volume data of the reference medical image MI also has position information. Therefore, the position correspondence specifying unit 54 calculates the coordinate conversion formula based on the position coordinates of the markers MK1u to MK3u in the ultrasonic image UI and the position coordinates of the markers MK1m to MK3m in the reference medical image MI. Ask.

  When the coordinate conversion formula is obtained in step S43, the alignment process in step S4 is completed. When the positioning process is completed, the reference medical image MI having the same cross section as the real-time ultrasonic image UI can be displayed so as to follow the ultrasonic probe 2 as it moves.

  When the positioning process in step S4 is completed, in step S5, the operator displays an ultrasonic image UI and a reference medical image MI for the observation target. Specifically, the operator removes the ultrasonic probe 2 from the holding member 105 and obtains an ultrasonic image UI of a portion to be photographed in the upper limb X in a state where the angle is fixed by the fixture 100. The ultrasonic probe 2 is brought into contact with the position. For example, when it is desired to observe the muscles of the forearm, the ultrasonic probe 2 is brought into contact with the forearm to transmit / receive ultrasonic waves. Thereby, the ultrasound image UI of the forearm is displayed, and the reference medical image MI having the same cross section is also displayed.

  When displaying the ultrasound image UI and the reference medical image MI for the observation target, the holding member 105 may be detached from the fixture main body 104.

  According to this example, when the volume data of the reference medical image MI is acquired by the medical image apparatus 90 and when the ultrasonic image UI is displayed, the elbow is bent at the same angle by the fixture 100 and the upper limb X Is fixed. In addition, the transmitting / receiving surface 2a of the ultrasonic probe 2 is held by the fixture 100 so as to abut the apex of the elbow. Therefore, the vertex of the elbow can be specified as the same position in the upper limb X by the ultrasonic image UI and the reference medical image MI. As a result, in the ultrasonic image UI and the reference medical image MI, the alignment processing is performed in the coordinate system of the ultrasonic image UI and the coordinate system of the reference medical image MI with reference to the vertex of the elbow. Can do.

  In addition, by holding the ultrasonic probe 2 by the holding unit 106 in the fixture 100, the ultrasonic wave transmission / reception surface of the upper limb can be set to a preset position. Therefore, the same cross section can be set in advance in the volume data of the reference medical image MI on the ultrasonic transmission / reception surface and the upper limb. Thereby, it is possible to easily display the ultrasonic image UI and the reference medical image MI having the same cross section in the upper limb.

  Further, the upper limb can be fixed at the same angle by the fixing device 100 when the volume data is acquired in the medical image apparatus 90 and when the ultrasonic image UI is captured. Thereby, once the coordinate conversion formula is calculated by the alignment processing, the reference medical image MI having the same cross section as the ultrasonic image UI can be displayed by the coordinate conversion using the coordinate conversion formula.

  The operator refers to the angle of the scale S indicated by the arrow A of the angle adjustment knobs 118 and 119, and thereby determines the angles of the first arm fixing member 110 and the second arm fixing member 111 to the medical image device 90. The same angle can be easily set at the time of acquiring volume data and at the time of photographing the ultrasonic image UI.

  Next, a modification of the above embodiment will be described. In step S4 of the above embodiment, a marker is set in the ultrasonic image UI and the reference medical image MI of one cross section in the upper limb X, and alignment processing is performed. However, a marker may be set in the ultrasonic image UI and the reference medical image MI of a plurality of cross sections in the upper limb X, and the alignment process may be performed.

  In this case, the probe holding hole 109 of the holding member 105 is formed larger than the width Wy of the ultrasonic probe 2 in the elevation direction (Y-axis direction) as shown in FIG. Thereby, in the probe holding hole 109, the ultrasonic probe 2 can be moved in the elevation direction, and ultrasonic waves can be transmitted and received for a plurality of cross sections of the subject.

  The holding member 105 may have a display or a structure for making the ultrasonic wave transmission / reception surface of the ultrasonic probe 2 constant. For example, as shown in FIG. 20, a mark L indicating an ultrasonic wave transmission / reception surface may be displayed on the holding member 105 in the vicinity of the probe holding hole 109. In this case, a mark (not shown) is also provided at the center of the ultrasonic probe 2 in the elevation direction. Then, the ultrasonic probe 2 is fitted into the probe holding hole 109 so that the mark of the ultrasonic probe 2 is aligned with the mark L of the holding member 105.

  Three marks L of the holding member 105 are provided on both sides of the probe holding hole 109 in the X-axis direction (marks L1 to L3). The marks L1 to L3 are provided at equal intervals in the Y-axis direction. FIG. 20 shows a state in which the mark of the ultrasonic probe is positioned at the center mark L1.

  As shown in FIG. 21, by aligning the mark of the ultrasonic probe 2 with the mark L2 at the top, the ultrasonic probe 2 comes into contact with the wall 109a on one end side in the Y-axis direction of the probe holding hole 109. . On the other hand, as shown in FIG. 22, by aligning the mark of the ultrasonic probe 2 with the mark L3 at the bottom, the ultrasonic probe 2 has a wall 109b on the other end side in the Y-axis direction in the probe holding hole 109. Abut. Accordingly, as shown in FIGS. 20 to 22, ultrasonic waves can be transmitted and received by the ultrasonic probe 2 at a fixed position in the holding member 105 for at least three cross sections.

  The setting of the markers MK1u to MK3u and the markers MK1m to MK3m in step S42 will be described. In step S42, an ultrasonic image UI is displayed for each of the three cross sections of the upper limb X, and the markers MK1u to MK3u are set one by one in the ultrasonic image UI of each cross section.

  For example, the ultrasonic image UI1 shown in FIG. 23 is an ultrasonic image obtained by transmitting and receiving ultrasonic waves at a position where the mark of the ultrasonic probe 2 is aligned with the mark L1 of the holding member 105. . In the ultrasonic image UI1, the operator sets a marker MK1u at the apex of the elbow with reference to the upper limb indicator In1 as necessary. Further, in the reference medical image MI1 having the same cross section as the ultrasonic image UI1, the operator sets a marker MK1m at the elbow apex as shown in FIG.

  Further, the ultrasonic image UI2 shown in FIG. 25 is an ultrasonic image obtained by transmitting and receiving ultrasonic waves at a position where the mark of the ultrasonic probe 2 is aligned with the mark L2 of the holding member 105. . In the ultrasonic image UI2, the operator sets a marker MK2u at the elbow apex with reference to the upper limb indicator In1 as necessary. Also in the reference medical image MI2 having the same cross section as the ultrasonic image UI2, the operator sets a marker MK2m at the apex of the elbow as shown in FIG.

  27 is an ultrasonic image obtained by transmitting and receiving ultrasonic waves at a position where the mark of the ultrasonic probe 2 is aligned with the mark L3 of the holding member 105. The ultrasonic image UI3 shown in FIG. . In the ultrasonic image UI3, the operator sets a marker MK3u at the apex of the elbow with reference to the upper limb indicator In1 as necessary. Also in the reference medical image MI3 having the same cross section as the ultrasonic image UI3, the operator sets a marker MK3m at the elbow apex as shown in FIG.

  In the ultrasonic image UI2, the marker MK2u is not the top of the elbow by the indicator display control unit 55, but as shown in FIG. It may be set at an intersection. In this case, the indicator display control unit 55 calculates a distance d1 ′ between the vertex of the elbow in the ultrasonic image UI2 and the marker MK2u. At this time, although not particularly illustrated, the operator may perform input for designating the vertex of the elbow in the ultrasonic image UI2. Then, as shown in FIG. 30, the indicator display control unit 55 sets the marker MK2m at the position of the distance d1 ′ from the top of the elbow in the upper limb X in the reference medical image MI2. At this time, although not particularly illustrated, the operator may perform input for designating the vertex of the elbow in the reference medical image MI2. Thus, the marker MK2m is set at a position corresponding to the marker MK2u in the reference medical image MI2.

  Further, in the ultrasonic image UI3, the marker MK3u is not the top of the elbow but the other end of the transmission area indicator In4 and the upper limb indicator In1 by the indicator display control unit 55, as shown in FIG. May be set at the intersection of In this case, the indicator display control unit 55 calculates a distance d2 ′ between the vertex of the elbow in the ultrasonic image UI3 and the marker MK3u. At this time, although not particularly illustrated, the operator may perform input for designating the vertex of the elbow in the ultrasonic image UI3. Then, as shown in FIG. 32, the indicator display control unit 55 sets the marker MK3m at the position of the distance d2 ′ from the top of the elbow in the upper limb X in the reference medical image MI3. At this time, although not particularly illustrated, the operator may perform input for designating the apex of the elbow in the reference medical image MI3. Thus, the marker MK3m is set at a position corresponding to the marker MK3u in the reference medical image MI3.

  Based on the markers MK1u to MK3u and the markers MK1m to MK3m set as described above, the position correspondence specifying unit 54 obtains the coordinate conversion formula.

  As mentioned above, although this invention was demonstrated by the said embodiment, of course, this invention can be variously implemented in the range which does not change the main point. For example, the fixture 100 may be attached to the lower limb of the subject and fixed with the lower limb bent at the knee.

  Further, as shown in FIG. 33, a magnetic sensor 120 (the magnetic sensor 120 provided on the frame body 102b is not shown) for performing the alignment process on the frame bodies 102a and 102b of the fixture 100, It may be provided instead of the magnetic sensor 10. In this case, the position calculation unit 51 detects the position of the ultrasonic transmission / reception surface of the ultrasonic probe 2 held by the holding unit 106 based on the magnetic detection signal of the magnetic sensor 120. However, the positional relationship between the position of the magnetic sensor 120 and the transmission / reception surface of the ultrasonic probe 2 held by the holding unit 106 is specified in advance.

DESCRIPTION OF SYMBOLS 1 Ultrasonic diagnostic apparatus 2 Ultrasonic probe 2a Transmission / reception surface 6 Display part
DESCRIPTION OF SYMBOLS 10 Magnetic sensor 51 Position calculation part 53 Display image control part 54 Position corresponding relationship specific | specification part 55 Indicator display control part 100 Fixing tool 104 Fixing tool main body 105 Holding member 106 Holding part 110 First arm fixing member 111 Second arm fixing member 118 Angle Adjustment knob 119 Angle adjustment knob A Arrow S Scale

Claims (13)

  A fixture that is attached to an upper limb or a lower limb of a subject and fixes the upper limb or the lower limb in a state of being bent at a joint, and includes an ultrasonic probe that transmits and receives ultrasonic waves to and from the upper limb or the lower limb. A holding portion for holding the ultrasonic probe, and the holding portion is provided at a position for holding the ultrasonic probe so that an ultrasonic wave transmitting / receiving surface of the ultrasonic probe is in contact with at least a vertex of a bent portion of the joint. Fixing device characterized by being.   The fixture according to claim 1, wherein a bending angle of the upper limb or the lower limb is variable.   The upper limb or the lower limb includes a first member attached to one side of the joint and a second member attached to the other side, and an angle formed by the first member and the second member is variable. The fixture according to claim 2.   The fixture according to claim 3, wherein the holding portion is provided between the first member and the second member, and is provided at a position of the joint.   The said holding | maintenance part has a holding member holding the said ultrasonic probe, and this holding member is provided with respect to the said fixing tool main body so that attachment or detachment is possible. Fixing device according to.   The fixture according to any one of claims 1 to 5, further comprising an angle determination unit that allows an operator to determine a bending angle of the upper limb or the lower limb. Display said fixture according, the ultrasound image based on the echo signal obtained by ultrasonic transmission and reception by the ultrasound probe held by the holding portion of said fixture in any one of claims 1 to 6 An ultrasonic diagnostic apparatus comprising a display image control unit to be displayed on the unit.   The ultrasonic diagnostic apparatus according to claim 7, wherein the display image control unit further displays a reference medical image based on volume data obtained in advance for the upper limb or the lower limb.   The bent portion of the joint in the reference medical image of the upper limb or the lower limb having the same cross section as the ultrasonic transmission / reception surface held by the ultrasonic probe held by the holding portion, and the bent portion of the joint in the ultrasonic image The ultrasound diagnostic apparatus according to claim 8, further comprising a position correspondence specifying unit that specifies a position correspondence between coordinates in the ultrasound image and coordinates in the reference medical image as a reference.   The display image control unit displays the ultrasonic image and the reference medical image on the display unit when the position correspondence relationship is specified by the position correspondence relationship specifying unit, and the display unit controls the holding image as the reference medical image. The ultrasonic diagnostic apparatus according to claim 9, wherein a reference medical image having the same cross section is displayed on the transmission / reception surface of the ultrasonic probe held at a preset position and the subject. A position detection unit for detecting a position of a cross section of the ultrasonic image of the upper limb or the lower limb in a three-dimensional space;
The position correspondence information specifying unit specifies position correspondence information between coordinates of an ultrasound image in which a position of a cross section is detected by the position detection unit and coordinates of the reference medical image. The ultrasonic diagnostic apparatus according to 10.   An indicator display control unit configured to display an indicator indicating the upper limb or the lower limb fixed in a state bent by a predetermined angle by the fixing device on the position of the upper limb or the lower limb in the ultrasonic image; The ultrasonic diagnostic apparatus according to claim 7, wherein the ultrasonic diagnostic apparatus is characterized. An input unit for an operator to input a bending angle of the upper limb or the lower limb;
The ultrasonic diagnostic apparatus according to claim 12, wherein the indicator display control unit displays an indicator of the upper limb or the lower limb having a bending angle corresponding to the bending angle input by the input unit.