JP6419441B2 - Medical image processing apparatus, medical image processing system, and medical image processing program - Google Patents

Description

  Embodiments as one aspect of the present invention relate to a medical image processing apparatus, a medical image processing system, and a medical image processing program.

  Various inspection devices (hereinafter referred to as modality devices) used in image diagnosis are indispensable in current medical care because they can inspect the body in a minimally invasive manner. The high-performance modality device has made it possible to acquire high-quality images with high resolution, enabling accurate and precise examinations in diagnostic imaging. For example, an X-ray CT (Computed Tomography) apparatus can acquire three-dimensional information of the internal tissue of a subject with high resolution, and an MRI (Magnetic Resonance Imaging) apparatus can acquire fresh blood containing no contrast medium. There are various imaging methods for each modality device, such as non-contrast angiography (MRA: MR Angiography) for imaging by MRI. In addition, as digitalization of medical images progresses, a hospital system (HIS: Hospital Information System) or radiology information system (RIS), which is an ordering system that processes examination requests from doctors via an electronic network, In addition, a medical image central management system (PACS: Picture Archiving and Communication Systems) that accumulates images acquired by modality devices as electronic data has been developed.

  Thus, with the development of the modality device, it has become possible to observe the inside of the living body easily and in detail. On the other hand, the amount of data that can be acquired is enormous, and many modality devices acquire data in the form of volume data composed of a plurality of images. The volume of the volume data is as large as several thousand images when the whole body is imaged, and the burden on the interpreting doctor who makes a diagnosis by using these data is increasing. Interpretation is an important task for diagnosing diseases and deciding treatment strategies. While early detection is desired, it is not easy to analyze a large amount of medical images and make decisions at an early stage. Therefore, as an invention that supports image diagnosis, a medical image processing apparatus (for example, Patent Document 1) that identifies an anatomical region using a segmentation technique and the like, and determines an abnormal area and its malignancy, There is provided an image analysis apparatus (for example, Patent Document 2) that determines a positional correspondence between images acquired in two different examinations by a structure having periodicity such as a spine.

  Moreover, accuracy is required for interpretation and diagnosis, and in order to make a high-quality diagnosis, it is necessary to accurately grasp an abnormal site or a treatment site in the acquired medical image. However, reading an anatomical part from a medical image requires skilled techniques and knowledge. Therefore, the provision and research of techniques for expressing and constructing the anatomical position of the human body using mathematical techniques are being carried out.

  An anatomical position is the position of a characteristic local structure of the human body (hereinafter referred to as local structure) that plays an important role in understanding medical images. It becomes a landmark. Examples of the local structure include the anterior arch (nodule) of the first cervical vertebra (cervical vertebra I) in the head, the tracheal bifurcation in the chest, and the upper right kidney in the abdomen. The anatomical position is automatically detected from a medical image acquired by a modality apparatus such as an X-ray CT apparatus or an MRI apparatus by general image analysis, pattern recognition technology, or the like.

  Furthermore, in order to accurately diagnose, there is a method called comparative interpretation, in which interpretation is performed while comparing with similar cases, or when performing follow-up observation, interpretation is performed while comparing the past and latest medical images. Used. In comparative interpretation, it is required to display a plurality of medical images with the anatomical parts synchronized (hereinafter referred to as follow-up display) for interpretation. However, imaging conditions such as slice intervals, imaging start positions, imaging methods, and the like may differ between different examinations. In view of this, an image display system is provided that determines slice planes based on a plurality of medical images in such comparative interpretation and aligns slice pairs in the body axis direction (for example, Patent Document 3).

Japanese Patent No. 5197029 Japanese Patent No. 5138431 JP-A-8-294485

  However, when the subject is different, there are differences in the size and position of the organ caused by individual differences, so search for slice images having the same anatomical position from among medical images having a huge amount of slice images It ’s difficult. Further, even in the case of the same subject, images of the organs that move, such as the lungs and the heart, are not always the same. For example, the lung is an organ that varies in size each time depending on the amount of air sucked. For such an organ, when comparative interpretation is performed between different examinations or between different series, positional deviation occurs even if the slice thickness, the slice interval, and the like match. Further, even if the positions are once aligned, if the follow-up display is continued, the position shift gradually occurs, and the position alignment may be necessary again. Furthermore, the same disease may be diagnosed from various modalities using various modality devices. Since medical images acquired between different modalities have organs or the like imaged in different modes, it is difficult to display following the anatomical positions. Thus, in a plurality of medical images of different patients, examinations, or series, it is a complicated and difficult task to always display the same anatomical position in synchronization with each other.

  Therefore, there is a demand for a medical image processing apparatus that uses the above-described anatomical positions to display a plurality of medical images following the comparative interpretation.

  The medical image processing apparatus according to the present embodiment is a medical image processing apparatus to which an interpretation target medical image composed of a plurality of slice images and a comparison target medical image composed of a plurality of slice images are input. An anatomical position detection unit that detects an anatomical position of a characteristic local structure in the human body from each of the input medical image to be interpreted and the medical image to be compared, and the inputted medical image to be interpreted And the comparison target slice image respectively identified from the plurality of slice images included in each of the comparison target medical images based on the anatomical position. And an image specifying unit.

1 is a conceptual configuration diagram illustrating an example of a medical image processing apparatus according to an embodiment. FIG. 3 is a functional block diagram showing an example functional configuration of the medical image processing apparatus according to the embodiment. 6 is a flowchart showing an example of the operation of the first embodiment of the medical image processing apparatus according to the embodiment. The figure explaining the detection method of an anatomical position. The figure explaining the kind of local structure. The figure explaining anatomical position information. The figure explaining the example of a display in 1st Embodiment of the medical image processing apparatus which concerns on embodiment. The figure explaining the anatomical position of the medical image data for interpretation in 1st Embodiment of the medical image processing apparatus which concerns on embodiment. The figure explaining specification of the comparison object slice image in 1st Embodiment in 1st Embodiment of the medical image processing apparatus which concerns on embodiment. The figure explaining the example of a display at the time of displaying simultaneously medical image data for interpretation and medical image data for comparison in a 1st embodiment of a medical image processing device concerning an embodiment. The figure explaining the example of a display at the time of inputting the local structure in 1st Embodiment of the medical image processing apparatus which concerns on embodiment. The figure explaining the case where the anatomical position corresponding to the interpretation target slice image is not in the vicinity in the medical image processing apparatus according to the embodiment. 9 is a flowchart showing an example of the operation of the second embodiment of the medical image processing apparatus according to the embodiment. The figure explaining the upper end position and lower end position which concern on 2nd Embodiment of the medical image processing apparatus which concerns on embodiment. The figure explaining the anatomical position of the upper end position and lower end position which concern on 2nd Embodiment of the medical image processing apparatus which concerns on embodiment. FIG. 10 is a diagram illustrating a first calculation method for calculating a corresponding slice image in the second embodiment of the medical image processing apparatus according to the embodiment. The figure explaining the comparison object slice image calculated by the 1st calculation method which calculates the corresponding slice image in 2nd Embodiment of the medical image processing apparatus which concerns on embodiment. FIG. 10 is a diagram illustrating a second calculation method for calculating a corresponding slice image in the second embodiment of the medical image processing apparatus according to the embodiment. 6 is a flowchart illustrating an example of an operation in image processing of the medical image processing apparatus according to the embodiment. The figure explaining the display expansion process of the medical image processing apparatus which concerns on embodiment. FIG. 6 is a diagram for explaining a synchronization method of display enlargement processing of the medical image processing apparatus according to the embodiment.

  Hereinafter, an embodiment of a medical image processing apparatus will be described with reference to the accompanying drawings.

(1) Configuration FIG. 1 is a conceptual configuration diagram illustrating an example of a medical image processing apparatus 100 according to an embodiment.

  As illustrated in FIG. 1, the medical image processing apparatus 100 includes a communication control device 10, a storage unit 20, a main control unit 30, a display unit 40, and an input unit 50. The medical image central management server 200, the modality device 300, and the HIS / RIS 400 are connected via the communication control device 10 via the electronic network. The communication control apparatus 10 implements various communication protocols according to the network form. Here, the electronic network means the entire information communication network using telecommunications technology. In addition to the hospital basic LAN, wireless / wired LAN and Internet network, telephone communication network, optical fiber communication network, cable communication network and satellite. Includes communication networks. The medical image processing apparatus 100 acquires examination data from the medical image central management server 200 or the modality apparatus 300 via an electronic network.

  The medical image central management server 200, the HIS / RIS 400, and the medical image processing apparatus 100 may be configured as a system on the cloud.

  The modality apparatus 300 includes various medical image imaging apparatuses such as an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, a PET (Positron Emission Tomography) apparatus, and an ultrasonic diagnostic apparatus. Data input to the medical image processing apparatus 100 is volume data composed of a plurality of slice images.

  The medical image processing apparatus 100 is connected to the HIS / RIS 400. The HIS / RIS 400 is a system that processes examination requests and the like created by doctors called examination orders. From HIS / RIS400, patient ID for uniquely identifying a patient, patient information such as patient name, patient gender and physique, and examination information such as examination type, examination purpose, modality device type, etc. via electronic network You can get it.

  By executing the program stored in the storage unit 20 by the main control unit 30, image display processing such as specifying an anatomical position and following display in comparative interpretation is performed on the input volume data.

  The storage unit 20 includes a storage medium such as a RAM and a ROM, and includes a storage medium that can be read by the main control unit 30, such as a magnetic or optical storage medium or a semiconductor memory. You may comprise so that a part or all of the program and data in these storage media may be downloaded via an electronic network. The identification of the anatomical position performed in the medical image processing apparatus 100 may be performed using a program or data stored in the storage unit 20 in advance, and is stored in an external storage device via the communication control apparatus 10. It may be executed using stored data or the like, or may be executed by a program stored in an external storage device or the like.

  The display unit 40 is configured by a general display device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display, and displays an image under the control of the main control unit 30.

  The input unit 50 is configured by a general input device such as a keyboard, a touch panel, a numeric keypad, and a mouse. The input unit 50 outputs an input signal corresponding to an operation such as a user's examination or selection of a display image, image processing, or the like to the main control unit 30.

  FIG. 2 is a functional block diagram illustrating a functional configuration example of the medical image processing apparatus 100 according to the embodiment. As shown in FIG. 2, the medical image processing apparatus 100 includes a medical image input unit 31, an anatomical position detection unit 32, a contrast image specifying unit 33, a corresponding slice calculation unit 34, an image processing synchronization control unit 35, and a display generation unit. 36, a display unit 40, and an input unit 50.

  Of the above configuration, the functions of the medical image input unit 31, the anatomical position detection unit 32, the contrast image specifying unit 33, the corresponding slice calculation unit 34, the image processing synchronization control unit 35, and the display generation unit 36 are stored in the storage unit 20. This is a function realized by the main control unit 30 executing the stored program.

  The medical image input unit 31 receives medical image data from the central medical image management server 200 and the modality device 300. A plurality of medical image data is input to the medical image input unit 31 for comparative interpretation. For example, interpretation target medical image data and one or more comparison target medical image data are input. Hereinafter, medical image data to be interpreted is referred to as “interpretation medical image data”, and medical image data to be compared is referred to as “comparison medical image data”. The medical image data input to the medical image input unit 31 is volume data composed of a plurality of slice images. The interpretation target medical image data and the comparison target medical image data input to the medical image input unit 31 may be automatically selected using examination information or patient information stored in the HIS / RIS 400, or may be selected by the user. It may be selected.

  The anatomical position detection unit 32 detects an anatomical position of the input medical image data, and inputs information on the detected anatomical position (hereinafter referred to as anatomical position information) to the input medical image. Give to data. The anatomical position detection unit 32 detects an anatomical position from the input interpretation target medical image data and the comparison target medical image data.

  The input medical image data may be preliminarily given anatomical position information. For example, the addition of the anatomical position information to the medical image data may be executed at the timing when the image is acquired by the modality device 300 or may be executed at the timing when the medical image data is stored in the centralized medical image management server 200. . In that case, the detection process of the anatomical position in the anatomical position detection unit 32 and the process of adding the anatomical position information to the medical image data can be omitted. A method for detecting the anatomical position in the anatomical position detection unit 32 will be described later.

  The anatomical position information given to the medical image data may be held in a state associated with the corresponding medical image data in a data format such as XML data or binary data, for example. Further, the input medical image data is data conforming to DICOM (Digital Imaging and Communication in Medicine) format, and the anatomical position information may be held as incidental information in the DICOM standard.

  The contrast image specifying unit 33 is based on an anatomical position from among a plurality of slice images included in the respective medical image data of the interpretation target medical image data and the comparison target medical image data input to the medical image input unit 31. Thus, the interpretation target slice image and the comparison target slice image corresponding to the anatomy are specified. Hereinafter, the slice image selected from the interpretation target medical image data is referred to as “interpretation target slice image”, and the slice image selected from the comparison interpretation target medical image data is referred to as “comparison target slice image”. And

  Further, the contrast image specifying unit 33 specifies an anatomical position based on the type, part, organ, and the like of the local structure input from the input unit 50, and the input medical image data to be interpreted and the medical image data to be compared Based on the anatomical position, the interpretation target slice image and the comparison target slice image are identified from the plurality of slice images included in each of the medical image data. Further, in accordance with the correspondence relationship between the slice images calculated by the corresponding slice calculation unit 34, the follow-up display that links the interpretation target slice image and the comparison target slice image is controlled. The contrast image specifying unit 33 controls the page turning operation such as the display change speed of the interpretation target slice image and the comparison target slice image and the display change timing of the slice image. A method for specifying a slice image by the contrast image specifying unit 33 will be described later.

  The corresponding slice calculation unit 34 calculates the slice correspondence between the interpretation target medical image and the comparison target medical image based on the anatomical position included in each input medical image data. The slice correspondence relationship is calculated using an interpolation formula derived from the slice numbers of the interpretation target medical image and the comparison target medical image. A method for determining a corresponding slice image in the corresponding slice calculation unit 34 will be described later.

  The image processing synchronization control unit 35 performs the image processing executed on any one of the interpretation target medical image data and the comparison target medical image data on the other medical images in the same manner. For example, when an operation for enlarging a slice image is performed on a certain medical image, control is performed so that the enlargement process is performed at the same ratio for slice images of other medical images. The image processing synchronization control in the image processing synchronization control unit 35 will be described later.

  The display generation unit 36 includes a slice image of a plurality of medical images, a display indicating the number of slices included in the medical image, a list of types of local structures corresponding to anatomical positions specified for the plurality of medical images, and the like. A configured display image is generated. The display generated by the display generation unit 36 will be described later.

(2) Operation The operation of the medical image processing apparatus 100 according to the embodiment will be described separately according to the method for specifying the slice image to be displayed. In the first embodiment, an anatomically corresponding slice image is specified based on the type of the input local structure and the anatomical position corresponding to the displayed interpretation target slice image. In the second embodiment, the corresponding slice image is specified by the interpolation formula derived based on the slice number specified from the anatomical position, and the slice image corresponding to the anatomical is specified.

(First embodiment)
FIG. 3 is a flowchart showing an example of the operation of the first embodiment of the medical image processing apparatus 100 according to the embodiment.

  In ST 101, interpretation target medical image data is input to the medical image input unit 31 from the central medical image management server 200 or the modality device 300. As the medical image data to be interpreted, the medical image related to the current examination in the same patient may be automatically selected using examination information or patient information registered in the HIS / RIS 400 or the like. It may be selected manually. For example, the medical image data to be interpreted may be determined by being selected by the user from the medical image data retrieved from the examination information or the like.

  In ST 103, comparison target medical image data is input to the medical image input unit 31 from the central medical image management server 200 or the modality device 300. Similar to the medical image data to be interpreted, the input medical image data to be compared is automatically obtained from the medical image related to the previous examination in the same patient using the examination information or patient information registered in the HIS / RIS400 or the like. It may be selected or manually selected by the user. For example, the comparison target medical image data input by the user selecting from the medical image data retrieved from the examination information or the like may be determined.

  In ST105, the anatomical position is detected by the anatomical position detection unit 32 for the input medical image data. Specifically, an anatomical position is detected for the medical image data to be interpreted and the medical image data to be compared. If an anatomical position has already been detected for the input medical image data to be interpreted and the medical image data to be compared, this process can be omitted.

  FIG. 4 is a diagram illustrating a method for detecting an anatomical position. FIG. 4A shows an example of a method for generating the model a5 used for detecting the anatomical position. The model a5 shown in FIG. 4A may be stored in advance in the storage unit 20 of the medical image processing apparatus 100, or may be stored in an external storage device.

  As shown in FIG. 4A, the model a5 used for detecting the anatomical position is generated by general machine learning or pattern recognition. FIG. 4A shows an example in which the model a5 is generated using the image database a1 and the anatomical position correct answer data a2. The image database a1 is a set of volume data obtained by an X-ray CT apparatus or an MRI apparatus for subjects having different body shapes. As illustrated in FIG. 4A, the image database a1 includes not only whole body volume data (image A) but also volume data (images B and C) obtained by imaging a part of the body. The correct anatomical position data a2 is data in which the correct anatomical position is determined in advance by a specialist such as a doctor for each image in the image database a1. As shown in FIG. 4A, the feature extraction unit a3 extracts features from the respective volume data in the image database a1, and generates a model a5 by the learning algorithm a4 using the anatomical position correct answer data a2. . The model a5 shows a method for associating the feature generated as a result of the learning algorithm a4 and extracted from the image database a1 with the anatomical position. The model a5 includes a model using machine learning, for example. In addition, different models may be generated according to sex, age, race, physique, and the like, or a model that can absorb these differences.

  FIG. 4B shows an example of processing executed by the anatomical position detection unit 32. The anatomical position detection unit 32 is similar to the feature extraction unit a3 in FIG. 4A for the analysis target image data b1 whose anatomical position is unknown (for example, interpretation target medical image data or comparison target medical image data). Then, a feature is extracted, and an anatomical position is detected using the already generated model a5. More specifically, the local structure is detected, and the position of the detected local structure in the medical image is calculated as an anatomical position. The anatomical position information b2 calculated in this way is given to the analysis target image data b1.

  The anatomical position is not limited to the above-described method, and can be detected by a mathematical statistical framework (computational anatomical model) called computational anatomy.

  FIG. 5 is a diagram for explaining the types of local structures. The local structure is a characteristic structure of the human body that plays an important role in understanding medical images, and is sometimes called an anatomical landmark (AL). For example, FIG. 5A shows an example of the local structure of the head and neck. In FIG. 5 (a), the anterior arch (nodule) of the first cervical vertebra (cervical vertebra I), the upper end of the dental process (cervical vertebra II), the right upper surface, the left upper surface, the right eye center, the left eye center, Is illustrated. Similarly, FIG. 5B illustrates the tracheal bifurcation, right apex, left apex, right subscapular angle, left subscapular angle, and left subclavian artery starting point for the local structure of the chest. Yes. FIG. 5 (c) illustrates the right kidney upper pole, the left kidney upper pole, the right kidney lower pole, the left kidney lower pole, the pancreatic head, and the pancreatic tail tip for the local structure of the abdomen. In FIG. 5D, as the local structure of the lower limb, the lateral epicondyle of the right femur, the medial epicondyle of the right femur, the lateral epicondyle of the left femur, the medial epicondyle of the left femur, and the lateral side of the right tibia The condyle, the medial condyle of the right tibia is illustrated. For example, the local structure is defined for the whole body with a granularity as shown in FIG. 5, and a plurality of local structures are defined for various bones, muscles, organs, and the like constituting the human body. An anatomical location is detected for each of these local structures.

  Such an anatomical position is held in association with medical image data as anatomical position information. The anatomical position information may be stored as a database in the storage unit 20 or the like in XML or text format in association with an ID for uniquely specifying a medical image, for example, or medical information as supplementary information of DICOM It may be held together with the image data.

  Anatomical position information includes anatomical position information, part information such as the chest and abdomen to which the local structure corresponding to the anatomical position belongs, and the anatomical position such as the bone system and respiratory system. The body tissue information according to the functional system in the human body of the local structure corresponding to can be included.

  FIG. 6 is a diagram for explaining anatomical position information. The table in FIG. 6A shows an example of anatomical position information. The table showing the anatomical position information in FIG. 6A includes, from the left, the identifier, name, reliability, part, body tissue, patient coordinate system (X axis, Y axis, Z axis) of the anatomical position. ) Position is shown. FIG. 6A illustrates a part of the anatomical position information of the abdomen. 6A, from the left, the identifier (ABDO25.C)), name (center of body of L5), reliability (0.87), part (abdomen), body tissue (bone system), patient coordinates The system (X-axis (-3.1), Y-axis (23.4), Z-axis (90.0)) is shown. Similarly, the second row includes the identifier (ABDO32.C)), name (upper right iliac spine), reliability (0.82), site (abdomen), body tissue (bone system), patient coordinate system (X Axis (-11.1), Y-axis (-54.4), Z-axis (84.1)), 3rd stage is identifier (ABDO39.C)), name (left iliac spine upper surface), reliability (0.83) site, (abdomen), body tissue (bone system), patient coordinate system (X axis (−3.0), Y axis (30.0), Z axis (104.0)) are shown ing.

  The identifier is an ID for uniquely identifying the anatomical position. The name indicates the name of the local structure, and is expressed in terms of anatomical and medical terms. The reliability is a numerical value indicating the accuracy of the anatomical position. Since anatomical positions are data estimated by calculation using machine learning algorithms or pattern recognition, a numerical value indicating how accurately each position is calculated for each anatomical position. Given. In the example shown in FIG. 6A, a numerical value between 0 and 1 is used, and a numerical value closer to 1 indicates higher reliability. The site | part has shown the site | part of the human body to which a local structure belongs, for example, it classifies like a chest and an abdomen. The body tissue is classified according to the function of the local structure, and includes, for example, the nervous system, the bone system, and the respiratory system. In addition to such parts and body tissues, information on organ names and units of anatomical structures such as the heart, lungs, and femur can be included as anatomical position information. The patient coordinate system indicates the anatomical position by the coordinates of the X axis, the Y axis, and the Z axis.

  FIG. 6B is a diagram illustrating the patient coordinate system. As shown in FIG. 6B, the patient coordinate system is a coordinate system in which the patient's left-right direction is the X axis, the patient's dorsal ventral direction is the Y axis, and the patient's head and foot direction is the Z axis. The X axis increases to the right from the patient center, the Y axis increases from the patient center to the dorsal direction, and the Z axis increases from the patient's foot to the head. Such a patient coordinate system is relatively represented by an arbitrary position such as a reference position of the volume data.

  The example of FIG. 6 shows an example of information and data format included in the anatomical position information.

  Returning to the flowchart of FIG.

  In ST107, it is determined whether or not a local structure type has been input. It is not limited to the type of local structure, but may be a region or an organ. When there is no input of anatomical position information, the processing from ST109 to ST111 is executed, and when there is an input such as the type of local structure, the processing of ST113 is executed.

  First, processing (ST109 to ST111) when there is no input such as the type of local structure will be described.

  In ST109, an interpretation target slice image is selected from the interpretation target medical image data and displayed on the display unit 40.

  In ST111, the contrast image specifying unit 33 specifies an anatomical position from the selected interpretation target slice image.

  In ST115, the contrast image specifying unit 33 specifies a comparison target slice image from the comparison target medical image data based on the specified anatomical position.

  In ST117, the display unit 40 displays the interpretation target slice image and the comparison target slice image side by side.

  FIG. 7 is a diagram for explaining a display example in the first embodiment of the medical image processing apparatus 100 according to the embodiment. FIG. 7A shows an example of the display unit 40. The display unit 40 shows two windows, a window 40a and a window 40b, and shows a display example when two medical images are comparatively interpreted. Note that the number of medical images to be compared in comparison interpretation is not limited to two, and may be three or more.

  In the example of FIG. 7A, a window 40c showing patient information and two pieces of medical image data input to the medical image input unit 31 is displayed above the windows 40a and 40b. A window 40a in FIG. 7A shows an example in which medical image data selected from the window 40c is displayed. In the example of FIG. 7A, the medical image data displayed in the window 40a is taken as interpretation target medical image data. When the medical image data to be interpreted is displayed in the window 40a of FIG. 7 (a), the first slice image may be automatically displayed, and the examination purpose and disease name can be determined from the patient information and examination information. It may be acquired, and a corresponding slice image may be retrieved from an anatomical position and automatically displayed. Moreover, you may display automatically the slice image corresponding to the image (key image) utilized for the diagnosis in the past test | inspection of the patient used as object.

  In the example shown in the window 40a in FIG. 7A, a slice image having a slice number 42 of the medical image data to be interpreted is displayed. When the displayed slice image is not a desired slice image, the user changes the slice image by operating the input unit 50. As a means for changing, for example, a slider G1 may be displayed as shown at the bottom of the window 40a in FIG. The slider G1 indicates the total number of slices included in the medical image. In the example of FIG. 7A, the slice image to be displayed can be changed by moving the slider G1 left and right. Further, the slice image may be changed by moving the mouse trackball or the like up and down on the displayed slice image. The user interface such as the slider G1 is generated by the display generation unit 36.

  FIG. 7B is a modification of FIG. The bar G2 is a bar corresponding to the total number of slices, and the slice image can be changed by moving the slider G4 up and down. In addition to the continuous movement as described above, the slice position can be instantaneously moved by pressing the desired position of the bar G2 with an input means such as a mouse. Furthermore, a scale for each anatomical position or part may be given to the bar G2, and it may be used as a guide when moving the display.

  The range display G3 in FIG. 7 (b) displays a group of sites and organs included in medical image data as a range that occupies all slices using information such as sites and organs included in the anatomical position information. An example of a user interface is shown. In the example of FIG. 7B, the volume data in which only one part (for example, the chest) is imaged is shown, but in the volume data in which two parts (for example, the chest and the abdomen) are imaged, range display G3 Two displays are displayed. When there are a plurality of range displays G3, any one of the range displays G3 may be selected by an input unit such as a mouse to move to a slice position corresponding to the selected part.

  Similarly, FIG. 7C is a modification of FIGS. 7A and 7B. FIG. 7C shows an example in which a label G5 indicating a name (local structure) included in the anatomical position information is displayed in a list in addition to the bar G2 of FIG. 7B. By moving the slider G4 shown on the mouse trackball or bar G2 up and down, the slice image is switched, and at the same time, the display of the local structure displayed on the label G5 is changed. When the anatomical position of slice number 42 in FIG. 7C corresponds to, for example, “right lung apex”, a display indicating “right lung apex” in the list of local structures indicated by label G5. Is displayed in an emphasized manner, such as being enlarged from other displays or highlighted in a different color. In addition, the list of local structures indicated by label G5 in FIG. 7C may be displayed by highlighting the selected local structure by rotating in the direction of arrow A, for example, by moving the mouse over. . Further, the local structure list shown in the label G5 may be rotated in conjunction with the operation of moving the slider G4 up and down. Furthermore, the slice image displayed in the window 40a may be changed to a slice image corresponding to the local structure displayed in the center by the rotation of the label G5 in response to an operation of rotating the label G5 by an input means such as a mouse. . Moreover, you may move to the slice image corresponding to the selected local structure by pressing down the local structure displayed on the label G5.

  In addition to the user interface shown in FIG. 7, the local structure may be indicated by a symbol, an image, a schematic diagram of a human body, or the like. Moreover, you may display with a list with not only a local structure but an identifier.

  The contrast image specifying unit 33 specifies the anatomical position of the slice image selected by the user from the medical image data to be interpreted displayed on the window 40a using the user interface shown in FIG. 7 (ST111). .

  FIG. 8 is a diagram illustrating the anatomical position of the interpretation target medical image data in the first embodiment of the medical image processing apparatus 100 according to the embodiment. The interpretation target medical image data illustrated in FIG. 8 is volume data including a plurality of slice images, and an arrow A indicates a slice direction. In FIG. 8, the slice image displayed by shading indicates the interpretation target slice image displayed in the window 40a of FIG. Each circle included in the volume data illustrated in FIG. 8 indicates an anatomical position, the anatomical position of the double circle is “AL1”, the anatomical position of the black circle is “AL2”, and the anatomy of the white circle is The target position is indicated by “AL3”, and the anatomical position of the shaded circle is indicated by “AL4”. In the example of FIG. 8, it is shown that the anatomical position “AL1” is included in the interpretation target slice image.

  FIG. 9 is a diagram for describing identification of a comparison target slice image in the first embodiment of the first embodiment of the medical image processing apparatus 100 according to the embodiment. The left figure of FIG. 9 shows volume data of the medical image to be interpreted, and the right figure shows volume data of the medical image to be compared. As illustrated in FIG. 6, each anatomical position has an X-axis, a Y-axis, and a Z-axis coordinate. As shown in the lower left of FIG. 9, when the horizontal axis of the volume data of the medical image is X, the depth is Y, and the slice direction is Z, the Z coordinate of the anatomical position corresponds to the slice number. The Z coordinate of the anatomical position can be converted into a slice number based on the slice thickness and the slice interval included in the imaging conditions acquired from the medical image data and examination information.

  As described in FIG. 8, the anatomical position specified for the interpretation target slice image is “AL1”. The contrast image specifying unit 33 specifies the comparison target slice image of the volume data of the comparison target medical image based on the anatomical position. As shown in the right diagram of FIG. 9, the comparison target medical image data also has the same anatomical position as that of the interpretation target medical image data. The contrast image specifying unit 33 searches the anatomical position information of the comparison target medical image data based on the anatomical position specified from the interpretation target slice image, and compares the slice images including the same anatomical position. The target slice image is specified (ST115). That is, a slice image including the anatomical position “AL1” specified from the interpretation target slice image is specified from the comparison target medical images. The right figure of FIG. 9 shows an example in which the slice image having the slice number 33 of the comparison target slice image specified in this way is specified.

  In the example of FIGS. 8 and 9, an example in which there is one anatomical position corresponding to the interpretation target slice image or the comparison target slice image is shown, but one slice image has a plurality of anatomical positions. May be associated. When a plurality of anatomical positions are associated, a slice image may be determined based on an anatomical position with high reliability.

  FIG. 10 is a diagram for explaining a display example when the medical image data to be interpreted and the medical image data to be compared are displayed simultaneously in the first embodiment of the medical image processing apparatus 100 according to the embodiment. The display unit 40 in FIG. 10 shows a screen similar to that in FIG. In FIG. 7A, the interpretation target slice image is displayed in the window 40a, and no image is displayed in the window 40b. FIG. 10 shows an example in which the comparison target slice image specified from the interpretation target slice image is displayed in the window 40b. Therefore, the interpretation target slice image is displayed in the window 40a of FIG. 10, and the comparison target slice image specified by the comparison image specifying unit 33 is displayed in the window 40b. As shown in FIG. 10, the comparison target slice image displayed in the window 40 b is a slice image with slice number 33.

  Returning to FIG. 3, the processing (ST113) when there is an input such as the type of local structure will be described.

  In ST113, the contrast image specifying unit 33 specifies the anatomical position information corresponding to the local structure, part, or organ input from the input unit 50, and the anatomical position included in the specified anatomical position information. Based on the above, the interpretation target slice image is identified from the interpretation target medical image data.

  In ST115, as in ST113, the contrast image specifying unit 33 specifies anatomical position information corresponding to the local structure, region, or organ input from the input unit 50, and is included in the specified anatomical position information. The comparison target slice image is specified from the comparison target medical image data based on the anatomical position to be compared.

  In ST117, the display unit 40 displays the interpretation target slice image and the comparison target slice image side by side.

  FIG. 11 is a diagram illustrating a display example when inputting a local structure in the first embodiment of the medical image processing apparatus 100 according to the embodiment.

  A window 40d in FIG. 11 illustrates an example in which, when one of the lists indicated by a part is selected, local structures belonging to the part are displayed in a list. For example, in the example of FIG. 11, “chest” is selected as the site, and the local structures belonging to the chest are displayed in a list. FIG. 11 further shows an example in which “right lung apex” is selected from the local structure belonging to the chest.

  In the example of FIG. 11, an example in which a local structure or a part is selected by displaying the window 40d is shown, but it may be displayed by a different selection method such as a pull-down menu or a link.

  The names of anatomical positions may be classified and displayed by organs or the like. Further, anatomical position information corresponding to a part, an organ, or the like is determined in advance, and the part, organ, or the like is selected by input from the input unit 50, so that the anatomical position information can be automatically specified. Good.

  Based on the anatomical position information input by the method shown in FIG. 11, the contrast image specifying unit 33 reads the interpretation target slice image (ST113) from the interpretation target medical image data and the comparative interpretation target medical image data. Then, the comparison target slice image is specified (ST115).

  The interpretation target slice image and the comparison target slice image specified as described above are respectively displayed in the window 40a and the window 40b of the display unit 40 illustrated in FIG. 10 (ST117).

  In the medical image processing apparatus according to the first embodiment, a part or an organ from which comparative interpretation is started is specified by anatomical position information, and the corresponding slice image is selected from the medical image data to be interpreted and the medical image data to be compared. Can be identified and displayed. With such a function, it is possible to omit the work of aligning the positions of the anatomical parts of the interpretation target slice image and the comparison target slice image or searching for the slice image at the same anatomical part position.

  Also, by using anatomical position information, imaging conditions such as slice thickness and interval, differences in the state of the organ of the subject at the time of imaging due to the respiratory cycle and progress of treatment, etc. Accurate alignment can be performed without depending on differences in different physiques.

  Also, as shown in FIG. 10, when one slice image is changed after the interpretation target slice image and the comparison target slice image are displayed, the contrast image specifying unit 33 specifies the other slice image, Display change control is performed in conjunction with the interpretation target slice image and the comparison target slice image (hereinafter, this control is referred to as follow-up display control). In the medical image display apparatus 100 according to the present embodiment, alignment is performed for each anatomical position included in the volume data by this follow-up display control, so that the interpretation target slice image and the comparison target slice image are displayed. Even if the follow-up display is continued, positional deviation is unlikely to occur.

  Further, in the medical image display apparatus 100 according to the present embodiment, the positional deviation that occurs when the follow-up display is performed by the conventional method is corrected using the anatomical position, and complemented so that the follow-up display can be continued at the correct position. It can also be used as a function to perform. In addition, after the user recognizes that a displacement has occurred during the follow-up display, the follow-up display control of the contrast image specifying unit 33 of the medical image display apparatus 100 according to the present embodiment is executed to correct the displacement by the user's judgment. May be.

  Furthermore, even if the images are acquired by different modality devices, the same part or anatomical position can be displayed using the anatomical position information. Therefore, comparative interpretation can be performed without interpretation methods and knowledge of different parts and anatomical positions depending on the modality device.

(Second Embodiment)
In the second embodiment, based on a plurality of anatomical positions included in a plurality of medical images, the corresponding slice calculation unit 34 calculates a correspondence relationship between slice images between the interpretation target medical image and the comparison target medical image. Further, the comparison image specifying unit 33 extracts a comparison target slice image anatomically corresponding to the specified interpretation target slice image from the comparison target medical image based on the correspondence relationship of the slice images. More specifically, the anatomically corresponding slice image is specified by the interpolation formula generated based on the anatomical position information.

  In the first embodiment, it is possible to specify an anatomical position included in the displayed interpretation target slice image or a slice image having the same anatomical position specified from the input content. However, as shown in FIG. 12, some slice images do not include an anatomical position.

  FIG. 12 is a diagram illustrating a case where the anatomical position is not in the vicinity in the medical image processing apparatus 100 according to the embodiment. In the example of FIG. 12A, the slice image with slice number 55 displayed by shading indicates the interpretation target slice image selected by the user. The medical image data to be interpreted illustrated in FIG. 12 shows three anatomical positions indicated by double circles (AL1), black circles (AL2), and white circles (AL3). However, all detected anatomical positions are located away from the slice image selected as the interpretation target slice image, and the interpretation target slice image does not include the anatomical position.

  As shown on the right side of FIG. 12B, even when there is no anatomical position in the vicinity of the interpretation target slice image, the first anatomical position (AL2 in the example of FIG. 12) is used to As in the embodiment, it is possible to specify the comparison target slice image. However, in such a case, from the comparison target medical image data on the left side of FIG. 12B, a slice image indicated by thin shading including AL2 is selected as the comparison target slice image. Originally, when the comparison target slice image corresponding to the interpretation target slice image in the left diagram of FIG. 12B is a slice image indicated by a broken line, the positional deviation from the interpretation target slice image of the left diagram in FIG. Will occur.

  In the second embodiment, even in the case of FIG. 12, in order to accurately compare the interpretation target slice image and the comparison target slice image, the interpretation target medical image data and the comparison target medical image are used using the anatomical position information. The comparison target slice image is specified by calculating the correspondence between the slice images of the respective image data.

  FIG. 13 is a flowchart illustrating an example of the operation of the second embodiment of the medical image processing apparatus 100 according to the embodiment. The same processes as those in the first embodiment described in FIG. 3 are denoted by the same reference numerals, and the description thereof is omitted. The configuration itself of the second embodiment is the same as that of the first embodiment shown in FIG.

  In ST201, the contrast image specifying unit 33 extracts the anatomical position sandwiching the interpretation target slice image selected by the user from the interpretation target medical image data as the upper end position and the lower end position.

  In ST203, the contrast image specifying unit 33 specifies slice numbers corresponding to the anatomical positions of the upper end position and the lower end position extracted for the interpretation target medical image data and the comparison target medical image data.

  In ST205, the corresponding slice calculation unit 34 generates an interpolation formula from the slice numbers of the slice images corresponding to the anatomical positions at the upper end position and the lower end position, and performs slice correspondence between the interpretation target medical image data and the comparison target medical image data. Calculate the relationship.

  FIG. 14 is a diagram illustrating the upper end position and the lower end position according to the second embodiment of the medical image processing apparatus 100 according to the embodiment. FIG. 14 shows volume data of a medical image to be interpreted, in which a liver is shown. The dark shading in FIG. 14 exemplifies the interpretation target slice image.

  The contrast image specifying unit 33 may extract the upper and lower anatomical positions corresponding to the interpretation target slice image, and the upper and lower anatomical positions near the interpretation target slice image. In this case, in the example of FIG. 14, the anatomical positions of the upper end position and the lower end position corresponding to the interpretation target slice image are AL1 and AL2. Further, when the anatomical positions of the upper end position and the lower end position are specified centering on the anatomical position (AL2) in the vicinity of the slice image, they are AL1 and AL3, respectively.

  In addition, the contrast image specifying unit 33 can acquire information such as the AL2 region and organ from the anatomical position information of AL2, which is the nearest anatomical position of the interpretation target slice image. As illustrated in FIG. 6, the anatomical position information includes information such as an organ and a structure to which the anatomical position belongs. In the example of FIG. 14, the organ to which the anatomical position (AL2) of the interpretation target slice image belongs is “liver”. Therefore, as shown in FIG. 14, for example, when the anatomical position in the vicinity of the interpretation target slice image belongs to the “liver”, the anatomical positions indicating the upper end position and the lower end position in the cranio-foot direction of the liver are respectively extracted. May be. As described above, the anatomical positions of the upper end position and the lower end position corresponding to the interpretation target slice image may be obtained from an organ to which the anatomical position near the interpretation target slice image belongs. Further, not only the upper end position and the lower end position, but an anatomical position included in the medical image data may be selected from the reliability, for example.

  In the second embodiment, the upper end position and the lower end position are specified from the interpretation target slice image. However, the upper end position and the lower end position can also be specified by inputting an organ or a part. That is, in addition to the method of selecting a specific slice image from the medical image data to be interpreted (ST109), the anatomy corresponding to the upper end position and the lower end position can be selected by directly selecting the organ or part where interpretation is desired. The target position may be specified.

  FIG. 15 is a diagram illustrating the anatomical positions of the upper end position and the lower end position according to the second embodiment of the medical image processing apparatus 100 according to the embodiment. 15A shows an anatomical position corresponding to the upper end position and the lower end position specified from the interpretation target medical image data, and FIG. 15B shows an upper end position and a lower end position specified from the comparison target medical image data. Each corresponding anatomical location is illustrated. Each anatomical location has an X-axis, Y-axis, and Z-axis coordinate. As described with reference to FIG. 15, when the horizontal axis of the volume data of the medical image is X, the depth is Y, and the slice direction is Z, the Z axis of the anatomical position corresponds to the slice number. The slice number of the anatomical position can be calculated from the patient coordinate system using the pixel size, slice thickness, and slice interval of the slice image from the imaging conditions included in the examination information and the supplementary information of the medical image.

  In the tables illustrated in FIG. 15A and FIG. 15B, the position, the anatomical position, the patient coordinate system, and the slice number are sequentially shown. From the table of FIG. 15A, the “top position” of the medical image data to be interpreted is the anatomical position “AL1”, the patient coordinate system “(X1a, Y1a, Z1a)”, and the slice number “45”. , The “lower end position” is specified as the anatomical position “AL3”, the patient coordinate system “(X2a, Y2a, Z2a)”, and the slice number “65”. Similarly, from the table of FIG. 15B, the “top position” of the medical image data to be compared is the anatomical position “AL1”, the patient coordinate system “(X1b, Y1b, Z1b)”, and the slice number “35”. That is, it is specified that the “lower end position” is the anatomical position “AL3”, the patient coordinate system “(X2b, Y2b, Z2b)”, and the slice number “55”.

  The contrast image specifying unit 33 specifies slice images corresponding to the anatomical positions of the upper end position and the lower end position shown in FIG. 15 (ST203), and the corresponding slice calculating unit 34 calculates the medical image data to be interpreted from the slice number. The slice correspondence of the medical image data to be compared is calculated (ST205).

  Hereinafter, the calculation method of the corresponding slice image based on the anatomical position will be described with reference to FIGS. 16 and 18.

  FIG. 16 is a diagram illustrating a first calculation method for calculating a corresponding slice image in the second embodiment of the medical image processing apparatus 100 according to the embodiment. The X axis in FIG. 16 indicates the slice number of the slice image included in the comparison target medical image data. The Y axis indicates the slice number of the slice image included in the medical image data to be interpreted. Based on the slice number specified from the anatomical position of each of the comparison target slice image and the interpretation target slice image, an interpolation formula for calculating the corresponding slice number is created.

  In the example of FIG. 16, an interpolation formula using a linear function is shown. An interpolation formula using a linear function can be calculated from two types of anatomical positions.

For example, when the interpolation formula is obtained from the slice numbers of the two anatomical positions of the upper end position and the lower end position shown in FIG. 15, the following formula can be obtained using a and b as constants.
Y = aX + b (1)

  By applying the above equation (1), the slice number of the comparison target slice image anatomically corresponding to the slice image selected as the interpretation target slice image can be calculated. The interpolation formula can be calculated based on slice numbers corresponding to two anatomical positions included in the medical image data as well as the upper and lower slice numbers. Further, the anatomical landmark used for calculation may be selected according to the reliability or the like.

  For example, a method for calculating the slice number at the upper end position and the lower end position shown in FIG. 15A will be described as an example. From the table illustrated in FIG. 15A, the slice numbers at the upper end position and the lower end position of the medical image data to be interpreted are 45 and 65, respectively. From the table illustrated in FIG. 15B, the slice numbers of the upper end position and the lower end position of the comparison target medical image data are 35 and 55, respectively. From these slice numbers, the constants a and b in the equation (1) are calculated as a = 1 and b = 10, respectively. When the slice number of the interpretation target slice image is 55, the slice number of the comparison target slice image is calculated to be 45 as indicated by the one-dot chain line arrow in the graph of FIG. .

  FIG. 17 is a diagram for explaining the comparison target slice image calculated by the first calculation method for calculating the corresponding slice image in the second embodiment of the medical image processing apparatus 100 according to the embodiment. As in the example of FIG. 16, when the slice image with slice number 55 is selected as the interpretation target slice image, the slice image with slice number 45 is specified as the comparison target slice image. The left figure of FIG. 17 shows the medical image data to be interpreted, and the right figure of FIG. 17 shows the medical image data to be compared. In the left diagram of FIG. 17, the slice image indicated by dark shading is the image of slice number 55 selected as the interpretation target slice image. Slice images indicated by thin shading that sandwich the interpretation target slice image indicate slice images at the upper end position and the lower end position, respectively. As shown in the right diagram of FIG. 17, the upper end position and the lower end position of the comparison target medical image data corresponding to the interpretation target medical image data are slice images indicated by thin shading. In this manner, the interpolation formula shown in FIG. 16 is generated from the slice numbers of the slice images at the upper end position and the lower end position shown by thin shading, and the comparison target slice image corresponding to the interpretation target slice image of slice number 55 is obtained. Identify. The slice image indicated by dark shading in the right diagram of FIG. 17 is the comparison target slice image specified by the interpolation formula.

  FIG. 18 is a diagram illustrating a second calculation method for calculating a corresponding slice image in the first embodiment of the medical image processing apparatus 100 according to the embodiment. FIG. 17 illustrates an interpolation formula using a linear function, but FIG. 18 illustrates an interpolation formula using a cubic function.

  The X axis in FIG. 18 indicates the slice number of the slice image included in the medical image data to be compared as in FIG. The Y axis indicates the slice number included in the medical image data to be interpreted. The interpolation function of the cubic function is calculated from the slice numbers of the four types of anatomical positions.

  For example, for each of the interpretation target slice image and the comparison target slice image, when an interpolation formula is obtained from the slice numbers of the anatomical positions of AL1, AL2, AL3, and AL4, a, b, c, and d are set as constants, and Can be obtained.

Y = aX ³ + bX ² + cX + d (2)

  By applying the above equation (2), the slice number of the comparison target slice image can be calculated from the slice number of the interpretation target slice image, similarly to the linear interpolation formula of FIG.

  Since there are a plurality of anatomical positions specified for the medical image, the anatomical position used for calculating the interpolation formula may be determined according to the reliability of the anatomical position.

  As the interpolation formula used in the corresponding slice calculation unit, in addition to the above-described linear function and cubic function, the N-order function, N-order spline interpolation, least square method, nearest neighbor interpolation, Newton interpolation Various interpolation methods such as formulas and Lagrange interpolation polynomials can be applied. From these various interpolation formulas, select an appropriate interpolation formula according to the shape and size of the organ, etc., and calculate the correspondence between slice images, thereby calculating a more accurate correspondence. can do.

  In the interpolation formula calculated as described above, in either the first embodiment or the second embodiment, after the interpretation target slice image and the comparison target slice image are displayed, one of the slice images is changed. In this case, it can be used for follow-up display control in which the other slice image is changed in conjunction. Hereinafter, one medical image that is an operation target such as a slice image change is referred to as an “operation image”, and the other medical image whose display change is performed in conjunction with the operation image by tracking display is referred to as a “following image”. To do. The operation image is one of a plurality of medical images displayed on the display unit 40, and is specified by an operation by the user.

  By applying the above interpolation formula, the slice number of the follow-up image can be calculated when the slice number of the operation image is changed. The contrast image specifying unit 33 calculates the slice number of the follow-up image using an interpolation formula in accordance with the turning change of the slice image of the operation image, and controls the display by adjusting the change of the slice image.

  For example, when the operation image is changed to the slice number 56 by the above-described interpolation formula, the contrast image specifying unit 33 calculates the slice number of the corresponding follow-up image as 43.6. In this case, the display of the slice image with the slice number 43 that is the follow-up image may be maintained, or the slice image with the slice number 44 may be displayed.

  Further, when the operation image is continuously changed, the change timing of the slice image between the operation image and the follow-up image may be shifted and displayed. For example, when the slice image of the operation image is changed from the slice number 56 to 57, the slice numbers of the corresponding follow-up images are 43, 44, and 45. In the display of the operation image, two images of slice numbers 56 to 57 are changed, whereas in the follow-up image, three images 43, 44, and 45 are changed. That is, it is calculated by the interpolation formula that 55.5 of the operation image corresponds to 44 of the follow-up image, and the change of the slice image of the follow-up image can be adjusted according to the timing calculated by the interpolation formula. In this way, the contrast image specifying unit 33 can smoothly represent the display change of the slice image of the follow-up image with respect to the change of the slice image of the operation image.

  In this way, by using the anatomical position, it is possible to perform the follow-up display while partially correcting the correspondence relationship between the slice images between the anatomical positions, and display misalignment hardly occurs. Positioning in conventional comparative interpretation is performed by determining a reference slice image for each of the interpretation-target medical image data and the comparison-target medical image data. For this reason, as the distance from the reference slice image increases, a positional deviation occurs, and the generated positional deviation gradually increases. For example, when a follow-up display is performed on a medical image including a plurality of organs, organs that have not been aligned are not displayed at the same time, and the display position needs to be adjusted each time. On the other hand, in the medical image processing apparatus 100 according to the present invention, alignment is performed for each anatomical position. Since multiple anatomical positions are defined for each organ, correction is made for each anatomical position detected in the medical image, so there is no need for complicated alignment, and the medical image is aligned. Even if the follow-up display is performed continuously, no deviation occurs.

  In addition to the follow-up display as described above, the medical image processing apparatus 100 according to the present embodiment performs various image processing on the operation image. For example, enlargement, reduction, rotation, movement of display position, gradation processing, image processing by MPR (multiplanar reconstruction) method for obtaining an arbitrary cross section from the medical image, and projection so as to appear three-dimensionally on a two-dimensional surface Various image processing, such as a rendering method for display and MRA, is executed. The image processing synchronization control unit 35 also performs the same processing as the image processing performed on the operation image on the follow-up image.

  FIG. 19 is a flowchart illustrating an example of an operation in image processing of the medical image processing apparatus 100 according to the embodiment. In the example of FIG. 19, an image enlargement process will be described as an example.

  In ST301, the interpretation target slice image and the comparison target slice image are displayed on the display unit 40.

  In ST303, image processing (enlargement) is performed on either the interpretation target slice image or the comparison target slice image. The image subjected to image processing is referred to as an operation image similarly to the change of the slice image in the follow-up display control. Similarly, an image that is subjected to the same image processing as the operation image by the image processing synchronization control unit 35 is referred to as a follow-up image.

FIG. 20 is a diagram for explaining a display enlargement process of the medical image processing apparatus 100 according to the embodiment. FIG. 20A shows an example in which the region A indicated by the alternate long and short dash line is selected for the operation image. FIG. 20B illustrates an example of the operation image after the enlargement process is actually performed on the region A. When specifying and enlarging an area in this way, the anatomical position can be used to specify the area specified for the operation image. More specifically, based on the same anatomical position as the anatomical position specified for the operation image, it is possible to calculate the area in which the follow-up image is enlarged and the enlargement ratio thereof. Further, if an anatomical position is used, a desired anatomical position can be designated and an enlargement process can be executed on an anatomical part to be observed. Even if the anatomical sites present in the interpretation target slice image and the comparison target slice image are the same, for example, the anatomical site is not always displayed at the same pixel coordinate position. Even in such a case, if the position to be enlarged is designated based on the anatomical position, the enlargement process can be executed without depending on such a difference in position.
Returning to FIG.

  In ST305, the image processing synchronization control unit 35 extracts an anatomical position after execution of the operation image enlargement processing.

  In ST307, the ratio and relative position of the distance between anatomical positions extracted for the operation image by the image processing synchronization control unit 35 are calculated.

  In ST309, the image processing synchronization control unit 35 extracts the same anatomical position as the anatomical position extracted for the operation image from the follow-up image.

  In ST311, the ratio and relative position of the distance between the anatomical positions of the follow-up image are the same based on the ratio and relative position of the distance between the anatomical positions extracted by the image processing synchronization control unit 35 for the operation image. The enlargement ratio is calculated and image enlargement processing is performed.

  FIG. 21 is a diagram illustrating a synchronization method of display enlargement processing of the medical image processing apparatus 100 according to the embodiment. FIG. 21A shows an operation image. In the operation image, an anatomical position (AL1) indicated by a double circle, an anatomical position (AL2) indicated by a black circle, and an anatomy indicated by a white circle are shown. Three anatomical positions of the anatomical position (AL3) are illustrated. The operation image shown in FIG. 21A shows a state after the enlargement process is executed, and illustrates the volume data corresponding to the area A. A region indicated by a one-dot chain line indicates a region A to be enlarged as in FIG. In the example of FIG. 21A, the image processing synchronization control unit 35 extracts an anatomical position existing in the volume data corresponding to the region A. The extracted anatomical position may be an anatomical position outside region A. In the lower part of FIG. 21A, an example in which the anatomical positions of AL1, AL2, and AL3 are projected onto a plane A parallel to the region A is shown.

  FIG. 21 (b) shows the volume data of the follow-up image before enlargement. As the anatomical position, an anatomical position (AL1) indicated by a double circle, an anatomical position (AL2) indicated by a black circle, An anatomical position (AL3) indicated by a white circle and an anatomical position (AL4) indicated by a shaded circle are illustrated. The anatomical position corresponding to the anatomical position of the operation image is indicated by the same circle. Among these, anatomical positions common to the operation image in FIG. 21A are AL1, AL2, and AL3, and the image processing synchronization control unit 35 can specify the region A from the relative positional relationship thereof. it can. Further, in the lower part of FIG. 21B, an example in which the anatomical positions of AL1, AL2, and AL3 are projected onto a plane B parallel to the region A is shown, as in the lower part of FIG. .

  FIG. 21C shows a plane A similar to the diagram in which the anatomical positions of AL1, AL2, and AL3 shown in the lower part of FIG. 21A are projected onto the plane A parallel to the region A. Similarly, FIG. 21D shows a plane B similar to the diagram in which the anatomical positions of AL1, AL2, and AL3 shown in FIG. 21B are projected onto the plane B parallel to the region A. . The distance between the anatomical positions projected onto the plane A shown in FIG. 21C is L1, L2, and L3, and the distance between the anatomical positions projected onto the plane B shown in FIG. The distances are L4, L5, and L6, and the enlargement ratio a is set so that L1, L2, and L3 = a (L4, L5, and L6) from the distances calculated from FIGS. 21 (c) and 21 (d). calculate. Further, the enlargement ratio may be calculated from either side.

  In this manner, by using the anatomical position, the same image processing as that performed on the operation image can be performed on the follow-up image. For example, when a myocardial infarction has occurred in the heart, the infarcted site does not expand normally, and when observed in a cross section, it is observed in a distorted shape compared to a normal heart. Also, there are individual differences in organ size and position depending on the physique, etc. When confirming between different subjects, if the same position is simply enlarged, there may be a deviation in the anatomical region to be enlarged . Even in such a case, by using the anatomical position, it is possible to perform enlargement processing linked with the operation image and the follow-up image.

  If the anatomical position is used, it is possible to accurately measure and compare the size, length or volume of the selected region on the operation image.

  Even when a cross section in an arbitrary direction (for example, an oblique cross section) is generated by interpolating voxel values in volume data, such as the MPR method, the cross section is determined based on the distance and positional relationship between anatomical positions. The same cross section can be generated from different medical image data. In addition, a high-quality cross-sectional image with less distortion can be generated.

  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.

100 Medical Image Processing Device 200 Centralized Medical Image Management Server 300 Modality Device 400 HIS / RIS
DESCRIPTION OF SYMBOLS 10 Communication control apparatus 20 Storage part 30 Main control part 40 Display part 50 Input part 31 Medical image input part 32 Anatomical position detection part 33 Contrast image specific part 34 Corresponding slice calculation part 35 Image processing synchronous control part 36 Display generation part

Claims (18)

A medical image processing apparatus to which an interpretation target medical image composed of a plurality of slice images and a comparison target medical image composed of a plurality of slice images are input,
An anatomical position detection unit that detects an anatomical position of a characteristic local structure in the human body from each of the input medical image to be interpreted and the medical image to be compared;
Based on the anatomical position, the anatomically corresponding interpretation target slice image and the comparison target out of the plurality of slice images included in the input interpretation target medical image and the comparison target medical image, respectively. A contrast image specifying unit for specifying each slice image;
A slice image of a plurality of medical images, a display indicating the number of slices included in the medical image, and a list of types of the local structures corresponding to the anatomical positions specified for the plurality of medical images A display generation unit for generating the displayed display image;
A medical image processing apparatus comprising: A corresponding slice calculating unit that calculates a correspondence relationship between the interpretation target medical image and the slice image of the comparison target medical image based on a plurality of anatomical positions included in the plurality of medical images;
The comparison image specifying unit specifies the comparison target slice image corresponding to the interpretation target slice image anatomically based on the correspondence relationship of the slice images from the comparison target medical image;
The medical image processing apparatus according to claim 1. The contrast image specifying unit controls the follow-up display that links the display of the interpretation target slice image and the display of the comparison target slice image based on the correspondence relationship of the slice images;
The medical image processing apparatus according to claim 2. The corresponding slice calculation unit calculates a correspondence relationship between the slice images using an interpolation formula derived from slice numbers of the plurality of slice images included in each of the interpretation target medical image and the comparison target medical image. ,
The medical image processing apparatus according to claim 2 or 3 . The contrast image specifying unit specifies the anatomical position corresponding to at least one of the type of the input local structure, the input part, and the organ, and the input medical image to be interpreted and the input Based on the identified anatomical position, the interpretation target slice image and the comparison target slice image are identified from the plurality of slice images included in each of the comparison target medical images, respectively. about,
The medical image processing apparatus according to any one of claims 1 to 4, characterized in. An image processing synchronization control unit that controls synchronization control in which image processing performed on any one of the plurality of medical images is similarly performed on other medical images,
The image processing synchronization control unit performs synchronization control according to at least one of a relative relationship between the anatomical positions and a ratio of a distance between the anatomical positions;
The medical image processing apparatus according to claim 1, wherein: The image processing includes enlargement, reduction, rotation, movement, gradation processing, a multiplanar reconstruction method for generating an arbitrary cross-section from the medical image, and a rendering method for projecting and displaying the image so as to appear stereoscopically on a two-dimensional surface. Contain at least one of them,
The medical image processing apparatus according to claim 6. The display generation unit is configured such that the list of types of the local structure includes at least one of a name, a symbol, an identifier, an image, and a schematic diagram indicating the local structure;
The medical image processing apparatus according to claim 1, wherein: The display generation unit generates a display indicating the number of slices included in the medical image and a slice position of the displayed slice image in the medical image;
The medical image processing apparatus according to claim 1, wherein: Based on the anatomical position included in the displayed slice image, the display generation unit generates a slice image corresponding to at least one of the local structure, part, and organ to which the displayed slice image belongs. Generating a display indicating the number of sheets as a range of the number of slices included in the medical image;
The medical image processing apparatus according to claim 1, wherein: The contrast image specifying unit specifies a medical image to be displayed in response to an operation on the display image generated by the display generation unit;
The medical image processing apparatus according to any one of claims 1 to 10, characterized in. A medical image processing program in which an interpretation target medical image composed of a plurality of slice images and a comparison target medical image composed of a plurality of slice images are input,
Computer
An anatomical position detecting means for detecting an anatomical position of a characteristic local structure in the human body from each of the input medical image to be interpreted and the medical image to be compared;
Based on the anatomical position, the anatomically corresponding interpretation target slice image and the comparison target out of the plurality of slice images included in the input interpretation target medical image and the comparison target medical image, respectively. Contrast image specifying means for specifying slice images, and
A slice image of a plurality of medical images, a display indicating the number of slices included in the medical image, and a list of types of the local structures corresponding to the anatomical positions specified for the plurality of medical images Display generating means for generating the displayed image for display,
Medical image processing program for functioning as The contrast image specifying means controls a follow-up display that links the display of the interpretation target slice image and the display of the comparison target slice image based on the correspondence relationship of the slice images;
The medical image processing program according to claim 12 . A medical image processing system operating on an electronic network, to which an interpretation target medical image composed of a plurality of slice images and a comparison target medical image composed of a plurality of slice images are input,
An anatomical position detection unit that detects an anatomical position of a characteristic local structure in the human body from each of the input medical image to be interpreted and the medical image to be compared;
Based on the anatomical position, the anatomically corresponding interpretation target slice image and the comparison target out of the plurality of slice images included in the input interpretation target medical image and the comparison target medical image, respectively. A contrast image specifying unit for specifying each slice image;
A slice image of a plurality of medical images, a display indicating the number of slices included in the medical image, and a list of types of the local structures corresponding to the anatomical positions specified for the plurality of medical images A display generation unit for generating the displayed display image;
A medical image processing system comprising: The anatomical position detector is
From each of the inputted said interpreted medical image wherein said comparable medical image, detects the anatomical location of characteristic the local structure in the human body more, with numerical value indicating the accuracy of the anatomical location ,
The contrast image specifying unit includes:
Based on an anatomical position where the numerical value is high among the plurality of anatomical positions from among the plurality of slice images included in each of the input medical image to be interpreted and the medical image to be compared. the comparison target slice images and anatomically corresponding interpreted slice image, that identifies each
The medical image processing apparatus according to claim 1 . Based on the three or more anatomical position included in the plurality of medical images, the interpreted medical image and the comparison from the target medical image slice number of the plurality of slice images included in each for the curve interpolation interpolating A corresponding slice calculating unit that calculates a correspondence relationship between the interpretation target medical image and the slice target medical image by performing curve interpolation using the interpolation formula ,
Further comprising
The contrast image specifying unit includes:
Of the plurality of slice images included in each of the input medical image to be interpreted and the comparison target medical image, anatomically corresponds to the slice image to be interpreted based on the correspondence relationship of the slice images. the comparison slice image, that identifies from said in comparison medical image,
The medical image processing apparatus according to claim 1 . The anatomical position detector is
From each of the inputted said interpreted medical image wherein said comparable medical image, detects multiple 3-dimensional coordinates of the anatomical location of characteristic the local structure in the human body,
Based on the positional relationship of the three-dimensional coordinates of the plurality of anatomical positions detected from each of the interpretation target medical image and the comparison target medical image, both images of the interpretation target slice image and the comparison target slice image are included. In order to equalize the distances of the plurality of anatomical positions in the image, the other enlargement ratio of one of the interpretation target slice image and the comparison target slice image is obtained, and using the enlargement ratio, the interpretation target slice image and the An image processing synchronization control unit for enlarging the other of the comparison target slice images ;
Further equipped with ,
The medical image processing apparatus according to claim 1 . The anatomical position detector is
From each of the inputted said interpreted medical image wherein said comparable medical image, detects multiple 3-dimensional coordinates of the anatomical location of characteristic the local structure in the human body,
The display generation unit
Based on the positional relationship of the three-dimensional coordinates of the plurality of anatomical positions, the slice image has a different inclination and the same inclination from each other from the interpretation target medical image and the comparison target medical image. that generates an image of the same cross-section,
The medical image processing apparatus according to claim 1 .

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