JP6559819B1 - Image processing apparatus and image processing program - Google Patents

Abstract

An image processing apparatus capable of associating a position of an endoscope inserted into a tooth with an image of a tooth acquired in advance. An image processing apparatus 1 is configured to determine a protruding amount of a fiber from an endoscope 2 when an inside of a tooth is photographed by an endoscope 2 having a nozzle and a fiber protruding from the nozzle and inserted into the tooth. A protrusion amount acquisition means 13 to be acquired; and position information addition means 14 for calculating position information of the fiber tip in the tooth from the protrusion amount of the fiber and adding position information to the tooth image acquired in advance. Prepare. [Selection] Figure 1

Description

  The present invention relates to an image processing apparatus and an image processing program.

  In endodontic treatment, the role of the dentist is to diagnose the presence or absence of infection sources due to pathogenic bacteria and other contaminants, root fractures, etc. It is to remove pollutants quickly. However, the root canal shape varies greatly between individuals, and it is actually difficult to accurately grasp the form and state of the root canal during treatment. In recent years, microscopes (microscopes) and the like for dental surgery have begun to spread, and it has become easier to observe the inside of the root canal than before. However, the root canal often curves as it goes forward, and there is a drawback that the state in the root canal cannot be confirmed when the observation position enters the blind spot of the microscope.

  On the other hand, in recent years, various electronic endoscope systems that detect the position of the distal end portion of an endoscope inserted into a human body have been proposed. For example, Patent Document 1 describes that the relative position between the distal end portion of a treatment tool that can freely protrude from an endoscope that enters the body cavity and the distal end portion of the endoscope can be detected.

  Also in dentistry, an endoscope is proposed in which a fiber entering and exiting from a nozzle at the tip of the endoscope can be inserted into the root canal of the tooth. According to this technique, the dentist can check the inside of the root canal by displaying the endoscopic image (video) acquired through the endoscope fiber during the treatment on the display device. is there.

JP 2006-223849 A

  In endodontic treatment, for example, a patient's teeth are generally imaged using an image diagnostic apparatus such as an X-ray apparatus or a CT apparatus before surgery. However, a previously acquired tooth image is not associated with an endoscopic image that the dentist observes when diagnosing or treating a patient. Therefore, a technique for associating the position of the endoscope when observing the root canal with an image of a tooth acquired in advance has been desired.

  Therefore, the present invention has been made in view of the above problems, and an image processing apparatus and an image processing program capable of associating the position of an endoscope inserted into a tooth with an image of a tooth acquired in advance. It is an issue to provide.

  In order to solve the above-described problem, an image processing apparatus according to the present invention provides an image of the fiber when the inside of the tooth is imaged by an endoscope having a nozzle and a fiber protruding from the nozzle and inserted into the tooth. A protrusion amount acquisition means for acquiring a protrusion amount from the endoscope; and a tip position of the fiber in the tooth is calculated from the protrusion amount of the fiber, and the tip position of the tip position is obtained with respect to a previously acquired tooth image. Position information adding means for adding information.

According to the image processing device and the image processing program according to the present invention, the position of the endoscope inserted into the tooth can be associated with the tooth image acquired in advance.
Further, conventionally proposed dental endoscopes are mainly intended for photographing, but according to the present invention, the photographing position of an image acquired by an endoscope inserted into a tooth can be easily set. It becomes possible to grasp.

1 is a block diagram schematically showing a configuration of an image processing apparatus according to an embodiment of the present invention. It is a perspective view showing typically the appearance of an endoscope. It is a schematic diagram which shows the state which contact | abutted the nozzle front-end | tip in the treatment location of a tooth. It is a schematic diagram which shows the modification of a nozzle front-end | tip. It is a schematic diagram which shows the modification of the position used as the reference | standard of a nozzle tip position. It is a schematic diagram which shows the example of a screen display. It is a flowchart which shows an example of a process of the image processing apparatus which concerns on embodiment of this invention. It is a schematic diagram which shows an example of the image of a tooth in case a nozzle front-end | tip exists in 1st depth. It is a schematic diagram which shows an example of the image of a tooth in case a nozzle front-end | tip exists in 2nd depth. It is a schematic diagram which shows an example of the image of a tooth in case a nozzle front-end | tip exists in the 3rd depth. It is a schematic diagram which shows an example of a head mounted display. It is a schematic diagram which shows the screen display which concerns on a modification. It is a schematic diagram which shows the screen display which concerns on a modification. It is a schematic diagram which shows the screen display which concerns on a modification.

Hereinafter, an image processing apparatus according to an embodiment of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a block diagram schematically showing the configuration of an image processing apparatus according to an embodiment of the present invention.
The image processing apparatus 1 can be realized by, for example, a general computer, and includes a central processing unit (CPU), a random access memory (RAM), a read only memory (ROM), a hard disk drive (HDD), and the like. And an input / output interface. In this computer, an image display program for displaying X-ray CT tomographic images and 3D images from the three-dimensional CT data 21, and an operation program for adding position information of an endoscope to a previously acquired tooth image Is installed.

  Here, the tooth image acquired in advance is, for example, a cross-sectional image taken by an X-ray CT (Computed Tomography) apparatus, a 3D image created from CT data, or a virtual internal created from CT data. It may be an endoscopic image. The tooth image acquired in advance may be a dental image or a panoramic image captured by an X-ray imaging apparatus.

  For example, an endoscope 2, a microscope 3, an input unit 4, and a display unit 5 are connected to the image processing apparatus 1.

  The endoscope 2 includes a nozzle and a fiber that protrudes from the nozzle and is inserted into a tooth. As this type of endoscope 2, a conventionally known endoscope can be used. Here, an example will be described using the endoscope 2 shown in FIG. The endoscope 2 includes a main body 31, a nozzle 32, a fiber 33, and an entry / exit operation unit 34.

  The main body 31 has a cylindrical shape and is large enough to hold the outer peripheral surface with one hand. A nozzle 32 that holds the fiber 33 is disposed on the distal end side of the main body 31. The nozzle 32 is made of metal or resin. A fiber 33 is inserted into the main body 31 and the nozzle 32.

  The fiber 33 is configured by bundling an image guide for imaging and a light guide for illumination, for example, and has a camera lens at the tip. Inside the main body 31, an image pickup device for picking up an image transmitted by the image guide, a light source of illumination light for illuminating the affected part through the light guide, and the like are arranged. An image (endoscopic image) captured by the image sensor is sent to the image processing apparatus 1 via the cable 35. The cable 35 is configured by bundling a plurality of signal lines.

  The in / out operation section 34 is attached to a predetermined position on the opposite side of the nozzle 31 on the outer peripheral portion of the main body 31. For example, when the entry / exit operation unit 34 is rotated to one side in the circumferential direction of the main body 31, the fiber 33 enters and exits according to the rotation direction. For example, an actuator or a rack and pinion is provided inside the main body 31, thereby converting the movement of the in / out operation unit 34 into the movement of the fiber 33. 2 shows a state in which the fiber 33 protrudes from the distal end portion 32a. However, as shown in FIG. 3A, the fiber 33 may not enter the distal end portion 32a.

  The endoscope 2 includes a sensor that detects the protruding amount of the fiber 33, for example, inside the main body 31. Examples of such a sensor include a rotation detection sensor such as a rotary encoder, and a displacement sensor such as a linear encoder. For example, when a rotation detection sensor is used, the detected value can be used as a protrusion amount by sensing the rotation angle and the rotation speed of a pinion provided inside the main body 31 as a mechanism for moving the fiber 33 in and out. When a displacement sensor is used, the detected value may be used as the protrusion amount by sensing the displacement of a member or actuator that moves linearly in conjunction with the rotation of the pinion inside the main body 31. The sensor output signal is sent to the image processing apparatus 1 via the cable 35.

  As the microscope 3, a conventionally known microscope for dental surgery can be used. As a usage form of the microscope, there are a case where the dentist looks directly into the eyepiece part of the microscope and a case where the camera is attached to the eyepiece part side of the microscope. This embodiment corresponds to a usage pattern in which a camera is attached to a microscope. An output signal from this camera is output to the image processing apparatus 1. Depending on the treatment policy of the dentist, the dentist may look directly into the eyepiece of the microscope or may not use the microscope. In such a case, there is no input signal from the microscope 3 to the image processing apparatus 1.

  The input unit 4 inputs information necessary for control such as processing performed by the image processing apparatus 1 and setting of a tomogram displayed on the display unit 5, and is a device such as a keyboard or a mouse. The display unit 5 displays an X-ray image or the like, and is, for example, a liquid crystal display. On the screen of the display means 5 connected to the image processing apparatus 1, windows, icons, buttons, and the like are displayed by a GUI (Graphical User Interface), and the operator performs an operation of selecting them with the input means 4 such as a mouse. It can be performed.

The image processing apparatus 1 includes a processing unit 10 and a storage unit 20.
The storage unit 20 stores various data used for image processing, processing results, an image display program, an operation program for adding position information of an endoscope to an X-ray image, and the like. The storage means 20 is composed of, for example, a magnetic disk, an optical disk, a general image memory, and the like.
In FIG. 1, the storage means 20 has memorize | stored the three-dimensional CT data 21, the dental image 22, the panorama image 23, and the virtual endoscopic image 24 as an example. The fiber tip position 25 is a processing result.

  The three-dimensional CT data 21 is based on three-dimensional data (volume data) obtained by imaging using dental CT (CBCT: Cone-Beam Computed Tomography) using a cone beam. This volume data is divided into 512 × 512 × 512 voxels, for example. The three-dimensional CT data 21 is obtained by calculating the pixel value of each voxel and reconstructing the image. As the three-dimensional CT data 21, for example, data in which the pixel value of each voxel is calculated in advance is input in advance.

The dental image 22 is an image of a tooth acquired by dental imaging for imaging a part of the teeth in the oral cavity.
The panoramic image 23 is an image of a tooth acquired by panoramic photographing for photographing the entire tooth.
The virtual endoscopic image 24 is an image created by CG (Computer Graphics) from CT data.

  The fiber tip position 25 is information obtained as a processing result of the processing means 10. The fiber tip position 25 is, for example, information in which information for identifying a tooth image is associated with coordinates of a position corresponding to the fiber tip position in the tooth image. Here, the information for identifying the tooth image is information for identifying the volume data, the tomographic direction, and the tomographic position when the tooth image is a CT cross-sectional image. In addition, when the tooth image is a 3D image of a tooth, a virtual endoscopic image, a dental image, or a panoramic image, this is information for identifying the image.

The processing unit 10 includes an endoscope image input unit 11, a microscope image input unit 12, a protrusion amount acquisition unit 13, a position information addition unit 14, and a display control unit 15. The processing means 10 is realized, for example, when the CPU stores the program stored in the storage means 20 in the RAM and executes it.
Hereinafter, each means will be described in detail.

  The endoscope image input unit 11 is a predetermined interface for inputting an endoscope image transmitted from the endoscope 2 via, for example, the cable 35. The endoscopic image is a moving image and is displayed on the display unit 5 by the display control unit 15.

  The microscope image input means 12 is a predetermined interface for inputting a microscope image transmitted from a camera (not shown) attached to the microscope 3. The microscope image is a moving image and is displayed on the display unit 5 by the display control unit 15.

  The protrusion amount acquisition means 13 acquires the protrusion amount of the fiber 33 when the inside of the tooth is imaged by the endoscope 2 from the endoscope 2. In the present embodiment, the protrusion amount acquisition unit 13 acquires a sensor output signal transmitted from the endoscope 2 via, for example, the cable 35 as the protrusion amount of the fiber 33. The protrusion amount acquisition unit 13 outputs the acquired protrusion amount of the fiber 33 to the position information addition unit 14.

  The position information adding means 14 calculates the tip position of the fiber 33 in the tooth from the protruding amount of the fiber 33, and adds information on the tip position of the fiber 33 to the tooth image acquired in advance. .

The position information adding unit 14 includes an origin setting unit 16.
The origin setting means 16 associates a fiber origin serving as a reference for the protruding amount of the fiber 33 with an origin serving as a reference for the tip position of the fiber 33 in a previously acquired tooth image. The origin setting means 16 receives an input of the origin setting position in the tooth image. The origin setting means 16 associates the tip position of the fiber 33 when the tip 32a of the nozzle 32 of the endoscope 2 contacts with the tooth as a fiber origin, and associates it with the origin setting position in the tooth image.

  In root canal treatment, as shown in FIG. 3A, a hole 42 for exposing the root canal 41 is usually formed in the center of the fitting surface of the tooth crown 40. As shown in FIG. 3A, the origin setting means 16 determines the distal end position of the fiber 33 when the distal end portion 32a of the nozzle 32 of the endoscope 2 abuts against the end surface around the root canal 41 in the tooth 40, for example. The fiber origin. Here, it is assumed that the distal end position of the fiber 33 coincides with the distal end portion 32a. When the fiber origin is determined in this way, the origin setting position in the tooth image is also the end surface around the root canal 41. A description of the modification shown in FIGS. 3B and 3C will be given later.

The display control unit 15 causes the display unit 5 to display an internal image (endoscopic image) of the tooth acquired by the endoscope 2 and an image of the tooth acquired in advance.
The display control unit 15 reads, for example, the three-dimensional CT data 21, constructs a CT tomographic image, and causes the display unit 5 to display the CT tomographic image.

  When the previously acquired tooth image is a cross-sectional image in the depth direction of the tooth, the display control unit 15 converts the mark image indicating the fiber tip position into the tooth image based on the fiber tip position information. It is displayed on the display means 5 so as to be superimposed. Here, the cross-sectional image in the depth direction of the tooth means a sagittal (sagittal) image or a coronal (coronal, frontal) image, for example, when taken with a dental X-ray CT apparatus. To do. In addition, a dental image or a panoramic image captured by a dental X-ray imaging apparatus is an example of a cross-sectional image in the depth direction of a tooth. Further, the mark image has an arbitrary shape, and may be, for example, a triangle, a quadrangle, a polygon, a circle, an ellipse, or the like.

  When the tooth image acquired in advance is a horizontal cross-sectional image of the tooth, the display control unit 15 causes the display unit 5 to display the cross-sectional image of the tooth at the position in the depth direction corresponding to the tip position of the fiber. . Here, the horizontal cross-sectional image of a tooth refers to, for example, an axial (distal, transverse) image of a CT image taken by a dental X-ray CT apparatus, or a virtual endoscopic image created from CT data. That is.

When the tooth image acquired in advance is a 3D image created from CT data, the display control means 15 converts the mark image indicating the fiber tip position into a tooth image based on the fiber tip position information. It is displayed on the display means 5 so as to be superimposed.
Here, the 3D image may be an image of a tooth included in an area irradiated with a CTBT cone beam. For example, it may be an image obtained by rendering a patient's head, upper jaw, entire lower jaw, a plurality of teeth, or a single tooth included in the beam irradiation range. The rendering processing may be, for example, volume rendering processing (surface rendering), surface rendering processing (surface rendering), or the like.

  In addition, when the image of the tooth acquired in advance is a 3D image in which a single tooth is rendered, for example, not only the appearance image of the entire tooth, for example, hard tissue such as enamel, dentin, cementum, It may be a 3D image including at least a part of soft tissues such as gums (gum), dental pulp, periodontal ligament. For example, a 3D image of the pulp when the pulp is present in the root canal before treatment can be treated as a 3D image of the root canal. Moreover, the 3D image of the dentin when the pulp in the root canal is removed by the previous treatment can also be handled as a 3D image of the root canal. A mark image indicating the tip position of the fiber may be displayed in a superimposed manner on the 3D image including at least a part of the tissue of the tooth.

The display control means 15 may display the virtual endoscopic image 24 created from the CT data side by side with the CT cross-sectional image acquired in advance.
The display control means 15 may display a 3D image created from the 3D CT data 21 side by side with a CT cross-sectional image.
The display control means 15 may display the tooth microscope image acquired by the microscope 3 side by side with the tooth image acquired in advance.

Here, an example of the screen display will be described with reference to FIG.
In this example, a state in which an endoscope window 60, X-ray image windows 61 to 63, and option image windows 65 and 66 are simultaneously displayed on the screen of the display means 5 is schematically shown. Show. However, these windows may be displayed individually.

  In the window 60, an endoscope image as an optical image taken by the endoscope 2 during treatment is displayed. Note that the photograph shown in FIG. 4 is an example of a still image extracted from a video-captured endoscopic image by a snapshot, and here, the model displayed in the windows 61 to 63 for X-ray images It does not match the figure.

  An axial image is displayed in the window 61. In the window 62, a coronal image is displayed. In the window 63, a sagittal image is displayed. Here, two orthogonal straight lines are displayed only in the axial image and omitted in the other images, but in the CT image viewer, a straight line indicating the tomographic position is generally displayed in each image. Is done. By changing the position and angle of these straight lines, it is possible to easily extract a target fault.

  In the window 65, a virtual endoscopic image created from CT data is displayed. A broken circle indicates a root canal. In the window 66, a microscope image is displayed.

Next, the flow of processing by the image processing apparatus 1 will be described with reference to FIG. 5 (refer to FIG. 1 as appropriate). Here, an example of a tooth image acquired in advance will be described as a CT cross-sectional image.
First, the image processing apparatus 1 reads the three-dimensional CT data 21 by the display control means 15 according to the operation of the operator (step S1). Although the three-dimensional CT data 21 is read from the storage unit 20 inside the image processing apparatus 1 by the display control unit 15 here, the three-dimensional CT data 21 may be read from an external CT apparatus. .

  Next, for example, when the operator designates a predetermined slice using the input unit 4, the image processing apparatus 1 uses the display control unit 15 to display a CT cross-sectional image (hereinafter also referred to as an X-ray image) on the display unit 5. Is displayed (step S2). Specifically, for example, the operator designates one tooth as a treatment target tooth (treatment tooth) from an axial image that lists all upper teeth and all lower teeth. An axial image is a cross-sectional image of a tooth in the horizontal direction. In order to set the origin position in the image in the next processing, it is preferable to display a cross-sectional image in the depth direction of the designated tooth. In addition, about the coordinate which shows the position of the designated tooth | gear, each coordinate can be matched between each cross-sectional image like an axial image-sagittal image. For example, the operator designates a desired tomographic position by the input unit 4 on the axial image. Thereby, it is possible to display a sagittal image or coronal image corresponding to the designated tomographic position and designate a region of interest or set an origin position in the cross-sectional image.

  Next, for example, when a sagittal image of the treatment tooth is displayed, the operator designates the origin position on the image of the treatment tooth by the input unit 4. Thereby, the image processing apparatus 1 receives the input of the origin setting position in the sagittal image of the treatment tooth by the origin setting means 16 (step S3). At this time, the operator designates, for example, an end face (see FIG. 3A) around the root canal as an origin position on the image of the treatment tooth. For example, the operator may click a position to be designated as the origin position on the image, for example, with a mouse.

  Next, the operator sets the fiber origin of the endoscope 2. At this time, the tip of the fiber 33 of the endoscope 2 is located at the tip 32a of the nozzle 32, for example. The operator brings the tip 32a of the nozzle 32 of the grasped endoscope 2 into contact with the end surface around the root canal (step S4: Yes), and the protrusion amount acquisition unit 13 reads the initial state read at this time. The protrusion amount is output to the position information adding means 14. Then, the position information adding unit 14 associates the initial projection amount input from the projection amount acquisition unit 13 with the origin setting position in the X-ray image.

In step S <b> 4, for example, the operator may output an initial protrusion amount to the position information adding unit 14 by operating an icon (not shown) with the input unit 4.
Or you may make it discriminate | determine in step S4 whether the front-end | tip part 32a of the nozzle 32 contact | abutted to the end surface around a root canal with the sensor which is not shown in figure. In this case, when it is determined that the sensor output does not indicate contact (step S4: No), the protrusion amount acquisition unit 13 repeats the determination. When the protrusion amount acquisition unit 13 determines that the sensor output indicates contact (step S4: Yes), the protrusion amount acquisition unit 13 outputs the read protrusion amount in the initial state to the position information addition unit 14 for the next processing. Proceed to

  Here, as a switch for directly detecting that the tip 32a of the nozzle 32 is in contact with the tooth, for example, a tactile sensor or a pressure sensor can be used. Further, it may be indirectly detected that the distal end portion 32a of the nozzle 32 is in contact with the tooth by detecting that the endoscope 2 is stably stationary at the position of the patient. In that case, for example, a vibration sensor, an optical sensor, a magnetic sensor, or the like may be used.

  Next, the operator rotates the entrance / exit operation portion 34 of the endoscope 2 while keeping the distal end portion 32a of the nozzle 32 of the endoscope 2 in contact with the end surface around the root canal, thereby the distal end portion 32a. The fiber 33 taken out from is inserted into the root canal. At this time, the protrusion amount acquisition means 13 acquires and reads the current protrusion amount of the fiber 33 from the endoscope 2 (step S5), and outputs the read protrusion amount to the position information addition means 14.

  Then, the position information adding means 14 compares the current protrusion amount input from the protrusion amount acquisition means 13 with the origin setting position in the X-ray image, and calculates the current fiber tip position on the X-ray image ( Step S6).

  Then, the position information adding unit 14 adds information on the tip position of the fiber to the X-ray image (step S7). For example, the coordinates of the position corresponding to the tip position of the fiber in the sagittal image are associated with the sagittal image designating the origin position. In addition, since coordinates can be matched between CT tomographic images, the coordinates of the position corresponding to the fiber tip position are also associated with the coronal image or the axial image. The associated information is stored in the storage unit 20 as the fiber tip position 25.

  When the X-ray image is a sagittal image or a coronal image, the display control unit 15 displays a mark image indicating the current tip position of the fiber 33 based on the fiber tip position 25 so as to be superimposed on the X-ray image. It is displayed on the means 5. Thereby, the display means 5 superimposes and displays the fiber tip position on the X-ray image (sagittal image or coronal image) (step S8). In the example of FIG. 4, the shape of the mark image is a triangle.

  On the other hand, when the X-ray image is an axial image, the display control means 15 displays the axial image at the position in the depth direction corresponding to the tip position of the fiber on the display means 5 according to the change in the tip position of the fiber 33. Display.

  Next, a display example of a CT image that is updated and displayed in real time together with an endoscopic image (video) will be described with reference to FIGS. 6A to 6C. 6A to 6C schematically show CT images of cross sections displayed on the display means 5 when the tip position of the fiber 33 changes. FIG. 6A is a schematic diagram when the tip of the fiber 33 is positioned at the first depth indicating the depth in the initial state. FIG. 6B is a schematic diagram when the tip of the fiber 33 is positioned at a second depth deeper than the first depth. FIG. 6C is a schematic diagram when the tip of the fiber 33 is located at a third depth deeper than the second depth.

  As shown in FIGS. 6A to 6C, in the coronal image displayed in the window 62 and the sagittal image displayed in the window 63, the mark image is displayed as the fiber 33 progresses downward in the root canal. Is displayed. On the other hand, the axial image displayed in the window 61 is displayed by switching to an image of a tomographic position corresponding to the depth of the tip of the fiber 33 as the fiber 33 travels downward in the root canal.

  As described above, according to the present embodiment, the position of the endoscope inserted into the tooth can be associated with the tooth image acquired in advance. In addition, the position of the endoscope can be displayed superimposed on the tooth image. Therefore, in endodontic treatment, after grasping the form and state in the root canal, it can be confirmed where the pathological cause exists, and the success rate of treatment can be improved.

  The present invention is not limited to the above-described embodiment, and various modifications can be made. Moreover, you may deform | transform as follows. For example, it can be realized by operating a general computer with an image processing program that functions as an image processing apparatus. This program can be provided via a communication line, or can be written on a recording medium such as a CD-ROM and distributed.

  The display means 5 has been described as being a liquid crystal display, for example, but may be a head mounted display. The head-mounted display 71 shown in FIG. 7 is of a transmissive type (see-through) that is used by the dentist 70 as an operator wearing it like glasses. As the head mounted display 71, for example, so-called optical see-through glass may be employed. Thereby, the operator can recognize the X-ray image etc. which were displayed on the small screen arrange | positioned at glass, looking at the external field (patient) through the glass which permeate | transmits light. Thus, by realizing the display means 5 with the head mounted display 71, it is possible to save time and effort for reciprocating between the patient position and the stationary monitor device.

  When the head-mounted display is a transmissive type, a so-called video see-through apparatus may be employed in addition to the optical see-through glass. The video see-through type device includes a camera that captures the outside world in front of the user's eyes, and projects the outside state through the camera on a screen (see-through screen) that the user wearing this device observes. The outside appearance projected on the see-through screen through the camera corresponds to the view seen when the user does not wear the head mounted display. This apparatus can synthesize and display a patient in a real environment in front of the user's eyes and an X-ray image or the like that shows the imaging position of the endoscope. The projection system of the head mounted display may be retinal projection in addition to virtual image projection.

The head mounted display may be a non-transmissive type, for example, so-called VR (Virtual Reality) goggles may be used. The VR goggles allow a user wearing this apparatus to experience VR, AR (Augmented Reality), or MR (Mixed Reality). The VR goggles may be of a type in which a mobile with a camera such as a smartphone is mounted, in addition to a type that includes a camera for photographing the outside world in advance. The VR goggles camera can project the outside view through the camera on the display that the user wearing it observes. According to this, the information acquired from the VR goggles camera and the X-ray image showing the photographing position of the endoscope can be displayed together.
Note that the user wearing the head mounted display may be a dental hygienist, a dental assistant, or the like in addition to a dentist.

  Moreover, in the said embodiment, although the image pick-up element, the light source, etc. were provided in the inside of the main body 31 of the endoscope 2, it is not limited to this. For example, a controller including an image sensor and a light source and a signal transmission cable may be provided. In this case, the fiber 33 inside the main body 31 is inserted into the controller through the signal transmission cable and connected to an image sensor, a light source, and the like. Further, the output of the image sensor (the output of the controller) is output to the image processing apparatus 1 via the cable 35. With this configuration, the main body 31 can be downsized, and a space for arranging a sensor or the like for detecting the protruding amount of the fiber 33 can be secured inside the main body 31.

  In the above-described embodiment, the operator designates a position to be designated as the origin position on the image, and then causes the tip 32a of the nozzle 32 of the grasped endoscope 2 to abut the end face around the root canal. However, the procedure may be changed. That is, after the contact position of the endoscope 2 is determined, the origin may be set on the tooth image acquired in advance. Further, when the origin is set on the tooth image, the origin setting position may be superimposed on the tooth image (X-ray image) as shown in FIGS. 8A to 8C.

As shown in FIG. 8A, when the X-ray images in the respective cross-sectional directions are displayed at the same time, the bar 81 indicating the origin setting position is superimposed on the coronal image in the window 62 and superimposed on the sagittal image in the window 63. The The window 61 displays an axial image of a fault having the same depth as the bar 81.
As shown in FIG. 8B, in addition to the bar 81 indicating the origin setting position, a mark image 91 indicating the tip position of the fiber may be superimposed on the X-ray image. In addition, after setting the origin, the bar 81 indicating the origin setting position may be continuously displayed while the endoscope 2 is being advanced.
The origin setting position displayed superimposed on the X-ray image may be a predetermined mark 82 as shown in FIG. In FIG. 8C, the mark image 91 indicating the tip position of the fiber is displayed as a triangle, and the mark 82 at the origin setting position is circular. However, the present invention is not limited to this. In the case of simultaneous display, the shape of the mark 82 at the origin setting position may be different from the shape of the mark image 91.

In the example shown in FIG. 3A, the fiber origin is positioned by bringing the end face of the thick portion of the nozzle 32 into contact with the end face around the root canal 41, but the present invention is not limited to this.
As shown in FIG. 3B, for example, a minute contact portion 32 b may be provided on the outer peripheral surface of the tip opening of the nozzle 32. Examples of the material of the contact portion 32b include soft materials such as silicone resin and silicone rubber. Further, the shape of the contact portion 32b is not limited to the illustrated disk shape, and may be a conical shape, a dome shape, a spherical shape, or the like. By providing the contact portion 32b in this manner, the nozzle 32 of the endoscope 2 can be easily fixed to the tooth 40, and the fiber 33 can be stably put in and out.

Further, the position where the tip 32 a of the nozzle 32 is brought into contact with the tooth is not limited to the end surface around the root canal 41 exposed from the hole 42 formed in the tooth 40. As long as it can be stably fixed, an end face around the hole 42 formed in the tooth 40, an inner surface of the hole 42, or the like may be used. For example, when the fiber origin is determined by contacting with the end face around the hole 42, the origin setting position in the tooth image acquired in advance is also the end face around the hole 42 on the image.
On the other hand, when the fiber origin is determined by abutting against the inner surface of the hole 42, it is preferable to perform measurement for obtaining the origin setting position in the tooth image. For example, as shown in FIG. 3C, the end surface position around the hole 42 can be measured by bringing the rod-shaped member 50 into contact. Similarly, the position of the inner surface of the hole 42 can be measured by using a member that contacts the inner surface of the hole 42. Therefore, these differences may be reflected in the difference in the origin setting position in the tooth image.

DESCRIPTION OF SYMBOLS 1 Image processing apparatus 2 Endoscope 3 Microscope 4 Input means 5 Display means 10 Processing means 11 Endoscope image input means 12 Microscope image input means 13 Protrusion amount acquisition means 14 Position information addition means 15 Display control means 16 Origin setting Means 20 Storage means 71 Head mounted display

Claims (11)

A protrusion amount acquisition means for acquiring the protrusion amount of the fiber from the endoscope when the inside of the tooth is imaged by an endoscope having a nozzle and a fiber protruding from the nozzle and inserted into the tooth;
An image processing apparatus comprising: a position information adding unit that calculates the tip position of the fiber in the tooth from the protruding amount of the fiber, and adds the tip position information to a previously acquired tooth image. The position information adding means includes
An origin setting means for associating a fiber origin serving as a reference of the protruding amount of the fiber and an origin serving as a reference of the tip position of the fiber in the previously acquired tooth image;
The origin setting means receives an input of an origin setting position in the image of the tooth, and uses the tip position of the fiber when the tip of the nozzle of the endoscope contacts the tooth as the fiber origin. The image processing apparatus according to claim 1, wherein the image processing apparatus is associated with an origin setting position in a tooth image.   The tooth image acquired in advance is a cross-sectional image taken by an X-ray CT apparatus, a 3D image created from CT data, or a virtual endoscopic image created from CT data. The image processing apparatus according to claim 1 or 2.   The image processing apparatus according to claim 1, wherein the tooth image acquired in advance is a dental image or a panoramic image captured by an X-ray imaging apparatus.   5. The display control unit according to claim 1, further comprising: a display control unit configured to display, on a display unit, an image inside the tooth acquired by the endoscope and an image of the tooth acquired in advance. The image processing apparatus according to one item.   The display control means, when the previously acquired tooth image is a cross-sectional image in the depth direction of the tooth, a mark image indicating the tip position of the fiber based on the information on the tip position of the fiber. The image processing apparatus according to claim 5, wherein the display unit displays the image so as to be superimposed on the tooth image.   When the previously acquired tooth image is a horizontal cross-sectional image of a tooth, the display control unit displays a cross-sectional image of the tooth at a position in the depth direction corresponding to the tip position of the fiber. The image processing apparatus according to claim 5, which is displayed on the screen.   When the previously acquired tooth image is a 3D image created from CT data, the display control means displays a mark image indicating the fiber tip position based on the fiber tip position information. The image processing apparatus according to any one of claims 5 to 7, wherein the image is displayed on the display unit so as to be superimposed on an image of the tooth.   The image according to any one of claims 5 to 8, wherein the display control unit displays the microscope image of the tooth acquired by a microscope side by side with the image of the tooth acquired in advance. Processing equipment.   The image processing apparatus according to claim 5, wherein the display unit is a head mounted display.   An image processing program for causing a computer to function as the image processing apparatus according to any one of claims 1 to 10.