JP6599113B2 - Automatic measuring device and automatic measuring method - Google Patents

Description

  The present invention relates to an automatic analysis device and an automatic analysis method.

  Diagnosis of pulmonary emphysema using a chest CT (Computed Tomography) image obtained by photographing the chest is standardized by the Godart method. The lungs are made up of a small space called sponge-like alveoli (yes), but this space will remain large for some reason and will not return, and will not be able to take in enough oxygen and cause shortness of breath. This is emphysema. The Godard method performs a two-dimensional analysis of a specific section of the lung. The lesion part of emphysema appears black in the CT image as shown in the emphysema lesion part 22 of FIG.

  On the other hand, a method for diagnosing interstitial pneumonia using a chest CT image has been proposed (see, for example, Patent Document 1). Ordinary pneumonia (bacterial pneumonia) causes inflammation in the contents (space) of the alveoli, and interstitial pneumonia causes inflammation in the alveolar wall (= interstitium). The lesion part of interstitial pneumonia appears white in the CT image as shown in the interstitial pneumonia lesion part 21 in FIG.

JP 2008-200368 A

  The diagnosis of interstitial pneumonia using chest CT images has not yet been standardized, and a method for simultaneously quantitatively evaluating emphysema and interstitial pneumonia has not been proposed. There are many interstitial pneumonia complicated with emphysema. However, when emphysema and interstitial pneumonia were combined, this combination could be missed.

  An object of the present invention is to make it possible to diagnose complications of emphysema and interstitial pneumonia.

  In order to achieve the above object, the automatic analysis device and the automatic analysis method of the present invention calculate the ratio of the pulmonary emphysema and interstitial pneumonia by the unit block using the chest CT image, and calculate the calculation result as a unit. Display according to the block position.

  Specifically, the automatic analyzer of the present invention divides a chest CT image including the entire lung into unit blocks having a volume, and indicates that the lesion is an interstitial pneumonia lesion with respect to the unit block. A processing unit that calculates a ratio of a high absorption area and a low absorption area that indicates a lesion part of emphysema in the unit block for each unit block, a ratio of the high absorption area in all the unit blocks, and A display unit configured to display the ratio of the low absorption region in correspondence with the position of the unit block in the chest CT image.

  In the automatic analysis device of the present invention, the processing unit divides all unit blocks with an equal volume, and the display unit displays all unit blocks in a display area having the same size and calculates from a common unit block. The ratio of the high absorption area and the ratio of the low absorption area are displayed from different ends in the display area at a ratio equal to the ratio of the high absorption area and the ratio of the low absorption area to the unit block. May be.

  In the automatic analysis device of the present invention, the processing unit extracts a contour of a lung from the chest CT image, and the display unit calculates a ratio of the high absorption region and a ratio of the low absorption region in all the unit blocks. The unit block may be displayed in correspondence with the position of the unit block in the lung outline.

  Specifically, the automatic analysis method of the present invention divides a chest CT image including the entire lung into unit blocks in which the volume is set, and indicates that the lesion is an interstitial pneumonia lesion with respect to the unit block. An analysis procedure for calculating a ratio of a high absorption area and a low absorption area indicating that the unit block is a lesion part of emphysema for each unit block, a ratio of the high absorption area in all the unit blocks, and A display procedure for displaying the ratio of the low absorption region in correspondence with the position of the unit block in the chest CT image.

  In the automatic analysis method of the present invention, in the analysis procedure, all unit blocks are divided by an equal volume, and in the display procedure, all unit blocks are displayed in a display area having the same size and calculated from a common unit block. The ratio of the high absorption area and the ratio of the low absorption area are displayed from different ends in the display area at a ratio equal to the ratio of the high absorption area and the ratio of the low absorption area to the unit block. May be.

  In the automatic analysis method of the present invention, in the analysis procedure, a lung outline is extracted from the chest CT image, and in the display procedure, the ratio of the high absorption area and the ratio of the low absorption area in all the unit blocks are calculated. The unit block may be displayed in correspondence with the position of the unit block in the lung outline.

  The above inventions can be combined as much as possible.

  According to the present invention, the proportion of the emphysema and interstitial pneumonia lesions is calculated for each unit block using the chest CT image, and the calculation result is displayed in correspondence with the position of the unit block. Diagnosis of complications of pneumonia can be made.

An example of the lesion part of the interstitial pneumonia projected on the CT image is shown. An example of a lesion part of pulmonary emphysema projected on a CT image is shown. 1 shows an example of the configuration of an automatic analyzer according to a first embodiment. An example of the division | segmentation of a chest CT image is shown. The 1st example of a display in a display part is shown. The 2nd example of a display in a display part is shown. The 3rd example of a display in a display part is shown. The 4th example of a display in a display part is shown. The 5th example of a display in a display part is shown. The 6th example of a display in a display part is shown. The 7th example of a display in a display part is shown. An eighth display example on the display unit is shown.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. In addition, this invention is not limited to embodiment shown below. These embodiments are merely examples, and the present invention can be implemented in various modifications and improvements based on the knowledge of those skilled in the art. In the present specification and drawings, the same reference numerals denote the same components.

(Embodiment 1)
FIG. 3 shows an example of an automatic analyzer according to this embodiment. The automatic analysis device 10 according to the present embodiment includes a processing unit 11, a storage unit 12, and a display unit 13.

  The automatic analyzer 10 according to the present embodiment may be realized by causing a computer to function as the processing unit 11, the storage unit 12, and the display unit 13. In this case, each configuration is realized by a CPU (Central Processing Unit) (not shown) included in the automatic analysis apparatus 10 executing a computer program stored in an information storage unit (not shown). Here, the computer for realizing the automatic analyzer 10 may further include an arbitrary device controlled by the computer. Further, it is possible to record a program for realizing the automatic analyzer 10 on a recording medium or to provide it through a network.

  The chest CT image analyzed by the processing unit 11 and the communication between the processing unit 11, the display unit 13, and the storage unit 12 are, for example, DICOM (Digital Imaging) which is an international standard for handling digital image data and related medical data. and Communication in Medicine). In this case, the chest CT image analyzed by the processing unit 11 includes, for example, patient identification information and gender information indicating the gender of the patient.

The automatic analysis method according to the present embodiment has an analysis procedure and a display procedure in order.
In the analysis procedure, the processing unit 11 divides the chest CT image into unit blocks, and calculates the respective proportions of lesions of interstitial pneumonia and emphysema in the unit block for each unit block.
In the display procedure, the display unit 13 displays each ratio in all unit blocks in correspondence with the position of the unit block.

  The processing unit 11 synthesizes the chest CT image into a three-dimensional image, extracts the trachea, bronchus, and lung field regions, extracts the lung contour, and equally divides the lung field region into unit blocks. FIG. 4 shows an example of a unit block when the processing unit 11 analyzes a chest CT image. FIG. 4 shows an example in which the right lung 91 and the left lung 92 connected to the bronchus 93 are divided in the x direction, the y direction, and the z direction. At this time, the right lung 91 and the left lung 92 are individually divided.

  In FIG. 4, among the unit blocks, R1 corresponds to Rx1 and Ry1, R2 corresponds to Rx2 and Ry1, R3 corresponds to Rx3 and Ry1, R4 corresponds to Rx1 and Ry2, and R5 corresponds to Rx2 and Ry2. R6 corresponds to Rx3 and Ry2, R7 corresponds to Rx1 and Ry3, R8 corresponds to Rx2 and Ry3, and R9 corresponds to Rx3 and Ry3. Unit blocks R1 to R9 exist for every Rz1 to Rz10 in the z direction. Although the correspondence relationship with the unit block of the right lung 91 has been described here, the unit blocks L1 to L9 of the left lung 92 are the same as the right lung 91.

  The processing unit 11 calculates a ratio of HAA (High Attenuation Area) and a ratio of LAA (Low Attenuation Area) included in the unit block. HAA is a high-absorption region that indicates a lesion of interstitial pneumonia. The high absorption area is an area that appears white among the areas included in the lung, and excludes areas that do not belong to the lung, such as bones. LAA is a low-absorption region indicating a lesion of emphysema. The low absorption area is an area that appears black in an area included in the lung, and excludes an area that does not belong to the lung, such as a cavity.

  Since emphysema becomes more serious as the size (volume) of alveoli increases, it is important to measure the size of emphysema at the time of diagnosis. Since the automatic analyzer 10 can measure the size of emphysema by calculating the ratio of LAA, it is also effective for diagnosing emphysema.

  The processing unit 11 calculates the HAA ratio and the LAA ratio for each unit block. For example, the gradation in the unit block R1 of Rz1 is analyzed, the volume of HAA and the volume of LAA are calculated, and the ratio of HAA and the ratio of LAA to the volume of the unit block R1 are calculated. Similarly, the HAA ratio and the LAA ratio in the unit blocks R2 to R9 of Rz1, the unit blocks R2 to R9 of Rz2 to Rz10, and the unit blocks L1 to L9 of Lz2 to Lz10 are calculated.

  The processing unit 11 transmits the HAA ratio and the LAA ratio to the storage unit 12 for each unit block. The storage unit 12 stores the HAA ratio and LAA ratio for each unit block sent from the processing unit 11. The display unit 13 displays the HAA ratio and the LAA ratio in correspondence with the position of the unit block in the chest CT image.

  The display unit 13 displays the HAA ratio and LAA ratio of the right lung 91 at the position of the right lung 91, and displays the HAA ratio and LAA ratio of the left lung 92 at the position of the left lung 92. At that time, the display unit 13 displays the HAA ratio and LAA ratio of the right lung 91 corresponding to one unit block in one line. The display unit 13 displays the HAA ratio and LAA ratio of the left lung 92 corresponding to one unit block in one line. The unit blocks of the right lung 91 and the left lung 92 that display the HAA ratio and the LAA ratio in the same row are, for example, R1 and L1.

  The display unit 13 preferably displays the contours of the right lung 91 and the left lung 92 so as to overlap each other. The contours of the right lung 91 and the left lung 92 are preferably lung contours extracted from a chest CT image. Further, the contours of the right lung 91 and the left lung 92 may be chest CT images.

  FIG. 5 shows a first display example. In the first display example, the HAA ratio and LAA ratio of the right lung 91 are displayed on the left side of the screen, and the HAA ratio and LAA ratio of the left lung 92 are displayed on the right side of the screen. As a result, a display that matches the position of the lung displayed on the chest CT image can be performed, so that the exact position of the lesion can be specified, and diagnosis by the doctor is facilitated.

  The display unit 13 of the present embodiment displays the HAA ratio PH and the LAA ratio PL in association with the position in the height direction of the unit block in the chest CT image. For example, when Rz1 is the lowest and Rz10 is the highest, the display unit 13 displays Rz10, Rz9,... Rz2, Rz1 in this order from the top. The positions of the unit blocks R1 to R9 in Rz10 are arbitrary, and in FIG. 5, the unit blocks R1 to R9 are displayed in this order.

  It is preferable that the positions of Rz1 to Rz10 substantially coincide with the height of the displayed right lung 91, and the positions of Lz1 to Lz10 substantially coincide with the height of the displayed left lung 92. In this case, it is preferable that the scales of the images of the right lung 91 and the left lung 92 superimposed on the HAA ratio PH and the LAA ratio PL are adjusted to the positions of Lz1 to Lz10.

  The automatic analyzer 10 according to the present embodiment simultaneously displays the HAA ratio PH and the LAA ratio PL present in a common unit block. Therefore, the HAA ratio PH and the LAA ratio PL that the unit blocks share are displayed so as to occupy an area corresponding to the HAA ratio PH and the LAA ratio PL within the frame in which the volume of the common unit block is 100%. To do. For example, the position of the bronchus 93 is set to 0%, the far end of the lung 91 and the lung 92 from the bronchi 93 is set to 100%, the HAA ratio PH is displayed as a bar graph from the 0% side, and the LAA ratio PL is set to 100%. Display as a bar graph from the side.

  In the present embodiment, when a bar graph for each displayed unit block is selected, the PH and PL values corresponding to the selected bar graph may be displayed. For example, when one of the bar graphs is clicked, the selected bar graph is enlarged and the PH and PL values corresponding to the selected bar graph are displayed.

  The HAA ratio PH is preferably such that the value of HU (Hounsfield Unit) can be visually recognized. For example, it is preferably divided into −700 HU or more, −650 HU or more, and −600 HU or more. Further, when displaying as a bar graph, it is preferable to display the color, color intensity, pattern, etc. separately for each HU range.

  FIG. 6 shows a second display example. In the second display example, the HAA ratio PH and LAA ratio PL of the right lung 91 are displayed on the right side of the screen, and the HAA ratio PH and LAA ratio PL of the left lung 92 are displayed on the left side of the screen. Accordingly, when viewing the patient from the back side, it matches the left-right direction of the person viewing the display unit 13, so that the patient can easily understand.

  FIG. 7 shows a third display example. In the third display example, the HAA ratio PH is displayed as a bar graph from the 100% side and the LAA ratio PL is displayed as a bar graph from the 0% side in the first display example shown in FIG. In the second display example shown in FIG. 6, the HAA ratio PH may be displayed as a bar graph from the 100% side, and the LAA ratio PL may be displayed as a bar graph from the 0% side.

  FIG. 8 shows a fourth display example. In the fourth display example, the HAA ratio PH is displayed as a bar graph from the 0% side in the first display example shown in FIG. In the fourth display example shown in FIG. 8, the HAA ratio PH may be displayed as a bar graph from the 100% side.

  FIG. 9 shows a fifth display example. The fifth display example displays the LAA ratio LH as a bar graph from the 0% side in the first display example shown in FIG. Also in the fifth display example shown in FIG. 9, the LAA ratio PH may be displayed as a bar graph from the 100% side.

  As described above, since the automatic analysis apparatus 10 can diagnose pulmonary emphysema and interstitial pneumonia by a single process, the patient does not need to take CT images many times. In addition, analysis of emphysema and interstitial pneumonia is performed at the same time, and the analysis area of the lungs and the analysis results are visually expressed in an easy-to-understand manner, making it easy to identify lesions and diagnose complications. Become. In addition, since the ease of onset of emphysema and interstitial pneumonia tends to depend on the height direction of the lungs, diagnosis according to the height direction of the lungs facilitates diagnosis of the disease state. In addition, since it is digitized and displayed objectively, misdiagnosis can be prevented, and blurring of diagnosis due to differences in doctors can also be prevented. In addition, it is easy to explain the medical condition when explaining to the patient. The automatic analysis device 10 enables evaluation based on a three-dimensional place where a symptom that cannot be determined only by numerical values occurs.

(Embodiment 2)
The display unit 13 of the present embodiment further displays the HAA ratio PH and the LAA ratio PL in correspondence with the position in the plane direction of the unit block in the chest CT image.

  FIG. 10 shows a sixth display example. In the sixth display example, the HAA ratio PH and the LAA ratio PL are displayed at the positions of the unit blocks R1 to R9 and L1 to L9. For example, on the plane of Rz4, the HAA ratio PH and the LAA ratio PL of the unit blocks R1 to R9 are displayed. The HAA ratio PH and the LAA ratio PL are displayed in, for example, a pie chart.

  FIG. 10 shows unit blocks R1 to R9 and L1 to L9 corresponding to Rz2, Rz4, Rz6, and Rz8 that are part of Rz1 to Rz10, and Lz2, Lz4, Lz6, and Lz8 that are part of Lz1 to Lz10. However, it is preferable to display all unit blocks in the height direction.

  Displaying as shown in FIG. 10 makes it easy to visually grasp the distance from the bronchus 93 of each pie chart. Therefore, when a symptom depending on the distance of the bronchus 93 is discovered, it becomes easy to diagnose in consideration of this dependence.

  The display unit 13 may display only the HAA ratio PH or the LAA ratio PL. For example, as shown in FIG. 11, the HAA ratio PH or LAA ratio PL may be displayed using a bar graph that increases as the numerical value increases. In addition, as shown in FIG. 12, the HAA ratio PH or LAA ratio PL may be displayed using a sphere having a larger radius as the value increases. At that time, the color of bar chart or sphere or the color intensity may be changed according to the numerical value of the ratio PH of HAA or the ratio PL of LAA.

  The HAA ratio PH and the LAA ratio PL can be easily grasped based on the height of the bar graph or the size of the sphere. 11 and 12, when one bar graph or sphere becomes taller or larger, another bar graph or sphere may be shaded. In that case, the visibility may be enhanced by blinking a shaded bar graph or sphere.

  Alternatively, the color indicating the HAA ratio PH and the color indicating the LAA ratio PL may be different colors, and the colors may be mixed and then displayed as one bar graph or sphere. At that time, the higher the ratio PL of HAA ratio PHLAA, the darker the color, the higher the ratio can be easily recognized. For example, if the color indicating PH is red and the color indicating PL is blue, the ratio of PH and PL is approximately the same when the color is displayed in purple, and the darker the color, the higher the ratio. I can grasp it.

  Furthermore, the automatic analyzer 10 can classify interstitial pneumonia in detail according to the pattern of the graph.

  Therefore, in this embodiment, since detailed classification of interstitial pneumonia is possible by the pattern of the graph, in addition to the effects of the first embodiment, the diagnosis of interstitial pneumonia can be facilitated.

(Example)
Twenty-one males (combined pulmonary fibrosis and emphysema) with an interstitial shadow of the lung field high absorption area (HAA) and emphysematous shadow of the lung field low absorption area (LAA) in chest CT (average 72.6) 12 subjects (average 46.8 years) were used as controls. As the chest CT, Toshiba 16-row MDCT was used. Automatic analysis software LungVision (Cybernet System Co., Ltd.) was improved, LAA score,% LAV (% of LAA Volume) and HAA score were calculated for low-absorption area (LAA) emphysematous lesions, and respiratory function was CHESTAC-8800 Measured with Here, the computer that executes the automatic analysis software LungVision corresponds to an automatic analyzer and executes an automatic analysis method.

  The lung field was evaluated for each of the left lung 92 and the right lung 91 by dividing the upper, middle and lower lung fields into six parts, and HAA% scores were evaluated with threshold values of −700 HU˜, −650 HU˜, −600 HU˜. In CPFE, the HAA% score from −600 HU to −600 HU was significantly increased in the right lower lung field and the left lower lung field, and the average values were 1.40% and 0.96%, respectively. The average values of LAA score and% LAV of all lung fields were 6.1 and 9.6%, respectively. In pulmonary function, obstructive disorder was observed in 4/21 cases and diffusion disorder was observed in 20/21 cases, and 2/21 cases were complicated with lung cancer.

  The automatic analysis device and automatic analysis method of the present invention can be applied to the medical device industry.

10: Automatic analyzer 11: Processing unit 12: Storage unit 13: Display unit 21: Interstitial pneumonia lesion 22: Emphysema lesion 91: Right lung 92: Left lung 93: Bronchi

Claims (4)

A chest CT (Computed Tomography) image including the entire lung is divided into unit blocks each having a volume, and a ratio of a high absorption area indicating a lesion of interstitial pneumonia with respect to the unit blocks and the unit blocks A processing unit that calculates a ratio of a low absorption area indicating a lesion part of emphysema in each unit block;
A display unit for displaying the proportion of the high absorption region and the proportion of the low absorption region in all the unit blocks in correspondence with the position of the unit block in the chest CT image;
With
The processing unit divides all unit blocks with an equal volume,
The display unit
Display all unit blocks in a display area of equal size,
The ratio of the high absorption area and the ratio of the low absorption area calculated from a common unit block, the ratio of the high absorption area to the unit block and the ratio of the low absorption area from different ends in the display area. Display at a ratio equal to
Automatic measuring device. The processing unit extracts a lung outline from the chest CT image,
The display unit displays the ratio of the high absorption area and the ratio of the low absorption area in all the unit blocks in correspondence with the position of the unit block in the contour of the lung.
The automatic measuring device according to claim 1 . A chest CT (Computed Tomography) image including the entire lung is divided into unit blocks each having a volume, and a ratio of a high absorption area indicating a lesion of interstitial pneumonia with respect to the unit blocks and the unit blocks A measurement procedure for calculating a ratio of a low absorption area indicating a lesion part of emphysema in each unit block;
A display procedure for displaying the proportion of the high absorption region and the proportion of the low absorption region in all the unit blocks in correspondence with the position of the unit block in the chest CT image;
In order,
In the measurement procedure, all unit blocks are divided into equal volumes,
In the display procedure,
Display all unit blocks in a display area of equal size,
The ratio of the high absorption area and the ratio of the low absorption area calculated from a common unit block, the ratio of the high absorption area to the unit block and the ratio of the low absorption area from different ends in the display area. Display at a ratio equal to
Automatic measurement method. In the measurement procedure, a lung contour is extracted from the chest CT image,
In the display procedure, the ratio of the high absorption area and the ratio of the low absorption area in all the unit blocks are displayed in correspondence with the position of the unit block in the contour of the lung.
The automatic measurement method according to claim 3 .

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