JP6747576B2 - Imaging equipment - Google Patents

Description

The present invention relates to an imaging device for simultaneously displaying an image of a lymph vessel and an image of a vein in a subject.

As a treatment method for swelling caused by lymphedema of the extremities, in addition to drainage, which is a direct method of sucking fat that causes swelling, there is an indirect method of improving the flow of lymph vessels. A lymphatic venous anastomosis has been adopted.

In this lymphatic venous anastomosis, in order to visualize the vein at the time of surgery, a method of irradiating the vein with near infrared light and directly observing the light absorbed by blood (hemoglobin) is adopted. (See Patent Document 1).

On the other hand, as a method for visualizing lymph vessels, a method called near infrared fluorescence imaging is used for angiography in surgery. In this near-infrared fluorescence imaging, indocyanine green (ICG), which is a fluorescent dye, is injected into a vein or lymph vessel by an injector or the like. Then, when this indocyanine green is irradiated with near infrared light having a wavelength of about 600 to 850 nm (nanometer) as excitation light, indocyanine green emits near infrared fluorescence having a wavelength of about 750 to 900 nm. This fluorescence is photographed by an image sensor capable of detecting near infrared light, and the image is displayed on a display unit such as a liquid crystal display panel. According to this near-infrared fluorescence imaging, it becomes possible to observe blood vessels, lymph vessels, etc. existing at a depth of about 20 mm from the body surface.

Patent Document 2 discloses an intensity distribution image of near-infrared fluorescence obtained by irradiating a living organ to which indocyanine green has been administered with excitation light of indocyanine green, and before indocyanine green administration. Compared with the cancer lesion distribution image obtained by applying X-rays, nuclear magnetic resonance or ultrasonic waves to the examined organs, the cancer lesion distribution image is detected by the near infrared fluorescence intensity distribution image. A data collection method is disclosed in which data of a region that is not detected in is collected as data of accessory lesion regions of cancer.

JP, 2011-139731, A International Publication No. 2009/139466

In the lymphatic venous anastomosis, blood flows back into the lymphatic vessels when the anastomotic vein becomes 1.5 mm or more, so a thin vein with a diameter of about 0.6 mm to 1.0 mm is selected. When performing a fine operation to anastomose such a venule and a lymphatic vessel (diameter of about 0.3 mm), the field of view can be increased to several to several tens of times by using an eyepiece lens such as a so-called surgical microscope. Enlarged and undergoing surgery. At this time, since a vein to be anastomosed adjacent to the lymph vessel is selected, marking with a blood vessel tape or the like is necessary to prevent misidentification of the vein and the preoperative vein. In order to eliminate such a need, it is preferable that the vein to be anastomosed and the lymphatic vessel be visible at the same time in the same visual field.

The present invention has been made to solve the above problems, and an object thereof is to provide an imaging device capable of simultaneously visualizing veins and lymph vessels to be anastomosed within the same visual field.

The invention according to claim 1 is an imaging apparatus for simultaneously displaying an image of a lymph vessel and an image of a vein in a subject, and excites a fluorescent dye administered to the lymph vessel of the subject. A first light source that irradiates the subject with light of a first wavelength and a second wavelength of light that is absorbed in the blood in the vein of the subject are directed toward the subject. A second light source for irradiating, a first image sensor for photographing the subject at a predetermined frame rate, and a synchronization of the first light source and the second light source with a frame rate for photographing by the first image sensor. The brightness of the image of the subject captured by the first image sensor while the light source control unit that alternately lights and the second light source is turned on is reversed, and the first light source is turned on. Of the region of the lymph vessels in the image taken by the first image sensor when the second light source is on, and the region of the vein in the image whose brightness is inverted by the first image sensor when the second light source is on. An image processing unit that displays at least one of these images on a display unit after coloring at least one of the colors is provided.

According to a second aspect of the present invention, in the first aspect of the invention, the image processing unit is provided in the image of the subject captured by the first image sensor when the first light source is on. The area of the lymphatic vessel is colored in a first color and then displayed on the display unit, and the brightness of the image of the subject captured by the first image sensor when the second light source is on. And the area of the vein in the luminance-inverted image is colored with a second color different from the first color, and then displayed on the display unit.

The invention according to claim 3 is the invention according to claim 2, further comprising a third light source for irradiating the subject with visible light, and a second image sensor for photographing the subject. The image processing unit includes a visible image captured by the second image sensor, together with the lymph vessel region and the vein region in the image of the subject captured by the first image sensor, and the display unit. It is synthesized and displayed.

According to a fourth aspect of the present invention, in the third aspect of the invention, the fluorescence from the fluorescent dye and the light of the second wavelength are made incident on the first image sensor, and visible light is transmitted to the second image sensor. A dichroic prism that enters the image sensor is provided.

According to a fifth aspect of the invention, in the invention according to the fourth aspect, between the dichroic prism and the first image sensor, fluorescence from the fluorescent dye excited by the light of the first wavelength and The dichroic is provided with a first bandpass filter that transmits light of a second wavelength and does not transmit fluorescence of the fluorescent dye excited by the light of the first wavelength and the light of the second wavelength. A second bandpass filter that transmits visible light but does not transmit light other than visible light is disposed between the prism and the second image sensor.

According to the invention described in claim 1, it becomes possible to simultaneously visualize the vein and the lymph vessel to be anastomosed in the same visual field.

According to the second aspect of the present invention, the veins and lymph vessels to be anastomosed can be colored in different colors so that they can be visualized at the same time in the same visual field, and the visibility of the veins and lymph vessels is improved. It becomes possible.

According to the invention described in claim 3, the veins and lymph vessels and the image of the subject can be visually recognized at the same time in a combined state, and the efficiency of surgery can be improved.

According to the invention of claim 4, the fluorescence from the fluorescent dye and the light of the second wavelength are efficiently incident on the first image sensor by the dichroic prism, and the visible light is efficiently captured by the second image. It becomes possible to make it enter the device.

According to the invention of claim 5, it is possible to prevent the fluorescence from the fluorescent dye excited by the light of the first wavelength and the light of the second wavelength by the first bandpass filter from entering the first image sensor. At the same time, the second bandpass filter can prevent light other than visible light from entering the second image sensor.

1 is a perspective view showing an imaging device 1 according to the present invention together with a display device 2. 3 is a schematic diagram of a lighting/imaging unit 12. FIG. 3 is a schematic diagram showing an internal structure of a lighting/imaging unit 12. FIG. It is a block diagram which shows the main control systems of the imaging device 1 which concerns on this invention. FIG. 9 is an explanatory diagram showing each step of an imaging operation in the camera 21 and the image processing section 73 in blocks. 6 is a graph showing a synchronization clock applied to the first and second light sources 22 and 23 and the first image sensor 61.

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a perspective view showing an imaging device 1 according to the present invention together with a display device 2.

The display device 2 has a configuration in which a display mechanism 52 including a large-sized liquid crystal display device or the like is supported by a support mechanism 51.

The imaging apparatus 1 according to the present invention is for simultaneously displaying an image of a lymph vessel and an image of a vein in a subject together with a visible image of the subject on the display unit 52. That is, the imaging apparatus 1 according to the present invention visualizes an image of a lymph vessel as a near-infrared image by fluorescence of indocyanine green, and visualizes an image of a vein as an inverted image of the brightness of the near-infrared image absorbed by blood. However, these images are combined with the visible image of the subject and displayed.

The imaging apparatus 1 according to the present invention includes a dolly 11 having four wheels 13, an arm mechanism 30 provided near the front of the dolly 11 on the upper surface of the dolly 11, and an arm mechanism 30. The lighting/imaging unit 12 arranged via the sub-arm 41 and the monitor 15 are provided. A handle 14 used when the carriage 11 is moved is provided behind the carriage 11 in the traveling direction. Further, on the upper surface of the dolly 11, a concave portion 16 for mounting an operation portion 74, which will be described later, used for remote operation of the imaging apparatus 1 is formed.

The arm mechanism 30 described above is arranged on the front side in the traveling direction of the carriage 11. The arm mechanism 30 includes a first arm member 31 that is connected by a hinge portion 33 to a support portion 37 that is disposed on a column 36 that is provided upright on the front side in the traveling direction of the carriage 11. The first arm member 31 is swingable with respect to the carriage 11 by the action of the hinge portion 33 via the support column 36 and the support portion 37. The monitor 15 described above is attached to the column 36.

The second arm member 32 is connected to the upper end of the first arm member 31 by a hinge portion 34. The second arm member 32 can swing with respect to the first arm member 31 by the action of the hinge portion 34. Therefore, the first arm member 31 and the second arm member 32 are the connecting portions of the first arm member 31 and the second arm member 32 shown in FIG. It is possible to take a photographing posture in which a certain angle is opened around a certain hinge portion 34 and a standby posture in which the first arm member 31 and the second arm member 32 are close to each other.

The support portion 43 is connected to the lower end of the second arm member 32 by a hinge portion 35. The support portion 43 is swingable with respect to the second arm member 32 by the action of the hinge portion 35. The rotation shaft 42 is supported by the support portion 43. Then, the sub-arm 41 supporting the illumination/imaging unit 12 rotates about a rotation shaft 42 arranged at the tip of the second arm member 32. For this reason, the illumination/photographing unit 12 rotates the sub-arm 41 to take a photographing posture or a standby posture shown in FIG. The carriage 11 moves between a position on the rear side in the traveling direction of the carriage 11 with respect to the arm mechanism 30, which is the posture when the carriage 11 is moved.

FIG. 2 is a schematic diagram of the illumination/imaging unit 12.

The illumination/imaging unit 12 is provided with a camera 21 including a first image sensor 61 that can detect near-infrared rays and a second image sensor 62 that can detect visible light, which will be described later, and an outer peripheral portion of the camera 21. The four first light sources 22, the four second light sources 23, and the four third light sources 24 are provided.

The first light source 22 irradiates the subject with light having a first wavelength that excites indocyanine green as a fluorescent dye that has been administered to the subject's lymph vessels. The first wavelength is, for example, 780 nm. The indocyanine green administered to the lymphatic vessel of the subject emits near-infrared light having a wavelength of about 820 nm, by being irradiated with near-infrared light of 780 nm. The wavelength of the first light source 22 is not limited to 780 nm, and may be any wavelength from 650 nm to 850 nm that can excite indocyanine green.

The second light source 23 irradiates the subject with light of the second wavelength that is absorbed in the blood in the vein of the subject. The second wavelength is, for example, 850 nm. This 850 nm near infrared light is absorbed by hemoglobin in blood. The wavelength of the second light source 23 may be, for example, about 700 nm to 900 nm.

The third light source 24 irradiates the subject with white light that is visible light.

In addition, in this embodiment, the illumination/imaging unit 12 in which the first light source 22, the second light source 23, the third light source 24, and the camera 21 are integrated is used. The light source 23, the third light source 24, and the camera 21 may be separately arranged.

FIG. 3 is a schematic diagram showing the internal structure of the illumination/imaging unit 12.

As described above, the illumination/imaging unit 12 includes the camera 21, the first light source 22, the second light source 23, and the third light source 24. Then, the camera 21 includes a lens system 66, a first image sensor 61 that can detect near infrared rays, a second image sensor 62 that can detect visible light, and a first image sensor 61 that transmits near infrared light. And a dichroic prism 65 that reflects visible light to enter the second image sensor 62. The first image sensor 61 and the second image sensor 62 are composed of CMOS or CCD.

Between the dichroic prism 65 and the first imaging element 61, fluorescence from indocyanine green excited by near-infrared light of a first wavelength and near-infrared light of a second wavelength are transmitted, and A first band-pass filter 63 that does not transmit near-infrared light having a wavelength of 1 and fluorescence from indocyanine green excited by light having a second wavelength is provided. Further, between the dichroic prism 65 and the second image pickup device 62, a second bandpass filter 64 that transmits visible light but does not transmit light other than visible light is arranged.

FIG. 4 is a block diagram showing a main control system of the imaging apparatus 1 according to the present invention.

The imaging apparatus 1 includes a CPU that executes logical operations, a ROM that stores an operation program necessary for controlling the apparatus, a RAM that temporarily stores data and the like during control, and the like that controls the entire apparatus. The unit 70 is provided. The control unit 70 is connected to the illumination/imaging unit 12 including the camera 21, the first light source 22, the second light source 23, and the third light source 24. The control unit 70 is also connected to the monitor 15. The control unit 70 is also connected to an operation unit 74 to which various information is input by an operator (operator). Further, the control unit 70 is also connected to the display device 2 including the display unit 52 described above.

The control unit 70 controls the camera 21 including the first image sensor 61 and the second image sensor 62, and turns on and off the first light source 22, the second light source 23, and the third light source 24. A light source control unit 72 for controlling the above, and an image processing unit 73 for executing various image processes including a brightness inversion process, a gamma correction process, a coloring process, and a synthesizing process described later.

Next, an imaging operation in the above-described imaging device 1 when performing surgery or the like on a subject will be described. FIG. 5 is an explanatory diagram showing each step of the imaging operation in the camera 21 and the image processing unit 73 in blocks.

When performing an operation or the like, in order to display the image of the lymph vessel and the image of the vein in the subject together with the visible image of the subject on the display unit 52 by the imaging device 1 according to the present invention, First, the operator operates the handle 14 to move the dolly 11 to move the imaging apparatus 1 to a place where surgery or the like is performed. Then, indocyanine green is injected into the vicinity of the suture vein in the subject by injection to allow the indocyanine green to flow into the lymphatic vessels.

In this state, the first image sensor 61 captures images of lymph vessels and veins of the subject, and the second image sensor 62 captures visible images of the subject, and these images are displayed on the display device 2. Is displayed on the display unit 52 and the monitor 15.

At this time, the third light source 24 is constantly turned on, and visible light is emitted toward the subject. Then, the visible light reflected by the subject passes through the lens system 66 of the camera 21 and is then reflected by the dichroic prism 65 to transmit the visible light but not the light other than the visible light. And then enters the second image sensor 62. The second image sensor 62 acquires this visible image at a frame rate of 60 FPS (Frame Per Second) under the control of the camera control unit 71. As the second image sensor 62, a color image sensor capable of acquiring a visible image as RGB signals is used. The image signal acquired by the second image sensor 62 is gamma-corrected in the image processing unit 73 to create a visible image.

On the other hand, the image of the lymph vessel and the image of the vein in the subject are captured by the first image sensor 61. The first image sensor 61 also acquires an image at a frame rate of 60 FPS. At this time, the first image pickup device 61, under the control of the camera control unit 71, according to the timings of the synchronous clock A and the synchronous clock B that synchronize the lymphatic vessel image and the vein image with the frame rate at the time of imaging. It is acquired alternately every frame, that is, at a frame rate of 30 FPS. In response to this, the first light source 22 and the second light source 23 are alternately turned on in synchronization with the frame rate of the image capturing by the first image sensor 61 under the control of the light source controller 72.

FIG. 6 is a graph showing the synchronization clocks given to the first and second light sources 22 and 23 and the first image sensor 61. In this graph, reference symbol A indicates a synchronous clock for turning on the first light source 22, and reference symbol B indicates a synchronous clock for turning on the second light source 23.

As described above, the first image sensor 61 alternately acquires images of lymph vessels and veins at a frame rate of 60 FPS. Therefore, the first light source 22 and the second light source 23 are alternately turned on in a state corresponding to the frame rate of 30 FPS. At this time, the turn-on and turn-off times of the first light source 22 and the second light source 23 are both 16.6 msec, as shown in FIG.

Referring again to FIG. 5, when the first light source 22 is turned on in response to the synchronous clock A shown in FIG. 6, indocyanine green in the lymphatic vessel of the subject is excited and fluorescence is generated. This fluorescence is, for example, near infrared light having a wavelength of 820 nm. This fluorescence passes through the lens system 66 of the camera 21, passes through the dichroic prism 65, further passes through the first bandpass filter 63, and then enters the first image sensor 61. Under the control of the camera controller 71, the first image sensor 61 acquires a fluorescence image from indocyanine green in response to the synchronization clock A shown in FIG. As the first image pickup device 61, a monochrome image pickup device that acquires a fluorescence image and a near-infrared image with a second wavelength described later as a black and white image is used.

The image processing unit 73 performs gamma correction on the fluorescence image acquired by the first image sensor 61 at a frame rate of 30 FPS. Then, the image processing unit 73 performs a coloring process of coloring the lymphatic vessel region in the fluorescent image with the first color. The first color is, for example, green.

On the other hand, in the state where the second light source 23 is turned on in response to the synchronous clock B shown in FIG. 6, the near-infrared light having a wavelength of 850 nm emitted from the second light source 23 is hemoglobin in the blood vessel in the vein. It is absorbed and reflected in areas other than veins. The near-infrared light passes through the lens system 66 of the camera 21, passes through the dichroic prism 65, further passes through the first bandpass filter 63, and then enters the first image sensor 61. The first image sensor 61 acquires a near-infrared image in response to the synchronization clock B shown in FIG. 6 under the control of the camera control unit 71.

The near-infrared image acquired by the first image sensor 61 at a frame rate of 30 FPS is an image in which near-infrared light is absorbed in the vein region and the vein region is dark. With respect to this near-infrared image, the image processing unit 73 performs a brightness inversion process for inverting the brightness of the pixel value. At this time, if each pixel of the first image sensor 61 has a pixel value of 1 Kbyte from 0 to 1023, for example, the output pixel value after the inversion processing is OUT(x, y). , When the input pixel value before the inversion processing is IN(x, y), the image processing unit 73 executes the operation represented by the following equation.
OUT(x,y)=1023-IN(x,y)

By this pixel value inversion process, the vein region of the subject can be visualized as an image with high brightness. Then, the image after the inversion processing is subjected to gamma correction in the image processing unit 73. After that, the image processing unit 73 performs a coloring process for coloring the vein region in the image after the inversion process with a second color different from the first color. The second color is a color other than green and is easily visible.

An image in which the lymph vessel region is colored in the first color and the vein region is colored in the second color are combined by the image processing unit 73, so that the vein and the lymph vessel to be anastomosed in the same field of view. It is possible to obtain a colored near-infrared image that can be simultaneously visualized within. Then, the colored near-infrared image and the visible image acquired by the second image sensor 62 are combined by the image processing unit 73 to combine the vein and lymph vessels with the image of the subject. In this state, it can be displayed on the display unit 52 and the monitor 15 of the display device 2 at the same time. This allows the operator to easily visually recognize the veins and lymph vessels and the image of the subject.

In addition, between the dichroic prism 65 and the first image sensor 61, fluorescence from indocyanine green excited by near-infrared light having a first wavelength and near-infrared light having a second wavelength are transmitted. However, a first band-pass filter 63 that does not transmit the near-infrared light of the first wavelength and the fluorescence from the indocyanine green excited by the light of the second wavelength is provided.

As mentioned above, the first wavelength is 780 nm and the second wavelength is 850 nm. Further, the peak wavelength of fluorescence from indocyanine green irradiated with the excitation light of 780 nm is 820 nm. Then, when indocyanine green is irradiated with near-infrared light having a second wavelength of 850 nm, indocyanine green emits fluorescence having a peak at 870 nm. Therefore, it is possible to prevent the near-infrared light having the first wavelength and the fluorescence from the indocyanine green excited by the light having the second wavelength, which are not used for visualization of the lymph vessels and blood vessels, from entering the first image sensor 61. Therefore, as the first bandpass filter 63, a filter that passes only near-infrared light of 800 nm to 860 nm is used.

As described above, according to the imaging apparatus 1 described above, the synchronization clock is used to perform the lighting of the first and second light sources 22 and 23 and the acquisition of the image by the first image sensor 61 in synchronization. It is possible to simultaneously visualize lymph vessels and veins in the same visual field. Therefore, the operator (operator) can visually check the lymph vessels and blood vessels within the same visual field, and can perform the surgery intensively. Further, at this time, it is not necessary to prepare dedicated devices for lymph vessels and veins.

Further, according to the above-described imaging apparatus 1, the lymph vessels and veins can be displayed in different colors, so that they can be easily distinguished. In addition, vein marking using a blood vessel tape or the like becomes unnecessary.

In the above-described embodiment, the lymph vessel region and the vein region are colored with different colors, but this coloring may be performed on only one of the lymph vessel and the vein. In this case, the non-colored areas of the lymph vessel area and the vein area are displayed in white.

Further, in the above-described embodiment, the visible image is displayed together with the lymph vessels and veins by irradiating the subject with visible light, but the visible image is omitted and the visible image is visually checked. You may make it observe directly.

Furthermore, although indocyanine green is used as the fluorescent dye in the above-described embodiments, other fluorescent dyes such as 5-aminolevulinic acid (5-ALA/5-Aminolevulinic Acid) may be used.

DESCRIPTION OF SYMBOLS 1 Imaging device 2 Display device 11 Carriage 12 Illumination/imaging unit 15 Monitor 21 Camera 22 First light source 23 Second light source 24 Third light source 30 Arm mechanism 52 Display unit 61 First image sensor 62 Second image sensor 63 First band pass Filter 64 Second bandpass filter 65 Dichroic prism 66 Lens system 70 Control unit 71 Camera control unit 72 Light source control unit 73 Image processing unit 74 Operation unit

Claims (5)

An imaging device for simultaneously displaying an image of a lymph vessel and an image of a vein in a subject,
A first light source for irradiating the subject with light having a first wavelength that excites a fluorescent dye administered to the lymph vessel of the subject;
A second light source for irradiating the subject with light having a second wavelength that is absorbed in blood in the vein of the subject;
A first image sensor for photographing the subject at a predetermined frame rate;
A light source controller that alternately turns on the first light source and the second light source in synchronization with a frame rate of image capturing by the first image sensor;
The brightness of the image of the subject captured by the first image sensor is inverted when the second light source is on, and the brightness of the image of the subject is inverted by the first image sensor when the first light source is on. After coloring at least one of the lymphatic vessel region in the captured image and the vein region in the image of which the brightness is inverted by the first image sensor when the second light source is turned on, these An image processing unit that displays the image of
An imaging device comprising: The imaging device according to claim 1,
The image processing unit,
While displaying the region of the lymphatic vessel in the image of the subject captured by the first image sensor with the first color when the first light source is turned on, the region is displayed on the display unit,
The brightness of the image of the subject captured by the first image sensor when the second light source is turned on is inverted, and the area of the vein in the brightness-inverted image is converted into the first color. An imaging device which is colored in a second color different from, and is displayed on the display unit. The imaging device according to claim 2,
A third light source for irradiating the subject with visible light;
A second image sensor for photographing the subject;
Further equipped with,
The image processing unit synthesizes, on the display unit, a visible image captured by the second image sensor together with the lymph vessel region and the vein region in the image of the subject captured by the first image sensor. And display the imaging device. The imaging device according to claim 3,
An imaging apparatus including a dichroic prism that causes fluorescence from the fluorescent dye and light of the second wavelength to enter the first image sensor and allows visible light to enter the second image sensor. The imaging device according to claim 4,
Between the dichroic prism and the first image sensor, the fluorescence from the fluorescent dye excited by the light of the first wavelength and the light of the second wavelength are transmitted, and the light of the first wavelength and While disposing a first bandpass filter that does not transmit fluorescence from the fluorescent dye excited by the light of the second wavelength,
An imaging device in which a second band-pass filter that transmits visible light but does not transmit light other than visible light is disposed between the dichroic prism and the second image sensor.

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