JP6780936B2 - Medical image processing equipment, medical image processing methods, and medical image processing programs - Google Patents

Description

The present disclosure relates to a medical image processing apparatus, a medical image processing method, and a medical image processing program.

A region expansion method (Region Growing) is known as a method of recognizing a spatially continuous region as one region in a medical image. Conventionally, there is known an image display device that detects and displays a branch of a blood vessel by analyzing a region change at each iteration when region expansion is performed (see Patent Document 1).

Japanese Unexamined Patent Publication No. 2011-45448

The image display device of Patent Document 1 can extract a point on the contour near the branch of a blood vessel, but the entrance (branch opening) of a branch of a tubular tissue such as a blood vessel and the clinically necessary property of the branch opening (property). ) Is not considered.

The present disclosure has been made in view of the above circumstances, and provides a medical image processing apparatus, a medical image processing method, and a medical image processing program capable of visualizing the properties of the branch mouth of a tubular tissue clinically necessary.

The medical image processing apparatus of the present disclosure includes a port for acquiring volume data of a subject including a tubular tissue having a main and a branch pipe branched from the main, and a portion where the branch pipe branches from the main. In the three-dimensional image, a processor that derives the position of the branch mouth, the size of the branch mouth, and the direction of the normal of the surface of the branch mouth, and the three-dimensional image of the tubular tissue based on the volume data. The present invention includes a display for superimposing and displaying marks on a three-dimensional space indicating the position of the branch opening, the size of the branch opening, and the direction of the normal of the surface of the branch opening.

The medical image processing method of the present disclosure is a medical image processing method in a medical image processing apparatus, and obtains volume data including a tubular tissue having a main and a branch pipe branched from the main, and obtains the main. The position of the branch mouth where the branch pipe branches, the size of the branch mouth, and the direction of the normal of the surface of the branch mouth are derived from the above, and a three-dimensional image of the tubular tissue based on the volume data is obtained. , The position of the branch opening in the three-dimensional image, the size of the branch opening, and the mark on the three-dimensional space indicating the direction of the normal of the surface of the branch opening are superimposed and displayed.

The medical image processing program of the present disclosure is a program for causing a computer to execute the above-mentioned medical image processing method.

According to the present disclosure, it is possible to visualize the properties of the branch port of a tubular tissue that is clinically necessary.

Block diagram showing a configuration example of the medical image processing apparatus according to the first embodiment Flowchart showing an operation example of a medical image processing device Schematic diagram showing an example of branching of a blood vessel A schematic diagram showing a ray-cast image showing abdominal blood vessels branching from the aorta, and an example of a tree and a mark showing blood vessel running superimposed on the ray-cast image. A schematic diagram showing an example of a Latham image corresponding to the Raycast image of FIG. 4 and a tree and a mark representing blood vessel running superimposed on the Latham image. A schematic diagram showing an example of a raycast image similar to the raycast image of FIG. 4 and a mark superimposed on the raycast image. Schematic diagram showing a display example of a mark in another embodiment

Hereinafter, embodiments of the present disclosure will be described with reference to the drawings.

(Background to obtain one form of this disclosure)
Hemostasis is an urgent task in emergency lifesaving in an accident. The doctor may confirm the CT (Computed Tomography) image to diagnose the internal bleeding, and then the doctor may stop the bleeding while checking the angio image to stop the internal bleeding. Angio images are images captured by angiography. In this process, the doctor inserts a catheter through the aorta, advances the catheter into the artery to the internal bleeding organ, and embolizes it in the artery to stop bleeding.

However, in the angio image, it may be blurred or small arteries may not be displayed, and it is difficult to visually recognize the entrance of the artery branched from the aorta. Therefore, it may be troublesome to insert the catheter into the appropriate branch.

Therefore, the doctor supplements the lacking information in the angio image by referring to the CT image. In the conventional medical image processing device, when the blood vessel running (path) is obtained by image processing the volume data acquired from the CT device, when the blood vessel is branched, the intersection of the blood vessel running of the main branch and the branch (Fig. (See point P1 of point 3) can be displayed. However, this intersection does not indicate the entrance of the branch blood vessel, that is, it is different from the clinically required position of the branch mouth. Therefore, when a catheter is inserted into a living body, it is difficult to visually recognize the entrance of a tubular tissue such as an artery.

Further, in the image display device of Patent Document 1, when a branch of a blood vessel is detected, a branch point, that is, a point on the contour of the branch opening (see point P2 in FIG. 3) is visualized. However, this one point is different from the clinically required branch opening position. Therefore, when a catheter is inserted into a living body, it is difficult to visually recognize the branch opening, which is the entrance of the artery, from the bifurcation point.

Hereinafter, a medical image processing device, a medical image imaging device, a medical image processing method, a medical image imaging method, and a medical image processing program capable of visualizing the properties of the branch mouth of a tubular tissue required clinically will be described.

(First Embodiment)
FIG. 1 is a block diagram showing a configuration example of the medical image processing apparatus 100 according to the embodiment. The medical image processing device 100 includes a port 110, a user interface (UI: User Interface) 120, a display 130, a processor 140, and a memory 150. A CT device 200 is connected to the medical image processing device 100. The medical image processing device 100 acquires volume data from the CT device 200 and processes the acquired volume data. The medical image processing device 100 may be composed of a PC (Personal Computer) and software installed in the PC.

The CT apparatus 200 irradiates a living body with X-rays and generates a slice image by utilizing the difference in X-ray absorption by tissues in the body. Examples of the living body include the human body. The CT apparatus 200 generates volume data including information on an arbitrary location in three dimensions inside the living body by stacking slice images. Any part of the living body may include blood vessels and the heart, which are tubular tissues. The CT device 200 transmits volume data as a CT image to the medical image processing device 100 via a wired line or a wireless line.

The CT device 200 includes a gantry (not shown) and a console (not shown). The gantry includes an X-ray generator and an X-ray detector, and detects X-rays transmitted through the human body by taking an image at a predetermined timing instructed by a console to obtain X-ray detection data. The console is connected to the medical image processing device 100. The console acquires a plurality of X-ray detection data from the gantry and generates volume data based on the X-ray detection data. The console transmits the generated volume data to the medical image processing apparatus 100. Further, the medical image processing device 100 may be included in the CT device 200.

Further, the CT apparatus 200 can acquire a plurality of three-dimensional volume data by continuously capturing images and generate a moving image. The display of moving images by a plurality of three-dimensional images is also referred to as 4D (4D) display (4D imaging).

The port 110 in the medical image processing device 100 includes a communication port and an external device connection port, and acquires volume data as a CT image. The acquired volume data may be immediately sent to the processor 140 for various processing, or may be stored in the memory 150 and then sent to the processor 140 for various processing when necessary.

The UI 120 may include a touch panel, a pointing device, a keyboard, or a microphone. The UI 120 accepts an arbitrary input operation from the user of the medical image processing device 100. The user may include a doctor, a radiologist, or other Paramedic Staff. The UI 120 accepts operations such as designation of a region of interest (ROI: Region of Interest) in volume data and setting of luminance conditions. Areas of interest may include areas of lesions or tissues (eg, blood vessels, organs). In this embodiment, blood vessels, which are tubular tissues, may be included in the region of interest.

The display 130 may include an LCD (Liquid Crystal Display) and displays various information. Various information includes a three-dimensional image obtained from the volume data. The three-dimensional image may include a volume rendering image, a surface rendering image, and an MPR (Muti Planar Reconnection) image.

The memory 150 includes various ROMs (Read Only Memory) and RAMs (Random Access Memory) primary storage devices. The memory 150 may include a secondary storage device such as an HDD (Hard Disk Drive) or an SSD (Solid State Drive). The memory 150 stores various information and programs. The various information may include volume data acquired by the port 110, an image generated by the processor 140, and setting information set by the processor 140.

The processor 140 may include a CPU (Central Processing Unit), a DSP (Digital Signal Processor), or a GPU (Graphics Processing Unit). The processor 140 performs various processes and controls by executing a medical image processing program stored in the memory 150. In addition, the processor 140 controls each part of the medical image processing device 100.

The processor 140 may perform a segmentation process on the volume data. In this case, the UI 120 receives the instruction from the user, and the instruction information is sent to the processor 140. Based on the information of the instruction, the processor 140 may perform a segmentation process from the volume data by a known method to extract a region of interest (segmentation). Further, the region of interest may be set manually according to a detailed instruction from the user. Further, when the observation target is predetermined, the processor 140 may perform a segmentation process from the volume data without a user instruction to extract an area of interest including the observation target.

The processor 140 generates a three-dimensional image based on the volume data acquired by the port 110. The processor 140 may generate a three-dimensional image from the volume data acquired by the port 110 based on the designated area. When the three-dimensional image is a volume-rendered image, the three-dimensional image may include a RaySum image, a MIP (Maximum Industry Projection) image, or a Raycast image.

In the blood vessel, when the branch blood vessel branches from the main blood vessel, the processor 140 draws the branch opening of the branch blood vessel with a mark mb (see FIG. 3) as a circle in a three-dimensional space. Here, the normal of the circle expresses the direction of the branch mouth.

[Operation, etc.]
Next, the operation of the medical image processing device 100 will be described.

FIG. 2 is a flowchart showing an operation example of the medical image processing device 100. In advance, the port 110 acquires volume data from the CT device 200 and stores it in the memory 150. Further, before the start of the process of FIG. 2, the processor 140 may generate a three-dimensional image based on the volume data and display it on the display.

The processor 140 receives an instruction from the user by the UI 120 in the volume data stored in the memory 150, and extracts the region A of the blood vessel (target blood vessel) having the main blood vessel and the branch blood vessel by a known method (S1).

The processor 140 acquires a path including a branch from the region A of the blood vessel and creates a tree T expressing the blood vessel running (S2). The processor 140 may derive the tree T by thinning the area A. The tree T is composed of a main blood vessel path Tmt and a branch blood vessel path Tbt.

The processor 140 acquires the region B of this blood vessel by the Morphology Opening process for the region A (S3). In the Morphology Opening process, small parts are removed from the area, so that this blood vessel is acquired.

The processor 140 subtracts the area B from the area A to obtain the area C (S4). Region C is a region representing a branch blood vessel.

The processor 140 acquires the coordinate data of the surface S in which the area C is in contact with the area B (S5). The surface S is the end surface of the branch blood vessel and represents the branch opening from the main blood vessel.

The processor 140 determines the position, size, and direction (orientation) of the branch opening based on the coordinate data of the surface S (S6). Here, the processor 140 uses the intersection of the surface S and the path Tbt of the branch blood vessel as the center point P of the branch opening sp. The processor 140 obtains, for example, the square root of the value obtained by dividing the area of the surface S by the pi, and obtains the diameter R when the branch port sp is assumed to be a circle. The processor 140 sets the direction of the branch blood vessel path Tbt at the center point P as the direction V of the branch opening sp. The direction of the branch mouth sp is the normal direction of the branch mouth sp. The processor 140 may obtain the direction V by obtaining the normal direction of the surface S. The processor 140 can estimate the normal direction of the surface S by performing principal component analysis on the point group on the surface S.

The processor 140 visualizes the tree T running through the blood vessels, generates a mark mb representing the branch mouth sp, and superimposes and displays the tree T and the mark mb on the three-dimensional image (S7). Here, the mark mb representing the branch opening sp is drawn by drawing a circle in a three-dimensional space whose normal direction is the direction V of the branch opening sp. Therefore, the shape of the circle or ellipse of the mark mb displayed on the screen of the display 130 changes according to the projection direction of the three-dimensional image. That is, the mark mb is drawn as an ellipse with a small flatness (closer to a perfect circle) as the direction V of the branch opening sp is closer to the line-of-sight direction, and an ellipse with a larger flatness as it is tilted with respect to the line-of-sight direction. It is drawn in a shape (close to a line segment).

In the three-dimensional image, the direction of the mark mb representing the branch opening sp (the normal direction of the ellipse representing the mark mb) is not the direction of the path Tbt of the branch blood vessel, but the normal direction of the surface S of the branch opening sp. It may be (see FIG. 3). As a result, the medical image processing apparatus 100 can draw the mark mb so as to approximate the shape of the actual branch opening sp. Further, even if the direction of the mark mb is the normal direction of the surface S of the branch opening sp (that is, even if the mark mb is not tilted), the user can set the direction of the branch opening sp to the flatness of the mark mb. Can be recognized from the direction of the path Tbt of the branch blood vessel. Alternatively, the weighted average direction of the path Tbt of the branch blood vessel and the normal direction of the surface S of the branch opening sp may be the direction of the mark mb.

Further, the processor 140 displays the mark mb depending on whether the direction V of the branch opening sp is on the front (front) side or the back (back) side of the main blood vessel mo when viewed from the projection plane. You may change it. As a result, the user can quickly grasp whether the branch opening sp is on the front side or the back side. In this case, the processor 140 may change the color, line type, and width of the mark mb (for example, an ellipse) as the display mode of the mark mb. In addition, the processor 140 may change the fill color, pattern, and alpha value (opacity) of the elliptical surface.

After the mark mb is generated, the processor 140 may superimpose the image of the mark mb on the displayed three-dimensional image. Further, the processor 140 may generate a three-dimensional image by re-rendering based on the volume data after the mark mb is generated, and display the three-dimensional image and the mark mb on the display 130.

FIG. 3 is a schematic showing the branching of the target blood vessel LB. In FIG. 3, a blood vessel that branches from a main blood vessel mo such as an aorta to a branch blood vessel bo such as an abdominal blood vessel is abstractly shown. In addition, for the sake of simplicity, this blood vessel mo is indicated by an elongated rectangle. Similarly, the branch blood vessel bo that branches diagonally from the main blood vessel mo is indicated by an elongated rectangle. Further, the path Tmt indicating the blood vessel running of the main blood vessel mo is indicated by a dotted line indicating the center line of the main blood vessel mo. Similarly, the path Tbt representing the blood vessel running of the branch blood vessel bo is indicated by a dotted line indicating the center line of the branch blood vessel bo.

Here, the visualization of the branch mouth sp will be considered. Assuming that the intersection of the path Tmt of the main blood vessel mo and the path Tbt of the branch blood vessel bo is the point P1, the point P1 extends the path Tbt of the branch blood vessel bo toward the main blood vessel mo and intersects the path Tmt of the main blood vessel mo. It is a point obtained by. Point P1 does not represent the branch opening sp, which is the insertion destination when the catheter is inserted, and is not the clinically necessary branch opening position.

Further, when the region expansion method shown in Patent Document 1 is applied, the point P2 at the base where the branch blood vessel bo branches from the main blood vessel mo is displayed. The point P2 is only one point on the contour line of the branch opening sp, and is not a clinically necessary branch opening position.

In the present embodiment, the display 130 displays the branch mouth sp of the branch blood vessel bo branching from the main blood vessel mo with the mark mb as described above under the control of the processor 140. The mark mb is drawn in an elliptical shape or the like that schematically represents the branch opening sp. The position of the displayed mark mb represents the position of the branch opening, and the size of the mark mb (for example, the major axis) represents the size of the branch opening. Further, the flatness and inclination of the mark mb represent the direction of the path Tbt of the branch blood vessel bo, that is, the direction of the branch opening. In this way, the medical image processing apparatus 100 can visualize the position, size, and orientation of the branch opening sp by displaying the mark mb.

FIG. 4 is a schematic view showing a raycast image GZ1 showing abdominal blood vessels branching from the aorta, and a tree T and a mark mb superimposed on the raycast image GZ1. In the raycast image GZ1, the main blood vessel mo, which is the aorta, and the three branch blood vessels bo1, bo2, and bo3 branching from the main blood vessel mo are displayed. Further, in the ray cast image GZ1, a path Tmt representing the blood vessel running of the main blood vessel mo and a path Tbt1, Tbt2, Tbt3 representing the blood vessel running of the branch blood vessels bo1, bo2, bo3 are displayed.

In FIG. 4, the path Tmt of the main blood vessel mo is drawn by a cross-shaped line, and each path Tbt1, Tbt2, Tbt3 of the branch blood vessels bo1, bo2, bo3 is drawn by a line thinner than the path Tmt. In addition, each tree T is not limited to this display mode, and for example, any line may be drawn in a different color with a striking line. Further, marks mb1, mb2, mb3 schematically representing each of the branch openings sp1, sp2, sp3 branching from the main blood vessel mo to the branch blood vessels bo1, bo2, bo3 are displayed.

The marks mb1, mb2, and mb3 may be drawn with red outlines, respectively. In this case, the user may be able to recognize that all the branch blood vessels bo1, bo2, and bo3 are blood vessels that branch from the screen to the front side (or the back side). If there is a blood vessel that branches from the screen toward the back (or front), the outline color of the mark may be drawn in a color other than red (for example, yellow).

Further, in FIG. 4, as a result of projecting a circle in the three-dimensional space on the projection plane, the mark mb3 is drawn as an ellipse closest to a perfect circle, and the marks mb1 and mb2 are drawn as an ellipse having a large flatness. Further, the sizes of the marks mb1, mb2 and mb3 correspond to the sizes of the branch mouth sp. Since the major axis of the ellipse of the mark mb1 is the longest, the branch opening sp1 related to the mark mb1 is the largest. Further, since the major axis of the ellipse of the marks mb2 and mb3 has substantially the same length, the user can recognize that the branch openings sp2 and sp3 related to these marks have substantially the same size.

Thus, by at least one of the position, size, color, inclination and flatness of the mark mb that schematically represents the branch mouth sp, the user can use the branch mouth sp (position, size of the branch mouth sp). , And orientation) can be visually confirmed. Therefore, when the user inserts the catheter into the branch blood vessel, the catheter can be smoothly advanced from the main blood vessel to the branch blood vessel.

FIG. 5 is a schematic view showing a Latham image GZ2 having the same projection angle as the Raycast image GZ1 of FIG. 4 and a tree T and a mark mb superimposed on the Latham image GZ2.

In the Latham image GZ2, as in the Raycast image GZ1 of FIG. 4, the path Tmt of the main blood vessel mo, the paths Tbt1, bt2, bt3 of the branch blood vessels bo1, bo2, bo3, and the marks mb1, mb2, mb3 are drawn. .. Thereby, the user can easily visually recognize the branch opening sp of the branch blood vessels bo1, bo2, and bo3 branching from the main blood vessel mo even by using the Latham image GZ2 which is an image close to the angio image referred to during the operation. It is desirable that the user makes a preoperative plan with reference to both the raycast image GZ1 and the latham image GZ2, and operate the catheter while observing the raycast image GZ1, the latham image GZ2, and the angio image during the operation. A MIP image may be used instead of the Latham image.

FIG. 6 is a schematic view showing a raycast image GZ3 similar to the raycast image GZ1 of FIG. 4 and a mark mb superimposed and displayed on the raycast image GZ3.

In the ray cast image GZ3, the tree T representing the blood vessel running is omitted, and the marks mb1, mb2, and mb3 are superimposed and displayed. Whether or not the path Tm representing the blood vessel running of the main blood vessel mo and the paths Tbt1, bt2, bt3 representing the blood vessel running of the branch blood vessels bo1, bo2, and bo3 are drawn or not can be determined by the user operating the UI 120. May be configurable. Further, based on the operation to the UI 120, the processor 140 individually sets the presence / absence of drawing for each of the path Tm of the main blood vessel mo and the paths Tbt1, bt2, bt3 of the branch blood vessels bo1, bo2, bo3. You may.

When the tree T is facing (running) in the direction of the user's line of sight (that is, in the direction perpendicular to the screen of the display 130), the branch opening of the branch blood vessel is almost a circle, so that it is displayed on the screen. The flatness of the elliptical mark mb to be formed is close to the value 0 representing a perfect circle. Further, when the tree T is oriented in the direction perpendicular to the user's line of sight (that is, in the horizontal direction with respect to the screen of the display 130), the branch opening of the branch blood vessel is close to the line segment, so that the screen is displayed. The flatness of the displayed elliptical mark mb is close to the value 1 representing the line segment.

[Effects, etc.]
The medical image processing apparatus 100 is used in an actual medical field, for example, as follows.

In the event of an emergency such as a traffic accident, the medical image processing apparatus 100 carries out a traumatic whole body CT (Trauma Panscan) as a preoperative study (PPP: Preprocedural Planning).

In traumatic whole-body CT, a CT image is taken by the CT device 200 while injecting a contrast medium. The user confirms abdominal bleeding while viewing a three-dimensional image based on the CT image displayed on the display 130. The user then identifies the feeding vessels and plans for hemostasis. In this case, the user can easily recognize the branch opening sp where the main blood vessel and the branch blood vessel branch by the mark mb superimposed on the three-dimensional image displayed on the display 130. This facilitates insertion of the catheter into the abdominal blood vessel and allows the user to smoothly advance the catheter into the bifurcated abdominal blood vessel. In this case, even if there is a branch blood vessel branching from this blood vessel that has irregularities due to aneurysm or calcification, the user can appropriately recognize the branch mouth sp by the mark mb superimposed on the three-dimensional image. it can.

Even if the UI 120 accepts an operation (whether or not the mark is displayed) on whether or not to superimpose the mark mb that schematically represents the branch opening sp (see FIG. 3) on the three-dimensional image displayed on the display 130. Good. As a result, the user can select whether or not to display the mark mb. Further, the UI 120 may accept an operation as to whether or not to display the tree T representing the blood vessel running. Further, the UI 120 may accept an operation of whether or not to individually display the path Tmt of the main blood vessel and the path Tbt of the branch blood vessel at the portion where the main blood vessel branches to the branch blood vessel. The tree T indicates, for example, a reference line such as the center line of a blood vessel. This blood vessel is thinner than the branch blood vessel. The main blood vessel may be an aorta, and the branch blood vessel may be an artery branched from the aorta (for example, an abdominal blood vessel).

Then, the user can promptly inject a hemostatic agent from the tip of the catheter into the artery toward the internal bleeding organ to embolize the artery to stop bleeding. After that, when lifesaving is confirmed, the user repairs the bleeding site by suturing and then restores blood flow.

In the medical image processing apparatus 100, the port 110 includes a blood vessel (an example of a tubular tissue) having a main blood vessel mo (an example of a main tube) and a branch blood vessel bo (an example of a branch tube) branched from the main blood vessel mo (an example of a tubular tissue). Get the data. Based on the volume data acquired from the port 110, the processor 140 derives the position, size, and orientation of the branch opening sp at which the branch blood vessel bo branches from the main blood vessel mo. The display 130 superimposes a mark mb on the three-dimensional space indicating the position, size, and orientation of the branch opening sp on the three-dimensional image of the blood vessel based on the volume data.

As a result, the user can easily visually recognize the position, size, and orientation of the branch opening sp leading from the main blood vessel mo to the branch blood vessel bo, using the mark mb as a guide. That is, the medical image processing apparatus 100 can visualize the properties (position, size, orientation) of the clinically useful branch mouth sp in the blood vessel which is a tubular tissue. In particular, by comparing the angio image referred to intraoperatively with the Latham image, which is a representation close to the angio image, the user can achieve more accurate and quick preoperative planning and intraoperative guidance. Therefore, the user can easily insert the catheter into the branch opening sp of the branch blood vessel bo.

Further, by calculating the position, size, and orientation of the branch opening sp as described above, the accuracy of the expression of the branch opening in the three-dimensional image can be improved. In addition, the user can determine the insertion angle of the catheter into the branch blood vessel bo by confirming the orientation of the branch opening sp.

Further, since the medical image processing apparatus 100 detects the branch by a method different from the detection of the branch by the region expansion method as shown in Patent Document 1, it is possible to suppress misidentification of the unevenness of the blood vessel as the branch. Further, instead of visualizing one point on the contour of the branch opening sp, the entire branch opening sp is visualized by the mark mb. Therefore, the user can easily visually recognize the position of the branch opening sp, which is different from one point of the contour of the branch point of the blood vessel or the intersection of the center line of the main blood vessel mon and the center line of the branch blood vessel bo. Further, the user cannot specify the size and direction of the branch opening sp at one point of the contour of the branch point of the blood vessel or the intersection of the center line of the main blood vessel mon and the center line of the branch blood vessel bo, but confirms the mark mb. Therefore, the size and orientation of the branch opening sp can be recognized.

Also, in the past, using the blood vessel diameter, it was sometimes estimated that the branch opening was at a certain distance from the path Tmt of this blood vessel, but if there is a lump in the blood vessel, the center of the blood vessel Since the line often does not pass through the center of the aneurysm, the estimation accuracy of the branch port deteriorates. Therefore, the point P1 in FIG. 3 was insufficient information in order to approach the catheter by assuming the diameter of the blood vessel simply based on the running of the blood vessel. On the other hand, the medical image processing apparatus 100 visualizes the branch opening sp with high accuracy by the mark mb even when the portion having the aneurysm and the portion without the aneurysm are mixed in the blood vessel by deriving the branch opening described above. it can.

Further, the mark mb may indicate the shape of the branch opening sp (the surface S or the contour of the surface S). As a result, the user can easily visually recognize the mode of the branch mouth sp leading from the main blood vessel mo to the branch blood vessel bo.

Further, the mark mb may be indicated by a polygonal shape or a circular shape. This makes it possible to simplify the mark mb. As a result, the user can concentrate on grasping the position, size, and orientation of the branch opening sp, which is necessary for inserting the catheter into the branch opening sp.

Further, the processor 140 may derive a tree T showing blood vessel running from a three-dimensional image of blood vessels. The tree T may be a reference line (eg, a center line) of the tubular tissue. The display 130 may superimpose the mark mb on the tree T. As a result, the user can easily see the blood vessel leading from the main blood vessel mo to the branch blood vessel bo and the branch opening sp thereof, and the catheter can be inserted more smoothly into the branch blood vessel bo.

(Other embodiments)
The present disclosure is not limited to the configuration of the above embodiment, and any configuration can achieve the functions shown in the claims or the functions of the configuration of the present embodiment. Is also applicable.

In the first embodiment, the processor 140 illustrates that the mark mb representing the shape of the branch opening sp is drawn by a circle in a three-dimensional space which is a simple figure, but the mark mb is divided into other shapes. The shape of the branch mouth may be represented. The processor 140 may draw the mark mb with a polygon such as a quadrangle or a pentagon. Further, instead of drawing the mark mb as a simple figure, the processor 140 acquires the coordinate data of the contour line of the end face where the branch blood vessel contacts the main blood vessel based on the volume data, and obtains a more accurate branch mouth shape. It may be drawn as a mark mb. In this case, the shape of the mark mb may be the shape of the contour of the branch opening. A shape that allows the mode of the branch port to be grasped at a glance is desirable.

The processor 140 may superimpose the enlarged mark mb in order to make the difference in the size of the branch port intuitive. Further, the processor 140 may distinguish branch openings smaller than a predetermined size and mark them with arrows indicating the branching direction. In this case, regarding the position and size of the branch opening sp, it can be expressed that the branch opening sp is smaller than a predetermined size and the direction. Regardless of the form, the mark mb may have a shape that allows the position, size, and orientation of the branch opening sp to be intuitively superimposed on the three-dimensional image. As a result, the user can easily grasp the change in the small branch opening where the insertion of the catheter changes, and also the direction of the branch opening which is difficult to understand in a circle on a small three-dimensional space. Become.

Further, the processor 140 may draw the mark mb by the arrow. FIG. 7 is a schematic view showing a display example of the mark mbk in another embodiment. The mark mbk has a shape in which a conical front mbk1 and a columnar rear mbk2 are combined. That is, the mark bmk may be drawn by a three-dimensional arrow. The thickness of the three-dimensional arrow, that is, the size of the ellipse corresponding to the back surface of the front portion mbk1, may represent the size of the branch opening sp. Further, the orientation of the branch opening sp may be represented by at least one of the flatness of the ellipse and the orientation of the tip of the front mbk1. As described above, the medical image processing apparatus 100 can also facilitate the user's visibility of the branch opening sp by drawing the mark mbk with an arrow.

In the first embodiment, the processor 140 acquires the branch mouth sp for the region A by the Morphology Opening process, but analyzes the short-axis images of the tree T and the path on the tree T. You may obtain the branch mouth sp. In this case, the processor 140 sequentially generates short-axis images on the path bt of the branch blood vessel from the root side. The position where the area of the blood vessel region A included in the short-axis image suddenly drops is the branch mouth sp.

In the first embodiment, it is exemplified that the volume data as the captured CT image is transmitted from the CT apparatus 200 to the medical image processing apparatus 100. Instead, the volume data may be transmitted to a server or the like on the network and stored in the server or the like so that the volume data is temporarily accumulated. In this case, the port 110 of the medical image processing device 100 may acquire the volume data from the server or the like via a wired line or a wireless line when necessary, or acquire the volume data via an arbitrary storage medium (not shown). You may.

In the first embodiment, it is exemplified that the volume data as the captured CT image is transmitted from the CT device 200 to the medical image processing device 100 via the port 110. This includes the case where the CT apparatus 200 and the medical image processing apparatus 100 are substantially combined into one product. It also includes the case where the medical image processing device 100 is treated as the console of the CT device 200.

In the first embodiment, it is illustrated that the CT device 200 captures an image and generates volume data including information inside the living body, but another device may capture an image and generate volume data. .. Other devices include MRI (Magnetic Resonance Imaging) devices, PET (Positron Emission Tomography) devices, angiography devices (Angiography devices), or other modality devices. Moreover, the PET apparatus may be used in combination with other modality apparatus.

In the first embodiment, the human body is exemplified as the subject, but it may be an animal body.

In the first embodiment, it is illustrated that a branch blood vessel bo toward each organ branches from a thick main blood vessel mo such as an aorta. Instead, among the blood vessels going to each organ, a relatively thick blood vessel may be a main blood vessel (main branch), and a relatively thin blood vessel branched from this main blood vessel may be a branch blood vessel (branch). Even in this case, the user can easily grasp the direction of travel of the catheter from the branched aortic artery to the further branched small artery. Further, in a cerebral aneurysm, when the aneurysm is generated from a blood vessel, the blood vessel may be regarded as a main tube and the aneurysm may be regarded as a branch tube. In the vicinity of the atrial appendage, the aorta may be regarded as the main canal and the atrial appendage may be regarded as the branch canal. In the arteries and false lumens in dissection, the arteries may be considered as mains and the false lumens as branch ducts. This is because the tubular tissue has a structure in which the main pipe and the branch pipe are branched.

Further, among the blood vessels, a blood vessel having a thickness equal to or more than a predetermined threshold value may be used as a main blood vessel, and a blood vessel having a thickness less than a predetermined threshold value may be used as a branch blood vessel. Further, among the blood vessels, a blood vessel having a predetermined threshold value of change in the traveling direction of the blood vessel (that is, a blood vessel that is almost not bent) is used as the main blood vessel, and a blood vessel having a traveling direction change rate of the blood vessel equal to or higher than the predetermined threshold value (that is, greatly bent) The blood vessel) may be a branch blood vessel. The predetermined threshold may be input via the UI 120 and set by the processor 140. The predetermined threshold may be variable. By making the predetermined threshold variable, the thickness of the target blood vessel and the degree of flexion can be changed.

In the first embodiment, blood vessels are exemplified as tubular tissue, but blood vessels other than blood vessels (for example, lymph vessels) may be used.

In the present disclosure, a program that realizes the function of the medical image processing device of the first embodiment is supplied to the medical image processing device via a network or various storage media, and is read and executed by a computer in the medical image processing device. The program is also applicable.

The present disclosure is useful for medical image processing devices, medical image processing methods, medical image processing programs, and the like that can visualize the properties of branch mouths of tubular tissues that are clinically necessary.

100 Medical image processor 110 Port 120 User interface (UI)
130 Display 140 Processor 150 Memory 200 CT device A, B, C area bo, bo1, bo2, bo3 Branch blood vessel Tbt, Tbt1, Tbt2, Tbt3, Tmt Path GZ1, GZ3 Raycast image GZ2 Latham image LB Target blood vessel mb, mb1, mb2, mb3, mbk mark mbk1 Front mbk2 Rear mo Main blood vessels P1, P2 Point S surface sp, sp1, sp2, sp3 Branch mouth T tree

Claims (6)

A port for acquiring volume data of a subject including a tubular tissue having a main tube and a branch tube branched from the main tube, and a port for acquiring volume data.
A processor that derives the position of the branch opening from which the branch pipe branches, the size of the branch opening, and the direction of the normal of the surface of the branch opening.
A three-dimensional image of the tubular tissue based on the volume data shows the position of the branch opening, the size of the branch opening, and the direction of the normal of the surface of the branch opening in the three-dimensional image. A display that superimposes marks in space and
A medical image processing device comprising. The medical image processing apparatus according to claim 1.
The mark is a medical image processing device indicating the shape of the branch opening. The medical image processing apparatus according to claim 2.
The mark is a medical image processing apparatus represented by a polygonal shape or a circular shape. The medical image processing apparatus according to any one of claims 1 to 3.
The processor derives a reference line of the tubular tissue from a three-dimensional image of the tubular tissue.
The display is a medical image processing device that superimposes a reference line and the mark of the tubular tissue on a three-dimensional image of the tubular tissue. A medical image processing method in a medical image processing device.
Obtain volume data including a tubular tissue having a main and a branch tube branched from the main.
From the main pipe, the position of the branch opening at which the branch pipe branches, the size of the branch opening, and the direction of the normal of the surface of the branch opening are derived.
A three-dimensional image of the tubular tissue based on the volume data shows the position of the branch opening, the size of the branch opening, and the direction of the normal of the surface of the branch opening in the three-dimensional image. Overlaying marks in space,
Medical image processing method. A medical image processing program for causing a computer to execute the medical image processing method according to claim 5.