JP6979906B2 - Image processing equipment, image processing methods and programs - Google Patents

Description

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

In the treatment of heart failure, etc., a tissue around the atrioventricle (eg, for example, using an instrument such as a catheter in which an injection material such as a biological substance such as a cell or an injection material such as a biomaterial is inserted into the atrioventricular chamber of the heart via the femoral artery or the like is used. Treatment that is expected to have therapeutic effects such as angiogenesis and cell differentiation by injecting into the myocardium around the left ventricle is being investigated.

In the treatment of injecting the injection material using the catheter as described above, in order to confirm the injection site and the postoperative therapeutic effect, the infarct site, the injection site where the injection material is injected, and other sites of interest are selected. It is desirable to express and record in three dimensions.

During the procedure for injecting an injection material using a catheter as described above, the operator generally performs the procedure while viewing an X-ray fluoroscopic image in which the heart is fluoroscopically viewed from a predetermined direction. However, it is difficult to express and record the atrioventricular chamber of the heart, which is a three-dimensional structure, in fluoroscopic images. Further, as a method of expressing / recording the region of interest, there is a method of superimposing an OHP (Overhead Projector) sheet on the fluoroscopic image and expressing / recording the region of interest on the OHP sheet. However, with this method, the position of the portion of interest can be expressed and recorded only two-dimensionally, and the information in the depth direction cannot be expressed and recorded.

Further, in Patent Document 1, the position of the site of interest is recorded on each of the two X-ray fluoroscopic images obtained by imaging the heart from two directions, and the two X-ray fluoroscopic images recording the position of the site of interest are used. A method of reconstructing a three-dimensional image that represents the heart in three dimensions is disclosed.

Japanese Unexamined Patent Publication No. 2002-153443

In the method disclosed in Patent Document 1, the region of interest is recorded in each of the two X-ray fluoroscopic images obtained by imaging the heart from two directions and the imaging from two directions, and the two Xs recording the regions of interest. Processing such as reconstruction of a three-dimensional image using a fluoroscopic image is required, which causes an increase in processing load. Therefore, there is a demand for a method for more easily expressing and recording a site of interest on a two-dimensional image in three dimensions.

An object of the present invention made in view of the above problems is an image processing capable of three-dimensionally expressing and recording a region of interest on the heart wall of the atrioventricular chamber of the heart on a two-dimensional image. To provide equipment, image processing methods and programs.

The image processing apparatus as the first aspect of the present invention is a predetermined two-dimensional image based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart taken from a predetermined direction, and a predetermined region of interest on the heart wall of the atrioventricular chamber. The image processing unit includes an image processing unit that generates a second two-dimensional image on which a marker indicating the above is superimposed, and an acquisition unit that acquires position information of the portion of interest including the depth direction seen from the predetermined direction. The unit changes the mode of the marker indicating the site of interest based on the position information of the site of interest.

As one embodiment of the present invention, in the position information, the site of interest is located on the heart wall on the front side of the atrioventricular when viewed from the predetermined direction, or the heart on the back side of the atrioventricular. The image processing unit includes information indicating whether or not the site of interest is present on the wall, and the image processing unit determines whether or not the site of interest is present on the heart wall on the front side of the atrioventricular chamber based on the position information of the site of interest. Depending on whether it is present on the heart wall at the back of the chamber, the aspect of the marker indicating the site of interest is changed.

In one embodiment of the invention, the site of interest is an injection site into which the injectable material has been injected via a catheter inserted into the atrioventricular chamber of the heart.

In one embodiment of the present invention, the site of interest is an infarcted site of the myocardium or a thin wall site in which the heart wall is thinned.

As one embodiment of the present invention, the image processing unit acquires an X-ray fluoroscopic image of at least one of the diastole and systole of the heart, and based on the acquired X-ray fluoroscopic image, said. Generate a first two-dimensional image.

As one embodiment of the present invention, the image processing unit acquires three-dimensional structure data showing the three-dimensional structure of the atrioventricular chamber of the heart, and is based on the acquired three-dimensional structure data and the X-ray fluoroscopic image. , The first two-dimensional image is generated.

As one embodiment of the present invention, the image processing unit acquires electrocardiographic information indicating the electrocardiographic potential of the heart wall of the atrioventricular chamber of the heart, and obtains the electrocardiographic potential indicated by the acquired electrocardiographic information. Map to 2 two-dimensional images.

As one embodiment of the present invention, the image processing unit acquires wall motion information indicating the wall motion of the heart wall of the atrioventricular chamber of the heart, and the wall motion indicated by the acquired wall motion information is the first. Map to the 2D image of 2.

As one embodiment of the present invention, the image processing unit is characterized in that the generated second two-dimensional image is displayed on a display device.

As one embodiment of the present invention, the image processing unit superimposes and displays the generated second two-dimensional image on the X-ray fluoroscopic image.

As one embodiment of the present invention, the image processing unit uses the generated second two-dimensional image to generate at least one of a three-dimensional image and a bullseye image in which the atrioventricular chamber of the heart is three-dimensionally displayed. do.

As one embodiment of the present invention, the image processing unit stores the generated second two-dimensional image in a storage means.

The image processing method as the second aspect of the present invention is an image processing method executed by an image processing apparatus, which includes the depth direction of the atrioventricular chamber of the heart as viewed from a predetermined direction. A marker indicating the site of interest is added to a step of acquiring position information of a predetermined site of interest on the wall and a first two-dimensional image based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart from the predetermined direction. A step of generating a second two-dimensional image superimposed is included, and the aspect of the marker indicating the portion of interest is different based on the position information of the portion of interest.

The program as the third aspect of the present invention causes the computer to function as the above-mentioned image processing device.

According to the image processing apparatus, image processing method and program according to the present invention, it is possible to more easily express and record a site of interest on the heart wall of the atrioventricular chamber of the heart in three dimensions on a two-dimensional image.

It is a figure which shows the structural example of the image processing apparatus which concerns on one Embodiment of this invention. It is a figure which shows an example of the X-ray fluoroscopy image of the heart into which a catheter was inserted. It is a figure which shows an example of the recorded image generated by the image processing unit shown in FIG. 1. It is a figure which shows another example of the recorded image generated by the image processing unit shown in FIG. 1. It is a figure which shows still another example of the recorded image generated by the image processing unit shown in FIG. 1. It is a flowchart which shows an example of the operation of the image processing apparatus shown in FIG. It is a figure which shows the vicinity of the tip of a catheter. It is a figure which shows the appearance of the contrast marker in the case of looking at the tip of the catheter toward the direction of the white arrow P1 shown in FIG. 7.

Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. In each figure, the same reference numerals indicate the same or equivalent components.

FIG. 1 is a diagram showing a configuration example of an image processing device 10 according to an embodiment of the present invention. In the image processing apparatus 10 according to the present embodiment, in a procedure of inserting a catheter into the atrioventricular chamber of the heart and injecting an injection material into the myocardium in the atrioventricular chamber, an injection site in which the injection material is injected via the catheter, an infarction, etc. It generates a two-dimensional image that expresses and records a site of interest, such as a site or a thin-walled site where the heart wall has become thin. The present invention is not limited to the above-mentioned procedure, but is an expression of a site of interest in an ablation technique for cauterizing the myocardium in the atrioventricular chamber, a myocardial biopsy technique for collecting and inspecting a part of the myocardium in the atrioventricular chamber, and the like. It can also be applied to records. In the following, a case of applying an injection material to the myocardium in the atrioventricular chamber using a catheter will be described as an example.

The image processing device 10 shown in FIG. 1 includes an acquisition unit 11, an image processing unit 12, and a storage unit 13.

As described above, during the procedure of inserting a catheter into the atrioventricular chamber of the heart and injecting an injection material into the myocardium of the atrioventricular chamber, the atrioventricular chamber of the heart is imaged from a predetermined direction by an X-ray fluoroscope. Then, the X-ray fluoroscopic image obtained by the imaging is displayed on the display device 20 so as to be visible to the operator or the like. The acquisition unit 11 acquires the position information of the region of interest including the depth direction when the atrioventricular chamber of the heart is imaged by the X-ray fluoroscope. Here, the position information includes information indicating whether the site of interest is present on the heart wall on the front side of the atrioventricular side or on the heart wall on the back side of the atrioventricular when viewed from a predetermined direction. Is done.

The acquisition unit 11 acquires, for example, an input regarding the position of the injection site determined by the operator who inserts the catheter into the heart as position information. Further, the acquisition unit 11 acquires an X-ray fluoroscopic image during the procedure of injecting an injection material into the myocardium in the atrioventricular chamber of the heart using a catheter, and the position of the tip of the catheter is obtained by image analysis of the acquired X-ray fluoroscopic image. The position information of the injection site may be acquired by specifying.

FIG. 2 is an example of a fluoroscopic image of the heart (left ventricle) into which a catheter is inserted.

As shown in FIG. 2, by providing a contrast marker at the tip of the catheter, the position of the tip of the catheter can be specified in the fluoroscopic image. Therefore, the acquisition unit 11 can specify the position of the tip of the catheter based on the position of the contrast marker at the tip of the catheter in the fluoroscopic image. The acquisition unit 11 can acquire the position information of the injection site based on the position of the tip of the catheter at the timing when the injection material is injected. The timing at which the injection material is injected is determined, for example, by the operator and is input to the image processing device 10.

In the present embodiment, the contrast marker is provided at a position including the tip of the tip of the catheter. To identify the tip of the catheter, for example, the tip of the catheter is contrasted more intensely in a contrast marker larger than the rest of the catheter and in a fluoroscopic image than the rest of the catheter. It is conceivable to provide a contrast marker, a contrast marker having a special shape, and the like. From the fluoroscopy image, it can be seen whether the tip of the catheter is in contact with the heart wall on the front side or the heart wall on the back side when viewed from the imaging direction of the fluoroscopy image. It may not be possible to determine. However, by providing a contrast marker with a specific shape on the catheter, whether the tip of the catheter is in contact with the anterior heart wall or the posterior heart wall from the fluoroscopic image. Can be determined. The details of the shape of such a contrast marker will be described later.

Further, the acquisition unit 11 captures images of an ultrasonic diagnostic apparatus, an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, a SPECT (Single Photon Emission Computed Tomography) apparatus, a PET (Positron Emission computed Tomography) apparatus, and the like. Position information such as an infarct site and a thin wall site specified in advance may be acquired based on three-dimensional structure data showing the three-dimensional structure of the heart obtained by imaging the heart with an apparatus. The acquisition unit 11 acquires, for example, input of positions such as an infarct site and a thin wall site previously specified by an operator or the like based on three-dimensional structural data as position information.

Referring to FIG. 1 again, the acquisition unit 11 outputs the acquired position information of the interest portion to the image processing unit 12.

The image processing unit 12 is a recording which is a two-dimensional image in which a marker indicating a predetermined region of interest on the heart wall of the atriosphere is superimposed on a two-dimensional image based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart from a predetermined direction. Generate an image.

Specifically, the image processing unit 12 is a RAO (Right Anterior Oblique) image which is an X-ray fluoroscopic image of, for example, an atrioventricular chamber of the heart taken from a direction inclined to the right with respect to the body axis of the subject. Generate a format diagram based on. The image processing unit 12 generates, for example, a two-dimensional image obtained by extracting the outline of the atrioventricular chamber of the heart from the RAO image as a format diagram (first two-dimensional image). Then, the image processing unit 12 generates a recorded image (second two-dimensional image) which is a two-dimensional image in which a marker indicating a predetermined region of interest on the heart wall of the atrioventricular chamber is superimposed on the format diagram.

Here, the image processing unit 12 changes the mode of the marker indicating the portion of interest based on the position information of the portion of interest acquired by the acquisition unit 11. Specifically, as described above, in the position information, the site of interest is present on the heart wall on the front side of the atrioventricular side or on the heart wall on the back side of the atrioventricular when viewed from a predetermined direction. Contains information indicating whether to do so. Based on the position information of the site of interest, the image processing unit 12 determines whether the site of interest is on the heart wall on the front side or the heart wall on the back side of the atrioventricular when viewed from a predetermined direction. Correspondingly, the aspect of the marker indicating the site of interest is changed.

FIG. 3 is a diagram showing an example of a recorded image generated by the image processing unit 12. FIG. 3 shows an example in which the site of interest is the injection site in the myocardium where the injection material is injected via the catheter.

As shown in FIG. 3, in the image processing unit 12, for example, when the injection site is present on the heart wall on the front side when viewed from a predetermined direction, the image processing unit 12 is marked with a circle as a marker indicating the injection site. 12a is used. Further, for example, when the injection site is present on the inner wall of the heart when viewed from a predetermined direction, the image processing unit 12 uses a square marker 12b as a marker indicating the injection site. By doing so, the information in the depth direction of the injection site can also be expressed and recorded on the recorded image.

Further, the image processing unit 12 may add the order in which the injections are performed to the markers indicating each injection site. In the example of FIG. 3, injection is performed at 6 points, and the 1st, 3rd, and 5th injection sites are located on the inner wall of the heart when viewed from a predetermined direction, and the 2nd, 4th, and 6th injection sites are present. The second injection site is located on the anterior heart wall when viewed from a predetermined direction. The mode of the marker according to the position in the depth direction is not limited to the example shown in FIG. 3, and various modes can be used as long as the marker can be identified between the front side and the back side. Further, for example, as the position information of the site of interest, the position information of the candidate site, which is the candidate site for injecting the injection material, is acquired, and the marker indicating the candidate site indicates whether or not the injection material is actually injected. (For example, "OK", "NG") may be added. The position information of the candidate site can be obtained as three-dimensional structural data obtained by imaging the heart with an imaging device such as an ultrasonic diagnostic device, an X-ray CT device, an MRI device, a SPECT device, or a PET device before surgery. Can be obtained based on.

FIG. 4 is a diagram showing another example of the recorded image generated by the image processing unit 12. FIG. 4 shows an example in which the site of interest is an infarct site or a thin wall site.

As shown in FIG. 4, for example, when the infarcted part or the thin wall part is present on the heart wall on the front side when viewed from a predetermined direction, the image processing unit 12 determines the infarcted part or the thin wall part. As the marker to be shown, a marker 12c with an upward-sloping hatch is used. Further, the image processing unit 12 is, for example, right as a marker indicating the infarcted portion or the thin wall portion when the infarcted portion or the thin wall portion is present on the inner wall of the heart when viewed from a predetermined direction. A marker 12d with a downward hatch is used. By doing so, information in the depth direction of the infarcted portion and the thin wall portion can also be expressed and recorded on the recorded image.

The mode of the marker according to the position in the depth direction is not limited to the example shown in FIG. 4, and various modes can be used as long as the marker can be identified between the front side and the back side. For example, a marker indicating an infarcted site or a thin wall site on the anterior side of the heart wall is hatched vertically, and a marker indicating an infarcted site or a thin wall site on the back side of the heart wall is horizontally oriented. Hatching may be added. Further, for example, the color may be different between the marker indicating the infarcted part or the thin wall part on the front side of the heart wall and the marker showing the infarcted part or the thin wall part on the back side of the heart wall. Further, for example, different symbols may be used between the marker indicating the infarcted site or the thin wall site on the anterior side of the heart wall and the marker indicating the infarcted site or the thin wall site on the posterior side of the heart wall.

Referring to FIG. 1 again, the image processing unit 12 may display the generated recorded image on the display device 20. Further, the image processing unit 12 may superimpose the generated recorded image on the X-ray fluoroscopic image and display it on the display device 20. The display device 20 is, for example, a display device provided so that the operator can see it, or a head-mounted display worn by the operator. When the display device 20 is a stationary display device, a recorded image is projected onto the X-ray fluoroscopic image displayed on the display device 20 by using a projector or the like, and the recorded image is superimposed and displayed on the X-ray fluoroscopic image. You may.

Further, the image processing unit 12 may store the generated recorded image in the storage unit 13 as a storage means. The image processing device 10 does not necessarily have to include the storage unit 13. The image processing unit 12 may transfer the recorded image to an external storage means and store it.

As described above, the image processing unit 12 generates a format diagram based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart taken from a predetermined direction. Here, the image processing unit 12 acquires at least one X-ray fluoroscopic image of diastole and systole from the electrocardiogram waveform of the heart when the atrioventricular chamber is imaged with an X-ray contrast medium, and the acquired X-ray fluoroscopic image. Create a format diagram based on the contour of the atrioventricular chamber in. Further, the image processing unit 12 acquires X-ray fluoroscopic images of diastole and systole, respectively, and based on the contour of the atrioventricular chamber in the acquired X-ray fluoroscopic images of diastole and systole, each of diastole and systole. A format diagram may be generated. By doing so, it is possible to generate a format diagram having a more accurate shape. Further, the image processing unit 12 is based on an X-ray fluoroscopic image obtained from a predetermined direction of the atrioventricular chamber of the heart, which is typical as a disease to be treated, such as ischemic cardiomyopathy, dilated cardiomyopathy, and contractile cardiomyopathy. The format diagram generated in the above may be used as a representative model. In addition, the image processing unit 12 may create a format diagram from a normal heart without a disease to be treated as a standard model.

Further, the image processing unit 12 may acquire three-dimensional structure data showing the three-dimensional structure of the atrioventricular chamber of the heart, and may generate a format diagram based on the acquired three-dimensional structure data and the X-ray fluoroscopic image. By doing this, a more accurate format diagram can be generated. The three-dimensional structural information can be acquired in advance by using an imaging device such as an ultrasonic diagnostic device, an X-ray CT device, an MRI device, a SPECT device, and a PET device.

Further, the image processing unit 12 acquires the electrocardiographic potential indicating the electrocardiographic potential of the atrioventricular wall, and as shown in FIG. 5, even if the electrocardiographic potential indicated by the acquired electrocardiographic information is mapped to the recorded image. good. Further, the image processing unit 12 changes the mode of showing the electrocardiographic potential depending on whether the cardiac wall indicating the electrocardiographic potential is the ventricular wall on the front side or the cardiac wall on the back side when viewed from a predetermined direction. You may. For example, the image processing unit 12 displays the heart potential in different colors depending on whether the heart wall showing the heart potential is the heart wall on the front side or the heart wall on the back side when viewed from a predetermined direction. You may. As a method of acquiring electrocardiographic information, for example, there is a method of acquiring electrocardiographic information by providing an electrode at the tip of the catheter and bringing the electrode at the tip of the catheter into contact with the heart wall.

Further, the image processing unit 12 acquires wall motion information indicating the wall motion of the heart wall of the atrioventricular chamber, and as shown in FIG. 5, even if the wall motion shown in the acquired wall motion information is mapped to the recorded image. good. Further, the image processing unit 12 changes the mode of showing the wall movement depending on whether the heart wall showing the wall movement is the heart wall on the front side or the heart wall on the back side when viewed from a predetermined direction. You may. For example, the image processing unit 12 displays the wall movement in different colors depending on whether the heart wall indicating the wall movement is the heart wall on the front side or the heart wall on the back side when viewed from a predetermined direction. You may. As a method of acquiring wall motion information, for example, a contrast marker is provided at the tip of the catheter, and the heart is imaged by an X-ray fluoroscope with the tip of the catheter in contact with the heart wall of the heart. There is a method of acquiring wall motion information of the heart wall to which the tip of the catheter contacts based on the displacement of the contrast marker in the X-ray fluoroscopic image.

Further, the image processing unit 12 generates a three-dimensional image, a bull's eye image, or the like that three-dimensionally displays the atrioventricular chamber of the heart by using a recorded image including information on the depth direction of the portion of interest, and displays the image on the display device 20. You may. The recorded image contains information about the position in the depth direction as seen from a predetermined direction. That is, in the recorded image, the position of the site of interest in the chamber is shown three-dimensionally. Therefore, the image processing unit 12 can generate a three-dimensional image, a bullseye image, or the like from one recorded image.

Next, the image processing method executed by the image processing apparatus 10 according to the present embodiment will be described with reference to FIG. FIG. 6 is a flowchart showing an example of the operation of the image processing device 10.

First, the acquisition unit 11 acquires the position information of a predetermined region of interest on the heart wall of the atrioventricular chamber of the heart, including the depth direction when the atrioventricular chamber of the heart is viewed from a predetermined direction (step S11). As described above, the acquisition unit 11 acquires, for example, an input regarding the position of the portion of interest by an operator or the like as position information. Further, the acquisition unit 11 identifies the position of the tip of the catheter by, for example, image analysis of the fluoroscopic image during the procedure of injecting the injection material into the myocardium in the chamber using the catheter, thereby locating the injection site. Get information.

Next, the image processing unit 12 displays the site of interest on a format diagram (first two-dimensional image) (see the contour line in FIG. 3 and the like) based on an X-ray fluoroscopic image obtained by imaging the atrioventricular chamber of the heart from a predetermined direction. A recorded image (second two-dimensional image) (see FIG. 3 and the like) on which the indicated markers are superimposed is generated. Here, the image processing unit 12 changes the mode of the marker indicating the interest portion based on the position information of the interest portion acquired by the acquisition unit 11. More specifically, the image processing unit 12 is based on the position information of the site of interest, and the site of interest is present on the heart wall on the front side of the atrioventricular side or on the heart wall on the back side of the atrioventricular side. The mode of the marker indicating the site of interest is different depending on whether or not the marker is used. By doing so, the site of interest on the heart wall of the atrioventricular chamber of the heart can be expressed and recorded three-dimensionally on a two-dimensional image.

Next, a contrast marker provided on the tip of the catheter is provided in order to determine from the fluoroscopic image whether the tip of the catheter is in contact with the anterior heart wall or the back heart wall. The configuration of is described.

FIG. 7 is a diagram showing the vicinity of the tip portion 2a of the catheter 2 capable of determining whether the tip portion is in contact with the heart wall on the front side or the heart wall on the back side as described above. Is. As shown in FIG. 7, the contrast marker 3 of the catheter 2 includes the central axis O of the catheter 2 and has an asymmetrical shape with respect to any virtual plane parallel to the central axis O. Specifically, FIG. 7 shows two virtual planes Y1 and Y2 as an example of a virtual plane including the central axis O of the catheter 2 and parallel to the central axis O. As shown in FIG. 7, the contrast marker 3 has an asymmetrical shape with respect to the virtual surfaces Y1 and Y2, respectively. In other words, the contrast marker 3 includes the central axis O of the catheter 2 and has a shape that is not plane symmetric with respect to all virtual planes parallel to the central axis O. Hereinafter, for convenience of explanation, any virtual surface including the central axis O of the catheter 2 and parallel to the central axis O is simply referred to as “virtual surface Y”.

By making the contrast marker 3 have such a configuration, the appearance of the contrast marker 3 in the fluoroscopic image causes the back front direction (hereinafter, simply "back front direction A") orthogonal to the projection plane in the X-ray fluoroscopic image. The movement of the catheter 2 can be identified.

As shown in FIG. 7, the contrast marker 3 of the present embodiment includes a first contrast marker unit 4 and a second contrast marker unit 5. The first contrast marker portion 4 has an asymmetrical shape with respect to the first intermediate virtual surface of the virtual surface Y that passes through the intermediate position of the second contrast marker portion 5 in the circumferential direction B. Further, the second contrast marker unit 5 has an asymmetrical shape with respect to the second intermediate virtual surface of the virtual surface Y that passes through the intermediate position of the first contrast marker unit 4 in the circumferential direction B. The "first intermediate virtual surface" in the present embodiment is the virtual surface Y1 shown in FIG. 7. Further, the "second intermediate virtual surface" in the present embodiment is the virtual surface Y2 shown in FIG. 7.

The first contrast marker portion 4 of the present embodiment is formed over at least a part of the circumferential direction B of the catheter 2. More specifically, the first contrast marker portion 4 of the present embodiment extends linearly in the circumferential direction B. Further, the first contrast marker portion 4 of the present embodiment is provided at the tip end portion 2a of the catheter 2. More specifically, the first contrast marker portion 4 of the present embodiment is linearly formed in the circumferential direction B on the distal end surface of the catheter 2.

The second contrast marker portion 5 of the present embodiment extends linearly along the central axis direction C parallel to the central axis O.

Hereinafter, an identification method for discriminating the movement of the catheter 2 in the anterior-posterior direction A by the appearance of the contrast marker 3 shown in FIG. 7 will be described. FIG. 8 is a contrast marker for a case where the tip portion 2a of the catheter 2 is viewed in the direction of the white arrow P1 shown in FIG. 7 (hereinafter, simply referred to as “when viewed from the viewpoint of the arrow P1”). It is a figure which shows the appearance of 3.

FIG. 8A shows a state in which the tip portion 2a of the catheter 2 is not deformed in the back front direction A when viewed from the viewpoint of the arrow P1, that is, the tip portion 2a of the catheter 2 is orthogonal to the direction of the arrow P1. It shows the state of extending in the direction of The tip portion 2a of the catheter 2 in the state shown in FIG. 8A looks like the state shown in FIG. 8B when viewed from the viewpoint of arrow P1. As shown in FIG. 8B, when viewed from the viewpoint of arrow P1, the first contrast marker portion 4 of the contrast marker 3 extends linearly along the radial direction D orthogonal to the central axis direction C. It looks like an existing shape. Further, as shown in FIG. 8B, when viewed from the viewpoint of the arrow P1, the second contrast marker portion 5 of the contrast marker 3 has a shape extending linearly along the central axis direction C. appear.

8 (c) shows the front direction A2 (FIG. 8 (FIG. 8)) of the back front direction A as compared with the state where the tip portion 2a of the catheter 2 is in the state shown in FIG. 8 (a) when viewed from the viewpoint of the arrow P1. In c), it is in the downward direction, and shows a state of being deformed in the direction approaching the viewpoint when viewed from the viewpoint of the arrow P1). The tip portion 2a of the catheter 2 in the state shown in FIG. 8 (c) looks like the state shown in FIG. 8 (d) when viewed from the viewpoint of the arrow P1. As shown in FIG. 8D, when viewed from the viewpoint of the arrow P1, the first contrast marker portion 4 of the contrast marker 3 looks like an arc shape that is convex toward the proximal end side in the central axis direction C. .. As shown in FIG. 8D, when viewed from the viewpoint of the arrow P1, the second contrast marker portion 5 of the contrast marker 3 appears to have a shape extending linearly along the central axis direction C. The position of the second contrast marker portion 5 in the radial direction D orthogonal to the central axis direction C in FIG. 8 (d) is the same as the position of the second contrast marker portion 5 in the radial direction D of FIG. 8 (b). As described above, the shape of the first contrast marker portion 4 in FIG. 8 (d) is different from the shape of the first contrast marker portion 4 in FIG. 8 (b). On the other hand, the position and shape of the second contrast marker portion 5 in FIG. 8 (d) looks the same as the position and shape of the second contrast marker portion 5 in FIG. 8 (b).

8 (e) shows the depth direction A1 (FIG. 8 (FIG. 8)) in which the tip end portion 2a of the catheter 2 is in the depth direction A in the back front direction A as compared with the state shown in FIG. 8 (a) when viewed from the viewpoint of the arrow P1. In e), it is in the upward direction, and shows a state of being deformed in the direction away from the viewpoint when viewed from the viewpoint of the arrow P1). The tip portion 2a of the catheter 2 in the state shown in FIG. 8 (e) looks like the state shown in FIG. 8 (f) when viewed from the viewpoint of the arrow P1. As shown in FIG. 8 (f), when viewed from the viewpoint of the arrow P1, the first contrast marker portion 4 of the contrast marker 3 looks like an arc shape that is convex toward the tip end side in the central axis direction C. As shown in FIG. 8 (f), when viewed from the viewpoint of the arrow P1, the second contrast marker portion 5 of the contrast marker 3 appears to have a shape extending linearly along the central axis direction C. The position of the second contrast marker portion 5 in the radial direction D orthogonal to the central axis direction C in FIG. 8 (f) is the position of the second contrast marker portion 5 in the radial direction D of FIGS. 8 (b) and 8 (d). Same as the position. That is, the shape of the first contrast marker portion 4 in FIG. 8 (f) is different from the shape of the first contrast marker portion 4 in FIGS. 8 (b) and 8 (d). On the other hand, the position and shape of the second contrast marker portion 5 in FIG. 8 (f) are the same as the position and shape of the second contrast marker portion 5 in FIGS. 8 (b) and 8 (d).

Therefore, in the X-ray fluoroscopic image obtained by seeing X-rays from the direction of the arrow P1 shown in FIG. 7, by observing the change in the shape of the first contrast marker portion 4, the depth of the tip portion 2a of the catheter 2 is observed. The movement in the front direction A can be identified. More specifically, in the present embodiment, when the shape of the first contrast marker portion 4 looks like an arc that is convex toward the base end side in the central axis direction C, it moves in the front direction A2 in the back front direction A. It can be identified whether it is moving or moving (see FIGS. 8 (c) and 8 (d)). Further, in the present embodiment, when the shape of the first contrast marker portion 4 looks like an arc that is convex toward the tip end side in the central axis direction C, it means that the first contrast marker portion 4 is moving in the depth direction A1 in the back front direction A. Alternatively, it can be identified that it has moved (see FIGS. 8 (e) and 8 (f)).

When the tip 2a of the catheter 2 is viewed in the direction of the white arrow P2 shown in FIG. 7, the tip 2a of the catheter 2 is viewed in the direction of the white arrow P3 shown in FIG. 7. Similarly, when the tip portion 2a of the catheter 2 is viewed in the direction of the white arrow P4 shown in FIG. 7, X obtained by seeing through X-rays from each direction (directions of arrows P2 to P4). In the line-through image, by observing the change in the shape of the first contrast marker portion 4 and the positional relationship between the first contrast marker portion 4 and the second contrast marker portion 5, the direction toward the back of the tip portion 2a of the catheter 2 is observed. The movement in A can be identified.

As described above, according to the present embodiment, the image processing apparatus 10 provides a format diagram (first two-dimensional image) (contour line in FIG. 3 and the like) based on an X-ray fluoroscopic image obtained by capturing the atrioventricular chamber of the heart from a predetermined direction. (See) and an image processing unit 12 that generates a recorded image (second two-dimensional image) (see FIG. 3 and the like) in which a marker indicating a predetermined region of interest on the heart wall of the atrioventricular chamber is superimposed, and viewed from a predetermined direction. The acquisition unit 11 for acquiring the position information of the portion of interest including the depth direction is provided. The image processing unit 12 changes the mode of the marker indicating the portion of interest based on the position information of the portion of interest.

Based on the position information of the site of interest, including the depth direction when the atrioventricular chamber of the heart is viewed from a predetermined direction, by changing the aspect of the marker of the site of interest, the site of interest on the heart wall of the atrioventricular region of the heart can be divided into two. It is possible to generate a recorded image that is expressed and recorded three-dimensionally on a three-dimensional image. Further, since processing such as reconstruction of a plurality of images is not required, the site of interest on the heart wall of the atrioventricular chamber of the heart can be more easily expressed and recorded three-dimensionally on the two-dimensional image.

Although not particularly mentioned in the embodiment, the image processing device 10 can also be realized by a computer and a program. The program may also be recorded on a computer-readable medium. It can be installed on a computer using a computer-readable medium. Here, the computer-readable medium on which the program is recorded may be a non-transient recording medium. The non-transient recording medium is not particularly limited, but may be, for example, a recording medium such as a CD-ROM and a DVD-ROM. The program can also be provided via a network.

The present invention is not limited to the configuration specified in the above-described embodiment, and various modifications can be made without departing from the gist of the invention described in the claims. For example, the functions included in each component and each step can be reconfigured so as not to be logically inconsistent, and a plurality of components or steps can be combined or divided into one. Is.

2 Catheter 2a Tip of catheter 3 Contrast marker 4 1st contrast marker 5 2nd contrast marker 10 Image processing device 11 Acquisition section 12 Image processing section 13 Storage section 12a, 12b, 12c, 12d Marker 20 Display device

Claims (14)

A second two-dimensional image is generated by superimposing a marker indicating a predetermined region of interest on the heart wall of the atrioventrium on a first two-dimensional image based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart from a predetermined direction. Image processing unit and
The acquisition unit for acquiring the position information of the portion of interest including the depth direction seen from the predetermined direction is provided.
The image processing unit is an image processing apparatus characterized in that the mode of a marker indicating the portion of interest is changed based on the position information of the portion of interest. In the image processing apparatus according to claim 1,
The position information includes information indicating whether the site of interest is present on the heart wall on the front side of the atrioventricular side or on the heart wall on the back side of the atrioventricular when viewed from the predetermined direction. Is included,
Based on the position information of the site of interest, the image processing unit determines whether the site of interest is present on the heart wall on the front side of the atrioventricular chamber or on the heart wall on the back side of the atrioventricular chamber. An image processing apparatus characterized in that the aspect of the marker indicating the site of interest is changed accordingly. In the image processing apparatus according to claim 1 or 2.
The image processing apparatus, characterized in that the site of interest is an injection site in which an injection material is injected via a catheter inserted into the atrioventricular chamber of the heart. In the image processing apparatus according to claim 1 or 2.
The image processing apparatus, characterized in that the site of interest is an infarcted site of the myocardium or a thin wall site in which the heart wall is thinned. In the image processing apparatus according to any one of claims 1 to 4.
The image processing unit acquires at least one X-ray fluoroscopic image of the expansion phase and systole phase of the atrioventricular chamber of the heart, and generates the first two-dimensional image based on the acquired X-ray fluoroscopic image. An image processing device characterized by this. In the image processing apparatus according to any one of claims 1 to 4.
The image processing unit acquires three-dimensional structure data showing the three-dimensional structure of the atrioventricular chamber of the heart, and based on the acquired three-dimensional structure data and the X-ray fluoroscopic image, the first two-dimensional image is obtained. An image processing device characterized by generating. In the image processing apparatus according to any one of claims 1 to 6.
The image processing unit acquires electrocardiographic information indicating the electrocardiographic potential of the heart wall of the atrioventricular chamber of the heart, and maps the electrocardiographic potential indicated by the acquired electrocardiographic information to the second two-dimensional image. An image processing device characterized by. In the image processing apparatus according to any one of claims 1 to 7.
The image processing unit acquires wall motion information indicating the wall motion of the heart wall of the atrioventricular chamber of the heart, and maps the wall motion shown in the acquired wall motion information to the second two-dimensional image. An image processing device characterized by. The image processing apparatus according to any one of claims 1 to 8.
The image processing unit is an image processing device characterized in that the generated second two-dimensional image is displayed on the display device. The image processing apparatus according to any one of claims 1 to 8.
The image processing unit is an image processing apparatus characterized in that the generated second two-dimensional image is superimposed on the X-ray fluoroscopic image and displayed. In the image processing apparatus according to any one of claims 1 to 10.
The image processing unit is an image processing apparatus characterized in that the generated second two-dimensional image is used to generate at least one of a three-dimensional image and a bullseye image in which the atrioventricular chamber of the heart is three-dimensionally displayed. .. In the image processing apparatus according to any one of claims 1 to 11.
The image processing unit is an image processing apparatus characterized in that the generated second two-dimensional image is stored in a storage means. An image processing method executed by an image processing device.
A step of acquiring the position information of a predetermined region of interest on the heart wall of the atrioventricular chamber of the heart, including the depth direction when the atrioventricular chamber of the heart is viewed from a predetermined direction.
A step of generating a second two-dimensional image in which a marker indicating the site of interest is superimposed on a first two-dimensional image based on an X-ray fluoroscopic image of the atrioventricular chamber of the heart from the predetermined direction is included. ,
An image processing method characterized in that the mode of a marker indicating the site of interest is changed based on the position information of the site of interest. A program that causes a computer to function as the image processing device according to any one of claims 1 to 12.

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