JPS62221332A - Endoscope image diagnostic apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] [Objective of the Invention] (Industrial Application Field) The present invention provides an endoscopy system in which the condition of an affected area is displayed as an image on a display using an endoscope inserted into a subject. The present invention relates to a mirror image diagnostic device.

(Prior art) When diagnosing an organ with a branched tissue structure in a patient's body, such as the trachea, using an endoscope, intrabronchial P is used.
A mirror is used. When performing such an endoscopic diagnosis, the doctor first performs an X-ray contrast, either simple or by bronchography, as a pre-examination, and based on the images obtained, the doctor determines the path that the endoscope should take to reach the affected area. be done. Next, the affected area is diagnosed by using the image as a guide and inserting an endoscope into the body.

However, when making a diagnosis using such a method, the doctor uses the endoscope for a long time, which causes eye fatigue, and there is a risk of making mistakes in operation, which often causes damage to internal tissues. Also, if you advance the endoscope to the wrong path,
It is necessary to return it to the correct position, but it is difficult to judge to what position it should be returned to.

(Problem to be solved by the invention) In this way, conventional endoscopic diagnosis not only deteriorates diagnostic efficiency, but also places a heavy burden on doctors, and also places unnecessary burdens on patients. It was starting to cause pain.

The present invention has been made in response to such problems, and an object of the present invention is to provide an endoscopic image diagnostic apparatus that improves diagnostic efficiency and reduces the burden on doctors and patients. It is.

[Structure of the Invention] (Means for Solving the Problems) In order to achieve the above object, the present invention specifies an approach path of an endoscope for an image obtained from an organ having a branched tissue structure. The present invention includes an endoscope path input section ζ that stores information about the endoscopic path, and an endoscope path synthesis display section that sequentially displays the direction of the entry path of the endoscope on images obtained by the endoscope entering the body. It is characterized by:

(Function) When a user such as a doctor advances an endoscope toward a diseased part of the body, the direction of the approach path specified in advance by the endoscope path input section is sequentially displayed by the endoscope path synthesis display section. Since it is displayed on the image of the endoscope, the UNIZA can guide the endoscope precisely along the entry path.

(Example) An endoscopic image diagnostic apparatus according to an embodiment of the present invention will be described below.

For example, when performing a bronchial diagnosis in the lung field), the general diagnosis order is (11X@simple image, (2
) X-ray bronchography 11a shadow, and (3) endoscopic diagnosis procedures are followed. In other words, if some abnormality is found in (1), such as a lesion or affected area such as a lung tumor, a detailed examination is performed.Before proceeding to step (3), a pre-inspection is performed in which the endoscope is guided through the path. In order to know, (2) is applied. (In '2J, X-ray CT equipment, MRI
Images are taken using devices such as ultrasonic devices. Then (
3) is performed and tests close to a definitive diagnosis are performed. This (3
), cells from the affected area are actually collected for cell diagnosis.

The endoscopic image diagnostic apparatus of the present invention satisfies the above (1) or (2).
an endoscope path input section that is located in front of the target, and (3) above.
and an endoscope path synthesis display section that functions as a target.

When (2) is performed by the endoscope path input section, an image as shown in FIG. 4 is displayed on the display.

This image shows the trachea 1 and bronchi 2 contrasted in the left and right lungs with the spine 9 as the center, and these trachea 1 and bronchi 2 are divided into two branches one after another. It has a structure.

Let us assume that the number of affected areas to be inspected by the endoscope is 3. Next, a user such as a doctor operates a coordinate input device such as a trackball or joystick provided in the endoscope path input section to display the image. The approach path 4 of the endoscope can be designated by inputting the path leading to the affected area 3 into the corresponding memory as a free line ROI while looking.

Therefore, the endoscope path synthesis display section (3)
When this is done, an image like the one shown in FIG. 5 is displayed on the display. This image shows the endoscope moved by 1q when the endoscope enters the position 5 in FIG. The tracheas 7 and 8 can be seen to the right in the image, and the bronchus 6 can be seen to the left. In this image, the endoscope entry path 4 designated by the endoscope path input section is displayed as an arrow 10. In other words, since the approach path 4 specified in advance in FIG. 4 is the direction from the position 5 toward the bronchus 6,
Along this line, the endoscope at position 5 in FIG. 6 is supported so as to move in the direction of arrow 10. In this case, the method of supporting the approach direction is not limited to the arrow, but other methods can be used. For example, there may be a method in which only the direction of approach is made brighter than the surroundings by providing a brightness difference, or a method in which only the direction of approach is supported with a special color. However, methods that may interfere with endoscopic diagnosis should be avoided, and in some cases, it may be possible not to require instructions.

Next, details of the configuration of the endoscopic image diagnosis apparatus of the present invention will be explained with reference to FIG.

The endoscopic image diagnosis apparatus includes an endoscope path input section 11 and an endoscope path synthesis display section 12.

First, the endoscope path input section 11 will be explained.

For example, when the X-ray diagnostic apparatus 13 performs the above (2) X-ray bronchography contrast radiograph as a pre-examination, this radiograph information is stored as image data in the image memory 14 and the image shown in FIG. 4 is displayed on the display 16. is displayed. In response to this image, a user such as a doctor operates the coordinate input device 17 to input information on the approach path of the endoscope to the affected area 3 into the Gutwick memory 15 as a free line ROI via the recognition device 18. As a result, the input data is combined with the image data previously stored in the image memory 14 and displayed on the display 16 as the same screen. That is, as shown in FIG. 4, it is possible to specify the entry path 4 of the endoscope to a desired position while viewing the image of the bronchus. The user can repeat similar operations until the optimal path is obtained, and if the path specification is incorrect, it can be corrected. Information on these approach paths 4 is stored in the recording/limiting device 19.
is stored in memory. The path information is memorized in the form of coordinates, but if it is difficult to store all the coordinate information of the approach path 4 due to storage capacity limitations of the storage device 19, the path information is stored in the form of coordinates. This method is practical because there is no problem as long as the coordinate information for selecting the crossroads is stored in memory. This method will be selected below.

In the process of specifying the approach path 4, the branch point where the bronchus branches is first detected by the branch point detection device 20. This detection is easy since bronchography has been performed.

Next, the directional vectors of the two bronchi branching from the branch point are detected by the bronchial vector detection device 21, respectively.

As described later, this detection method is based on the large serration of the unit vector of each bronchus projected from the position immediately before the bifurcation to a plane perpendicular to the bifurcation point (the displayed image is two-dimensional, so it can be observed as a straight line). This is done by capturing the In this way, each time the approach path 4 is advanced, the branch points and vectors are sequentially detected by the branch point detection device 20 and the bronchial vector detection device 21 up to the affected area 3, so that this information is sequentially detected. The information is stored in memory by the tracheal vector information control device 22.

This memory method can be implemented, for example, in the form of a simple pointer database structure as shown in FIG.

Next, the endoscope path synthesis display section 12 will be explained.

Following the pre-examination in (2) above, (3) when the endoscopic diagnostic device (hereinafter simply referred to as an endoscope) 23 is advanced toward the affected area 3 in the body for endoscopic diagnosis, the internal Image data from the endoscope 23 is sequentially stored in the image memory 24, and the image shown in FIG. 4 is displayed on the display 30.

When the endoscope 23 reaches the first branch point, this branch is recognized by the branch opening recognition device 25, which approximately recognizes the outline of the entrance of the branching bronchus as a circle and locates its center. Find points.

Further, the bronchial vector is recognized by the endoscopic image/bronchial vector recognition device 26 from this center point and the center of the endoscopic image. The endoscope position determining device 27 determines the current position of the endoscope based on the movement information up to the present time, and the information of this determining device 27 is added to the bronchial vector matching device 28 together with the information of the musical note recognition device @26. .

The endoscope position determining device 27 has a mouthpiece structure as shown in FIG. 6, for example, and has a cylindrical mouthpiece 2.
An endoscope flexible part 27C is arranged so as to be inserted through a measuring device part 27B provided on the inner wall of the endoscope 7A, and a flexible part 27C is provided on the circumferential surface of the flexible part 27C to measure the amount of rotational movement along the axial direction. A protrusion strip 27D and a protrusion piece 27E for measuring axial movement resistance are provided. When the endoscope advances, the amount of movement in the rotational direction is measured via the protrusion 27D, and the amount of movement in the axial direction is measured via the protrusion piece 27E. still,
Information regarding angle operation can be obtained from the mechanism. According to such a mouthpiece structure, it is possible to eliminate harmful effects such as fiber breakage and image deterioration caused by being bitten by a patient.

The bronchial vector I-le matching device 28 compares the added image information by extracting the corresponding information from the bronchial vector information control device 22 in the endoscopic 11 path input section 11, and compares the added image information by extracting the corresponding information from the bronchial vector information control device 22 in the endoscopic 11 path input section 11. A graphic image for displaying an arrow indicating the direction of the path on the image is created and stored in the graphic memory 29. As a result, the image shown in FIG. 5 is displayed on the display 30. Incidentally, the endoscope position r11 cutting device 27 can fulfill the function 'b' by simply counting the number of branch points.

Furthermore, the bronchial vector matching device 28 can also process the image memory 24 depending on the specified path display method.

In this way, by advancing the endoscope along the arrow 10 indicating the direction of the approach path 4 of the endoscopic image displayed on the display 30 based on the information on the bronchial vector at each branch point, the endoscope can be accurately guided. It is possible to reach the affected area 3 with the endoscope.

Next, a method for detecting a bronchial vector I.L by the bronchial vector detecting device 21 of the endoscope path input section 11 described above will be described in detail. As shown in FIG. 2(a), it is assumed that the bronchus 31 branches into forks 32 and 33, and that an approach path from 31 to 32 is designated. When the endoscope enters this approach path, it follows the center 34 of the bronchus 31 in FIG.
>The endoscope that entered downward at the crossroads 32
．． A bronchial vector on a plane 35 perpendicular to the direction toward the branch point 33 is displayed as an image. In other words, for this purpose, each unit vector of the crossroads 32.33 is 36.3
7, the vectors 38 and 39 projected onto the surface 35 will be detected as bronchial vectors, and the corresponding image will be obtained as an endoscopic image.

In this case, the bronchial vector 38 in the specified path direction is selected, but the two bronchial vectors 38 and 39 are memorized together. This is the crossroads 32.3 as shown in Figure 2(a).
3 can be clearly distinguished, but this is to prepare for the case where the crossroads 32 and 33 are branched at a narrow angle and cannot be clearly distinguished as shown in FIG. 2(b). In this case, the ratio of the two branches 32 and 33 is required rather than the size of the bronchial vector. By moving the endoscope a little here,
If the center 34 is shifted to the position 34' as shown in FIG. 2(C), the arrangement can be made close to that in FIG. 2(a), making it easier to obtain information. That is, by taking the ratio of the unit vectors 36' and 37' to the bronchial vectors 38' and 39' projected onto 35' in the arrangement shown in FIG. You can choose as.

In this case, the endoscopic diagnosis is performed using the endoscope path synthesis display section 12. It is then returned to the endoscopic path input unit 11 for re-detection.At this point, it is necessary to align the vertical position of the endoscopic image with the projection plane 35 using the bronchial vector matching device 2B.

However, as shown in Figure 7(b), the branched bronchus 52.5
3 is in one direction, for example, 1 as shown in 54 when viewed from the Y-axis direction.
If the results overlap, it is impossible to determine the branch. Therefore, it is necessary to display two arrows on the corresponding endoscopic image. However, Fig. 7 (C
), it can be determined if a projected image from another direction (for example, the X-axis direction) is obtained. For this reason, it is desirable to specify the approach path of the endoscope based on a single X-ray image projected from two different directions, and for actual examinations, it is recommended to use X-ray images projected from two directions. is common.

Detection of the bifurcation point is performed using 2 because the contrast of the contrast image is strong 1-.
Convert it into a value, and if necessary, thin the line (calculate from 5).The detected information is a pointer 41 to the next branching point information (structure) and a bronchial vector 38, 39, as shown in Fig. 3. is stored in memory as a block-like database structure.If you have the capacity and processing capabilities, you may include it as branch point information other than the approach path like 42.This allows you to This is effective when the endoscope is advanced in this direction.

The operating principle of the endoscopic image/bronchial vector recognition device 26 in the endoscope path synthesis display unit 12 is shown in FIGS. 8(a) and 8(b).
Shown below. This shows a case where the outline of the branch mouth can be easily recognized as approximately a circle. This is possible because the trachea consists of a U-shaped soft mass and a cartilage ring connected by an annular ligament. FIG. 8(a) corresponds to FIG. 2(a), and FIG. 8(b) corresponds to FIG. 2(b). The center 61 of the whole wedding celebration LM fl is the center 3 in Fig. 2
It corresponds to 4. In addition, each center 62 of the branch mouth
．． Find 63, and find the respective solids 1 to 63 from 61 to 62 and from 61 to 63. The direction in which the X-rays were irradiated [Y direction (40) in Figure 2 (a)]
The vector 66.67 obtained by projecting onto the plane 65 perpendicular to 64 can correspond to 38.39 in FIG. 2(a).

Here, it is necessary to always maintain a correspondence between the display coordinate system in the endoscopic image and the fixed coordinate system of the projection plane 35 in the X-ray image. When the endoscope is rotated, the plane 65 in FIG. 8 is also rotated, and bronchial vectors 66 and 67 are obtained. The direction of the vector and the ratio of the major jags are used to correlate FIG. 2 with FIG. 8. In the above explanation, we talked about the case where the branch point can be easily found as an approximate circle, but
If the branch opening is complex, it is possible to use the dark area and the information about the next branch, as shown in FIG.

First, the center 71 of the endoscope is determined. Next, if the bronchus continues to the back, there is no reflection of light, resulting in a dark area. By recognizing this dark area, the center 74 is determined from the outline 72, which can be regarded as a circle with a smaller diameter, and from this, the bronchial vector 75 can be found. Furthermore, since the next dark area 76 exists, by using this to distinguish it from the surroundings, the bronchial solid can be determined in the same way.

Furthermore, when the image in Fig. 5 is displayed supplementarily, the fourth
It is also possible to display the image of the diagram and the current position on the designated path.

In addition, in order to specify the approach path of the endoscope at the beginning,
2) Images obtained by X-ray bronchography pupil shadows are not limited to two-dimensional images, but three-dimensional images such as the one shown in Figure 10 obtained by using an X-ray CT device or MRI device can be used. This allows for more accurate entry path designation. At this time, it is also possible to perform a simulation-like pre-diagnosis in which the endoscope is entered in a pseudo manner using three-dimensional information.

Roughly, by obtaining detailed information on the bronchial vector along the approach path using three-dimensional information, etc., and based on this information and the feedback information of the endoscopic image, the bronchial vector I to Automatic entry of the endoscope is achieved by adding a new endoscope a structure control unit 80 to the matching device @28 that controls the entry of the endoscope.

Automatic operation is also possible.

Although the present embodiment has been described using the bronchus as an example, the present invention is not limited to the bronchus, and can be applied to any container having a similar branched tissue 4M structure.

[Effects of the Invention] As explained above, according to the present invention, the approach path of the endoscope is specified in images obtained in advance, and the approach path is sequentially displayed in the images obtained in endoscopic diagnosis. As a result, the endoscope can be accurately advanced to the affected area. Therefore, diagnostic efficiency can be improved, and the burden on doctors and patients can be reduced.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing an endoscopic image diagnostic apparatus according to an embodiment of the present invention, and FIGS. 2(a), (b), and (c) show a method for detecting bronchial solids according to an embodiment of the present invention. Principle diagram, Figure 3 is a database structure showing the memory used in the embodiment of the present invention, Figure 4 is an X-ray image obtained in the pre-examination of the embodiment of the present invention, and Figure 5 is the endoscope of the embodiment of the present invention. Endoscopic image obtained in diagnosis, Figure 6 is the mouthpiece for measuring the amount of movement of the endopA mirror used in the embodiment of the present invention, Figures 7 (a), (b), (c)
FIG. 8(a) is a projection view showing the bronchus of the embodiment of the present invention;
(b) is a detection principle diagram showing another method of detecting bronchial vectors according to the embodiment of the present invention, FIG. 9 is a detection principle diagram showing another method of detecting bronchial vectors according to the embodiment of the present invention, and FIG. This is a three-dimensional packed image obtained in a pre-inspection of an embodiment of the invention. 1... Trachea, 2... Bronchus, 3... Affected area, 4...
- Endoscope approach path, 6.7.8...Bronchi, 10...Direction of endoscope II scope approach path, 11...Endoscope path input section, 12...Endoscope path synthesis Display section. Agent Patent Attorney Nori Chika Ken Shu
Ogo Norifu 9ri fTwei Figure 4

Claims (4)

[Claims] (1) An endoscopic image diagnostic device that uses an endoscope inserted into the subject to visualize the condition of the affected area on a display, and targets organs with a branched compositional structure within the subject. an endoscope path input section for specifying an approach path of the endoscope to a desired affected part of the organ with respect to the obtained image and storing this information; an endoscope path synthesis display section that sequentially displays the specified approach path direction of the endoscope on images obtained by the endoscopic image diagnosis apparatus. (2) The endoscopic image diagnosis apparatus according to claim 1, wherein the image obtained by targeting the organ is a two-dimensional packed image. (3) The endoscopic image diagnostic apparatus according to claim 1, wherein the image obtained by targeting the organ is a three-dimensional image. (4) The endoscope path synthesis display section is provided with an endoscope mechanism control section for automatically advancing the endoscope along a designated entry path. Endoscopic image diagnostic equipment.