JPWO2010016293A1 - MEDICAL IMAGE DISPLAY DEVICE, MEDICAL IMAGE DISPLAY METHOD, AND PROGRAM - Google Patents

Abstract

When comparing and interpreting tomographic image groups having different slice intervals, both a displacement in the body axis direction during imaging and a decrease in diagnostic performance between images to be compared are prevented. According to the client terminal 20 of the present invention, when the slice intervals in the plurality of examination tomographic image groups are different from each other, the CPU 21 performs the inspection of one examination among the plurality of examination tomographic image groups based on the slice intervals. The tomographic images belonging to the tomographic image group are classified into a single unit or a group of multiple units with adjacent positions in the body axis direction at the time of imaging, and the tomographic images belonging to the tomographic image group of other examinations Each group in the image group and the position in the body axis direction at the time of photographing are classified into groups for each tomographic image. Then, one integrated image is created by synthesizing tomographic images classified into the same group, and the integrated images of the corresponding groups among a plurality of examinations are associated with each other and displayed on the display unit 23.

Description

  The present invention relates to a medical image display device, a medical image display method, and a program.

  In the medical field, so-called comparative interpretation is performed in which diagnosis is performed by comparatively observing current and past tomographic images acquired in modalities such as CT (Computed Tomography) apparatuses and MRI (Magnetic Resonance Imaging) apparatuses. In comparative interpretation, it is necessary to match the position in the body axis direction at the time of imaging between the current tomographic image to be compared and the past tomographic image.

  For example, Patent Document 1 describes a technique of calculating past images having the same anatomical position as the current tomographic image by image analysis, and displaying both of them side by side.

In Patent Document 2, when the slice interval in the current tomographic image group is different from the slice interval in the past tomographic image group, the slice position matching is performed between the current tomographic image group and the past tomographic image group. A technique for performing with high accuracy is described. When the slice interval is different, for example, when the image is taken with different types of modalities, such as a CT apparatus and an MRI apparatus, even if the model is different even with the same type of modality as the CT apparatus and CT apparatus, For example, the same apparatus may have different reconstruction conditions.
JP 2001-137230 A JP 2006-187499 A

  However, since Patent Document 1 does not consider the difference in slice interval between the current tomographic image and the past tomographic image, the position in the body axis direction at the time of imaging is applied when comparing images having different slice intervals. This is not preferable because images having different values are compared with each other.

  Further, in Patent Document 2, as shown in FIG. 23, images having the same distance between slices from a reference position (indicated by Z in FIG. 23) among current and past tomographic images (indicated by arrows in FIG. 23). Is selected and displayed, the information of the tomographic image (shown in gray in FIG. 23) thinned out on the display is not used for diagnosis, and there is a problem that the diagnostic performance is degraded.

  An object of the present invention is to prevent both a shift in the body axis direction position during imaging and a deterioration in diagnostic performance between images to be compared when comparatively interpreting tomographic image groups having different slice intervals.

In order to solve the above problems, according to a first aspect of the present invention, a medical image display apparatus comprises:
An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition means;
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. Image grouping means for classifying into groups for each tomographic image;
Image integration means for creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing means for displaying an integrated image in each group of the one tomographic image group on a display means in association with an integrated image in the group of the other tomographic image group corresponding to the group;
Is provided.

  The image grouping means calculates a common multiple of slice intervals in the plurality of tomographic image groups, and divides the calculated common multiple by a slice interval in each of the plurality of tomographic image groups, thereby obtaining the plurality of tomographic images. It is preferable to classify the tomographic images by determining the number of group-by-group images in each group.

  The image grouping means classifies tomographic images belonging to one tomographic image group having the largest slice interval among the plurality of tomographic image groups into a group of one sheet, and tomographic images belonging to other tomographic image groups. It is preferable to associate with the group of the one tomographic image group having the closest position in the body axis direction at the time of imaging and classify into groups for each tomographic image associated with the same group.

  When an area having a slice interval width based on the position in the body axis direction at the time of imaging is a slice area of each tomographic image, the image grouping means has the largest slice interval among the plurality of tomographic image groups The tomographic images belonging to one tomographic image group are classified into groups of one sheet, and the tomographic images belonging to other tomographic image groups are associated with the group of the one tomographic image group with overlapping slice regions, and the same group is assigned. It is preferable to classify them into groups for each associated tomographic image.

  Preferably, the image grouping means performs association when an area where the slice areas overlap exceeds a predetermined threshold.

  Preferably, the image integration unit creates a single integrated image by averaging pixel signal values for each corresponding pixel between tomographic images classified into the same group by the image grouping unit.

  The image integration unit acquires a maximum pixel signal value for each corresponding pixel between tomographic images classified into the same group by the image grouping unit, and one integrated image composed of the acquired maximum pixel signal value It is preferable to create

  The image integration unit acquires a minimum pixel signal value for each corresponding pixel between tomographic images classified into the same group by the image grouping unit, and one integrated image composed of the acquired minimum pixel signal value It is preferable to create

  It is preferable that the image forming apparatus further includes an integration cancellation unit that expands and displays the integrated image displayed on the display unit on a plurality of tomographic images used to create the integrated image.

The medical image display device includes:
Operation means;
When a closed curve indicating a region of interest is marked by the operation means in at least three or more of the integrated image displayed on the display means or the developed tomographic image, the plurality of marked images are between the marked images. A region of interest interpolation means for calculating a region of interest of an image having a position in the body axis direction at the time of photographing by interpolation based on the marked region of interest, and displaying a mark on the calculated region of interest;
It is preferable to provide.

The medical image display device includes:
It is preferable to provide a three-dimensional display processing unit that creates a three-dimensional image of the region of interest based on the marked region of interest and the interpolated region of interest and displays the image on the display unit.

According to a second aspect of the present invention, a medical image display method comprises:
An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition process;
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. An image grouping process for classifying into groups for each tomographic image;
An image integration step of creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing step of displaying an integrated image in each group of the one tomographic image group on a display unit in association with an integrated image in the group of the other tomographic image group corresponding to the group;
including.

According to a third aspect of the present invention, the program is
Computer
An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition means,
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. Image grouping means for classifying into groups for each tomographic image;
Image integration means for creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing means for displaying an integrated image in each group of the one tomographic image group on a display means in association with an integrated image in the group of the other tomographic image group corresponding to the group;
To function as.

  According to the present invention, when tomographic image groups having different slice intervals are compared and interpreted, it is possible to prevent both displacement of the body axis direction position during imaging and deterioration of diagnostic performance between images to be compared.

It is a figure which shows the function structural example of the medical image management system in embodiment of this invention. It is a block diagram which shows the functional structure of the client terminal of FIG. It is a flowchart which shows the display control process performed by CPU of FIG. It is a flowchart which shows the image grouping process by the algorithm 1 performed by CPU of FIG. It is a conceptual diagram which shows the grouping of the image in the image grouping process by the algorithm 1 shown in FIG. It is a figure which shows the specific example of the grouping of the image by the algorithm 1 shown in FIG. It is a flowchart which shows the image grouping process by the algorithm 2 performed by CPU of FIG. It is a figure for demonstrating a slice area | region. It is a figure which shows an example of the calculation result of the slice area | region in the image grouping process by the algorithm 2 shown in FIG. FIG. 10 is a diagram showing a result of grouping and associating examinations A and B shown in FIG. 9 in the image grouping process by algorithm 2. FIG. 10 is a diagram showing a result of grouping examinations A and B shown in FIG. 9 and associating them when the overlapping slice area is equal to or greater than a threshold in the image grouping process by algorithm 2. It is a flowchart which shows the image grouping process by the algorithm 3 performed by CPU of FIG. It is a flowchart which shows the image integration process performed by CPU of FIG. It is a figure which shows an example of the integrated image display screen displayed on a display part in FIG.3 S8. It is a flowchart which shows the integration cancellation | release display process performed by CPU of FIG. It is a figure which shows the example which expand | deployed the integration image of the test | inspection whose slice space | interval is 5 mm and 2 mm to a tomographic image (integration cancellation | release). It is a figure which shows the correspondence at the time of matching the tomographic image of two inspections shown to FIG. 15A on the maximum reference | standard. It is a figure which shows the example of a display at the time of displaying the tomographic image matched by FIG. 15B. It is a figure which shows the example which expand | deployed the integrated image of a test | inspection with a slice space | interval of 5 mm and 2 mm to a tomographic image (unintegration). It is a figure which shows the correspondence at the time of matching the tomographic image of two test | inspections shown to FIG. 16A by the minimum standard. It is a figure which shows the example of a display at the time of displaying the tomographic image matched by FIG. 16B. FIG. 16B is a diagram illustrating a display example when the tomographic image associated with FIG. 16B is displayed when the group G12 illustrated in FIG. 16A is selected and integration cancellation is instructed. It is a figure which shows the example of a lesion drawing in the integrated image whose slice space | interval is 10 mm. It is a figure which shows the example of depiction of the lesion in the tomographic image of 1 mm slice space | interval. It is a figure which shows the lesion drawn by the tomographic image of 1 mm space | interval. It is a figure which shows having marked on 3 sheets of the tomographic image shown to FIG. 18A. It is a figure which shows the result of having performed interpolation based on the mark attached | subjected to the three tomographic images shown to FIG. 18B. It is a flowchart which shows the region of interest interpolation process performed by CPU of FIG. It is a figure for demonstrating the interpolation in step S602 of FIG. It is a figure which shows the marking display in step S603 of FIG. It is a figure which shows the change of the slice space | interval in the same test | inspection (series). It is a figure for demonstrating a prior art.

[Configuration of Medical Image Management System 100]
FIG. 1 shows a system configuration of the medical image management system 100.
The medical image management system 100 is a system installed in a hospital. As shown in FIG. 1, a medical image management system 100 includes an image management server 10 as an image storage device and a client terminal 20 as a medical image display device, and each device is a LAN (Local Area Network) or WAN (WAN). It is connected to be able to transmit and receive data via a communication network N composed of a communication line such as a Wide Area Network. Each device constituting the medical image management system 100 conforms to the DICOM (Digital Image and Communications in Medicine) standard, and communication between the devices is performed according to DICOM. The number of each device is not particularly limited.

  The image management server 10 is a computer device that accumulates, stores, and manages medical image data generated by various modalities such as a CT apparatus, an MRI apparatus, and a CR (Computed Radiography) apparatus, and additional information related to the medical image. The medical image includes a tomographic image generated by a CT apparatus, an MRI apparatus, or the like, a simple X-ray image generated by a CR apparatus, or the like. Specifically, the image management server 10 includes a storage unit 15 configured by a hard disk or the like. The storage unit 15 stores a medical image DB 151 that stores medical image data, and an additional information DB 152 that stores additional information related to medical images stored in the medical image DB (Data Base) 151 in a searchable manner.

  Medical images stored in the medical image DB 151 are stored in a DICOM file format that conforms to the DICOM standard. The DICOM file is composed of an image part and a header part. Actual data of the medical image is written in the image portion, and supplementary information related to the medical image is written in the header portion.

  The incidental information includes, for example, patient information, examination information, series information, and detailed image information.

The patient information includes patient identification information for identifying the patient (for example, patient ID), various information related to the patient of the medical image such as the patient's name, sex, date of birth, and the like.
The examination information includes examination identification information (for example, examination ID) for identifying the examination, examination date, and various types of information relating to the examination such as a doctor in charge.

The series information includes the series number for identifying the series in the same examination, the type of modality that generated the medical image included in the series, the examination site, the slice interval when the medical image is a tomographic image, the total number of slices, etc. Contains various information about the series.
Here, the series refers to a group of a series of medical images related to each other. For example, in a CT apparatus and an MRI apparatus, a plurality of ranges of a human body (for example, from the chest to the abdomen) are continuously provided at predetermined slice intervals (for example, 1 mm intervals) along the body axis direction (head-to-foot direction). A plurality (100 to thousands) of tomographic images are generated by photographing. This generated group of tomographic images is handled as one series. The same series information is attached to all tomographic images belonging to the same series. The total number of slices is the total number of tomographic images belonging to the same series.
In the present embodiment, when there are a plurality of series in the same examination, the imaging range of each series is different. That is, it is assumed that a doctor does not comparatively interpret a plurality of series in the same examination.

Detailed image information includes image number, slice position (position in the body axis direction when each tomographic image is taken when the position in the body axis direction of the first tomographic image taken in the same series is 0 mm (reference)), Various information about the image such as the image generation time and the file path name indicating the storage location of the medical image is included.
The image number is a number indicating the imaging order 1 to n (n is the total number of slices) of medical images generated as the same series.

  In response to a search request from the client terminal 20 via the communication network N, the image management server 10 searches the supplementary information DB 152 for a medical image that matches the condition transmitted from the client terminal 20, and the medical image that matches the condition. The image list data is transmitted to the client terminal 20. Also, the medical image data requested to be acquired from the client terminal 20 is read from the medical image DB 151 and transmitted to the client terminal 20.

  The client terminal 20 is a terminal device such as a PC (Personal Computer) for acquiring medical images stored and stored in the image management server 10 and displaying them for interpretation by a doctor.

[Configuration of Client Terminal 20]
FIG. 2 shows a functional configuration of the client terminal 20.
As shown in FIG. 2, the client terminal 20 includes a CPU 21, an operation unit 22, a display unit 23, a communication unit 24, a RAM 25, a storage unit 26, and the like, and each unit is connected by a bus 27.

  The CPU 21 reads out various processing programs including a system program and a display control processing program stored in the storage unit 26, develops them in a work area formed in the RAM 25, and controls each unit according to the program.

  The operation unit 22 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The operation signal is input to the CPU 21 through key operations on the keyboard and mouse operations. Output.

  The display unit 23 is configured by a monitor such as an LCD (Liquid Crystal Display) or a CRT (Cathode Ray Tube), and displays various screens, medical images, and the like according to instructions of display signals input from the CPU 21.

  In the present embodiment, the display unit 23 displays a setting screen for the user to set an integration algorithm, an integration cancellation algorithm, and an interpolation algorithm used in a display control process described later. On the setting screen for setting the integrated algorithm, for example, the user can select a desired algorithm from the candidates such as “average”, “maximum value luminance projection”, and “minimum value luminance projection” by the operation unit 22. On the setting screen for setting the integration cancellation algorithm, the user can select a desired algorithm from the candidates such as “maximum criterion” and “minimum criterion” using the operation unit 22. On the setting screen for setting the interpolation algorithm, the user can select a desired algorithm from the candidates such as “linear interpolation”, “cubic convolution interpolation”, and “spline interpolation” by the operation unit 22.

  The communication unit 24 includes a LAN adapter, a router, a TA (Terminal Adapter), and the like, and transmits and receives data to and from each device connected to the communication network N.

  The RAM 25 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 26 in various processes controlled and executed by the CPU 21.

The storage unit 26 includes an HDD (Hard Disc), a semiconductor nonvolatile memory, or the like.
The storage unit 26 stores system programs executed by the CPU 21, various programs such as a display control processing program, and data necessary for executing these programs (for example, algorithm setting contents, reference values, threshold values, etc.). To do. Various programs are stored in the storage unit 26 in the form of computer-readable program codes, and the CPU 21 sequentially executes operations according to the program codes.

[Operation of Client Terminal 20]
Next, the operation of the present embodiment will be described.
FIG. 3 shows a flow of display control processing executed when an integrated display request is input from the operation unit 22 in the client terminal 20. The display control process is realized by a software process in cooperation with the CPU 21 and a display control process program stored in the storage unit 26.

Here, the integrated display is a display mode used when comparatively interpreting a plurality of tomographic image groups having different slice intervals (in this embodiment, tomographic image groups having a plurality of examinations having different slice intervals).
When comparing and interpreting tomographic images of a plurality of examinations at a ratio of 1: 1, generally, the tomographic images having the closest positions in the body axis direction at the time of imaging are displayed in association with each other. However, if the slice interval between examinations is different, a tomographic image that does not correspond 1: 1 with the tomographic images of other examinations appears (see the gray portion in FIG. 23). Such tomographic images are thinned out on the display and are not used for diagnosis.
In the integrated display, the tomographic image group of each examination is grouped in a range where the position of the body axis direction at the time of imaging can be matched with the tomographic image group of other examinations, and the tomographic images in the group are integrated and displayed, This is a display mode in which the information of tomographic images that do not correspond 1: 1 with the tomographic images of other examinations is also utilized for diagnosis and diagnostic performance is improved.

First, a plurality of examination tomographic image groups to be compared are acquired from the image management server 10 (step S1).
Specifically, a search screen for inputting search conditions is displayed on the display unit 23. An operator such as a doctor inputs, for example, an examination date, an examination ID, a patient ID, a combination thereof, and the like via the operation unit 22. When a medical image search condition is input from the operation unit 22, the input search condition and search request are transmitted to the image management server 10 via the communication unit 24, and an examination that matches the search condition is transmitted from the image management server 10. List data is acquired. When the list data is acquired, an image selection screen (not shown) based on the acquired list data is displayed on the display unit 23. On the image selection screen, for example, a list having items such as examination ID, patient ID, patient name, modality type, examination site / direction, and series number is displayed in examination units (for examinations including a plurality of series, in units of series). In this configuration, a plurality of inspections to be compared can be selected. When a plurality of examinations to be subjected to comparative interpretation are selected from the list data displayed on the display unit 23 by the operation of the operation unit 22 by the operator and a display request is input, the examination requested to be displayed by the image management server 10 Is acquired and stored in the RAM 25. The acquired individual tomographic images of the respective examinations are displayed on the display unit 23 in the order of photographing.

Next, selection of a comparison reference image in each examination by the operation unit 22 is accepted (step S2).
Here, the comparison reference image refers to an image serving as a reference for aligning positions in the body axis direction between examinations. In the examination in a CT apparatus or the like, as described above, a certain range in the body axis direction of the human body is photographed at a predetermined slice interval. However, the setting method of the range may be different for each examination. That is, the slice position of image number 1 does not necessarily indicate the same position in the body axis direction between a plurality of examinations. Therefore, in step S2, a doctor or the like uses the operation unit 22 to select images recognized as having the same position in the body axis direction from the tomographic image group of each examination. The image number of the comparison reference image in each selected examination is stored in the RAM 25.

  Next, the slice interval of the tomographic image group of each examination is acquired from the incidental information attached to the acquired tomographic image, and the least common multiple of the acquired slice interval is calculated (step S3). Then, it is compared with a predetermined reference value (step S4).

  When the calculated least common multiple ≦ reference value (step S4; least common multiple ≦ reference value), the image grouping process of the tomographic image group in each examination is executed by the algorithm 1 (step S5).

FIG. 4 shows a flow of image grouping processing by algorithm 1 executed in step S5 of FIG.
First, the least common multiple of slice intervals in the tomographic image group of each examination is calculated, and the number of images of each examination group is calculated based on the calculated least common multiple (step S101). Specifically, for each examination, the calculated least common multiple is divided by the slice interval of the tomographic image group of the examination to determine the number of images in groups.

For example, in the inspections A and B to be compared, when the slice interval is inspection A: 5 mm and inspection B: 2 mm, if the same range is imaged in the body axis direction, as shown in FIG. , B is the same as the least common multiple of the slice intervals of 10 mm. Therefore, the tomographic image groups of examinations A and B are grouped in units of 10 mm from the reference position, respectively, so that the tomographic image groups of both examinations are composed of tomographic images corresponding to positions in the body axis direction at the time of photographing. Can be classified into units.
The group unit number of inspections A and B is as follows.
Number of group units for inspection A = 10 mm / 5 mm = 2 sheets Number of group units for inspection B = 10 mm / 2 mm = 5 sheets

  In the image grouping process by the algorithm 1 of the present embodiment, the least common multiple of the slice interval of each examination is used for calculating the number of images of each examination group to be compared. It is only a form of the above, and it may be a common multiple. This is because, when imaging is performed from a reference position in a plurality of examinations, the imaging ranges match in units of common multiples of the slice intervals of each examination.

When the number of tomographic images for each examination group is calculated, the tomographic image group for each examination is classified into groups for each calculated number of group units (step S102).
Specifically, for each examination, tomographic images arranged in the order of image numbers (imaging order) are grouped by group unit number from the comparison reference image selected in step S2.
For example, when the image number of the comparison reference image of inspection A is 5 and the image number of the comparison reference image of inspection B is 24, for inspection A, every two sheets from the tomographic image of image number 5 as shown in FIG. The tomographic images are grouped, and for examination B, the tomographic images are grouped every five from the tomographic image of image number 24.

Here, in step S4 in FIG. 3, the least common multiple of the slice interval of the inspection to be compared is compared with the reference value, and the image grouping process by the algorithm 1 is applied only when the least common multiple ≦ the reference value. When the least common multiple is larger than the reference value, such as a combination of slice intervals of 5 mm and 6 mm, the imaging range of the tomographic image to be integrated when creating the integrated image may be larger than the lesion, which is not suitable for diagnosis. It is. The reference value is a predetermined value based on the size of the lesion or the like.
As described above, the calculation of the number of images for each group of each examination in the image grouping process by the algorithm 1 is not limited to the least common multiple of slice intervals of each examination, and other common multiples can be used. When another common multiple is used, the value compared with the reference value in step S4 in FIG. 3 is the common multiple used.

  On the other hand, if the calculated least common multiple> reference value in step S4 in FIG. 3 (step S4; least common multiple> reference value), the algorithm 2 performs image grouping processing of tomographic image groups in each examination (step S4). Step S6).

FIG. 7 shows a flow of image grouping processing by algorithm 2 executed in step S6 of FIG.
First, for each examination, a slice area of each tomographic image is calculated (step S201).
The slice area of each tomographic image refers to an area having a width of a slice interval on the basis of the position in the body axis direction when the image is captured. FIG. 8 shows a slice region in a tomographic image in which the position in the body axis direction at the time of photographing is 3 mm from the photographing reference position (for example, the position of the comparison reference image), and the slice interval is 3 mm. A range from 1.5 mm to 4.5 mm from the imaging reference position is a slice area of this tomographic image.

  For example, in inspections A and B to be compared, the slice intervals are inspection A: 5 mm, inspection B: 3 mm, the slice position of image number 1 is 0 mm for both inspections A and B, and the image number of the comparison reference image is inspection A: Image In the case of No. 1 and Examination B: Image No. 2, the slice area of each tomographic image is the result shown in the upper two stages of FIG.

Next, the tomographic image group of the examination with the largest slice interval is grouped in units of one sheet (step S202). Then, the tomographic images of other examinations are associated with the group in which the slice areas overlap (the group classified in step S202), and the tomographic image groups of other examinations are grouped for each tomographic image associated with the same group. (Step S203).
In step S202, first, when the values indicating the slice positions of the comparison reference images are not aligned, the value of one of the slice areas is entirely the difference between the slice positions of the comparison reference images so that they match. Shifted. For example, in the inspection A, the slice position of the image number 1 that is the comparison reference image is 0 mm, and in the inspection B, the slice position of the image number 2 that is the comparison reference image is 3 mm. The slice area value is shifted by -3 mm. The lower part of FIG. 9 shows a calculation result obtained by shifting the value of the slice area of examination B shown in the middle part of FIG. 9 by -3 mm. Then, tomographic images in which slice regions overlap among the tomographic images of examination B are associated with each group of examination A, and the tomographic images of examination B are grouped for each tomographic image associated with the same group of examination A. The

  FIG. 10A shows the result of grouping the tomographic images of examination B in which the slice regions overlap with the group of examination A in FIG. In FIG. 10A, group g1 of inspection A and group g1 ′ of inspection B, group g2 of inspection A and group g2 ′ of inspection B, group g3 of inspection A and group g3 ′ of inspection B, group g4 of inspection A and inspection B group g4 ′ is a corresponding group.

  In step S203 described above, even a few tomographic images with overlapping slice regions are associated with each other, but the association may be performed when the overlapping slice regions exceed a predetermined threshold. . FIG. 10B shows a result of associating each tomographic image of examination A shown in FIG. 9 with the tomographic image of examination B in which the slice region overlaps ½ or more of the slice interval of examination B. In FIG. 10B, group G11 of inspection A and group g11 ′ of inspection B, group g12 of inspection A and group g12 ′ of inspection B, group g13 of inspection A and group g13 ′ of inspection B, group g14 of inspection A and inspection The group g14 ′ of B is a corresponding group.

When the least common multiple> reference value, the image grouping process may be performed using an algorithm (algorithm 3) different from the algorithm 2 described above.
FIG. 11 shows a flow of image grouping processing by algorithm 3.

In the image grouping process using the algorithm 3, first, a process of matching slice positions between examinations is performed (step S301).
As described above, when the values indicating the slice positions of the comparison reference images are not aligned, one of the slice positions is entirely shifted by the difference between the slice positions of the comparison reference images so that they match. For example, in the inspection A, the slice position of the image number 1 that is the comparison reference image is 0 mm, and in the inspection B, the slice position of the image number 2 inspection B that is the comparison reference image of the slice position is 3 mm. The slice position of each tomographic image is shifted by -3 mm.

  Next, the tomographic image group of the examination with the largest slice interval is grouped in units of one sheet (step S302), and the tomographic image of the other examination is the group closest to the slice position at the time of photographing (the group classified in step S302). ) And tomographic image groups of other examinations are grouped for each tomographic image associated with the same group (step S303).

  Whether the algorithm 2 or the algorithm 3 is used in step S <b> 6 of FIG. 3 may be set by the user via the operation unit 22.

In FIG. 3, when the image grouping process ends, an image integration process is executed, and the tomographic images classified into the same group are integrated (step S7).
FIG. 12 shows a flow of the image integration process executed in step S7.
First, the integration algorithm setting is acquired (step S401). When the set integration algorithm is “average” (step S402; YES), an average value of pixel signal values is calculated for each corresponding pixel between tomographic images classified in the same group, and the calculated average value A single integrated image (averaged image) is created (step S403).
In general, noise does not occur at a specific position in a series of tomographic images, but occurs at random positions in each image. Therefore, the noise of tomographic images used for comparative interpretation is reduced by averaging the pixel signal values of the corresponding pixels of the tomographic images in the group (pixels having the same XY coordinates when each tomographic image is taken as the XY plane). In addition, the S / N ratio can be improved.

When the set integration algorithm is “maximum value luminance projection” (step S402; YES), the maximum pixel signal value is calculated for each corresponding pixel between tomographic images classified in the same group, and the calculated maximum pixel One integrated image (maximum luminance projection image) composed of signal values is created (step S405).
By taking the maximum value of the pixel signal value of the corresponding pixel of the tomographic image in the group, an image with a clear outline of the structure of the subject can be acquired. For example, drawing performance such as nodules can be improved.

When the set integration algorithm is “minimum luminance projection” (step S406; YES), a minimum pixel signal value is calculated for each corresponding pixel between tomographic images classified in the same group, and the calculated minimum pixel One integrated image (minimum luminance projection image) composed of signal values is created (step S407).
By taking the minimum value of the pixel signal value of the corresponding pixel in the tomographic image in the group, it is possible to improve the drawing performance of the signal intensity portion close to air such as bronchi and emphysema.

Returning to FIG. 3, when an integrated image is created, an integrated image display process is executed (step S8). That is, the integrated image of each group of each examination is displayed on the display unit 23 in association (aligned) with the integrated image of another examination group associated by the image grouping process.
FIG. 13 shows an example of the integrated image display screen 231 displayed on the display unit 23 in step S8 of FIG. As shown in FIG. 13, on the integrated image display screen 231, integrated images of groups corresponding to examinations A and B are displayed side by side. In this way, in multiple examinations with different slice intervals, integrated images corresponding to positions in the body axis direction at the time of imaging are automatically displayed side by side, so doctors can easily compare images of multiple examinations with different slice intervals. Interpretation is possible. Since the integrated image is created according to the purpose of diagnosis using all pixel signal values of the tomographic images in the group, the diagnostic performance is improved.

  On the integrated image display screen 231, the integrated images to be displayed can be sequentially switched by a predetermined operation of the operation unit 22. For example, the mouse wheel operation of the operation unit 22 (for example, if it is rotated up, “image number (photographing order) is switched to the front direction”, and if it is rotated down, “image number (photographing order) is set to the back (For example, switching to “direction”), pressing an arrow key on the keyboard (for example, pressing the up (right) arrow key switches the “image number (shooting order) to the previous direction”, and pressing the down (left) arrow key If the button is pressed, switching can be performed by “switching the image number (photographing order) to the backward direction”. Further, a scroll bar may be displayed on the screen of the integrated image display screen 231 and the integrated image to be displayed may be switched by a moving operation of the displayed scroll bar.

First, the doctor searches for the presence of a region of interest suspected of being a lesion while switching the integrated image to be displayed on the integrated image display screen 231. When there is a region of interest suspected of being a lesion, an image in which the region of interest exists is observed in detail to determine whether the region of interest is a lesion, the possibility of being a lesion, or the like.
Here, if there is a region of interest that is suspected to be a lesion in the integrated image, it is possible to cancel the integration of the integrated image in which the region of interest exists and observe each integrated tomographic image. Will improve. Therefore, the integrated image display screen 231 is provided with an “integration cancellation” button 231a for instructing the integration cancellation. The “integration cancellation” button 231a is a button for inputting an integration cancellation display request.

When the “integration cancellation” button 231a is pressed by the operation unit 22 and an integration cancellation display request is input (step S9; YES), an integration cancellation display process is executed (step S10).
FIG. 14 shows a flow of the integration cancellation display process.
First, the setting of the integration cancellation algorithm is acquired (step S501). Next, each of the integrated images is developed in the RAM 25 into a plurality of tomographic images used to create the integrated image (step S502).

  Next, the set integration algorithm is determined, and when the set integration algorithm is “maximum reference” (step S503; YES), each slice of the examination with the larger slice interval between the examinations to be compared. The image is associated with an image of another examination closest to the center position in the slice area of the tomographic image (step S504). When there are three or more inspections to be compared, the two inspections are sequentially associated in descending order of the slice interval. Then, in accordance with the association in step S504, the integrated image of each examination is expanded and displayed on the display unit 23 on a plurality of tomographic images used to create the integrated image (step S506).

  15A to 15C, an integrated image of a group G1 (group consisting of image numbers 1 and 2) having a slice interval of 5 mm and 2 mm and a slice interval of 5 mm (5 mm image) and a slice interval of 2 mm are used. An integrated image of a group G1 ′ (group consisting of image numbers 1 to 5) of (2 mm image) is displayed in association with each other, and an integrated image and a slice interval of group G2 (group consisting of image numbers 3 and 4) having a slice interval of 5 mm are displayed. A description will be given of the integration cancellation processing in the case where the integrated images of the 2 mm group G2 ′ (the group consisting of image numbers 6 to 10) are displayed in association with each other.

  In step S502, as shown in FIG. 15A, in the RAM 25, the integrated image of group G1 is the tomographic image of image numbers 1 and 2, the integrated image of group G2 is the tomographic image of image numbers 3 and 4, and The integrated image is developed into tomographic images with image numbers 1 to 5, and the integrated image of group G2 ′ is developed into tomographic images with image numbers 6 to 10.

  In step S504, as shown in FIG. 15B, each tomographic image having a 5 mm slice interval is associated with a tomographic image having a 2 mm interval closest to the center position of the slice region of the tomographic image. Specifically, among the tomographic images having a slice interval of 5 mm, the image number 1 is the image number 2 of the tomographic image having the interval of 2 mm, the image number 2 is the image number 4, the image number 3 is the image number 7, and the image number 4 is Corresponding to image number 9. When the center position is equidistant from the two tomographic images, the smaller image number has priority.

  In step S506, the screen display is changed from the display of the integrated image shown in the upper part of FIG. 15C to the integration release display shown in the lower part. In the integration cancellation display, as shown in the lower part of FIG. 15C, the tomographic images having the slice intervals of 2 mm are displayed in the order of the image numbers, and the tomographic image of 5 mm is placed on the tomographic image of 2 mm associated in step S504. Is displayed.

  When the set integration algorithm is “minimum standard” (step S503; NO), each tomographic image having a smaller slice interval in the inspection to be compared is closest to the center position in the slice region of the tomographic image. (Step S505). When there are three or more inspections to be compared, the two inspections are sequentially associated in ascending order of the slice interval. Then, in accordance with the association in step S505, the integrated image of each examination is expanded and displayed on the display unit 23 on a plurality of tomographic images used to create the integrated image (step S506).

  16A to 16D, the slice interval of the inspection to be compared is 5 mm and 2 mm, and the integrated image of the group G11 (group consisting of image numbers 1) and the slice interval of 2 mm (2 mm) with the slice interval of 5 mm (5 mm image) are used. An integrated image of a group G11 ′ (group consisting of image numbers 1 to 3) of the image) is displayed in association with each other, and an integrated image of a group G12 (group consisting of image number 2) with a slice interval of 5 mm and a group G12 with a slice interval of 2 mm. ′ (Group consisting of image numbers 4 to 5) are displayed in association with each other, and an integrated image of group G13 (group consisting of image number 3) with a slice interval of 5 mm and a group G13 ′ (image number 6) having a slice interval of 2 mm. ) Are displayed in association with each other, and a group with a slice interval of 5 mm is displayed. A description will be given of a process of canceling the integration when the integrated image of G14 (group consisting of image numbers 4) and the integrated image of the group G14 ′ (group consisting of image numbers 9 to 10) with a slice interval of 2 mm are displayed in association with each other. .

  In step S502, as shown in FIG. 16A, in the RAM 25, the integrated image of group G11 is the tomographic image of image number 1, the integrated image of group G12 is the tomographic image of image number 2, and the integrated image of group G13 is the image number. The integrated image of group G14 is developed into the tomographic image of image number 4 in the tomographic image of 3. Further, the integrated image of the group G11 ′ is a tomographic image of image numbers 1 to 3, the integrated image of the group G12 ′ is a tomographic image of image numbers 4 to 5, and the integrated image of the group G13 ′ is a tomographic image of image numbers 6 to 8. The integrated image of the group G14 ′ is developed into tomographic images with image numbers 9 to 10 on the image.

  In step S505, as shown in FIG. 16B, each tomographic image having a 2 mm slice interval is associated with a tomographic image having a 5 mm interval closest to the center position of the slice region of the tomographic image. Specifically, among the tomographic images having a slice interval of 2 mm, the image numbers 1 to 3 are the image number 1, the image numbers 4 to 5 are the image number 2, the image numbers 6 to 8 are the image number 3, the image numbers 9 to 10 is associated with image number 4. When the center position is equidistant from the two tomographic images, the smaller image number has priority.

  In step S506, the screen display is changed from the display of the integrated image shown in the upper part of FIG. 16C to the integration release display shown in the lower part. In the integrated cancellation display, as shown in FIG. 16C, tomographic images with a slice interval of 2 mm are displayed in the order of image numbers, and the 5 mm tomographic image associated in step S505 is displayed on each tomographic image. Is done.

  When an integration cancellation display request is input by the operation unit 22 in a state where any one of the integrated images displayed on the integrated image display screen 231 is selected, the selected integrated image and the integrated image correspond to the selected integrated image. Only the integrated images of other examinations to be integrated are displayed. For example, when the integration cancellation display request is input in a state where the integrated image of the group G12 in FIG. 16A is selected, only the integrated images of the group G12 and the group G12 ′ are expanded and displayed on the tomographic image as shown in FIG. 16D. Is done. The same applies when the integration cancellation algorithm is the maximum standard.

  In step S11 of FIG. 3, three or more integrated images of any one of the tomographic image groups displayed on the integrated image display screen 231 by the operation unit 22 or three or more tomographic images among the tomographic images in which the integrated images are developed. When the image indicating the region of interest is marked (step S11), the region of interest interpolation processing is executed (step S12).

The doctor compares and interprets the integrated images or tomographic images of a plurality of examinations displayed on the integrated image display screen 231, and marks the region of interest determined to be a lesion by the operation unit 22.
For example, a mark button 231b is displayed on the integrated image display screen 231 as shown in FIG. 13, and after the mark button 231b is pressed by the operation unit 22, the displayed integrated image or tomographic image is displayed. When a closed curve indicating a region of interest is input from, the closed curve is recognized as a mark indicating the region of interest. When the interpolation button 231c is pressed after inputting the closed curve, the region of interest interpolation processing is executed.

Here, assuming that the length of the lesion P in the body axis direction is about 10 mm, in the integrated image having a slice interval of about 10 mm, one lesion P is depicted in one or two images as shown in FIG. 17A. The However, if marking is performed in this state, only the planar size of the lesion P can be pointed out, and the three-dimensional size cannot be obtained.
On the other hand, if the integration is canceled in this state and a tomographic image having a 1 mm slice interval is marked, since one lesion P is depicted in 10 or more images as shown in FIG. 17B, the lesion P If the two-dimensional marking is performed on all the images in which the image is drawn, the three-dimensional size of the lesion P can be obtained approximately. However, in this case, marking all the images in which the lesion P is depicted has a large amount of work for the doctor and the interpretation efficiency is reduced.

Therefore, in the present embodiment, three or more integrated images or three of the tomographic images in which the integrated images are developed in any of the tomographic image groups displayed on the integrated image display screen 231 by the operation unit 22 are displayed. When marking that indicates a region (region of interest) determined to be a lesion on two or more tomographic images, based on the region of interest of the marked image, a plurality of marked images are captured at the time of shooting. A region of interest in an image having a position in the body axis direction is calculated by interpolation.
For example, in a tomographic image having an interval of 1 mm as shown in FIG. 18A, for example, as shown in FIG. 18B, for example, three or more (three in this case) that are representative such as images of both ends and the center where the lesion P is depicted. When the region of interest of the image is marked, the region of interest of the image located between the images marked as shown by the dotted line in FIG. 18C is calculated by interpolation.

FIG. 19 shows a flow of region of interest interpolation processing executed in step S12 of FIG.
First, an interpolation algorithm setting is acquired (step S601). The interpolation algorithm can be set by the user from among linear interpolation, cubic convolution interpolation, spline interpolation, and the like.

  Next, the closed curve group is interpolated based on the acquired interpolation algorithm (step S602). For example, as shown in FIG. 20, interpolation is performed by regarding the input closed curve of the region of interest as contour lines and the slice position as height. By capturing the closed curve as a contour line, it is possible to obtain an interpolated contour line even in a complicated three-dimensional region having two peaks when viewed from the side. Note that the input information about the position of the closed curve and the position of the interpolated region of interest are written in the accompanying information of each tomographic image.

  Next, the display on the integrated image display screen 231 is updated based on the interpolation result (step S603). That is, as shown in FIG. 21, the region of interest calculated by the interpolation is displayed as a mark on the image located between the marked images displayed on the integrated image display screen 231. The region of interest drawn by interpolation is corrected by pressing the “correction” button 231d (see FIG. 13) on the integrated image display screen 231 and re-inputting the closed curve of the region of interest in any image. be able to.

  When the region of interest is corrected by the operation unit 22 (step S604), the process returns to step S602, and interpolation processing is performed based on the corrected region of interest.

  When an instruction for three-dimensional display of the region of interest is input by the operation unit 22 (step S605; YES), a three-dimensional image of the region of interest is generated based on the region of interest input manually and the region of interest obtained by interpolation. The created three-dimensional image is displayed on the display unit 23 (step S606). For example, as in the graph shown in FIG. 20, a three-dimensional image of the region of interest is created and displayed with the contours of the closed curve of the region of interest in each image to which the mark is attached and the slice position as the height.

  When an instruction to return to the two-dimensional display is input by the operation unit 22 (step S607; YES), the process returns to step S603. When a diagnosis end instruction is input from the operation unit 22 (step S608; YES), this process ends.

  In the above description of the display control process, the case where the slice interval is constant within the same examination (same series) has been described as an example. However, the present invention can be applied to a case where the slice interval changes even within the same examination (series). Applicable. In such a case, as shown in FIG. 22, the tomographic image group of each examination may be divided into image groups by dividing each slice interval.

  As described above, according to the client terminal 20, when the slice intervals in the plurality of examination tomographic image groups are different from each other, the CPU 21 selects one of the plurality of examination tomographic image groups based on the slice interval. The tomographic images belonging to the group of tomographic images of the examination are classified into a single unit or a group of multiple units with adjacent positions in the body axis direction at the time of imaging, and the tomographic images belonging to the group of tomographic images of other examinations are inspected as one Each tomographic image group is classified into a group for each tomographic image corresponding to the position in the body axis direction at the time of imaging. Then, one integrated image is created by synthesizing tomographic images classified into the same group, and the integrated images of the corresponding groups among a plurality of examinations are associated with each other and displayed on the display unit 23.

  Therefore, when comparatively interpreting tomographic image groups of a plurality of examinations having different slice intervals, the integrated images of the groups corresponding to the positions in the body axis direction at the time of imaging are displayed in association with each other. It is possible to prevent the displacement of the position in the body axis direction during photographing. In addition, since an integrated image is created using all the tomographic images in the group, it is possible to prevent the diagnosis performance from being prevented without using information useful for diagnosis in order to prevent displacement of the position in the body axis direction. It becomes possible.

  For example, in the image grouping process by algorithm 1, a tomographic image group of each examination is calculated by calculating a common multiple of slice intervals in a plurality of examination tomographic image groups and dividing the calculated common multiple by a slice interval of each examination. The number of images in group units is determined, and the tomographic image groups of each examination are classified into groups for each determined number of images from the comparison target images. Therefore, in each examination to be compared, it is possible to easily associate integrated images in a range corresponding to positions in the body axis direction at the time of photographing.

  For example, in the image grouping process by algorithm 2, the tomographic images belonging to the tomographic image group having the largest slice interval among the plurality of tomographic image groups of the plurality of examinations are classified into a single unit and the tomographic images of other examinations The tomographic images belonging to the image group are associated with a group in which slice regions overlap, and are classified into groups for each tomographic image associated with the same group. Therefore, it is possible to always obtain an integrated image suitable for diagnosis regardless of the common multiple of the slice interval of each examination. Further, by performing the association when the area where the slice areas overlap exceeds a predetermined threshold, grouping can be performed in consideration of the overlapping state of the slice areas.

  For example, in the image grouping process by the algorithm 3, the tomographic images belonging to the tomographic image group having the largest slice interval among the plurality of tomographic image groups are classified into a single unit, and other tomographic image groups Are associated with the group having the closest position in the body axis direction at the time of imaging, and are classified into groups for each tomographic image associated with the same group. Therefore, it is possible to always obtain an integrated image suitable for diagnosis regardless of the common multiple of the slice interval of each examination.

  In addition, by creating a single integrated image by averaging pixel signal values for each corresponding pixel between tomographic images classified into the same group, reducing noise in tomographic images used for comparative interpretation, The S / N ratio can be improved.

  In addition, by acquiring a maximum pixel signal value for each corresponding pixel between tomographic images classified into the same group, and creating a single integrated image composed of the acquired maximum pixel signal value, the structure of the subject It is possible to acquire an integrated image with a clear outline.

  In addition, by acquiring a minimum pixel signal value for each corresponding pixel between tomographic images classified in the same group and creating a single integrated image consisting of the acquired minimum pixel signal value, bronchi, emphysema, etc. The drawing performance of the signal intensity portion close to the air can be improved.

  Further, in the client terminal 20, the CPU 21 expands and displays the integrated image displayed on the display unit 23 in accordance with a predetermined operation of the operation unit 22 into a plurality of tomographic images used to create the integrated image. , It is possible for doctors to cancel the integration of the integrated image with the region of interest that seems to be a lesion by simple operation and observe each tomographic image, which can improve the convenience and efficiency of diagnosis .

  Further, in the client terminal 20, the CPU 21 determines that a closed curve indicating a region of interest is marked by the operation unit 22 in at least three or more of the integrated image displayed on the display unit 23 or the developed tomographic image. A region of interest in an image in which a position in the body axis direction at the time of photographing exists between the marked images is calculated by interpolation based on the marked region of interest, and a mark is displayed. Therefore, it is possible to reduce the marking work by the doctor and improve the interpretation efficiency.

  In the client terminal 20, the CPU 21 creates a three-dimensional image of the region of interest based on the marked region of interest and the interpolated region of interest and displays it on the display unit 23. This is suitable for comparison for follow-up observation.

In addition, the description content in the said embodiment is a suitable example of this invention, and is not limited to this.
For example, the slice interval in the above embodiment is an example, and the present invention is not limited to this. Further, the display mode of the integrated image between the examinations to be compared on the display unit 23 is not limited to the illustrated one.

  In the above embodiment, image data of a medical image is stored in the image management server 10 as an image storage device, and the client terminal 20 as a medical image display device is connected via the communication network N to the image management server 10. In the above description, the medical image is read out from the image and displayed as an example. However, the image storage device and the medical image display device may be integrated.

  For example, in the above description, an example in which an HDD or a semiconductor nonvolatile memory is used as a computer-readable medium of the program according to the present invention is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. Further, a carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operations of the medical image management system 100 and the devices constituting the medical image management system 100 can be changed as appropriate without departing from the spirit of the invention.

  It should be noted that the Japanese Patent Application No. 1993 filed on August 8, 2008, including the description, claims, drawings and abstract. The entire disclosure of 2008-205897 is incorporated in its entirety into this application.

  In the medical field, there is a possibility of use in a medical image display device that displays a medical image for diagnosis by a doctor.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100 Medical image management system 10 Image management server 15 Memory | storage part 151 Medical image DB
152 incidental information DB
20 Client terminal 21 CPU
22 Operation unit 23 Display unit 24 Communication unit 25 RAM
26 Memory 27 Bus

Claims (13)

An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition means;
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. Image grouping means for classifying into groups for each tomographic image;
Image integration means for creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing means for displaying an integrated image in each group of the one tomographic image group on a display means in association with an integrated image in the group of the other tomographic image group corresponding to the group;
A medical image display device comprising:   The image grouping means calculates a common multiple of slice intervals in the plurality of tomographic image groups, and divides the calculated common multiple by a slice interval in each of the plurality of tomographic image groups, thereby obtaining the plurality of tomographic images. The medical image display apparatus according to claim 1, wherein the tomographic image classification is performed by determining the number of group-by-group images in each group.   The image grouping means classifies tomographic images belonging to one tomographic image group having the largest slice interval among the plurality of tomographic image groups into a group of one sheet, and tomographic images belonging to other tomographic image groups. The medical image display apparatus according to claim 1, wherein the medical image display apparatus is associated with the group of the one tomographic image group having the closest position in the body axis direction at the time of imaging and is classified into groups for each tomographic image associated with the same group.   When an area having a slice interval width based on the position in the body axis direction at the time of imaging is a slice area of each tomographic image, the image grouping means has the largest slice interval among the plurality of tomographic image groups The tomographic images belonging to one tomographic image group are classified into groups of one sheet, and the tomographic images belonging to other tomographic image groups are associated with the group of the one tomographic image group with overlapping slice regions, and the same group is assigned. The medical image display apparatus according to claim 1, wherein the medical image display apparatus classifies the group into groups for each of the associated tomographic images.   The medical image display apparatus according to claim 4, wherein the image grouping unit performs association when an area where the slice areas overlap exceeds a predetermined threshold.   The said image integration means produces one integrated image by averaging a pixel signal value for every corresponding pixel between the tomographic images classified into the same group by the said image grouping means. The medical image display device according to any one of the above.   The image integration unit acquires a maximum pixel signal value for each corresponding pixel between tomographic images classified into the same group by the image grouping unit, and one integrated image composed of the acquired maximum pixel signal value The medical image display device according to any one of claims 1 to 5, wherein the medical image display device is created.   The image integration unit acquires a minimum pixel signal value for each corresponding pixel between tomographic images classified into the same group by the image grouping unit, and one integrated image composed of the acquired minimum pixel signal value The medical image display device according to any one of claims 1 to 5, wherein the medical image display device is created.   The medical image display according to any one of claims 1 to 8, further comprising an integration cancellation unit that expands and displays the integrated image displayed on the display unit on a plurality of tomographic images used to create the integrated image. apparatus. Operation means;
When a closed curve indicating a region of interest is marked by the operation means in at least three or more of the integrated image displayed on the display means or the developed tomographic image, the plurality of marked images are between the marked images. A region of interest interpolation means for calculating a region of interest of an image having a position in the body axis direction at the time of photographing by interpolation based on the marked region of interest, and displaying a mark on the calculated region of interest;
A medical image display apparatus according to any one of claims 1 to 9.   The medical image display apparatus according to claim 10, further comprising: a three-dimensional display processing unit that creates a three-dimensional image of the region of interest based on the marked region of interest and the interpolated region of interest and displays the region on the display unit. An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition process;
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. An image grouping process for classifying into groups for each tomographic image;
An image integration step of creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing step of displaying an integrated image in each group of the one tomographic image group on a display unit in association with an integrated image in the group of the other tomographic image group corresponding to the group;
A medical image display method including: Computer
An image for acquiring a plurality of tomographic image groups to be compared from an image storage device that stores a plurality of tomographic image groups acquired by continuously photographing a human body along a body axis direction at predetermined slice intervals. Acquisition means,
When slice intervals in the acquired plurality of tomographic image groups are different from each other, based on the slice intervals, tomographic images belonging to one tomographic image group among the plurality of tomographic image groups are taken as a single unit or at the time of imaging. The positions in the body axis direction are classified into adjacent groups, and the tomographic images belonging to the other tomographic image groups correspond to the groups in the one tomographic image group and the positions in the body axis direction at the time of photographing. Image grouping means for classifying into groups for each tomographic image;
Image integration means for creating one integrated image by synthesizing tomographic images classified into the same group by the image grouping means;
An integrated image display processing means for displaying an integrated image in each group of the one tomographic image group on a display means in association with an integrated image in the group of the other tomographic image group corresponding to the group;
Program to function as.

Images