JPWO2018212249A1 - Image display device and image display device set - Google Patents

Abstract

An image display device according to the present disclosure includes an image acquisition unit capable of acquiring a three-dimensional image of a heart from outside a body, and a detection unit capable of detecting a medical device inserted into the heart in the three-dimensional image. A control unit that specifies a position of the medical device in an axial direction of a predetermined coordinate axis set in the three-dimensional image; and a control unit that determines a position of the medical device in the three-dimensional image at a position of the medical device. A cross-sectional image of a cross-section that intersects at an angle with a display unit that can switch and display the cross-sectional image in accordance with a change in position of the medical device in the heart in the axial direction with respect to the axial direction.

Description

  The present disclosure relates to an image display device and an image display device set.

  2. Description of the Related Art Conventionally, it has been known that a medical instrument is inserted into a blood vessel, a heart, or the like, and diagnosis or treatment is performed while detecting the position of the medical instrument in a body using an extracorporeal three-dimensional ultrasonic diagnostic apparatus. . Patent Document 1 describes an ultrasonic diagnostic apparatus used for this type of diagnosis.

  The ultrasonic diagnostic apparatus described in Patent Literature 1 includes an ultrasonic generating unit that generates an ultrasonic wave near a distal end, and transmits and receives ultrasonic waves to and from a catheter or a small-diameter probe inserted into the subject. An ultrasonic probe in which a plurality of ultrasonic transducers that wave are arranged two-dimensionally. Further, the ultrasonic diagnostic apparatus described in Patent Document 1 includes a first transmission driving unit that generates a driving signal so that an ultrasonic probe performs ultrasonic transmission for generating an ultrasonic image, and an ultrasonic generation unit. Second transmission driving means for generating a drive signal so as to perform ultrasonic transmission for position detection a plurality of times, an ultrasonic reception signal based on a plurality of ultrasonic waves for position detection are added, and based on the reception signal after the addition, Position calculating means for obtaining position information of the catheter or the small diameter probe. Further, the ultrasonic diagnostic apparatus described in Patent Literature 1 includes an ultrasonic image generating unit that generates an ultrasonic image based on an ultrasonic reception signal corresponding to an ultrasonic transmission for generating an ultrasonic image, a catheter, or a catheter. Display means for displaying the position of the catheter or the small diameter probe together with the ultrasonic image based on the position information of the diameter probe.

  Further, Patent Literatures 2 and 3 disclose a configuration in which a medical device can be guided by displaying an image at a real-time position.

JP 2001-297756 A JP 2006-51359 A JP-T-2009-511185

  A medical worker such as a doctor displays a medical device inserted into a heart from a blood vessel on a screen, and executes diagnosis and treatment while monitoring the screen. Patent Documents 1 to 3 describe displaying the position of a medical device in a body as an image. However, in consideration of the workability of medical personnel such as doctors, the display of a medical device in the heart is described. Still has room for improvement.

  Therefore, an object of the present disclosure is to provide an image display device and an image display device set capable of displaying a medical device to be inserted into a heart so as to improve the workability of a medical worker.

  An image display device according to a first aspect of the present invention includes an image acquisition unit capable of acquiring a three-dimensional image of a heart from outside the body, and detecting a medical device inserted into the heart in the three-dimensional image. A possible detection unit, a control unit that specifies the position of the medical device in an axis direction of a predetermined coordinate axis set in the three-dimensional image, and a control unit that specifies the position of the medical device in the three-dimensional image. A cross-sectional image of a cross section that intersects with the axial direction at a predetermined angle, a display unit that can be displayed by switching according to a change in position of the medical device in the heart along with the advance / retreat in the axial direction, Is provided.

  As one embodiment of the present invention, the image acquisition unit can acquire the three-dimensional image of the heart over time, and the display unit becomes a source of the cross-sectional image as time passes. Switch between three-dimensional images.

  As one embodiment of the present invention, the predetermined coordinate axis set by the control unit is common between the three-dimensional images acquired at different timings over time, and the predetermined coordinate axis is This is a straight line connecting the position of the aortic valve or the mitral valve and the position of the apex.

  As one embodiment of the present invention, the image acquisition unit includes: an ultrasonic transmission unit that transmits an ultrasonic wave; an ultrasonic reception unit that receives an ultrasonic wave; An image forming unit for forming a two-dimensional image.

  As one embodiment of the present invention, the display unit is a follow-up display mode that displays the cross-sectional image in accordance with the movement of the position of the medical device in the heart along with the reciprocation in the axial direction, A fixed display mode for displaying a predetermined cross section that intersects with the axial direction without following the movement of the position of the medical device in the heart in the axial direction, When the detection unit detects the medical device, the detection unit switches from the fixed display mode to the follow-up display mode.

  As one embodiment of the present invention, the display unit can display both the cross-sectional image and the external appearance image of the heart among the three-dimensional images.

  As one embodiment of the present invention, the detection unit is capable of detecting a predetermined position on the proximal side from the distal end in the insertion direction of the medical instrument, and the cross-sectional image displayed by the display unit is Includes the location of the tip of the medical device.

  A screen display device set according to a second aspect of the present invention includes the image display device and the medical device, wherein the medical device has a tubular member and a proximal end side of a distal end of the tubular member. A detection member provided on the peripheral wall of the tubular member at the position of the detection member, wherein the detection unit can detect, the control unit specifies the position of the detection member in the axial direction, the display unit Is a cross section of the three-dimensional image that intersects the axis direction at the predetermined angle at the position of the detected member, and includes the position of the distal end of the tubular member.

  As one embodiment of the present invention, when the detection target member is a first detection target member, the medical instrument is provided at a tip of the tubular member, and the second detection target that can be detected by the detection unit is provided. The control unit specifies a position of the second detected member in the axial direction, and the display unit adds or replaces the cross-sectional image at the position of the first detected member. In the three-dimensional image, at least one of a cross-sectional image and a tomographic image of a cross section that intersects the axis direction at the predetermined angle at the position of the second detected member can be displayed.

  A screen display device according to a third aspect of the present invention includes an image acquisition unit capable of acquiring a three-dimensional image of a heart from outside the body, a position of an aortic valve or a mitral valve, and a position of an apex in the three-dimensional image. A control unit that sets a linear coordinate axis connecting the position and a display unit that displays a cross-sectional image of the heart showing the left ventricle along the coordinate axis in the three-dimensional image.

  According to the present disclosure, it is possible to provide an image display device and an image display device set that can display a medical device to be inserted into a heart so as to improve the workability of a medical worker.

It is a figure showing an image display device set as one embodiment of the present invention. FIG. 2 is a schematic diagram illustrating an outline of a treatment performed using the image display device set illustrated in FIG. 1. FIG. 2 is a diagram showing various images of a heart displayed on a display unit of the image display device of the image display device set of FIG. 1.

  Hereinafter, embodiments of a screen display device and a screen display device set according to the present invention will be described with reference to the drawings. In the drawings, common members / parts are denoted by the same reference numerals.

  FIG. 1 is a diagram showing an image display device set 100 as one embodiment of an image display device set according to the present invention. An image display device set 100 shown in FIG. 1 includes an image display device 1 as one embodiment of an image display device according to the present invention, and a medical device 31 inserted into a heart. FIG. 2 is a schematic diagram showing an outline of a treatment performed using the image display device set 100.

  As shown in FIG. 2, the image display device 1 according to the present embodiment delivers a medical device 31 into a heart through a blood vessel and performs a predetermined diagnostic or therapeutic operation in the heart. Is a monitoring device capable of monitoring the state inside the heart. The monitoring device as the image display device 1 is, for example, the position and contour in the left ventricle LV of a tubular device such as a catheter as a medical device 31 inserted into the left ventricle LV from the femoral artery FA through the aorta AO and the aortic valve AV. Is displayed for monitoring from outside the body. A medical worker such as a doctor relies on the position and contour of the tubular device as the medical device 31 in the left ventricle LV displayed on the monitoring device as the image display device 1 to enter the left ventricle LV through the tubular device. Using a treatment device as another delivered medical instrument 31, a treatment such as a predetermined diagnosis or treatment is executed.

  The predetermined treatment performed in the left ventricle LV includes, for example, a treatment in which various therapeutic substances are administered into the myocardium for treating a heart disease or the like. Examples of various therapeutic substances include substances that can provide therapeutic effects such as cell replenishment, induction of angiogenesis, reinforcement of the heart wall, scaffolding materials, or tissue repair or regeneration by preventing apoptosis / necrosis. Or a polymer or the like. Cells as a therapeutic substance are administered into the myocardium in the form of a cell suspension dispersed in a liquid such as physiological saline.

  Cells as therapeutics include, for example, adherent cells (adherent cells). Adherent cells include, for example, adherent somatic cells (eg, cardiomyocytes, fibroblasts, epithelial cells, endothelial cells, hepatocytes, pancreatic cells, kidney cells, adrenal cells, periodontal ligament cells, gingival cells, periosteal cells, skin Cells, synovial cells, chondrocytes, etc.) and stem cells (eg, tissue stem cells such as myoblasts, cardiac stem cells, embryonic stem cells, pluripotent stem cells such as iPS (induced pluripotent stem) cells, mesenchymal stem cells, etc.) Including. The somatic cells may be stem cells, particularly cells differentiated from iPS cells. Non-limiting examples of cells as therapeutic agents include, for example, myoblasts (eg, skeletal myoblasts), mesenchymal stem cells (eg, bone marrow, adipose tissue, peripheral blood, skin, hair root, muscle tissue, uterus Intima, placenta, cord blood-derived cells), cardiomyocytes, fibroblasts, cardiac stem cells, embryonic stem cells, iPS cells, synovial cells, chondrocytes, epithelial cells (eg, oral mucosal epithelial cells, retinal pigment epithelium) Cells, nasal mucosal epithelial cells, etc.), endothelial cells (eg, vascular endothelial cells, etc.), hepatocytes (eg, liver parenchymal cells, etc.), pancreatic cells (eg, pancreatic islet cells, etc.), renal cells, adrenal cells, periodontal ligament cells Gingival cells, periosteal cells, skin cells and the like.

  Drugs as therapeutic agents include, for example, proteins, plasmids, genes, growth factors, chemoattractants, synthetic polypeptides, various pharmaceutical compositions, and the like, and other therapeutically beneficial substances alone, Alternatively, it can be included in any combination.

  Polymers as therapeutic substances include injectable, biocompatible single or multi-component materials, polymer-based beads, polymer hydrogels, fibrin adhesives, synthetic polymeric materials such as collagen, alginate, polyethylene glycol, and the like, and Chitosan and the like.

  In the present embodiment, as shown in FIG. 2, a treatment of administering a therapeutic substance from the left ventricle LV to or near the infarct site X of the myocardium of the left ventricle LV is monitored by the monitoring device as the image display device 1. An example of performing the treatment while monitoring is performed using a monitoring device as the image display device 1. The treatment performed while monitoring is not limited to administration of a predetermined therapeutic substance, and is, for example, a treatment for diagnosing an infarction state of the myocardium of the left ventricle LV. And so on. The infarct site X of the myocardium in the left ventricle LV is obtained by acquiring a tomographic image of the heart from outside the body using a magnetic resonance imaging device (hereinafter, referred to as an MRI device) or an X-ray computed tomography device (hereinafter, referred to as an X-ray CT device). Can be specified in advance from the acquired tomographic image.

  Further, the monitoring device as the image display device 1 of the present embodiment is a device that enables monitoring of the operation in the left ventricle LV described above. For example, the monitoring device may be in any of the right ventricle, the left atrium, and the right atrium. It is also possible to monitor the procedure to be performed from outside the body. As described later, the image display device 1 of the present embodiment is a three-dimensional ultrasonic diagnostic device. Therefore, a tomographic image in a different cross section can be acquired in any of the left ventricle LV, the right ventricle, the left atrium, and the right atrium, and monitoring can be performed by using these tomographic images. However, the image display device 1 of the present embodiment sets a predetermined coordinate axis O for monitoring the left ventricle LV (see FIG. 2). Details of the predetermined coordinate axis O will be described later.

  Hereinafter, details of the image display device 1 of the present embodiment will be described.

  As shown in FIG. 1, the image display device 1 includes an image acquisition unit 2, a detection unit 3, a control unit 4, a display unit 5, an operation unit 6, and a storage unit 7.

  The image acquisition unit 2 can acquire a three-dimensional image of the heart from outside the body. More specifically, the image acquisition unit 2 can acquire a three-dimensional image of the heart over time, and continuously displays the three-dimensional image of the heart acquired at predetermined time intervals on the display unit 5 described later. By doing so, a three-dimensional moving image of the heart can be formed.

  The image acquiring unit 2 according to the present embodiment includes an ultrasonic transmitting unit 11 that transmits an ultrasonic wave, an ultrasonic receiving unit 12 that receives an ultrasonic wave, and measurement information of the ultrasonic wave received by the ultrasonic receiving unit 12. And an image forming unit 13 that forms a tomographic image and a three-dimensional image from the ultrasonic data. The ultrasonic wave receiving unit 12 receives the ultrasonic waves transmitted from the ultrasonic wave transmitting unit 11 and reflected from each part of the heart.

  More specifically, the monitoring device as the image display device 1 of the present embodiment is a three-dimensional ultrasonic diagnostic device. “Three-dimensional ultrasonic diagnostic apparatus” means an ultrasonic diagnostic apparatus capable of capturing a three-dimensional image. The three-dimensional ultrasonic diagnostic apparatus as the image display apparatus 1 according to the present embodiment is a three-dimensional ultrasonic probe 1a to be brought into contact with the body surface, and a device capable of communicating with the three-dimensional ultrasonic probe 1a by wire or wirelessly. And a main body 1b. The three-dimensional ultrasonic probe 1a includes the ultrasonic transmitting unit 11 and the ultrasonic receiving unit 12 of the image acquiring unit 2 described above. The apparatus main body 1b includes the image forming unit 13 of the image acquiring unit 2 described above. The image forming unit 13 includes a processor such as a CPU and an MPU.

  As shown in FIG. 2, the three-dimensional ultrasonic probe 1 a is provided near the ribs on the front surface of the body so that the ultrasonic waves can be transmitted from the ribs toward the heart and the reflected ultrasonic waves can be received. Placed on the skin. In that state, an ultrasonic diagnosis is performed using the ultrasonic transmitting unit 11 and the ultrasonic receiving unit 12.

  The apparatus main body 1b acquires ultrasonic measurement information from the three-dimensional ultrasonic probe 1a. Next, the image forming unit 13 of the apparatus main body 1b forms a tomographic image of the heart based on the acquired ultrasonic measurement information.

  Thus, the image acquisition unit 2 can capture tomographic images at various cross sections of the heart. That is, the image forming unit 13 forms a tomographic image of the predetermined one plane based on the measurement information of the predetermined one plane received by the ultrasonic receiving unit 12. Further, the image acquisition unit 2 is configured to stack a plurality of tomographic images of the heart captured by scanning the ultrasound transmitting unit 11 and the ultrasound receiving unit 12 and to collect the tomographic images during scanning for capturing a plurality of tomographic images. By processing the three-dimensional data that is the basis of each tomographic image, rendering can be performed and a three-dimensional image of the heart can be captured. Specifically, the image forming unit 13 of the image acquiring unit 2 combines the plurality of tomographic images or processes the three-dimensional data collected when each tomographic image is captured, thereby obtaining a three-dimensional heart image. A three-dimensional model image as an image can be formed.

  FIG. 3 is a diagram illustrating an example of a state in which a three-dimensional image of the heart acquired by the image acquisition unit 2 is displayed on the display unit 5. More specifically, the display unit 5 shown in FIG. 3 includes two cross-sectional images of the left ventricle LV of the heart (reference numerals “51” and “51” in FIG. 3) among the three-dimensional images of the heart acquired by the image acquisition unit 2. 52 ”) and one appearance image of the heart (see reference numeral“ 53 ”in FIG. 3). The two cross-sectional images 51 and 52 shown in FIG. 3 both intersect at a predetermined angle with a line segment connecting the aortic valve AV (see FIG. 2) and the apex Y of the left ventricle LV (see FIG. 2). It is a cross-sectional image of a cross section (which is substantially orthogonal in the embodiment) and is an image of the apex Y side viewed from the aortic valve AV side. If a three-dimensional image of the heart is acquired by the image acquisition unit 2, not only the two cross sections 51 and 52 shown in FIG. 3 but also a desired cross section of the heart can be displayed on the display unit 5 described later. In the embodiment, two sectional images 51 and 52 shown in FIG. 3 are displayed. The difference between these two cross-sectional images 51 and 52 will be described later.

  Further, as described above, the image acquiring unit 2 acquires a tomographic image and a three-dimensional image at predetermined time intervals. Specifically, the image acquisition unit 2 can capture a tomographic image at the same position every predetermined time and display the tomographic image as a moving image on the display unit 5 over time. In addition, the image acquisition unit 2 can capture a three-dimensional image of the heart at predetermined time intervals and display it as a moving image on the display unit 5 over time. If the imaging interval of the three-dimensional image is set to, for example, one second, and the display unit 5 displays the tomographic image, the three-dimensional image, or the like as a moving image over time at the same interval, a tomographic image of the heart, a three-dimensional image, or the like is obtained. Can be monitored in real time. In other words, an image of the heart can be displayed on the display unit 5.

  The imaging interval of the three-dimensional image is not limited to one second and can be set as appropriate. It is preferable to perform imaging at the following intervals. Further, the time interval at which the tomographic image or the three-dimensional image displayed on the display unit 5 is switched over time may be the same as the imaging interval of the three-dimensional image, or may be a different interval. For example, when displaying only the tomographic image on the display unit 5 in real time, the imaging interval for capturing the tomographic image at the same position is set to 200 msec or the like, and the display on the display unit 5 is switched at the same interval as the imaging interval. The display may be switched at a time interval different from the imaging interval. As an example in which the display unit 5 is switched at a time interval different from the imaging interval, for example, a tomographic image displayed on the display unit 5 and a tomographic image not displayed on the display unit 5 are alternately captured at predetermined time intervals. Configuration. When only the three-dimensional image is displayed on the display unit 5 in real time, the imaging interval for imaging the three-dimensional image at the same position is set to 1 second or the like, and the display unit 5 displays the image at the same interval as the imaging interval. The display may be switched, or the display may be switched at a time interval different from the imaging interval. As an example in which the display unit 5 is switched at a time interval different from the imaging interval, for example, a three-dimensional image displayed on the display unit 5 and a three-dimensional image not displayed on the display unit 5 are alternately displayed at predetermined time intervals. There is a configuration for imaging.

  As described above, the monitoring device serving as the image display device 1 according to the present embodiment displays an image of the heart in real time and performs a treatment for administering a predetermined therapeutic substance by relying on the image. Therefore, during this treatment, the three-dimensional ultrasonic probe 1a is fixed at a predetermined position on the body surface described above. The fixation of the three-dimensional ultrasonic probe 1a on the body surface can be realized by sticking to the body surface with an adhesive or the like.

  The detecting unit 3 can detect the medical device 31 inserted into the heart in the three-dimensional image of the heart acquired by the image acquiring unit 2. The detection unit 3 can be, for example, an ultrasonic detection device that detects using an ultrasonic wave. The detection unit 3 of the present embodiment is provided in the three-dimensional ultrasonic probe 1a, but is separate from the ultrasonic transmission unit 11 and the ultrasonic reception unit 12 of the image acquisition unit 2 described above. However, it is preferable that the ultrasonic transmission unit 11 and the ultrasonic reception unit 12 of the image acquisition unit 2 also serve as the detection unit 3.

  The detection unit 3 of the present embodiment can detect both a predetermined position on the base end side of the distal end in the insertion direction of the medical device 31 and the position of the distal end in the insertion direction of the medical device 31. As described later, the medical device 31 includes a first detected member 33 and a second detected member 34 that are easily detected by ultrasonic waves (see FIGS. 1 to 3). The ultrasonic detection device as the detection unit 3 can detect the first detected member and the second detected member 34.

  As illustrated in FIG. 2, the control unit 4 sets a predetermined coordinate axis in the three-dimensional image of the heart acquired by the image acquisition unit 2. In addition, the control unit 4 specifies the position of the medical device 31 in the axial direction A of the predetermined coordinate axis O to be set. That is, the control unit 4 generates position information indicating the position of the medical device 31 on the set coordinate axis O. More specifically, the control unit 4 of the present embodiment specifies the positions in the axial direction A of a first detected member 33 and a second detected member 34 described later in the medical device 31. The details will be described later.

  The above-described predetermined coordinate axis O set by the control unit 4 is common between the three-dimensional images of the heart acquired at different timings over time, and the predetermined coordinate axis O is the aortic valve AV (see FIG. 2) or the position of the mitral valve MV (see FIG. 2) and the position of the apex Y (see FIG. 2). The coordinate axis O of this embodiment is a straight line connecting the position of the aortic valve AV (see FIG. 2) and the position of the apex Y (see FIG. 2), and the cross-sectional image shown in FIG. 9 is an image of a cross section orthogonal to a predetermined coordinate axis O as a cross section that intersects the line O at a predetermined angle.

  The display unit 5 can display a tomographic image of the heart and a three-dimensional image of the heart. Then, the display unit 5 displays a cross-sectional image of a cross section that intersects (at a right angle in the present embodiment) the axis direction A at a predetermined angle at the position of the medical device 31 in the heart of the medical device 31 in the three-dimensional image. Can be switched and displayed in accordance with the change of the position accompanying the reciprocation in the axial direction A in the inside. That is, when the medical device 31 moves along the predetermined coordinate axis O, the position based on the coordinate axis O changes. Therefore, the control unit 4 switches the cross-sectional images displayed on the display unit 5 according to the position change. That is, the control unit 4 causes the display unit 5 to display a cross-sectional image corresponding to the position of the medical device 31. Therefore, a medical worker such as a doctor can check the cross-sectional image of the heart adjusted to the position of the medical device 31 at any time, thereby improving the workability of the medical worker during treatment.

  Specifically, the cross-sectional images 51 and 52 shown in FIG. 3 are switched in accordance with a change in the position of the medical device 31 as it moves in the axial direction A in the heart. The cross-sectional image 51 shown in FIG. 3 is a cross-sectional image of the medical device 31 at the position of the first detected member 33 (see FIGS. 1 and 2). The cross-sectional image 52 illustrated in FIG. 3 is a cross-sectional image of the medical device 31 at the position of the second detected member 34 (see FIGS. 1 to 3). Alternatively, the cross-sectional image 52 illustrated in FIG. 3 may be a tomographic image at the position of the second detected member 34 of the medical device 31.

  Hereinafter, further details of the present embodiment will be described.

  As described above, the image acquisition unit 2 of the present embodiment can acquire a three-dimensional image of the heart over time, and the display unit 5 displays the three-dimensional image that is the basis of the cross-sectional image as time elapses. Switch. That is, the cross-sectional image of the heart can be displayed on the display unit 5 over time as a moving image. At this time, based on the time information, the control unit 4 specifies a three-dimensional image of the heart, which is a source of the cross-sectional image displayed on the display unit 5, and a cross-sectional position of the cross-sectional image displayed on the display unit 5, The display unit 5 displays a predetermined cross-sectional image. As described above, in the image display device 1 of the present embodiment, the cross-sectional position of the cross-sectional image displayed on the display unit 5 not only changes in accordance with the position change of the medical device 31, but also changes the original of the cross-sectional image. The three-dimensional image is updated as needed based on the time information. Thereby, the cross-sectional image of the heart can be monitored in more real time, and the workability of the medical worker during the operation can be further improved.

  In addition, the display unit 5 of the present embodiment is not limited to the above-described follow-up display mode in which the cross-sectional image is switched and displayed following the movement of the position of the medical device 31 in the heart along the axial direction A in the heart. And a fixed display mode for displaying a predetermined cross section orthogonal to the axial direction A without following the movement of the position of the medical device 31 in the axial direction A within the heart. Then, when the detection unit 3 detects the medical device 31, the control unit 4 switches from the fixed display mode to the follow-up display mode. In other words, the control unit 4 causes the display unit 5 to display the left ventricle LV in the fixed display mode when the medical instrument 31 has not reached the left ventricle LV at the start of the operation. The cross-sectional image displayed in the fixed display mode of the present embodiment is at a position near the aortic valve AV on the coordinate axis O (see FIG. 2) connecting the aortic valve AV (see FIG. 2) and the apex Y (see FIG. 2). Is a cross-sectional image of one cross section orthogonal to the coordinate axis O, but may be any cross section intersecting with the axial direction A of the coordinate axis O, and is not limited to one cross section perpendicular to the coordinate axis O.

  After that, when the medical device 31 reaches the left ventricle LV through the aortic valve AV, for example, and the detection unit 3 detects the medical device 31, the control unit 4 switches the mode to be displayed on the display unit 5. Switch from fixed display mode to follow-up display mode. The detection of the medical device 31 by the detection unit 3 is not limited to the case where the detection unit 3 detects the first detected member 33 or the second detected member 34, and the detection unit 3 may detect other positions of the medical device 31. It may be the case where it is detected.

  When the display unit 5 is in the fixed display mode, the image acquisition unit 2 has not acquired a three-dimensional image of the heart with time, and when the display unit 5 switches to the follow-up display mode, the control unit 4 sets the image acquisition unit. For 2, the acquisition of a three-dimensional image of the heart over time may be started, and the real-time display on the display unit 5 may be started. Accordingly, it is possible to suppress the useless imaging of the three-dimensional image of the heart.

  Here, as shown in FIG. 3, the display unit 5 of the image display device 1 of the present embodiment can display not only the cross-sectional images 51 and 52 of the heart but also the external appearance image 53 of the heart. As described above, the display unit 5 simultaneously displays images from a plurality of viewpoints among the three-dimensional images of the heart, so that the convenience of a medical staff such as a doctor during the operation can be further improved. As shown in FIG. 3, the display unit 5 of the present embodiment can display the cross-sectional images 51 and 52 and the appearance image 53 at the time, but if both the cross-sectional image and the appearance image can be displayed, For example, for example, the display may be switched separately. However, if simultaneous display is possible as in the present embodiment, it is preferable because a medical worker can easily monitor during a treatment and a screen switching operation during the treatment is not required.

  As illustrated in FIG. 3, the display unit 5 according to the present embodiment includes two cross-sectional images 51 orthogonal to the coordinate axis O as cross-sectional images of cross sections that intersect the axis direction A of the coordinate axis O at a predetermined angle. 52 can be displayed simultaneously. As described above, the cross-sectional image 51 in FIG. 3 is a cross-sectional image at a predetermined position closer to the proximal end than the distal end of the medical device 31. The cross-sectional image 52 in FIG. 3 is a cross-sectional image at the position of the distal end of the medical device 31.

  As shown in FIGS. 1 and 2, the medical device 31 is provided on the tubular member 32 and on the peripheral wall of the tubular member 32 at a position closer to the base end than the distal end of the tubular member 32, and the detection unit 3 can detect it. A first detected member 33 and a second detected member 34 provided at the distal end of the tubular member 32 and capable of being detected by the detection unit 3. When the detection unit 3 detects the first detected member 33, the control unit 4 of the image display device 1 specifies the position of the first detected member 33 on the coordinate axis O, and performs image display (mapping). In addition, when the detection unit 3 detects the second detected member 34, the control unit 4 of the image display device 1 specifies the position of the second detected member 34 on the coordinate axis O and displays (maps) the image.

  3 is a cross-sectional image of a cross section orthogonal to the coordinate axis O at the position of the first detected member 33 of the medical device 31. The cross-sectional image 52 illustrated in FIG. 3 is a cross-sectional image of a cross section orthogonal to the coordinate axis O at the position of the second detected member 34 of the medical device 31. Therefore, the cross-sectional image 51 shown in FIG. 3 includes the position of the distal end of the tubular member 32 as the distal end of the medical device 31. That is, according to the cross-sectional image 51, the tip of the tubular member 32 in the left ventricle LV can be confirmed. On the other hand, the cross-sectional image 52 shown in FIG. 3 does not include the distal end of the tubular member 32 as the distal end of the medical device 31. Instead, the state of the myocardial infarct site X at the position of the distal end of the tubular member 32 can be confirmed.

  As described above, the detection unit 3 detects a predetermined position on the base end side of the distal end of the medical device 31 in the insertion direction and enables monitoring of the cross-sectional image 51 at the predetermined position in real time. The position and the direction of the tip of the tubular member 32 of the appliance 31 can be confirmed. On the other hand, when administering the therapeutic substance to or near the infarct site X, as shown in FIG. 3, the puncture member 35 is protruded from the distal end opening of the tubular member 32 to puncture the myocardium and inject the therapeutic substance. I do. That is, the position of the myocardium to which the therapeutic substance is actually administered is not the position of the myocardium shown in the cross-sectional image 51 of FIG. 3, but the position of the myocardium shown in the cross-sectional image 52 of FIG. Therefore, the position of the myocardium to which the therapeutic substance is to be administered, the thickness of the myocardium at that position, and the like need to be confirmed from the cross-sectional image 52 in FIG. As described above, by using the cross-sectional image 51 at a position closer to the proximal end than the distal end of the tubular member 32, the position and the direction of the distal end of the tubular member 32 of the medical device 31 can be confirmed. The operation inside the heart becomes easier. Furthermore, by using the cross-sectional image 52 at the position of the distal end of the tubular member 32, the myocardial condition at the position where the therapeutic substance is actually administered can be confirmed, and the administration position and the depth of the myocardium to be administered can be clarified. can do. A cross-sectional image 51 of the present embodiment illustrated in FIG. 3 is a cross-sectional image at the position of the first detected member 33 attached at a position of about 30 mm from the distal end to the proximal end of the tubular member 32. Further, the control unit 4 may be configured to be able to control the length of the puncture member 35 projecting from the distal end opening of the tubular member 32 based on the thickness information of the myocardium in the cross-sectional image 52.

  In the present embodiment, as shown in FIG. 3, the cross-sectional images 51 and 52 are simultaneously displayed on the display unit 5, but the cross-sectional image 51 at the position of the first detected member 33 and the second detected member 34 are displayed. The display unit 5 may be configured to switch and display the cross-sectional image 52 at the position. However, if the cross-sectional images 51 and 52 are simultaneously displayed as in the display unit 5 of the present embodiment, both the moving operation and the administration operation of the medical device 31 can be easily performed without switching the screen. can do.

  In addition, the display unit 5 of the present embodiment is configured to simultaneously display a total of three images of the cross-sectional images 51 and 52 shown in FIG. 3 and the appearance image 53 shown in FIG. Of these, another image may be further displayed. Further, a configuration in which an image other than a three-dimensional image such as a tomographic image is displayed may be employed.

  As described above, in the treatment exemplified here, the position and size of the infarct site X of the myocardium of the left ventricle LV have been acquired in advance using an MRI apparatus or an X-ray CT apparatus. Then, as shown in FIG. 3, the cross-sectional images 51 and 52 of the three-dimensional images captured by the image acquisition unit 2 are displayed on the display unit 5. The display indicating the position and the size of the part X is superimposed or synthesized. That is, the real-time cross-sectional images 51 and 52 that are switched to the latest state at any time can indicate the position and size of the infarct site X to be treated or the vicinity thereof. Therefore, the actual treatment can be performed while confirming the position and size of the infarct site X, which is the target site of the treatment for administering the therapeutic substance, and the vicinity thereof in the cross-sectional image in real time.

  Further, as shown in FIG. 3, the display unit 5 displays an external appearance image 53 of the heart in addition to the cross-sectional images 51 and 52 described above. Are superimposed or combined.

  When a therapeutic substance is administered to or near the infarct site X displayed in the above-described cross-sectional images 51 and 52 and the appearance image 53, the control unit 4 places a predetermined mark on the administration position, for example. A display, such as a display, for identifying the position where the therapeutic substance is administered is displayed on the display unit 5 so as to be superimposed or combined with the cross-sectional images 51 and 52 and the appearance image 53. This makes it easy for a medical worker such as a doctor to grasp the progress of the treatment while checking the image display device 1.

  Hereinafter, other configurations of the image display device 1 will be described.

  The operation unit 6 is a part that receives an operation by a user. The operation unit 6 can be configured by, for example, various user interfaces such as a switch provided on an outer wall of the apparatus main body 1b of the image display apparatus 1 and a liquid crystal touch panel.

  The storage unit 7 stores an image acquisition program by the image acquisition unit 2, various control programs of the control unit 4, and the like, for example, a ROM (abbreviation of Read Only Memory) and a RAM (abbreviation of Random Access Memory). It can be constituted by a memory.

  The control unit 4 performs various operations on the image acquisition unit 2, the detection unit 3, the display unit 5, the operation unit 6, and the storage unit 7 at predetermined timings as well as the various controls described above. To instruct. The control unit 4 reads, for example, an image acquisition program stored in the storage unit 7 and causes the image acquisition unit 2 to execute an image acquisition operation. The control unit 4 is configured by a processor such as an MPU and a CPU. The image forming unit 13 of the image acquiring unit 2 is also configured by a processor such as an MPU and a CPU. Although the control unit 4 and the image forming unit 13 of the present embodiment are configured by different processors, they may be configured by a common processor.

  The image acquisition unit 2 according to the present embodiment includes an ultrasonic transmission unit 11, an ultrasonic reception unit 12, and an image forming unit 13 and is configured to be able to perform imaging by itself. The image acquisition unit may acquire the three-dimensional image obtained by receiving the three-dimensional image via wired communication or wireless communication.

  Finally, as the image display device 1 used in the left ventricle LV, as shown in the present embodiment, the control unit 4 uses the aortic valve AV (see FIG. 2) or the mitral valve MV in a three-dimensional heart image. It is desirable to set a linear coordinate axis O connecting the position of the apex (see FIG. 2) and the position of the apex Y (see FIG. 2). Further, as in the present embodiment, it is desirable that the display unit 5 displays a cross-sectional image of the heart (see FIG. 3) showing the inside of the left ventricle LV along the coordinate axis O in the three-dimensional image of the heart. If the control unit 4 sets such a coordinate axis O and the display unit 5 displays the left ventricle LV from a viewpoint along the coordinate axis O, it is possible to improve the workability of the treatment in the left ventricle LV. And a coordinate system relatively insensitive to the pulsation of the heart.

  The image display device and the image display device set according to the present invention are not limited to the specific configuration of the embodiment described above, and various changes and modifications can be made without departing from the scope of the claims. .

  The present disclosure relates to an image display device and an image display device set.

1: image display device 1a: three-dimensional ultrasonic probe 1b: device main body 2: image acquisition unit 3: detection unit 4: control unit 5: display unit 6: operation unit 7: storage unit 11: ultrasonic transmission unit 12: supersonic Sound wave receiving unit 13: Image forming unit 31: Medical instrument 32: Tubular member 33: First detected member 34: Second detected member 35: Puncturing members 51 and 52: Cross-sectional image 53: External image 100: Image display device Set A: axial direction AO: aorta AV: aortic valve FA: femoral artery LV: left ventricle MV: mitral valve O: coordinate axis X: infarct site Y: apex

Claims (10)

An image acquisition unit capable of acquiring a three-dimensional image of the heart from outside the body,
In the three-dimensional image, a detection unit capable of detecting a medical device inserted into the heart,
A control unit that specifies a position of the medical device in an axis direction of a predetermined coordinate axis set in the three-dimensional image;
Among the three-dimensional images, a cross-sectional image of a cross section that intersects with the axial direction at a predetermined angle at the position of the medical device is obtained by calculating the position of the medical device along the axial direction within the heart in the axial direction. An image display device comprising: a display unit that can be switched and displayed according to a change. The image acquisition unit is capable of acquiring the three-dimensional image of the heart over time,
The image display device according to claim 1, wherein the display unit switches the three-dimensional image serving as the basis of the cross-sectional image in accordance with a lapse of time. The predetermined coordinate axis set by the control unit is common between the three-dimensional images acquired at different times over time,
The image display device according to claim 1, wherein the predetermined coordinate axis is a straight line connecting a position of an aortic valve or a mitral valve and a position of an apex. The image acquisition unit,
An ultrasonic transmitter for transmitting ultrasonic waves,
An ultrasonic receiving unit that receives ultrasonic waves,
The image display device according to claim 1, further comprising: an image forming unit configured to form the three-dimensional image from the measurement information received by the ultrasonic receiving unit. The display unit is a follow-up display mode that displays the cross-sectional image in accordance with the movement of the position of the medical device along the axial direction in the heart in the heart, and in the heart of the medical device. A fixed display mode for displaying a predetermined cross section that intersects with the axial direction without following the movement of the position accompanying the advance and retreat in the axial direction,
5. The image display device according to claim 1, wherein when the detection unit detects the medical device, the device switches from the fixed display mode to the follow-up display mode. 6.   The image display device according to claim 1, wherein the display unit is capable of displaying both the cross-sectional image and the external appearance image of the heart among the three-dimensional images. The detection unit is capable of detecting a predetermined position on the proximal side from the distal end in the insertion direction of the medical device,
The image display device according to claim 1, wherein the cross-sectional image displayed by the display unit includes a position of a tip of the medical device. An image display device according to claim 7, and the medical device,
The medical device includes a tubular member, and a detected member that is provided on a peripheral wall of the tubular member at a position closer to a base end than a distal end of the tubular member, and that the detection unit can detect,
The control unit specifies a position of the detected member in the axial direction,
The cross-sectional image displayed by the display unit is a cross-section of the three-dimensional image that intersects the axis direction at the predetermined angle at the position of the detected member, and includes a position of the distal end of the tubular member. Image display device set. When the detected member is a first detected member,
The medical device is provided at a tip of the tubular member, and includes a second detected member that can be detected by the detection unit,
The control unit specifies a position of the second detected member in the axial direction,
The display unit may include, in addition to or instead of the cross-sectional image at the position of the first detected member, the three-dimensional image at the position of the second detected member at the predetermined angle with the axis direction. The image display device set according to claim 8, wherein at least one of a cross-sectional image and a tomographic image of a crossing cross section can be displayed. An image acquisition unit capable of acquiring a three-dimensional image of the heart from outside the body,
A controller configured to set a linear coordinate axis connecting the position of the aortic valve or the mitral valve and the position of the apex in the three-dimensional image;
A display unit that displays a cross-sectional image of the heart showing the left ventricle along the coordinate axis line in the three-dimensional image.

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