WO2005112774A1 - 超音波診断装置および超音波診断装置の制御方法 - Google Patents
超音波診断装置および超音波診断装置の制御方法 Download PDFInfo
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- WO2005112774A1 WO2005112774A1 PCT/JP2005/009162 JP2005009162W WO2005112774A1 WO 2005112774 A1 WO2005112774 A1 WO 2005112774A1 JP 2005009162 W JP2005009162 W JP 2005009162W WO 2005112774 A1 WO2005112774 A1 WO 2005112774A1
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- cardiac cycle
- ultrasonic diagnostic
- ultrasonic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0858—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving measuring tissue layers, e.g. skin, interfaces
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1075—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/54—Control of the diagnostic device
- A61B8/543—Control of the diagnostic device involving acquisition triggered by a physiological signal
Definitions
- the present invention relates to an ultrasonic diagnostic apparatus for measuring elastic properties of living tissue using ultrasonic waves, and a control method for the ultrasonic diagnostic apparatus.
- Atherosclerosis is closely related to the onset of myocardial infarction and cerebral infarction. Specifically, when atheroma is formed on the arterial wall or new cells of the artery are not produced due to various factors such as hypertension, the artery loses elasticity and becomes hard and brittle. When the atheroma is formed, blood vessels are blocked, or the vascular tissue covering the atheroma is ruptured. These diseases can be caused by the rupture of the affected parts. Therefore, early diagnosis of arteriosclerosis is important for prevention and treatment of these diseases.
- arteriosclerosis can be diagnosed at an early stage and a therapeutic agent for arteriosclerosis can be administered to a patient, it will be effective in treating arteriosclerosis. However, as arteriosclerosis progresses, it is said that it is difficult to completely restore a hardened artery even if the therapeutic agent can suppress the progress of arteriosclerosis.
- Measuring a cholesterol level or a blood pressure level that contributes to arteriosclerosis is a test that can be easily performed with a small burden on a patient. But these values Does not directly indicate the degree of arteriosclerosis.
- an ultrasonic diagnostic apparatus As a medical diagnostic apparatus that places less burden on a patient, an ultrasonic diagnostic apparatus has been conventionally used. By irradiating ultrasonic waves from outside the body using an ultrasonic diagnostic apparatus, it is possible to obtain information on the shape, movement, or quality of the body without causing pain to the patient.
- the measurement is performed by the ultrasonic wave
- the motion information of the object to be measured can be obtained, so that the elasticity characteristics of the object to be measured can be obtained. That is, it is possible to obtain the elastic characteristics of the blood vessels in the living body, and it is possible to directly know the degree of arteriosclerosis.
- the measurement can be performed simply by applying the ultrasonic probe to the patient, the burden on the patient is small. For this reason, if an ultrasonic diagnostic apparatus is used, accurate diagnosis of arteriosclerosis is possible, and it is expected that a checkup for prevention is performed without imposing a burden on the subject.
- conventionally used ultrasonic diagnostic apparatuses include, for example, an ultrasonic diagnostic apparatus for observing the shape of a fetus and auscultating the heart sound of a fetus, such as an ultrasound diagnostic apparatus.
- the resolution is not very high. For this reason, it has been impossible to determine the elastic characteristics of an artery that expands and contracts in accordance with the cardiac cycle using a conventional ultrasonic diagnostic apparatus. For example, in many cases, the displacement measurement accuracy of a measurement target is not sufficient, such as that shown in Patent Document 1.
- Patent Document 2 discloses an ultrasonic vibration device that determines the instantaneous position of a target by using a constrained least squares method using both the amplitude and phase of a detection signal, and realizes highly accurate phase tracking. Te ru. This device can measure micro-vibration on a tissue that is moving largely due to pulsation. According to Patent Literature 2, it is possible to measure a minute vibration up to several hundred Hz on a large amplitude displacement movement associated with a beat having an amplitude of 10 mm or more even if the beat is repeated about 10 times, with sufficient reproducibility.
- Patent Documents 2 and 3 can measure high frequency components up to several hundred Hz with high reproducibility, and focus the ultrasonic beam on the myocardium or artery wall.
- the elastic characteristics in the region of about l to 2 mm in diameter can be obtained.
- an ultrasonic signal of any time phase component can be obtained during one cardiac cycle, and that it has excellent features such as being capable of analyzing the frequency spectrum of the signal.
- the ultrasonic diagnostic apparatus using the technology of this publication for example, in a health checkup, the degree of progression of arteriosclerosis is examined over time without imposing a burden on the subject, and the disease caused by arteriosclerosis is examined. Is expected to be able to be prevented. It is expected that by measuring the elastic properties of micro-regions of arteries, it is possible to identify sites where vascular rupture is likely to occur and to treat those sites.
- Patent Document 1 JP-A-62-266040
- Patent Document 2 JP-A-10-5226
- Patent Document 3 Japanese Patent Application Laid-Open No. 2000-229078
- the maximum value and the minimum value of the blood pressure are obtained by blood pressure measurement using a sphygmomanometer or the like.
- the maximum thickness change amount Ah of the blood vessel wall is obtained from the maximum value and the minimum value of the change amount of the blood vessel wall thickness measured using, for example, the method of Patent Document 2 described above.
- the above calculation requires a much higher calculation capability than a conventional ultrasonic diagnostic apparatus for displaying the shape of a living tissue, and requires a computer having a high calculation processing capability. For this reason, the entire apparatus becomes expensive. Computing capacity is not high When a computer is used, it takes time to perform the calculation, so that a time lag occurs in displaying the measurement results.
- An ultrasonic diagnostic apparatus of the present invention includes a transmitting unit that drives an ultrasonic probe for transmitting an ultrasonic transmission wave to a body tissue of a living body, and the ultrasonic transmission wave transmits the ultrasonic transmission wave to the body tissue.
- a receiving unit that receives an ultrasonic reflected wave obtained by the reflection using the ultrasonic probe, a phase detecting unit that performs phase detection of the ultrasonic reflected wave, and a signal force obtained by the phase detection. Calculates the amount of displacement of the tissue at a plurality of measurement target positions, and calculates the maximum thickness change between two points selected from the plurality of measurement target positions and the Z or elastic characteristic from the position displacement.
- the calculation unit calculates the maximum value and the minimum value of the thickness or the amount of change in the thickness between the two points obtained by the position displacement force of the two points obtained during a part of one cardiac cycle of the living body.
- the maximum and minimum values Calculate the maximum thickness change amount and Z or elastic property from the difference.
- the body tissue is a circulatory organ
- the calculation unit receives the information on the blood pressure value of the living body, and calculates the elastic characteristic based on the blood pressure value.
- the ultrasonic diagnostic apparatus according to claim 1 or 2, wherein a part of the one cardiac cycle is set in synchronization with a biological signal obtained from the living body.
- the biological signal is an electrocardiographic waveform obtained by an electrocardiograph.
- the partial period of one cardiac cycle is at least one of a P wave, a Q wave, an R wave, an S wave, a T wave, and a U wave of the electrocardiographic waveform. Is set based on
- the partial period of the one cardiac cycle is set based on the R wave and the T wave of the electrocardiographic waveform.
- the biological signal is a heart sound waveform obtained by a heart sound meter.
- the partial period of the one cardiac cycle is set based on at least one of the I sound, the II sound, the III sound, and the IV sound of the heart sound waveform.
- the biological signal is a pulse waveform obtained by a pulse wave meter.
- the partial period of the one cardiac cycle is set based on at least one of an S wave, a P wave, a T wave, a C wave, and a D wave of the pulse wave waveform.
- the calculating unit previously obtains a position displacement waveform indicating a position displacement amount of the body tissue in the one cardiac cycle, and based on the position displacement waveform, calculates a part of the one cardiac cycle. Set the time period.
- the calculation unit previously obtains a thickness change amount waveform indicating the thickness change amount of the body tissue in the one-core period from the position displacement amount, and calculates the thickness change amount in advance.
- a partial period of the one cardiac cycle is set based on the change amount waveform.
- the arithmetic unit preferably obtains in advance the blood vessel diameter change amount waveform indicating the blood vessel diameter change amount of the body tissue in the one cardiac cycle from the position displacement amount, A partial period of the one cardiac cycle is set based on the change amount waveform.
- the partial period has a length of 5% or more and 75% or less of the one cardiac cycle.
- a display unit for displaying the maximum thickness change amount and the Z or elastic characteristic is further provided, and the arithmetic unit is configured to end a part of the one cardiac cycle. Then, during one cardiac cycle including the partial period, the maximum thickness change amount and the Z or elastic characteristic are calculated, and the display unit displays the maximum thickness change amount and the Z or elastic characteristic display on the part. Start during a cardiac cycle that includes a period.
- the transmitting unit drives an ultrasonic probe during a part of the one-heart cycle, and drives the ultrasonic probe in a part other than the one-part cycle. Stop driving the probe.
- the control method of the ultrasonic diagnostic apparatus of the present invention is a control method of the ultrasonic diagnostic apparatus by the control unit of the ultrasonic diagnostic apparatus, wherein the ultrasonic wave is transmitted, and the ultrasonic wave is transmitted to the body tissue of the living body.
- Position displacement force The maximum value and the minimum value of the thickness or the thickness change between the two points are calculated, and the maximum thickness change and the Z or the elastic property are calculated from the difference between the maximum value and the minimum value.
- the body tissue is a circulatory organ
- the calculating step calculates the elastic characteristic based on a blood pressure value of the living body.
- a part of the one cardiac cycle is set in synchronization with a biological signal obtained from the living body.
- the biological signal is an electrocardiographic waveform obtained by an electrocardiograph.
- the partial period of one cardiac cycle is at least one of a P wave, a Q wave, an R wave, an S wave, a T wave, and a U wave of the electrocardiographic waveform. Is set based on
- the partial period of the one cardiac cycle is set based on the R wave and the T wave of the electrocardiographic waveform.
- the biological signal is a heart sound waveform obtained by a phonograph.
- the partial period of the one cardiac cycle is set based on at least one of the I sound, the II sound, the III sound, and the IV sound of the heart sound waveform.
- the biological signal is a pulse waveform obtained by a pulse wave meter.
- the partial period of the one cardiac cycle is set based on at least one of an S wave, a P wave, a T wave, a C wave, and a D wave of the pulse waveform.
- the calculation unit previously obtains a position displacement waveform indicating a position displacement amount of the body tissue in the one cardiac cycle, and based on the position displacement waveform, calculates a part of the one cardiac cycle. Set the time period.
- the calculation unit previously obtains a thickness change amount waveform indicating the thickness change amount of the body tissue in the one cardiac cycle from the position displacement amount, and calculates the thickness change amount. A partial period of the one cardiac cycle is set based on the change amount waveform.
- the calculation unit may previously obtain a blood vessel diameter change amount waveform indicating a blood vessel diameter change amount of the body tissue in the one cardiac cycle from the position displacement amount, and A partial period of the one cardiac cycle is set based on the change amount waveform.
- the partial period of the one cardiac cycle includes at least an ejection period or a part of the ejection period.
- the partial period of one cardiac cycle includes at least a systole or a part of the systole.
- the partial period has a length of 5% or more and 75% or less of the one cardiac cycle.
- the method further includes a step of displaying the maximum thickness change amount and the Z or elasticity property, wherein the calculating step is performed after a part of the one cardiac cycle ends. Calculating the maximum thickness change amount and Z or elastic characteristic during one cardiac cycle including the partial period, and displaying the maximum thickness change amount and Z or elastic characteristic in the partial cardiac cycle. Start during a cardiac cycle that includes a period.
- the step of transmitting the ultrasonic wave and receiving the ultrasonic reflection is performed during a part of the one cardiac cycle, and the step of transmitting the ultrasonic wave is performed during a part of the one cardiac cycle. Suspend during periods other than.
- the calculation of the maximum value and the minimum value of the thickness or the thickness change amount in the calculation unit is obtained based on the position displacement amount obtained in a partial period of one cardiac cycle of the living body. Since the elastic properties are obtained using the maximum and minimum values, the effect of noise can be reduced and the elastic properties can be measured accurately.
- FIG. 1 is a block diagram showing a configuration for diagnosing a vascular wall tissue property using the ultrasonic diagnostic apparatus of the present invention.
- FIG. 2 is a block diagram showing a configuration of an ultrasonic diagnostic apparatus according to the present invention.
- FIG. 3 is a diagram schematically showing an ultrasonic beam propagating through a body tissue.
- FIG. 4 is a schematic diagram showing a relationship between a measurement target position and an elastic modulus at a measurement target portion.
- FIG. 5 The graph (a) and the force (c) show the positional displacement, the thickness change, and the blood vessel inner diameter change in the human carotid blood vessel measured by the ultrasonic diagnostic apparatus according to the present invention.
- Force (f) shows electrocardiogram, electrocardiogram and pulse wave.
- Chart (g) illustrates the cardiac cycle phenomenon.
- Chart (a) shows the timing of measurement, calculation and display in the ultrasonic diagnostic apparatus of the present invention
- chart (b) shows measurement, calculation and display in the conventional ultrasonic diagnostic apparatus. The timing is shown.
- FIG. 7 is a graph showing the time change of the thickness change amount of the posterior wall of the human carotid artery.
- FIG. 8 is a graph showing the time change of the thickness change of the posterior wall of the human carotid artery, showing a case where the period for searching for the maximum value and the minimum value of the thickness change is set shorter than one cardiac cycle. It is.
- the ultrasonic diagnostic apparatus of the present invention measures the speed of movement of each part of the measurement object, the maximum thickness change amount in each minute area, and the elasticity.
- the ultrasonic diagnostic apparatus of the present invention is particularly suitable for measuring elastic properties of various parts of a living body and has high spatial resolution, and therefore, is suitably used for measuring the maximum thickness change amount and elastic properties of a blood vessel wall. Can be.
- the ultrasonic diagnostic apparatus of the present invention will be described by taking as an example the case of measuring the maximum thickness change amount and elasticity of a blood vessel wall.
- FIG. 1 is a block diagram showing a configuration used when diagnosing tissue properties of a blood vessel wall using the ultrasonic diagnostic apparatus 11 of the present invention.
- the ultrasonic probe 13 connected to the ultrasonic diagnostic apparatus 11 is installed so as to be in close contact with the body surface 2 of the subject, and transmits ultrasonic waves to the inside of the body tissue including the extravascular tissue 1 and the blood vessel 3.
- the extravascular tissue is composed of fat, muscle and the like.
- the transmitted ultrasonic wave is reflected and scattered by the blood vessel 3 and the blood 5, and a part of the transmitted ultrasonic wave returns to the ultrasonic probe 13 and is received as an echo.
- the ultrasonic probe 13 includes a plurality of ultrasonic transducers (a group of ultrasonic transducers) arranged in an array, and a known ultrasonic probe used in a conventional ultrasonic diagnostic apparatus can be used.
- the ultrasonic diagnostic apparatus 11 analyzes and calculates the received signal to obtain motion information of the blood vessel wall 4.
- a blood pressure monitor 12 is connected to the ultrasonic diagnostic apparatus 11, and data relating to the blood pressure value of the subject measured by the blood pressure monitor 12 is input to the ultrasonic diagnostic apparatus 11.
- the ultrasonic diagnostic apparatus 11 determines the instantaneous position of the target by the constrained least squares method using both the amplitude and the phase of the detection signal by the method disclosed in Patent Document 2, and obtains a highly accurate By performing a phase tracking (measurement accuracy of the position displacement amount is about ⁇ 0.2 ⁇ m), it is possible to measure the time change of the position and the thickness of the minute portion on the blood vessel wall 4 with sufficient accuracy. Further, by using the blood pressure data obtained from the sphygmomanometer 12, it is possible to obtain the elastic characteristics of the minute part in the blood vessel wall 4.
- An electrocardiograph 22 is connected to the ultrasonic diagnostic apparatus 11, receives an electrocardiographic waveform from the electrocardiograph 22, and uses it as a trigger signal for determining data acquisition and data reset timing.
- a part of a cardiac cycle is set using an electrocardiographic waveform, and the elastic characteristic is obtained based only on information obtained in the set part of the period. As a result, the influence of noise can be reduced, and highly accurate and elastic characteristics can be obtained.
- FIG. 2 is a block diagram showing a configuration of the ultrasonic diagnostic apparatus 11.
- the ultrasonic diagnostic apparatus 11 includes a transmission unit 14, a reception unit 15, a delay time control unit 16, a phase detection unit 17, a filter 18, a calculation unit 19, a calculation data storage unit 20, and a display unit 21.
- a control unit 50 which is powerful such as a computer is provided.
- the transmitting section 14 generates a predetermined drive pulse signal and outputs the signal to the ultrasonic probe 13.
- the ultrasonic transmission wave transmitted from the ultrasonic probe 13 by the driving pulse signal is reflected and scattered by a body tissue such as the blood vessel wall 4 and the generated ultrasonic reflected wave is received by the ultrasonic probe 13.
- the receiving unit 15 receives the ultrasonic reflected wave using the ultrasonic probe 13.
- the receiver 15 includes an AZD converter, and the ultrasonic reflected wave amplified by the receiver 15 is converted into a digital signal.
- the transmitting unit 14 and the receiving unit 15 are configured using electronic components and the like.
- the delay time control unit 16 is connected to the transmission unit 14 and the reception unit 15, and controls the delay time of a drive pulse signal given from the transmission unit 14 to the ultrasonic transducer group of the ultrasonic probe 13. Thereby, the direction and the depth of focus of the acoustic line of the ultrasonic beam of the ultrasonic transmission wave transmitted from the ultrasonic probe 13 are changed. Also, by controlling the delay time of the received reflected wave signal received by the ultrasonic probe 13 and amplified by the receiving unit 15, the direction of the acoustic line of the received ultrasonic wave can be changed. The output of the delay time controller 16 is input to the phase detector 17.
- the phase detector 17 performs phase detection on the received reflected wave signal that has been delay-controlled by the delay time controller 16, and separates the signal into a real part signal and an imaginary part signal.
- the separated real part signal and imaginary part signal are input to the filter unit 18.
- the filter unit 18 removes reflection components and noise components from components other than the measurement target.
- the phase detector 17 and filter 18 can be hard- It can also be configured by hardware.
- the operation unit 19 obtains the movement speeds of a plurality of tracking positions set inside the blood vessel wall 4 using the real part signal and the imaginary part signal of the phase-detected signal, and integrates the movement speeds.
- the time displacement of each of the plurality of tracking positions inside the blood vessel wall 4 can be obtained.
- the thickness change amount between the two points can be obtained.
- the elasticity of the tissue located between the two points is determined from the difference between the maximum and minimum values of the obtained thickness change and the blood pressure data obtained from the sphygmomanometer 12 from the maximum thickness change obtained.
- the electrocardiographic waveform obtained from the electrocardiograph 22 is input to the calculation unit 19 and used as a trigger signal for determining data acquisition and data reset timings.
- the electrocardiograph 22 can be replaced with a heart sound meter or a pulse wave meter, which is another means of detecting a biological signal. It is also possible to use as.
- the data such as the amount of positional displacement, the amount of change in thickness, and the elasticity characteristics calculated by the calculation unit 19 are stored in the calculation data storage unit 20 and can be read at any time. Further, the data such as the amount of displacement, the amount of change in thickness, and the elastic properties calculated by the calculation unit 19 are input to the display unit 21 so that the data can be visualized as a two-dimensional image. Further, if the display unit 21 is connected to the operation data storage unit 20, the stored various data can be displayed on the display unit 21 as needed. The various data calculated by the calculation unit 19 are output to the display unit 21 and also output to the storage unit 20, so that the data is displayed in real time and stored so that the data can be used later. Is preferred. But it doesn't work without either one
- the transmitted ultrasonic wave emitted from the ultrasonic probe 13 propagates through the extravascular tissue 1 and the vascular wall 4 as an ultrasonic beam 26 having a certain finite width.
- a part of the ultrasonic wave reflected or scattered by 1 and the blood vessel wall 4 returns to the ultrasonic probe 13 and is received as an ultrasonic reflected wave.
- the reflected ultrasonic wave is detected as a time-series signal r (t), and the reflected time-series signal, which provides a tissue force close to the ultrasonic probe 13, can be obtained. Is located near the origin on the time axis.
- the width (beam diameter) of the ultrasonic beam 26 can be controlled by changing the delay time.
- the ultrasonic reflected wave is generated by both the extravascular tissue 1 and the blood vessel wall 4.
- a plurality of measurement target positions P (P, P, P, P ⁇ ⁇ , ⁇ is a natural number of 3 or more) in the blood vessel wall 4 located on the acoustic line 25 which is the central axis of the ultrasonic beam is ⁇ 1 2 3 kn
- the reflected wave signal r (t) is phase-detected by a phase detector 17, and the detected signal is separated into a real-part signal and an imaginary-part signal and passed through a filter part 18.
- the amplitude does not change, and only the phase and the reflection position change.
- the phase difference is determined by the least squares method so that the matching error of the waveform with the reflected wave signal r (t) tv (t + At) is minimized (constrained least squares method). From this phase difference, the motion velocity V (t) of the measurement target position Pn is obtained, and by integrating this, the position displacement d (t) can be obtained.
- FIG. 4 is a diagram showing the relationship between the measurement target position P and the target tissue T for calculating the elastic modulus.
- the target tissue T has a thickness h in a range sandwiched between adjacent measurement target positions P and P, and has a thickness k k k + 1
- the change in the thickness of the tissue T kk + 1 k k + 1 k k of the blood vessel wall 4 is caused by a change in the blood flowing through the blood vessel formed by the blood vessel wall 4 due to a heartbeat. Therefore, the maximum thickness H of the target tissue T (the value at the time of diastolic blood pressure), the target tissue k k
- the elastic modulus between adjacent measurement target positions is obtained.
- any two points of a plurality of measurement target positions can be selected as the elastic modulus.
- the same calculation can be performed using the maximum value of the thickness between the selected two points and the difference between the maximum value and the minimum value of the thickness change between the selected two points.
- the maximum thickness change ⁇ h, the pulse pressure ⁇ p, and the maximum thickness H are all numerical values updated every one cardiac cycle. . Therefore, it is preferable to obtain a value for each elastic cycle in synchronization with the cardiac cycle. In order to obtain the maximum thickness change Ah in one cardiac cycle, the maximum value and the minimum value of the thickness change in one cardiac cycle are required. In the present invention, the maximum value and the minimum value of this thickness change are obtained. Find values from periods shorter than one heart cycle. The measurement timing of these numerical values will be described in detail.
- FIG. 5 schematically show the positional displacement, the thickness change, and the blood vessel inner diameter change at an arbitrary position in the human carotid artery blood vessel wall measured by the ultrasonic diagnostic apparatus 11, respectively.
- Is shown in Graphs (d) to (f) in Fig. 5 show the electrocardiogram, electrocardiogram, and pulse wave, which are the biological signals obtained when the displacements shown in Figs. 5 (a) to (c) were measured. ing.
- the horizontal axis is the time axis, and the time axes are drawn to coincide.
- Chart (g) in FIG. 5 illustrates the cardiac cycle phenomena on the time axis of graphs (a) to (f).
- the one cardiac cycle is roughly divided into systole and diastole.
- the systole is further divided into the early ejection phase and the ejection phase, and the diastole is equal volume relaxation.
- the systole corresponds approximately from the beginning of the Q wave to the end of the T wave in the electrocardiogram (graph (d) in Fig. 5), and the onset of the I sound in the electrocardiogram (graph (e) in Fig. 5). It is almost equivalent to the start of II sound.
- the diastole is almost equivalent from the end of the T wave to the beginning of the Q wave in the electrocardiogram, and is almost equivalent from the beginning of the II sound to the beginning of the I sound in the electrocardiogram.
- FIG. 5 one heart cycle triggered by the onset of systole seen in the heart is indicated by a dotted line!
- the waveform of the pulse wave sharply rises to the S wave force and the P wave due to ejection of blood having a heart force. Then, after reaching the peak (P wave), a slightly upwardly convex ridge (T wave) is created, leading to a notch (C wave), where an upwardly convex ridge (D wave) is again formed. Descends gently.
- the C and D waves are called dichroic notch and dichroic wave, respectively, and are events that occur when the aortic valve is closed.
- the maximum value bl is observed at the same time as the pulse wave S wave, and the minimum value b2 is the same time as the pulse wave P wave. Observed. That is, it is understood that the maximum thickness change amount A h does not need to measure the entire one cardiac cycle, but may include the time when the S wave and the ⁇ wave of the pulse wave are observed.
- the minimum blood pressure value and the maximum blood pressure value for obtaining the pulse pressure ⁇ are also obtained from the S wave and the ⁇ wave power. Further, the maximum value ⁇ of the thickness is obtained when the thickness variation reaches the maximum value bl.
- the elastic characteristics of a circulatory organ such as a blood vessel wall of a living body include the ejection period and the systole (ventricular systole) in the cardiac cycle, including the time when the S wave and the P wave of the pulse wave are observed, or It can be obtained by performing measurements during at least part of the ejection period and part of the systole (ventricular systole).
- the thickness change amount there is no maximum or minimum value of the thickness change amount.Therefore, even if measurement is performed during this period and the maximum and minimum values are searched, the desired maximum and minimum values are obtained. No value obtained.
- the period for obtaining the correct maximum value and minimum value of the thickness change amount within one cardiac cycle is set shorter than the one cardiac cycle.
- the possibility of erroneously recognizing noise as a maximum value or a minimum value can be reduced. For example, if measurement is performed only during the ejection period within one cardiac cycle, the ejection period occupies about 30% of the time of the entire cardiac cycle, so the possibility of being affected by noise can be reduced to 1 Z3 or less. .
- Chart (a) in FIG. 6 shows the timing of measurement, calculation and display in the ultrasonic diagnostic apparatus of the present invention
- chart (b) in FIG. 6 shows the measurement, calculation and display in the conventional ultrasonic diagnostic apparatus. The timing is shown.
- the measurement period before and after an arbitrary cardiac cycle “A” is a partial period shorter than one cardiac cycle.
- the R wave power of the electrocardiogram Fig. 5 (d)
- the arithmetic unit 19 measures the amount of displacement and the amount of thickness change at the same time as the start of the cardiac cycle A.
- the display unit 21 displays the result of the previous cardiac cycle A-1.
- the calculation unit 19 starts the calculation process using the measurement result. Specifically, the maximum value and the minimum value of the thickness change amount are extracted. Then, the display unit 21 displays the elastic characteristics of the cardiac cycle A obtained by the calculation.
- the cardiac cycle of the subject is still “A”, and the display unit 21 starts displaying the elastic characteristics of the cardiac cycle A during the cardiac cycle A.
- the operator of the ultrasonic diagnostic apparatus 11 can capture the calculation result in the cardiac cycle A in real time and reflect it in the measurement in the next cardiac cycle A + 1. Specifically, for example, the operator can finely adjust the position of the ultrasonic probe 13 or hold it so that the ultrasonic probe 13 can be held more stably.
- the transmission unit 14 stops driving the ultrasonic probe 13, and the ultrasonic diagnostic apparatus 11 interrupts the measurement. May be. By interrupting the measurement, the load on the computer that controls the ultrasonic diagnostic apparatus can be reduced, and calculations based on the measurement results in the cardiac cycle A can be processed at high speed. Can be calculated.
- the arithmetic unit 19 suspends the arithmetic until the start of the cardiac cycle A + 1. Using this period, other signal processing may be performed, such as obtaining the average value of the elastic characteristic in the latest plurality of heartbeats.
- measurement is performed over the entire period of each cardiac cycle, and after completion of each cardiac cycle, Using the obtained measured values, the maximum and minimum values of the thickness change are obtained, and the maximum thickness change and elastic properties are calculated. These calculation processes are performed during the next cardiac cycle.
- the operator of the ultrasonic diagnostic apparatus finely adjusts the position of the ultrasonic probe 13 while watching the display on the display unit 21 or moves the ultrasonic probe 13 more. It will be difficult to pick it up so that it can be held stably.
- Patent Document 3 analyzes a large-amplitude displacement motion of a blood vessel wall by setting a constraint condition that the sum of displacements in one heartbeat is zero in order to stably and accurately measure minute motion of a blood vessel. Is disclosed. For this reason, in Patent Literature 3, it is necessary to continuously measure the displacement movement and the thickness change over one entire cardiac cycle. Patent Document 3 discloses that an average elastic modulus E of a blood vessel is obtained from a ratio between a pulse pressure (difference between a systolic blood pressure ps and a diastolic blood pressure pd) and a maximum value ⁇ ⁇ max of a strain amount.
- Patent Document 3 does not suggest at all that obtaining the maximum value and the minimum value of the thickness change amount from a part of the cardiac cycle.
- the time at which the S wave and the P wave of the pulse wave are observed, or the time at which the maximum value bl and the minimum value b2 of the thickness change are obtained can be easily determined.
- the data acquisition period is set to the period from the R wave to the T wave, that is, the R wave Is used as the reference for the start of the data acquisition period, and the T wave is used as the reference for the end of the data acquisition period, whereby the maximum and minimum values of the thickness change amount can be suitably obtained.
- R wave, P wave, Q wave, S wave may be used, the data acquisition period is set to 0.5 seconds after R wave power based on R wave, or from R wave to 40% of one heart cycle The same effect can be obtained even after a corresponding time.
- the data acquisition period is set to the period until the I sound also reaches the ⁇ sound, so that the maximum thickness change amount can be suitably adjusted. Values and minimum values can be determined. You may use the IV sound instead of the I sound, or use the II I sound instead of the II sound.
- the data acquisition period for the sound I should be set to 0.5 seconds after the sound intensity of I sound, or from 10% of the one heart cycle of the sound I to 30% of the time after the sound I.
- the data acquisition period is set to a period up to the S wave force C wave, so that the thickness change amount can be suitably adjusted. Maximum and minimum values can be determined. T wave or D wave may be used instead of C wave, or S wave shall be used as reference, and data acquisition period shall be 0.5 seconds after S wave, or equivalent to 10% of one heart cycle of S wave Even before the time when you do it, until 30% of the time after the S wave!
- a device may be separately provided outside the ultrasonic diagnostic apparatus 11 as a biological signal detecting means, and a numerical value measured by the ultrasonic diagnostic apparatus 11 may be used as a trigger signal without capturing a biological signal.
- the measured position displacement at any position in the carotid artery is characterized by a change in the position displacement as shown by points al, a2, and a3 compared to the other parts. Typical maximum point or minimum point.
- the points al, a2, and a3 can be extracted in the calculation unit 19, and the points al, a2, and a3 can be used to determine a period for obtaining the maximum value and the minimum value of the thickness change within one cardiac cycle.
- the point al is the blood pressure minimum point at the measurement target site of the blood vessel 3
- the point a2 is the blood pressure maximum point at the measurement target site
- the point a3 is an event derived from the dichroic notch.
- the data acquisition period is set to a point a
- the maximum value and the minimum value of the thickness change amount can be suitably obtained.
- the point a2 may be used instead of the point a3, the data acquisition period may be set to 0.5 seconds after the point al based on the point al, or a time force a2 corresponding to 10% of the al cardiac cycle may be used. Even after 10% of the time! / ,.
- points cl, c2, and c3 may be extracted from the change in the inner diameter of the blood vessel as shown in the figure, and may be used for setting the measurement period. 5
- the points bl, b2, and b3 may be extracted from the thickness change amount itself shown in (b), and the measurement period may be set.
- the electrocardiographic waveform obtained from the electrometer 22 is input to the calculation unit 19, and when the R wave is detected as described above, the thickness change amount is calculated.
- the calculation may be interrupted.
- the detection of the R wave and the T wave is performed, for example, by using the magnitude of the amplitude in the electrocardiographic waveform, the value obtained by differentiating the electrocardiographic waveform, and the timing at which they appear in the arithmetic section 19. Can be done.
- this detection may be performed by the electrocardiograph 22 and a control signal may be output to the calculation unit 19 based on the detection of the R wave and the T wave.
- the timing of a unique signal such as a waveform that triggers a biological signal is close to the timing at which the maximum value and the minimum value of the thickness change are obtained, or the maximum value and the maximum value of the thickness change
- the trigger may be a trigger in a measurement period in a cardiac cycle next to the cycle in which the singular signal used as the trigger is obtained.
- the measurement period for obtaining the maximum value and the minimum value of the thickness change amount is preferably 5% or more and 75% or less of one cardiac cycle. If the measurement period is shorter than 5% of the cardiac cycle, it may not be possible to obtain at least one of the maximum and minimum thickness changes. If it is longer than 75% of one heart cycle, the effect of shortening the measurement period may not be sufficiently obtained, and may be easily affected by noise. Therefore, when the measurement period is set using the above-described biological signal as a trigger, it is preferable to set the measurement period to fall within this range. By setting the measurement period to this length, the amount of calculation can be reduced by about 25% to 95%, and the effect of noise can be reduced by about 25% to 95%. It is thought that it is possible.
- the amount of change in thickness is determined by the difference in the amount of positional displacement between two points that define the thickness. Therefore, the position displacement force between the two points obtained during the period for obtaining the maximum and minimum values of the thickness change may be obtained from the maximum and minimum values of the thickness change.
- the ultrasonic diagnostic apparatus 11 measures the position displacement amount over the entire cardiac cycle, that is, continuously, and within the obtained position displacement amount, finds the maximum value and the minimum value of the thickness change amount described above.
- the maximum value and minimum value of the thickness change amount may be obtained by extracting the obtained position displacement amount.
- the ultrasonic diagnostic apparatus 11 may intermittently measure the position displacement amount only during the above-described period in one cardiac cycle and obtain the maximum value and the minimum value of the thickness change amount.
- the calculation for obtaining the maximum value and the minimum value of the thickness change amount may be performed in real time during the above-described period set by a biological signal or the like, or may be different from the above-described period. As described above, in order to reduce the load on the computer that controls the entire ultrasonic diagnostic apparatus 11 and to reduce the time required for the calculation in the calculation unit, it is preferable to measure the position displacement amount intermittently.
- the living body is kept in a resting state, so that the cardiac cycle does not vary much. Therefore, it is not always necessary to set the measurement period every time. Based on the above-described biological information, the measurement period may be set once, and then the measurement period may be repeated at the same cycle. On the other hand, if the biological signal is detected for each cardiac cycle and the measurement period is determined based on the biological signal, the elastic characteristics can be reliably measured even if the biological cardiac cycle is irregular due to arrhythmia or the like. it can.
- a measurement period may be set.
- the R wave of the electrocardiographic waveform may be used as a signal for setting the start of the measurement period
- the point c3 of the change in the inner diameter of the blood vessel may be used as a signal for setting the end of the measurement period.
- the force itself for obtaining the maximum value and the minimum value of the thickness change amount is measured, and the maximum value and the minimum value are calculated.
- the maximum thickness change may be obtained.
- the thickness change is measured, when the thickness change is known If the thickness is known, the amount of change in thickness over time can be obtained from the sum of the thickness at the start of measurement and the amount of change in thickness.
- the thickness at the start of measurement is not only an initial value of an arbitrary point-to-point distance for obtaining two positional displacement amounts, but also a parameter known in the ultrasonic diagnostic apparatus 11 described in the present embodiment.
- a waveform serving as a trigger signal for setting a measurement period may be displayed on display unit 21, and the measurement period may be highlighted on the waveform.
- the operator of the apparatus can easily confirm the period for obtaining the maximum value and the minimum value of the thickness or the thickness change amount.
- the ultrasonic diagnostic apparatus 11 is used to measure the maximum thickness change amount and the elastic characteristic of a certain part of the carotid artery wall.
- FIG. 6 shows the result of measuring the change in thickness of the posterior wall of the human carotid artery using the ultrasonic diagnostic apparatus 11.
- the subject was a 41-year-old man, who measured one cardiac cycle (approximately 800 [ms]) using the R wave of the subject's electrocardiogram as a trigger signal.
- the maximum thickness of the measurement target part was 160 [m]
- the maximum and minimum values are based on the signals seen at about 380 ms and about 500 ms during a cardiac cycle, as shown in FIG. You.
- the amount of change in thickness that gives the maximum value and the minimum value is a behavior that cannot occur as a change in the thickness of the blood vessel wall. Conceivable.
- the maximum value and the minimum value of the thickness change amount are obtained using the entire period of one cardiac cycle, inaccurate elastic characteristics may be obtained due to the influence of noise.
- Fig. 7 shows the same measurement results of the change in the thickness of the posterior wall of the human carotid artery as in Fig. 6. As shown in Fig. 7, it is possible to select the correct maximum and minimum values by changing the period for calculating the maximum and minimum values of the thickness change amount by changing the R-wave trigger signal force to after 300 [ms]. .
- the period for acquiring data becomes approximately 3Z8, so that the memory capacity for storing the acquired data can be reduced, and the amount of computation by the computer in one cardiac cycle can be reduced. Can be reduced. Therefore, the capacity of the memory to be mounted on the ultrasonic diagnostic apparatus can be reduced, and the elastic characteristic measurement can be obtained at higher speed. In this case, it is possible to adopt a computer having a low calculation capability in accordance with the reduction in the calculation amount. In this case, the cost of the ultrasonic diagnostic apparatus can be reduced.
- the calculation of the maximum value and the minimum value of the thickness change amount is performed based on the positional displacement amount obtained in a period shorter than one cardiac cycle. Therefore, the effects of noise and the like can be reduced, and more accurate measurement results can be obtained.
- the ultrasonic diagnostic apparatus of the present invention is suitably used for measuring the elastic properties of living tissue, and is particularly suitable for measuring the elastic properties of blood vessel walls, for finding arteriosclerotic lesions, and for preventing arteriosclerosis. Can be used.
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Abstract
Description
Claims
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JP2006515333A JP3842285B2 (ja) | 2004-05-21 | 2005-05-19 | 超音波診断装置および超音波診断装置の制御方法 |
EP05740921A EP1688094A4 (en) | 2004-05-21 | 2005-05-19 | ULTRASONIC DIAGNOSTIC APPARATUS AND DEVICE CONTROLLING DEVICE |
US11/224,265 US7708692B2 (en) | 2004-05-21 | 2005-09-12 | Ultrasonic diagnostic apparatus and method for controlling the same |
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JP2004-151689 | 2004-05-21 |
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US11/224,265 Continuation US7708692B2 (en) | 2004-05-21 | 2005-09-12 | Ultrasonic diagnostic apparatus and method for controlling the same |
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WO2005112774A1 true WO2005112774A1 (ja) | 2005-12-01 |
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PCT/JP2005/009162 WO2005112774A1 (ja) | 2004-05-21 | 2005-05-19 | 超音波診断装置および超音波診断装置の制御方法 |
Country Status (5)
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US (1) | US7708692B2 (ja) |
EP (1) | EP1688094A4 (ja) |
JP (1) | JP3842285B2 (ja) |
CN (1) | CN100475155C (ja) |
WO (1) | WO2005112774A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2011019617A (ja) * | 2009-07-14 | 2011-02-03 | Olympus Medical Systems Corp | 超音波診断装置 |
JP6202510B1 (ja) * | 2017-01-31 | 2017-09-27 | 株式会社Arblet | 血圧情報測定システム、血圧情報測定方法、血圧情報測定プログラム、血圧情報測定装置、サーバ装置、演算方法及び演算プログラム |
Families Citing this family (9)
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WO2007080870A1 (ja) * | 2006-01-11 | 2007-07-19 | Matsushita Electric Industrial Co., Ltd. | 超音波診断装置 |
RU2448649C2 (ru) * | 2006-05-25 | 2012-04-27 | Конинклейке Филипс Электроникс Н.В. | Количественная оценка и отображение утолщения стенки камеры сердца |
US8512248B2 (en) * | 2006-09-25 | 2013-08-20 | Tohoku University | Ultrasonograph that measures tissue displacements based on a reference point |
US8647276B2 (en) * | 2009-09-04 | 2014-02-11 | Hitachi Medical Corporation | Ultrasonic diagnostic device |
CN102764141B (zh) * | 2012-07-20 | 2014-05-21 | 中国科学院深圳先进技术研究院 | 弹性成像方法和系统及其中的生物组织位移估计方法和系统 |
US20140142438A1 (en) | 2012-11-19 | 2014-05-22 | Biosense Webster (Israel), Ltd. | Using location and force measurements to estimate tissue thickness |
CN106963424A (zh) * | 2017-03-15 | 2017-07-21 | 深圳大学 | 检测动脉血管粘弹性的系统及方法 |
JP6764022B2 (ja) * | 2017-04-19 | 2020-09-30 | 学校法人 関西大学 | 生体情報の推定装置 |
WO2020061770A1 (zh) * | 2018-09-25 | 2020-04-02 | 深圳迈瑞生物医疗电子股份有限公司 | 一种弹性成像的方法及设备、存储介质 |
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JP6202510B1 (ja) * | 2017-01-31 | 2017-09-27 | 株式会社Arblet | 血圧情報測定システム、血圧情報測定方法、血圧情報測定プログラム、血圧情報測定装置、サーバ装置、演算方法及び演算プログラム |
JP2018121829A (ja) * | 2017-01-31 | 2018-08-09 | 株式会社Arblet | 血圧情報測定システム、血圧情報測定方法、血圧情報測定プログラム、血圧情報測定装置、サーバ装置、演算方法及び演算プログラム |
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Also Published As
Publication number | Publication date |
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EP1688094A4 (en) | 2009-08-05 |
CN100475155C (zh) | 2009-04-08 |
JP3842285B2 (ja) | 2006-11-08 |
CN1838914A (zh) | 2006-09-27 |
US20060004288A1 (en) | 2006-01-05 |
US7708692B2 (en) | 2010-05-04 |
JPWO2005112774A1 (ja) | 2008-03-27 |
EP1688094A1 (en) | 2006-08-09 |
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