WO2006013883A1 - 脳内出血/くも膜下出血診断支援システム - Google Patents
脳内出血/くも膜下出血診断支援システム Download PDFInfo
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- WO2006013883A1 WO2006013883A1 PCT/JP2005/014189 JP2005014189W WO2006013883A1 WO 2006013883 A1 WO2006013883 A1 WO 2006013883A1 JP 2005014189 W JP2005014189 W JP 2005014189W WO 2006013883 A1 WO2006013883 A1 WO 2006013883A1
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/0002—Inspection of images, e.g. flaw detection
- G06T7/0012—Biomedical image inspection
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/10—Segmentation; Edge detection
- G06T7/12—Edge-based segmentation
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/10—Image acquisition modality
- G06T2207/10072—Tomographic images
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/30—Subject of image; Context of image processing
- G06T2207/30004—Biomedical image processing
- G06T2207/30016—Brain
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/30—Subject of image; Context of image processing
- G06T2207/30004—Biomedical image processing
- G06T2207/30101—Blood vessel; Artery; Vein; Vascular
Definitions
- the present invention relates to an intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system, and more particularly, to an intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system that calculates the degree of intracerebral hemorrhage Z subarachnoid hemorrhage based on a patient's brain image. .
- Intracerebral hemorrhage and subarachnoid hemorrhage are diseases with a very high mortality rate, and sequelae such as involuntary half-body tend to remain. For this reason, an emergency treatment by a doctor is necessary.
- a diagnosis of intracerebral hemorrhage z subarachnoid hemorrhage is made. This diagnosis is generally performed by performing a CT (Computed Tomography) / MR (Magnetic Resonance) examination of the head and visually checking the results.
- CT Computer Tomography
- MR Magnetic Resonance
- Patent Document 1 JP 2001-198112 A
- Intracerebral hemorrhage When there is a small amount of Z subarachnoid hemorrhage (in the case of subarachnoid hemorrhage), it is a problem that it is too late due to a misdiagnosis by a doctor. Such misdiagnosis is particularly likely in emergency hospitals (such as medical institutions) where specialized neurosurgeons are not employed. That is, aneurysms are generally less than 90% concentrated near the branch of the main artery (eg, internal carotid artery), but are otherwise difficult to identify. In the case of a small amount of bleeding, it is difficult to specify the position of the MRI image.
- An object of the present invention is to provide a diagnosis support system for intracerebral hemorrhage z subarachnoid hemorrhage that calculates the degree of intracerebral hemorrhage Z subarachnoid hemorrhage based on an image of the brain of a patient.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system of the present invention includes an image capturing unit that acquires an image of a patient's brain, and luminance of a brain wrinkle region and a brain non-uniform region in the brain image. And a risk level calculation unit for calculating the degree of bleeding.
- the bleeding is intracerebral hemorrhage or subarachnoid hemorrhage.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system further comprises a cerebral region detection unit for determining a cerebral region from the image of the brain.
- the cerebral region detection unit obtains a cerebral region from the brain image by a region expansion method.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system Further, by obtaining the difference between the convex hull and the brain region in the cerebral region obtained from the brain image, the wrinkle region of the brain And a wrinkle region detection unit for detecting a non-uniform region of the brain.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system power Further, from the image of the brain, a cerebral region detection unit for obtaining a cerebral region, and a difference between the convex hull and the brain region in the cerebral region are obtained. And a wrinkle region detecting unit for detecting the wrinkle region of the brain and the non-uniform region of the brain.
- the image of the patient's brain is composed of a plurality of two-dimensional images, and the cerebral region is obtained for each of the two-dimensional images, Based on this, a wrinkle region of the brain and a non-uniform region of the brain are detected, and the degree of bleeding is calculated based on the brightness of the image in the wrinkle region and non-uniform region of the brain.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system further comprises a blood vessel removing unit that removes a blood vessel region from the wrinkle region and a non-uniform region of the brain, and the risk calculating unit includes the blood vessel The degree of bleeding is calculated based on the brightness of the wrinkled area and the non-uniform brain area.
- the risk level calculation unit calculates the risk level of bleeding based on the degree of bleeding.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system further includes a display device for displaying an image of the brain of the patient, and the display device has a risk of bleeding for each of the two-dimensional images. Is higher than a predetermined value, and a two-dimensional image is displayed so as to be specified.
- intracerebral hemorrhage is performed, for example, for each two-dimensional image in the brain, based on the brightness of the wrinkle region of the brain and the nonuniform region of the brain.
- the degree of bleeding such as subarachnoid hemorrhage is calculated.
- an image of a patient's brain is obtained, a cerebral area is obtained, and a difference between the convex hull and the brain area in the cerebral area is obtained to detect a wrinkle area and a non-uniform brain area.
- the blood vessel region is removed from the wrinkle region and the non-uniform region of the brain according to the above, and the degree of bleeding is calculated based on the brightness of the image thus obtained, or the risk of bleeding is calculated, The risk of bleeding is higher than a predetermined value.
- an aneurysm other than the vicinity of a branch of a major artery for example, the internal carotid artery
- the risk of intracerebral hemorrhage Z subarachnoid hemorrhage can be estimated by computer for every two-dimensional image in the brain.
- diagnosis of intracerebral hemorrhage Z subarachnoid hemorrhage can be supported, for example, in a medical institution where a specialized neurosurgeon is not working, and misdiagnosis in the hospital can be prevented. Therefore, even in the case of minute intracerebral hemorrhage Z subarachnoid hemorrhage, it is possible to prevent misdiagnosis by a doctor and to avoid delaying treatment.
- FIG. 1 is a block diagram of an intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system.
- FIG. 2 is an explanatory diagram of intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support.
- FIG. 3 is a flowchart of the diagnosis support process for intracerebral hemorrhage Z subarachnoid hemorrhage.
- Figure 4 is an explanatory diagram of intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support.
- FIG. 5 is an explanatory view of intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support.
- FIG. 6 is an explanatory view of intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support.
- FIG. 7 is an explanatory view of intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support.
- FIG. 1 is a configuration diagram of the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system, and shows the configuration of the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system of the present invention.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system of the present invention includes an image acquisition device 1, a diagnosis support device 2, and a display device 3.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system or diagnosis support apparatus 2 according to the present invention is used to support the diagnosis of minute intracerebral hemorrhage Z subarachnoid hemorrhage in the same manner as an experienced neurosurgeon. Focus on the cerebral sulcus (brain wrinkles) in each tomographic image (cross-sectional image), that is, a slice (two-dimensional image).
- the image acquisition device 1 is a device that acquires an image of a patient's brain, and in this example, includes a well-known MR device. As a result, a brain image (image data) in a known data format (for example, DIC OM) is obtained from the image acquisition device 1.
- the image acquisition device 1 is an X-ray CT device, A device that can obtain a two-dimensional image (plane image) of the human brain by well-known tomography or the like, such as a positron CT device.
- DICOM is a data format mainly used in MR and CT devices. By following DICOM, not only image data but also related information such as patient information and imaging date / time can be obtained.
- the diagnosis support apparatus 2 receives a brain image (image data) according to a predetermined data format (for example, DICOM) from the image acquisition apparatus 1, and holds it in an image memory (not shown).
- the diagnostic support device 2 and the image acquisition device 1 may be directly connected by a cable or the like, or may be connected via a network such as a wireless or wired LAN (Local Area Network) or the Internet. good.
- the image acquisition device 1 may be installed in a plurality of hospitals without specialized neurosurgeons, the diagnosis support device 2 may be installed in a hospital with specialized neurosurgeons, and these may be connected via a network.
- the display device 3 may be provided in both the neurosurgeon! /, The hospital and the neurosurgeon! /, And the hospital.
- the diagnosis support apparatus 2 includes a cerebral region detection unit 21, a wrinkle region detection unit 22, a blood vessel removal unit 23, and a risk degree calculation unit 24.
- Each of these processing units 21 to 24 stores a processing program for executing the processing resident in the main memory (not shown) of the diagnosis support apparatus 2 which is a computer, as a CPU (not shown) of the diagnosis support apparatus 2. Realized by executing above.
- the cerebral area detection unit 21 obtains a “cerebral area” from the brain image (image data) held in the image memory by a known means.
- the cerebral region detection unit 21 obtains a cerebral region from a brain image by, for example, a well-known region growing method.
- the region expansion method is a method of dividing a region by sequentially executing a process of merging into a single region when the small region of interest and the small region (or pixel) adjacent to it have the same characteristics. It is a technique to do.
- the “same feature” means that the pixels in the region are similar in the image data. Specifically, when the image data is, for example, a 256-tone monochrome image, It is necessary that “pixel values are similar” and “positions are close to each other”, and the range can be determined empirically.
- the wrinkle region detection unit 22 obtains a difference between the “convex hull” and the “brain region” in the cerebral region obtained from the brain image, thereby obtaining “brain wrinkle region” and “brain defect”. Detect ⁇ uniform area '' To do.
- the remaining regions after excluding the convex hull region are the wrinkle region of the brain and the non-uniform region of the brain.
- the brain region refers to a region (uniform region) that has similar pixel values and is a group, and does not include a region such as “hippocampus”, for example.
- the non-uniform region of the brain refers to a region such as the hippocampus.
- 2D Active Net which is a two-dimensional deformation model
- 2D Active Net (to be precise, “network model using energy minimization principle”) gives a circular net as the initial shape, and the network is located at the site to be extracted by repeating the process based on the energy minimization principle. It is to approach.
- 2D Active Net see, for example, “Sakagami, Yamamoto” Dynamic Network Model Active Net and its Application to Domain Extraction, Television Journal, Vol.
- a brain region (a uniform region, in this example, the cerebral region obtained earlier) is used as an energy image, and 2D Activity Net is applied to this to create a region where the brain region is bundled with rubber bands, That is, the (approximate) convex hull is obtained. Then, by obtaining the difference between the inside of the region and the brain region, it is possible to detect “brain wrinkle region” and “brain non-uniform region”.
- FIG. 2 (A) is an initial image and shows a brain region (uniform region).
- Figure 2 (B) shows the image when the process based on the energy minimization principle is repeated 400 times.
- Figure 2 (C) shows the image when the above process is repeated 800 times.
- Figure 2 (D) shows an image when the above process is repeated 2000 times. From Fig. 2 (D), it can be seen that "brain wrinkle region” and "brain non-uniform region" were detected.
- the convex hull (region) obtained by using 2D Active Net is not a convex hull in a strict sense. In other words, the convex hull obtained by using 2D Active Net partially bites into the actual convex hull, and therefore the proximity value of the convex hull (region) is obtained.
- the blood vessel removing unit 23 removes the "blood vessel region" from the wrinkled region of the brain and the non-uniform region of the brain. Except.
- the reason for removing the blood vessel region is that the blood vessel (which is a round tube in the tomographic slice) becomes very white (high brightness) in the case of an MRI image, so this part should be removed first This is because the accuracy of detection of bleeding can be improved. In the case of an image obtained by a CT apparatus, this does not occur, so there is no need to remove the blood vessel region.
- the blood vessel region has a round shape with high brightness in the slice of tomography.
- a region having a value larger than the threshold value can be removed as a blood vessel region using a predetermined threshold value. That is, the pixel value of the image data of the blood vessel region is changed to a value that is the same as or similar to the pixel value of the surrounding region (or an average value thereof).
- the region where the “blood vessel region” is removed from the wrinkle region of the brain and the non-uniform region of the brain that is, the “region of the wrinkle of the brain” and the “remaining region where the luminance values are not uniform” S is found.
- the “remaining area where the luminance value is uniform” is the part of the brain area (or cerebral area) that is almost uniform and connected! /, The pixel area subtracted (connected and connected) It is.
- the risk level calculation unit 24 calculates the degree of bleeding based on the brightness of the image (original image, in this case, MRI image) in the wrinkled region of the brain and the non-uniform region of the brain. Calculate the risk. Therefore, the bleeding for which the degree of bleeding is calculated is intracerebral bleeding or subarachnoid bleeding. Specifically, in this example, the risk level calculation unit 24 creates the degree of bleeding as a histogram as shown in FIG. For example, when the image data is a monochrome image of, for example, 256 gradations, a histogram is created by counting the number of pixels having each pixel value in the region.
- the risk level calculation unit 24 calculates the degree of bleeding based on the luminance of the wrinkled area of the brain from which the blood vessel area has been removed and the uneven area of the brain (histogram). Create a ram).
- the non-bleeding area is a black pixel
- the bleeding area is a white pixel.
- the risk level calculation unit 24 further calculates the risk level of bleeding based on the calculated degree of bleeding (histogram). Therefore, the risk of intracerebral hemorrhage or subarachnoid hemorrhage is calculated.
- a threshold value for calculating (determining) the degree of risk is input from outside the diagnosis support apparatus 2. In this example, the threshold value is determined with reference to the aforementioned histogram.
- the threshold is set by inputting the external force of the diagnosis support apparatus 2 each time, based on the result of creating the histogram. It may be set automatically based on this.
- the risk calculating unit 24 uses the boundary when the histogram has a boundary as shown in FIG. 5 as the threshold, and when the histogram has no boundary as shown in FIG. The value at the right end of the distribution may be adopted.
- an image of a patient's brain also has a plurality of continuous two-dimensional image forces obtained by tomography. Therefore, for each two-dimensional image, a cerebral region is obtained, and based on this, a wrinkle region of the brain and a non-uniform region of the brain are detected, and a wrinkle region of the brain and a non-uniform region of the brain as necessary.
- the force also removes the blood vessel region, calculates the degree of bleeding based on the brightness of the wrinkled region of the brain and the uneven region of the brain, and calculates the risk of bleeding.
- the display device 3 displays, for example, for each two-dimensional image, a two-dimensional image in which the risk of intracerebral hemorrhage Z subarachnoid hemorrhage is higher than a predetermined value. As a result, for each two-dimensional image, a determination can be made and an indication of a part at risk of bleeding can be displayed. In this example, as will be described later, since the presence or absence of bleeding can be determined only by the shape of the histogram, the display device 3 displays the calculated intracerebral hemorrhage Z subarachnoid hemorrhage (histogram) together with the risk level. You can omit the display of either force V or displacement.
- Fig. 3 is a process flow for diagnosing intracerebral hemorrhage Z subarachnoid hemorrhage, and cerebral hemorrhage according to the present invention.
- Intracerebral hemorrhage in Z subarachnoid hemorrhage diagnosis support system An example of Z subarachnoid hemorrhage diagnosis support processing is shown.
- the image acquisition device 1 acquires an MRI image (two-dimensional image) of the patient's brain (step S1) and transmits it to the diagnosis support device 2.
- the cerebral region detection unit 21 determines the cerebral region of the patient's brain using the region expansion method (step S2), and the wrinkle region detection unit 22 detects the convex hull in the calculated cerebral region.
- the brain region are detected by detecting the difference between the cerebral wrinkle region and the brain non-uniform region (step S3).
- the blood vessel region is removed (Step S4), and the risk calculation unit 24 calculates the degree of intracerebral hemorrhage Z subarachnoid hemorrhage (histogram) based on the brightness in the wrinkled and non-uniform regions of the brain. Further, the risk of intracerebral hemorrhage Z subarachnoid hemorrhage is calculated (step S5), and the calculation result is transmitted to display device 3. Receiving this, the display device 3 displays the calculation result (histogram and risk level) for each two-dimensional image (step S6).
- FIGS. 4 to 7 show actual diagnosis support for intracerebral hemorrhage Z subarachnoid hemorrhage in the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system of the present invention.
- FIG. 4A is an original image of the patient's brain read by the MR apparatus that is the image acquisition apparatus 1.
- the image size is 460 dots x 460 dots.
- This original image (MRI image) is image data taken the next day for a patient who actually developed subarachnoid hemorrhage.
- Fig. 4 (B) is an image after segmentation of the cerebral region using the region expansion method.
- the seed point was selected interactively, the global parameter was set to 20, and the local parameter was set to 10.
- an image of the converged net region can be obtained as shown in Fig. 4 (C).
- the convex hull of the brain region is obtained as shown in FIG. 4 (D).
- the parameters at this time were 30 X 100 for the mesh shape and 2000 times for the number of repetitions, and a, j8, and ⁇ were 1.0, 1.0, and 0.5, respectively.
- the 2D Active Net program is written in OpenGL, and the image of the convex hull shown in Fig. 4 (D) was obtained by painting the inside of the image net as the application result.
- FIG. 5 is a histogram of the region obtained in FIG. 4E (that is, all pixels of the difference mask).
- the horizontal axis is the pixel value (1 to 256 gradations, but one part is omitted), and the vertical axis is the number of pixels having the pixel value (the same in FIG. 7). .
- a portion with a high luminance value ie, a bleeding portion
- a low portion ie, a normal portion
- the part with high luminance value is the part that is bleeding
- the right peak of the two peaks is the bleeding part
- the pixel value is approximately “at 256 gradations”. If it is about 120 ”, it can be seen that the patient is bleeding. Therefore, by using the pixel value as a threshold value, the bleeding site can be easily specified in pixel units.
- the “risk level” is calculated using the total number of pixels of the difference mask as the denominator and the number of pixels higher than the threshold as the numerator.
- the boundary of the histogram is the threshold value (90).
- the degree of risk in this image was "0.489476".
- the total number of pixels was “20904”, which was higher than the threshold and the number of pixels was “10232”.
- FIGS. For comparison, when the present invention is applied to an MRI image of a healthy person, the results are as shown in FIGS. That is, an image of the cerebral region shown in FIG. 6 (B) is obtained from the original image of the patient's brain (image size is 256 dots x 256 dots) read by the MR device shown in FIG. 6 (A).
- image size is 256 dots x 256 dots
- 2D Active Net the image of Fig. 6 (C) is obtained, and based on this, an image of a convex hull (not shown) is obtained, and this and an image of the cerebral region (Fig. 6 (B)).
- the image obtained by taking the difference from the image is the image in Fig. 6 (D).
- the threshold value (100) is used as the rightmost part of the distribution as a guide.
- the risk level was “0.029474”. That is, about 1Z16 It turns out that it is a risk. In this way, the presence or absence of intracerebral hemorrhage Z subarachnoid hemorrhage can be judged from the risk level.
- the intracerebral hemorrhage Z subarachnoid hemorrhage diagnosis support system as in the case of an experienced neurosurgeon, focusing on the cerebral sulcus (brain wrinkles), Based on the brightness of the image in the region, the degree of hemorrhage such as intracerebral hemorrhage z subarachnoid hemorrhage or the risk of bleeding can be calculated.
- the risk of Z subarachnoid hemorrhage can be estimated by a computer.For example, in a hospital where specialized neurosurgeons are not working, it is possible to support the diagnosis of Z subarachnoid hemorrhage. In the case of intracerebral hemorrhage Z subarachnoid blood, it is possible to prevent misdiagnosis by a doctor and avoid delays in treatment.
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JP2004229435A JP2006043200A (ja) | 2004-08-05 | 2004-08-05 | 脳内出血/くも膜下出血診断支援システム |
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WO2007114238A1 (ja) * | 2006-03-30 | 2007-10-11 | National University Corporation Shizuoka University | 脳萎縮判定装置、脳萎縮判定方法及び脳萎縮判定プログラム |
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JP5383486B2 (ja) * | 2006-06-13 | 2014-01-08 | ジーイー・メディカル・システムズ・グローバル・テクノロジー・カンパニー・エルエルシー | 脳出血部位セグメンテーションする装置の作動方法および装置 |
EP2432384B1 (en) * | 2009-05-18 | 2015-07-15 | Koninklijke Philips N.V. | Arrangement for detecting magnetic particles and for monitoring bleeding |
US9044194B2 (en) | 2010-08-27 | 2015-06-02 | Konica Minolta, Inc. | Thoracic diagnosis assistance system and computer readable storage medium |
CN103068312B (zh) * | 2010-08-27 | 2015-07-15 | 柯尼卡美能达医疗印刷器材株式会社 | 诊断支援系统以及图像处理方法 |
JP6775944B2 (ja) | 2015-12-14 | 2020-10-28 | キヤノンメディカルシステムズ株式会社 | 画像処理装置 |
EP3228266B1 (en) | 2016-04-07 | 2021-02-24 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz | A device for ultrasonic-accelerated hematoma lysis or thrombolysis of intracerebral or intraventricular hemorrhages or hematomas |
JP6945493B2 (ja) * | 2018-05-09 | 2021-10-06 | 富士フイルム株式会社 | 医用画像処理装置、方法およびプログラム |
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Cited By (3)
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WO2007114238A1 (ja) * | 2006-03-30 | 2007-10-11 | National University Corporation Shizuoka University | 脳萎縮判定装置、脳萎縮判定方法及び脳萎縮判定プログラム |
US8112144B2 (en) | 2006-03-30 | 2012-02-07 | National University Corporation Shizuoka University | Apparatus for determining brain atrophy, method of determining brain atrophy and program for determining brain atrophy |
JP5186620B2 (ja) * | 2006-03-30 | 2013-04-17 | 国立大学法人静岡大学 | 脳萎縮判定装置、脳萎縮判定方法及び脳萎縮判定プログラム |
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