WO2011093193A1 - 超音波診断装置およびその計測点追跡方法 - Google Patents
超音波診断装置およびその計測点追跡方法 Download PDFInfo
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- WO2011093193A1 WO2011093193A1 PCT/JP2011/050912 JP2011050912W WO2011093193A1 WO 2011093193 A1 WO2011093193 A1 WO 2011093193A1 JP 2011050912 W JP2011050912 W JP 2011050912W WO 2011093193 A1 WO2011093193 A1 WO 2011093193A1
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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
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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
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
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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
- A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
- A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
- A61B8/469—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means for selection of a region of interest
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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
- A61B8/48—Diagnostic techniques
- A61B8/485—Diagnostic techniques involving measuring strain or elastic properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
- A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
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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
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5284—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving retrospective matching to a physiological signal
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
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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
- A61B8/02—Measuring pulse or heart rate
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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
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/4461—Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
Definitions
- the present invention relates to an ultrasonic diagnostic apparatus, and in particular, tracks the movement of a living tissue based on an ultrasonic image of the living tissue of a subject, and correlates with the movement of the living tissue or the nature of the living tissue based on the tracking result.
- the present invention relates to an ultrasonic diagnostic apparatus that calculates and displays a specific physical quantity.
- the ultrasonic diagnostic apparatus transmits ultrasonic waves to the inside of the subject using an ultrasonic probe, receives an ultrasonic reflected echo signal corresponding to the structure of the living tissue from the inside of the subject, and generates an ultrasonic image (e.g., B An ultrasonic tomographic image such as a mode image) is constructed and displayed for diagnosis.
- an ultrasonic image e.g., B
- An ultrasonic tomographic image such as a mode image
- a movement of a living tissue is tracked based on an ultrasound image, and a specific physical quantity (hereinafter simply referred to as a specific physical quantity) correlated with the movement of the living tissue or the property of the living tissue is calculated based on the tracking result. It is used for diagnosis.
- diagnosis target is a myocardium
- a specific physical quantity such as strain (distortion) that is the property of the myocardial tissue based on the tracking result of the myocardium
- Tissue Doppler and speckle tracking methods have been proposed as biological tissue tracking methods in ultrasonic diagnosis.
- speckle tracking method it is possible to track the position where the living tissue moves without depending on the direction of the ultrasonic beam, and to quantify the deformation of the living body part related to the living tissue. It is applied to tracking the movement of the myocardium of the specimen.
- a plurality of traceable points are extracted from an ultrasonic image, tracking processing is performed, and a specific physical quantity is determined based on movement information of the tracking points. It is known to calculate. Also, as described in Non-Patent Document 1, a method is known in which a left ventricular myocardium is divided into 17 regions and measured, and a lesion is diagnosed from each measured value.
- Patent Document 1 Japanese Patent Document 1
- Non-Patent Document 1 do not consider myocardial stretching measurement that accurately reflects the stretching and contracting of the myocardium and each measured value is a comparison target suitable for diagnosis. .
- the prior art does not consider setting a plurality of measurement points along the stretching direction of the myocardium (for example, the direction along the endocardium and epicardium of the myocardium).
- each measurement value does not accurately reflect the expansion and contraction of the myocardium.
- each measured value is a comparison target suitable for diagnosis. There is a risk that it will not.
- An object of the present invention is to provide an ultrasonic diagnostic apparatus and a measurement point tracking method thereof that accurately reflect the expansion and contraction of the myocardium and that can measure the expansion and contraction of the myocardium as a comparison target in which each measured value is suitable for diagnosis. is there.
- a measurement position setting unit sets a region of interest in a myocardium on an ultrasound image displayed on a display unit, and a tracking calculation unit performs extracardiac myocardial imaging at a plurality of measurement points in the region of interest.
- a plurality of measurement points are tracked by a plurality of first dividing lines along the membrane and endocardium and a plurality of second dividing lines orthogonal to the plurality of first dividing lines.
- an ultrasonic diagnostic apparatus of the present invention includes an ultrasonic probe that transmits and receives ultrasonic waves to and from a subject, and a myocardium of a heart of the subject that is received by the ultrasonic probe.
- An ultrasonic signal generation unit that generates an ultrasonic signal based on a reflected echo signal of a tomographic plane of the tissue, an ultrasonic image generation unit that generates an ultrasonic image based on the ultrasonic signal, and the ultrasonic image displayed
- a display unit a measurement position setting unit that sets a region of interest in the myocardium on the ultrasonic image displayed on the display unit, a tracking calculation unit that tracks the movement of the myocardium at a plurality of measurement points of the region of interest,
- a physical quantity calculation unit that calculates a specific physical quantity based on a tracking result, and displays the calculated specific physical quantity on the display unit, wherein the tracking calculation unit includes a heart of the myocardium Multiple first dividing lines along the epicardium and endo
- the ultrasonic probe transmits / receives ultrasonic waves to / from the subject and is received by the ultrasonic probe by the ultrasonic signal generator.
- An ultrasonic signal is generated based on a reflected echo signal of a tomographic plane of a tissue including the heart muscle of the subject's heart
- an ultrasonic image is generated based on the ultrasonic signal by an ultrasonic image generating unit
- a display unit The ultrasonic image is displayed, a region of interest is set in the myocardium on the ultrasonic image displayed on the display unit by the measurement position setting unit, and the movement of the myocardium at a plurality of measurement points in the region of interest is tracked by the tracking calculation unit.
- a measurement point tracking method of an ultrasonic diagnostic apparatus that calculates a specific physical quantity based on the tracking result by a physical quantity calculation unit, and displays the calculated specific physical quantity on the display unit, the tracking calculation unit In Tracking a plurality of measurement points with a plurality of first dividing lines along the epicardium and endocardium of the myocardium and a plurality of second dividing lines orthogonal to the plurality of first dividing lines. .
- the present invention it is possible to accurately measure the expansion and contraction of the myocardium, which accurately reflects the expansion and contraction of the myocardium, and each measured value is suitable for diagnosis.
- Block diagram showing the overall configuration of the ultrasonic diagnostic apparatus of the present embodiment
- the flowchart which shows the flow of a process of the ultrasound diagnosing device of this embodiment.
- the figure which shows the other example of the display screen of an ultrasonic diagnosing device Enlarged area of interest Diagram showing an example of a measurement method for 3D ultrasound images
- FIG. 1 is a block diagram showing the overall configuration of the ultrasonic diagnostic apparatus of the present embodiment.
- the ultrasonic diagnostic apparatus 100 includes an ultrasonic probe 3 that transmits and receives ultrasonic waves to and from the subject 1, and a reflected echo measured by the ultrasonic probe 3.
- An ultrasonic signal generation unit 5 that generates an ultrasonic signal based on the signal
- an ultrasonic image generation unit 7 that generates an ultrasonic image based on the ultrasonic signal
- the generated ultrasonic image and ultrasonic diagnostic device Storage unit 9 storing various programs to be controlled, input unit 11 serving as an input interface, display unit 13 serving as an output interface, control unit 15 controlling each unit of the ultrasonic diagnostic apparatus, and display on the display unit 13
- a measurement position setting unit 17 that sets a region of interest in the biological tissue of the diagnostic target region on the ultrasonic image
- a tracking calculation unit 19 that tracks the movement of the biological tissue of the diagnostic target region at a plurality of measurement points in the region of interest
- Physics that calculates specific physical quantities based on tracking results
- the system includes a quantity calculation unit 21 and a system bus 23 that connects the units.
- the ultrasonic probe 3 is a device that transmits and receives ultrasonic waves toward the subject 1 and has a scanning method such as a linear type, a convex type, and a sector type. These can be obtained by arranging transducers in one dimension to obtain a two-dimensional signal, by arranging transducers in two dimensions to obtain a three-dimensional signal, or by arranging transducers in one dimension and performing spatial scanning By doing so, what obtains a three-dimensional signal can be used.
- a scanning method such as a linear type, a convex type, and a sector type.
- the ultrasonic signal generation unit 5 transmits / receives an ultrasonic signal converted into an electric signal to / from the ultrasonic probe 3. Transmission / reception is controlled so that a desired ultrasonic signal is obtained by receiving transmission / reception power and timing information from the control unit 15. Further, the signal received from the ultrasonic signal transmission / reception unit is subjected to signal processing according to the imaging setting of the apparatus through a phasing circuit and an amplification circuit to obtain a shaped ultrasonic signal. This signal is stored in the storage unit 9 for use in later measurement.
- the ultrasonic image generation unit 7 generates an image of the living tissue of the subject 1. An ultrasonic signal that has passed through the ultrasonic signal generation unit is input, and an ultrasonic image based on the imaging setting of the apparatus is generated. This signal is stored in the storage unit 9 for use in later measurement.
- the storage unit 9 stores programs for operating various systems constituting the ultrasonic diagnostic apparatus 100, and stores signal data, image data, measurement data, and the like, and can be read and written according to the processing. Done.
- the input unit 11 is an interface for performing various operations of the diagnostic apparatus.
- An input device such as a keyboard, a trackball, a switch, or a dial, is used to perform an operation for acquiring an image, specify a region of interest in a living tissue, or perform various measurement settings.
- the display unit 13 displays a region of interest, a measurement value, and an ultrasonic image on the screen, and outputs the measurement value to a measurement report.
- the control unit 15 controls the entire system. For example, a control device such as a CPU is used.
- the measurement position setting unit 17 sets a region of interest on the ultrasonic screen. For example, the region of interest is divided into meshes, and the intersection of the dividing lines is set as a measurement point. Details of the measurement position setting unit 17 will be described later.
- On the ultrasonic screen an ultrasonic image read from the storage unit 9 is displayed. Since the images are stored in time series, it is possible to select and display a frame of a desired time phase using the input device. If an image is acquired in synchronization with a biological signal (for example, an electrocardiogram), for example, an R wave time phase image of the electrocardiogram may be automatically selected.
- a biological signal for example, an electrocardiogram
- the tracking calculation unit 19 performs an operation for tracking the movement of the living tissue using the ultrasonic signal near the position of the measurement point or the amplitude information of the image, and calculates the displacement. Since the ultrasonic signal and image information are stored in the storage unit 9, they are read and used for calculation.
- the start frame and end frame of the tracking calculation may be set by the user with the input device, or if an image is acquired in synchronization with a biological signal (for example, an electrocardiogram), for example, the next R from the R wave of the electrocardiogram It may be automatically limited to a frame group between waves.
- a biological signal for example, an electrocardiogram
- the physical quantity calculation unit 21 calculates physical quantities such as speed, strain, area, and volume as time series information based on the displacement according to the measurement item specified by the examiner using the input device.
- the calculated physical quantity is displayed in pseudo color on the ultrasonic image, a numerical value is displayed on the ultrasonic image, or a file is output as a measurement report.
- Example 1 is an example in which a short axis image of the heart is taken as an example, the inside of the myocardium is continuously measured spatially and temporally, and a measured value is calculated for each local area inside the myocardium.
- the object will be described as a two-dimensional ultrasonic signal and a two-dimensional ultrasonic image.
- FIG. 2 is a flowchart showing a processing flow of the ultrasonic diagnostic apparatus according to the present embodiment.
- the examiner first captures and displays an ultrasound image of the living tissue (myocardium) (S101).
- the ultrasonic transmission / reception surface of the ultrasonic probe 3 is brought into contact with the subject 1, and an area including the measurement target is imaged.
- An image for a certain period is acquired for tracking.
- a biological signal for example, an electrocardiogram
- one heartbeat from the R wave of the electrocardiogram to the next R wave may be automatically acquired, or after acquiring an image, a start frame and an end frame are specified for a frame group in a certain section. You may do it.
- the specified frame group is stored in the storage unit 9, but when performing a tracking calculation using an ultrasonic signal, the ultrasonic signal is also stored in the storage unit 9 and can be read out in the same manner as the ultrasonic image. Keep it in a proper state.
- FIG. 3 is a diagram showing an example of a display screen of the ultrasonic diagnostic apparatus.
- an ultrasonic image 203 is displayed on the left side of the screen, and here, an example in which a short axis image of the heart is displayed is shown. That is, the ultrasound image 203 includes a heart short-axis image including the heart cavity 205 of the subject's heart and the myocardium 207 surrounding the heart cavity 205 in a donut shape.
- an endocardium 209 exists along the circumferential direction at the boundary between the myocardium 207 and the heart chamber 205, and extracardiac along the circumferential direction exists at the boundary between the myocardium 207 and other tissues on the outer peripheral side of the cardiac muscle 207.
- a membrane 211 is present.
- the examiner sets a region of interest by the measurement position setting unit 17 (S102).
- the setting is made using the input device on the ultrasonic image displayed in S101.
- FIG. 3 shows an example of a screen for setting a region of interest. A short-axis image is depicted on the screen, and strip-shaped regions of interest 213 and 215 are set on this image.
- the setting method an automatic setting method based on an existing region division method may be used, or the myocardial contour may be manually traced and set.
- the band shape surrounds the myocardium, but is not limited.
- one or more regions of interest can be set.
- the region of interest can be set separately in a partial region of a plurality of myocardiums among the donut-shaped myocardium of the short axis image of the heart. Thereby, specific physical quantities of the myocardium in a plurality of regions of interest can be compared and observed.
- the first region of interest 213 on the side close to the transmission / reception surface of the ultrasound probe 3 and the second region of interest 215 on the far side are set separately with the heart chamber 205 interposed therebetween. .
- FIG. 5 is a diagram showing another example of the display screen of the ultrasonic diagnostic apparatus.
- a donut-shaped region of interest 217 surrounding the entire donut-shaped myocardium may be set, and this may be divided into 6 based on the 17-segment method recommended by ASE (American Society-of-Echocardiography).
- the examiner sets a mesh division method by the measurement position setting unit 17 (S103). What is necessary is just to match the mesh division
- the directions for dividing the mesh are the circumferential direction and the radial direction. That is, it aims at measuring the expansion and contraction of the myocardium in the circumferential direction and the expansion and contraction in the radial direction.
- the region of interest is meshed with a plurality of first dividing lines 221 along the myocardial epicardium 211 and endocardium 209 and a plurality of second dividing lines 223 orthogonal to the plurality of first dividing lines 221.
- a plurality of intersections of the first dividing line 221 and the second dividing line 223 are set as measurement points, respectively.
- the density of the mesh that is, the number of the first dividing lines 221 and the second dividing lines 223 for a certain region can be arbitrarily adjusted.
- measurement based on the distance between the inner membrane surface and the outer membrane surface may be performed without division at all as in the conventional method.
- the number of divisions may be set freely by the examiner, and is set using an input device.
- the set value is displayed in the mesh setting display 225.
- FIG. 6 is an enlarged view of the region of interest.
- the lower right of FIG. 6 shows one section of the region of interest extracted.
- the region of interest separation line 231 is set when the inside of the region of interest is further divided into several groups for measurement (in this example, the region of interest is separated into two). As shown in Figs. 3-6, the myocardial endocardium side and epicardial side are expected to have different properties, so a region-of-interest separation line 231 is set approximately halfway between the endocardium and epicardium. However, it can be set freely according to the target measurement. For example, it may be set so as to surround the tumor.
- any of the plurality of second dividing lines 223 can be set as the region-of-interest separation line 231.
- the region-of-interest separation line 231 may be set separately from the first parting line 221 or the second parting line 223.
- the tracking calculation unit 19 measures the movement of the measurement point group (S105).
- the tracking calculation unit tracks a plurality of measurement points using the first dividing line 221 and the second dividing line. That is, a plurality of measurement points set based on the first dividing line 221 and the second dividing line are tracked. For example, as described above, the intersections of the first dividing line 221 and the second dividing line may be used as measurement points, respectively, or a predetermined position in the lattice formed by the first dividing line 221 and the second dividing line is measured. It can also be a point.
- a general tracking method such as a correlation method or an optical flow method is applied.
- the target signal is an ultrasonic signal or an ultrasonic image stored in the storage unit 9.
- the tracking calculation is applied by artificially improving the resolution of the target image. Further, the tracking operation is recursively applied while changing the block size for matching.
- a solution method such as applying a tracking calculation combining the cross-correlation method and the optical flow method.
- the time phase to be measured is a frame group of the ultrasonic image acquired and set in S101. As the tracking result, data of position coordinates of each measurement point in each frame is obtained.
- the physical quantity calculation unit 21 calculates a physical quantity (S106). As shown in the lower right of FIG. 6, for a group of measurement points 227, a physical quantity based on the distance between the two measurement points is calculated between adjacent measurement points. For example, the distance between two points and the rate of change (strain) from the initial distance are calculated. The radial direction is a radial strain, and the circumferential direction is a circular strain. The area strain may be calculated based on the change in the area surrounded by the four points. Thereby, the physical quantity of each small area of the mesh is calculated. Furthermore, the measured value of the region of interest is obtained by taking the average value of these physical quantities for the entire mesh. In addition, an average value is obtained by dividing the epicardial side and the endocardial side divided by the region-of-interest separation line 231 to obtain respective measured values.
- the examiner or the device selects a result display area (S107).
- the selection criterion is tracking accuracy.
- an evaluation value for self-evaluating the tracking accuracy is calculated.
- the higher the resolution the lower the tracking accuracy.
- the presence of artifacts and low pulse resolution tend to be an adverse condition for the tracking calculation. Therefore, depending on the conditions, it is not always possible to track accurately.
- a method based on erroneous vector detection is used as the evaluation value.
- a method of determining that a displacement vector at a certain measurement point is different (incorrect) from surrounding displacement vectors is used to quantify the amount of the erroneous vector. Since an evaluation value is obtained at each measurement point, this may also be calculated separately for the entire region of interest or the endocardial side and the epicardial side across the region of interest separation line 231. The examiner selects the result display area so as to hide the region of interest with low measurement accuracy while looking at the magnitude of the evaluation value. Further, the apparatus may automatically select based on a preset threshold value.
- FIG. 4 shows an example of a measurement result display screen.
- the physical quantity is converted into a luminance value for pseudo color display. These luminance values are superimposed on the mesh of the region of interest, and the entire region of interest is colored by smoothly complementing the luminance change.
- the entire regions of interest 213 and 215 are colored. Tracking self-assessment values are shown in the table of tracking self-assessment results 235.
- a graph is displayed on the right side of FIG.
- the graph is displayed for each local region of the region of interest.
- the graph is displayed as a strain value 241 for the entire region of interest, a strain value 243 for the endocardial side region, and a strain value 245 for the epicardial side.
- a biological signal 247 is also displayed.
- a time phase bar 249 is provided at the time phase of the currently displayed image to display a moving image. As shown in FIG. 5, when six regions of interest are set, pseudo-color display is performed for each region of interest, and as many graphs 250 as the number of regions of interest are displayed.
- the graph of the first region of interest 213 is indicated by a solid line
- the graph of the second region of interest 215 is indicated by a dotted line.
- the examiner finely adjusts the region of interest separation line 231 by the measurement position setting unit 17 (S109).
- the position of the region of interest separation line is adjusted while viewing the graph of the result of tracking the movement.
- the measurement result in the local region changes. This is reflected in the graph and adjusted so that the measurement result at the desired measurement position is obtained while viewing the reflected result.
- the present embodiment it is possible to set a region of interest that matches the shape of the living tissue, and by setting the measurement points in a mesh shape, it is possible to track the movement inside the living tissue.
- the region-of-interest separation line 231 By separating the region of interest by the region-of-interest separation line 231 to make it a local region, or by displaying the measured value in a pseudo color, it becomes possible to easily distinguish a difference in local properties inside the living tissue.
- you can set the measurement location according to the lesion of the subject or set the image quality to a location that is sufficient for measurement. Measurement accuracy can be improved.
- the amount of calculation can be reduced as compared with tracking the entire myocardium, so that the efficiency of the examination is improved.
- a myocardial region other than the myocardium on the side closer to the transmitting / receiving surface of the ultrasound probe across the heart chamber for example, the myocardial region in FIG. 4
- the image quality of the ultrasonic image is not sufficient due to the influence of noise or the like, and the accuracy of motion tracking may be lowered. Therefore, even if a physical quantity is calculated for this myocardial region, reliability may be lacking. Nevertheless, when the region of interest is set in a donut shape, measurement is performed even on a portion having low reliability, which is not preferable in terms of the efficiency of calculation processing. In this regard, as shown in Fig.
- the region of interest is separated into the myocardium on the side close to the transmitting / receiving surface of the ultrasound probe and the myocardium on the far side of the doughnut-shaped myocardium in the short axis image of the heart
- the calculation processing efficiency can be improved, and the myocardium on the side closer to the transmission / reception surface of the ultrasonic probe and the myocardium on the far side can be compared and observed with the myocardium in between.
- the measurement points are appropriately set according to the shape of the myocardium, the direction of expansion and contraction, and the like. That is, a plurality of measurement points are set along the main expansion and contraction directions of the myocardium (circumferential direction and radial direction (radial direction) of the myocardium in the short axis image of the heart). According to the present embodiment, since the measurement points are set along the expansion and contraction direction of the myocardium in this way, for example, between the adjacent measurement points on the first dividing line 221 or between the adjacent measuring points on the second dividing line 223 When a change in distance or the like is measured, each measurement value is useful for diagnosis because it appropriately reflects the properties of each part of the myocardium.
- the distances from the endocardium 209 and the epicardium 211 are all constant for a plurality of measurement points set on the plurality of first dividing lines 221 respectively. Therefore, for example, when measuring changes in the distance from each measurement point on a certain first dividing line 221 to the endocardium 209 and epicardium 211, the properties of each part of the myocardium can be determined by comparing each measurement value. Since it can be contrasted appropriately, it is useful for diagnosis. Therefore, according to the present embodiment, it is possible to accurately measure the expansion and contraction of the myocardium, which accurately reflects the expansion and contraction of the myocardium and each measured value is suitable for diagnosis.
- Example 2 is a method of taking a short axis image of the heart as an example, continuously measuring the inside of the myocardium spatially and temporally, and calculating a measurement value for each local area inside the myocardium.
- the present embodiment is different from the first embodiment in that the target is a three-dimensional signal and a three-dimensional image. Therefore, the description of the parts similar to the first embodiment such as the apparatus configuration and the processing procedure is omitted, and the parts different from the first embodiment will be mainly described.
- FIG. 7 is a diagram showing an example of a measurement method in a three-dimensional ultrasound image.
- the left side of FIG. 7 shows an extracted endocardial contour 301 and epicardial contour 303 of the entire left ventricle.
- the right side of FIG. 7 shows an extracted 3D region of interest 305 set on the 3D ultrasound image.
- the myocardium has a bell-like shape with a thickness of about 10 mm, for example.
- the mesh setting (S103) it is divided into three directions: radial direction, short axis direction, and long axis direction. That is, the division method is intended to perform measurement in each direction of radial, circularferential, and longitudinal.
- the region of interest in a cross section orthogonal to the major axis direction, includes a plurality of first dividing lines 221 along the myocardial epicardium 211 and endocardium 209, and a plurality of orthogonal to the plurality of first dividing lines 221.
- the second division line 223 is divided into a mesh shape.
- first dividing line 221 and the second dividing line 223 are extending along the epicardium and endocardium in the major axis direction, by cutting a cross section perpendicular to the major axis direction at a predetermined interval in the major axis direction It is divided into a three-dimensional mesh. Intersections of these dividing lines are set as measurement points 227.
- the 3D region of interest is separated into local regions by setting the region of interest separation line 231 (S104).
- S104 region of interest separation line 231 for dividing the endocardial side and the epicardial side is set.
- the region of interest separation line 231 extends along the endocardium and epicardium in the long axis direction, so that the three-dimensional region of interest is on the endocardial side. It is separated into a 3D region and a 3D region on the epicardial side.
- the apparatus performs motion measurement (S105) for each measurement point 227 in the 3D ultrasonic signal or 3D ultrasonic image, and calculates the physical quantity (S106).
- the physical quantity includes a distance in each direction of radial, circularferential, and longitudinal, a strain based on a change in the distance, an area of a cross section having a three-dimensional region of interest, a volume of the three-dimensional region of interest, and the like.
- the examiner or the device selects a result display area based on the self-evaluation of motion tracking (S107).
- the measurement value is converted into a luminance value, and the surface of the region of interest is colored. Then, the position of the region of interest separation line is adjusted while looking at the graph of the motion tracking result (S109).
- the measurement points are appropriately set according to the three-dimensional shape of the myocardium and the stretching direction. It is possible to measure the expansion and contraction of the myocardium whose value is suitable for diagnosis.
- the three-dimensional space it is possible to set a region of interest that matches the shape of the living tissue, and to track the movement inside the living tissue. Compared with the analysis in two dimensions, the dimension in the depth direction is added, so that the measurement accuracy is improved and three directions can be measured simultaneously.
- the region of interest separation line into a local region, or by displaying the measured value in pseudo color, it becomes possible to easily discriminate the difference in local properties inside the living tissue.
- the ultrasonic diagnostic apparatus includes an ultrasonic probe that transmits and receives ultrasonic waves to and from a subject, and a tomographic plane of a tissue including a heart myocardium of the subject that is received by the ultrasonic probe.
- An ultrasonic signal generation unit that generates an ultrasonic signal based on the reflected echo signal, an ultrasonic image generation unit that generates an ultrasonic image based on the ultrasonic signal, a display unit that displays the ultrasonic image, and a display unit
- a measurement position setting unit that sets the region of interest in the myocardium on the ultrasound image displayed on the screen, a tracking calculation unit that tracks the movement of the myocardium at multiple measurement points in the region of interest, and a specific physical quantity based on the tracking result
- a physical quantity calculation unit that performs the basic configuration, and displays the calculated specific physical quantity on the display unit.
- Specific physical quantities include the myocardial velocity at multiple measurement points in the region of interest, the myocardial strain at multiple measurement points in the region of interest, the area of the myocardium surrounded by the region of interest, and a 3D ultrasound image. There may be at least one of the myocardial volumes surrounded by the three-dimensional region of interest.
- the tracking calculation unit includes a plurality of first dividing lines along the epicardium and endocardium of the myocardium, and a plurality of second dividing lines orthogonal to the plurality of first dividing lines. It is characterized by tracking a plurality of measurement points. For example, a plurality of measurement points can be set based on a plurality of first division lines and a plurality of second division lines, and the plurality of measurement points can be tracked.
- the region of interest is divided into a mesh shape by a plurality of first dividing lines and a plurality of second dividing lines, and an intersection of the first dividing line and the second dividing line is set as a plurality of measurement points. Can be configured.
- the plurality of measurement points include the major stretching direction of the myocardium (for example, the short axis of the heart including the heart chamber of the subject's heart and the myocardium surrounding the heart chamber in a donut shape). In the case of an image, it is set along the circumferential direction and radial direction (radial direction) of the myocardium.
- each measurement Since measurement points are set along the direction of expansion and contraction of the myocardium in this way, for example, when measuring a change in distance between adjacent measurement points on the first division line or between adjacent measurement points on the second division line, each measurement Since the value appropriately reflects the properties of each part of the myocardium, it is useful for diagnosis.
- the distances from the endocardium and the epicardium are all constant for the plurality of measurement points set on the plurality of first dividing lines, respectively. Therefore, for example, when changes in the distance from each measurement point on the first dividing line to the endocardium or epicardium are measured, the properties of each part of the myocardium are appropriately compared by comparing the measured values. This is useful for diagnosis.
- the measurement position setting unit is configured to set the region of interest in a donut shape in accordance with the shape of the donut-shaped myocardium in the short heart image. can do.
- the measurement position setting unit can be configured to separate and set a region of interest in a plurality of myocardial partial regions of the doughnut-shaped myocardium of the short-axis image of the heart. By separating and setting a plurality of regions of interest in this way, a specific physical quantity in each region of interest can be compared and observed, which is preferable.
- the measurement position setting unit separates the region of interest into the myocardium on the side closer to the transmission / reception surface of the ultrasonic probe and the myocardium on the far side of the doughnut-shaped myocardium in the short axis image of the heart with the heart chamber interposed therebetween. It can also be configured to set.
- the myocardial region other than the myocardium on the side closer to the transmitting / receiving surface of the ultrasound probe across the heart chamber and the myocardial region on the far side are affected by noise, etc. Therefore, the image quality of the ultrasonic image is not sufficient and the accuracy of motion tracking may be lowered, so that even if the physical quantity is calculated, the reliability may be lacking. Nevertheless, when the region of interest is set in a donut shape, measurement is performed even on a portion having low reliability, which is not preferable in terms of the efficiency of calculation processing.
- the donut-shaped myocardium of the short axis image of the heart by setting the region of interest separately in the myocardium on the side closer to the transmitting / receiving surface of the ultrasound probe and the myocardium on the far side across the heart chamber, The efficiency of the arithmetic processing can be increased, and the myocardium on the side closer to the transmission / reception surface of the ultrasonic probe and the myocardium on the far side can be compared and observed with the myocardium in between.
- the measurement position setting unit sets either the plurality of first division lines or the plurality of second division lines set in the region of interest as a region of interest separation line that separates the region of interest into two, Alternatively, the region-of-interest separation line may be set on the ultrasonic image separately from the plurality of first division lines or the plurality of second division lines. According to this, since the region of interest once set can be separated by a simple operation, for example, the endocardial side and the epicardial side of the myocardium are evaluated separately, or the normal and abnormal regions of the myocardium are evaluated. Convenient when evaluating separately.
Abstract
Description
図1は、本実施形態の超音波診断装置の全体構成を示すブロック図である。図1に示すように、本実施形態の超音波診断装置100は、被検体1との間で超音波を送受信する超音波探触子3と、超音波探触子3で計測された反射エコー信号に基づいて超音波信号を生成する超音波信号生成部5と、超音波信号に基づいて超音波画像を生成する超音波画像生成部7と、生成された超音波画像や超音波診断装置を制御する各種プログラムが格納された記憶部9と、入力インターフェースとなる入力部11と、出力インターフェースとなる表示部13と、超音波診断装置の各部を制御する制御部15と、表示部13に表示された超音波画像上の診断対象部位の生体組織に関心領域を設定する計測位置設定部17と、関心領域の複数計測点における診断対象部位の生体組織の動きを追跡する追跡演算部19と、追跡結果に基づいて特定の物理量を算出する物理量演算部21と、各部を接続するシステムバス23とを備えて構成される。
メッシュ分割方法は、対象とする組織の計測項目に合わせればよい。ここでは、心筋を対象としているため、図3に示すように、メッシュを区切る方向を円周方向と半径方向にしている。すなわち、心筋の円周方向の伸縮と半径方向への伸縮を計測することを目的としている。言い換えれば、関心領域は、心筋の心外膜211及び心内膜209に沿った複数の第1分割線221と、複数の第1分割線221に直交する複数の第2分割線223によりメッシュ状に分割され、第1分割線221と第2分割線223の複数の交点がそれぞれ計測点として設定されている。メッシュの密度つまりある領域に対する第1分割線221と第2分割線223の本数は任意に調整可能である。
図6右下に示すように、計測点227の群に対して、隣接する計測点どうしで、その2点間距離に基づく物理量を算出する。例えば、2点間の距離や、初期距離からの変化率(strain)を算出する。半径方向には、radial strain、円周方向には、circumferential strainとなる。また4点で囲まれる面積の変化に基づいてarea strainを算出してもよい。これによりメッシュの各小領域の物理量が算出される。さらに、メッシュ全体についてこれらの物理量の平均値をとることで、関心領域の計測値とする。また、関心領域分離線231で分割した心外膜側と心内膜側で分けて平均値をとり、それぞれの計測値とする。
各計測点において評価値が得られるので、これもまた、関心領域全体や、関心領域分離線231を挟んで心内膜側、心外膜側に分けて算出してもよい。検者は、評価値の大小を見ながら、計測精度が低い関心領域については、非表示するように結果表示領域を選択する。また、装置が、予め設定されたしきい値に基づいて自動選択するようにしてもよい。
Claims (15)
- 被検体との間で超音波を送受信する超音波探触子と、前記超音波探触子で受信された前記被検体の心臓の心筋を含む組織の断層面の反射エコー信号に基づいて超音波信号を生成する超音波信号生成部と、前記超音波信号に基づいて超音波画像を生成する超音波画像生成部と、前記超音波画像を表示する表示部と、前記表示部に表示された超音波画像上の心筋に関心領域を設定する計測位置設定部と、前記関心領域の複数計測点における心筋の動きを追跡する追跡演算部と、前記追跡結果に基づいて特定の物理量を算出する物理量演算部とを備え、前記算出された特定の物理量を前記表示部に表示する超音波診断装置であって、
前記追跡演算部は、前記心筋の心外膜及び心内膜に沿った複数の第1分割線と、該複数の第1分割線に直交する複数の第2分割線によって前記複数計測点を追跡することを特徴とする超音波診断装置。 - 請求項1の超音波診断装置であって、
前記関心領域は、前記心筋の心外膜及び心内膜に沿った複数の第1分割線と、該複数の第1分割線に直交する複数の第2分割線により分割され、前記第1分割線と第2分割線の交点が前記複数計測点として設定される超音波診断装置。 - 請求項1の超音波診断装置であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部は、前記心臓短軸像の心筋の形状に合わせて前記関心領域を設定可能に構成される超音波診断装置。 - 請求項1の超音波診断装置であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部は、前記心臓短軸像の心筋のうち、複数の心筋の部分領域に前記関心領域を分離して設定可能に構成される超音波診断装置。 - 請求項1の超音波診断装置であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部は、前記心臓短軸像の心筋のうち、前記心腔を挟んで前記超音波探触子の送受信面に近い側の心筋と遠い側の心筋に前記関心領域を分離して設定可能に構成される超音波診断装置。 - 請求項1の超音波診断装置であって、
前記計測位置設定部は、前記関心領域に設定された複数の第1分割線若しくは複数の第2分割線のいずれかを、該関心領域を2つに分離する関心領域分離線として設定するか、又は前記複数の第1分割線若しくは複数の第2分割線とは別に、超音波画像上に前記関心領域分離線を設定可能に構成される超音波診断装置。 - 請求項1の超音波診断装置であって、
前記超音波探触子は、前記被検体との間で超音波を送受信する複数の振動子が2次元配置されるか、又は1次元配列された前記複数の振動子を機械的に空間走査可能に構成され、前記被検体の心臓の心筋を含む組織の複数断層面の反射エコー信号を計測する探触子であり、
前記表示部は、前記複数断層面の超音波信号に基づいて生成された3次元超音波画像を表示し、
前記計測位置設定部は、前記表示部に表示された3次元超音波画像上に3次元関心領域を設定する超音波診断装置。 - 請求項1の超音波診断装置であって、
前記特定の物理量は、前記関心領域の複数計測点の心筋の速度、前記関心領域の複数計測点の心筋のストレイン、前記関心領域により囲まれる心筋の面積、及び前記3次元関心領域により囲まれる心筋の容積の少なくとも1つである超音波診断装置。 - 超音波探触子によって被検体との間で超音波を送受信し、超音波信号生成部によって前記超音波探触子で受信された前記被検体の心臓の心筋を含む組織の断層面の反射エコー信号に基づいて超音波信号を生成し、超音波画像生成部によって前記超音波信号に基づいて超音波画像を生成し、表示部によって前記超音波画像を表示し、計測位置設定部によって前記表示部に表示された超音波画像上の心筋に関心領域を設定し、追跡演算部によって前記関心領域の複数計測点における心筋の動きを追跡し、物理量演算部によって前記追跡結果に基づいて特定の物理量を算出し、前記算出された特定の物理量を前記表示部に表示する超音波診断装置の計測点追跡方法であって、
前記追跡演算部によって前記心筋の心外膜及び心内膜に沿った複数の第1分割線と、該複数の第1分割線に直交する複数の第2分割線によって前記複数計測点を追跡するステップを含むことを特徴とする超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記関心領域は、前記心筋の心外膜及び心内膜に沿った複数の第1分割線と、該複数の第1分割線に直交する複数の第2分割線により分割され、前記第1分割線と第2分割線の交点が前記複数計測点として設定される超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部は、前記心臓短軸像の心筋の形状に合わせて前記関心領域を設定可能に構成される超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部によって前記心臓短軸像の心筋のうち、複数の心筋の部分領域に前記関心領域を分離して設定可能に構成される超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記表示部に表示される超音波画像が、前記被検体の心臓の心腔と該心腔の周囲を囲む心筋とを含む心臓短軸像である場合、
前記計測位置設定部によって前記心臓短軸像の心筋のうち、前記心腔を挟んで前記超音波探触子の送受信面に近い側の心筋と遠い側の心筋に前記関心領域を分離して設定可能に構成される超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記計測位置設定部によって、前記関心領域に設定された複数の第1分割線若しくは複数の第2分割線のいずれかを、該関心領域を2つに分離する関心領域分離線として設定するか、又は前記複数の第1分割線若しくは複数の第2分割線とは別に、超音波画像上に前記関心領域分離線を設定可能に構成される超音波診断装置の計測点追跡方法。 - 請求項9の超音波診断装置の計測点追跡方法であって、
前記超音波探触子は、前記被検体との間で超音波を送受信する複数の振動子が2次元配置されるか、又は1次元配列された前記複数の振動子を機械的に空間走査可能に構成され、前記被検体の心臓の心筋を含む組織の複数断層面の反射エコー信号を計測する探触子であり、
前記複数断層面の超音波信号に基づいて生成された3次元超音波画像を前記表示部に表示し、
前記表示部に表示された3次元超音波画像上に3次元関心領域を前記計測位置設定部により設定する超音波診断装置の計測点追跡方法。
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- 2011-01-20 US US13/520,856 patent/US20120283567A1/en not_active Abandoned
- 2011-01-20 WO PCT/JP2011/050912 patent/WO2011093193A1/ja active Application Filing
- 2011-01-20 CN CN2011800074230A patent/CN102724918A/zh active Pending
- 2011-01-20 JP JP2011551820A patent/JP5753798B2/ja not_active Expired - Fee Related
- 2011-01-20 EP EP11736907.4A patent/EP2529666B1/en not_active Not-in-force
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Publication number | Priority date | Publication date | Assignee | Title |
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JP2012090821A (ja) * | 2010-10-27 | 2012-05-17 | Ge Medical Systems Global Technology Co Llc | 超音波診断装置 |
JP2012090819A (ja) * | 2010-10-27 | 2012-05-17 | Ge Medical Systems Global Technology Co Llc | 超音波診断装置 |
WO2017206023A1 (zh) * | 2016-05-30 | 2017-12-07 | 深圳迈瑞生物医疗电子股份有限公司 | 一种心脏容积识别分析系统和方法 |
Also Published As
Publication number | Publication date |
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CN102724918A (zh) | 2012-10-10 |
EP2529666A1 (en) | 2012-12-05 |
JPWO2011093193A1 (ja) | 2013-06-06 |
JP5753798B2 (ja) | 2015-07-22 |
EP2529666B1 (en) | 2017-01-18 |
US20120283567A1 (en) | 2012-11-08 |
EP2529666A4 (en) | 2014-01-15 |
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