WO2013024831A1 - 画像処理表示装置及び画像処理表示プログラム - Google Patents
画像処理表示装置及び画像処理表示プログラム Download PDFInfo
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- blood vessel
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- 238000012545 processing Methods 0.000 title claims abstract description 84
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 148
- 238000002594 fluoroscopy Methods 0.000 claims abstract description 3
- 238000003384 imaging method Methods 0.000 claims description 36
- 230000001225 therapeutic effect Effects 0.000 claims description 32
- 238000000034 method Methods 0.000 claims description 11
- 238000000605 extraction Methods 0.000 claims description 9
- 230000008569 process Effects 0.000 claims description 2
- 230000017531 blood circulation Effects 0.000 claims 1
- 239000000284 extract Substances 0.000 abstract description 8
- 238000010521 absorption reaction Methods 0.000 abstract 1
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- 238000001514 detection method Methods 0.000 description 6
- 230000009466 transformation Effects 0.000 description 6
- 239000013598 vector Substances 0.000 description 6
- 239000000203 mixture Substances 0.000 description 5
- 238000006243 chemical reaction Methods 0.000 description 4
- 238000002583 angiography Methods 0.000 description 3
- 210000004351 coronary vessel Anatomy 0.000 description 3
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- 239000002872 contrast media Substances 0.000 description 2
- 230000002194 synthesizing effect Effects 0.000 description 2
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- 210000001367 artery Anatomy 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 230000003073 embolic effect Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
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- 230000000250 revascularization Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Images
Classifications
-
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/12—Arrangements for detecting or locating foreign bodies
Definitions
- Embodiments described herein relate generally to an image processing display device and an image processing display program.
- hybrid therapy In recent years, a new system called hybrid therapy has been developed. For example, in this method of treatment, a combination of both methods is performed so that a coronary artery that is difficult to treat with a catheter is bypassed in a short time, and then the remaining coronary artery lesion is treated with a catheter. Thereby, the advantages of both can be utilized, and complete revascularization can be performed more safely.
- therapeutic instruments such as stent grafts and embolic coils are inserted into the artery.
- Some therapeutic instruments have the property of absorbing X-rays.
- fluoroscopic images are used.
- Patent Document There is a technique for reading information registered in a database from the position of a surgical instrument tip detected by a position detection device and a pixel position of volume data corresponding to the position, and providing necessary information to an operator (Patent Document) 1).
- An object is to provide an image processing display device and an image processing display program.
- an image processing display device displays an X-ray fluoroscopic image acquired by X-raying a region including a blood vessel during treatment, and extracts a therapeutic instrument image.
- the therapeutic instrument image extracting means extracts a therapeutic instrument image representing a therapeutic instrument having the property of absorbing X-rays based on the X-ray fluoroscopic image.
- the image processing means obtains the position of the distal end portion of the catheter, and superimposes and displays an image representing the obtained position of the distal end portion of the catheter on the region where the therapeutic instrument exists on the fluoroscopic image.
- FIG. 1 is a functional block diagram of an image processing display device according to a first embodiment.
- the figure which shows an example by which the two-dimensional image of the front-end
- the flowchart which shows a series of flows of the image processing display in a hybrid treatment.
- the functional block diagram of the image processing part which concerns on 2nd Embodiment.
- requires the position of the front-end
- the functional block diagram of the image processing part which concerns on 3rd Embodiment.
- the functional block diagram of the blood vessel core processing part which concerns on 4th Embodiment.
- FIG. 1 is a functional block diagram of an image processing display device
- FIG. 2 is a diagram showing an example in which a two-dimensional image of a distal end portion of a catheter is displayed on an X-ray fluoroscopic image.
- the image processing display device includes a blood vessel running information creation unit 13, a storage unit 14, a blood vessel core line processing unit 15, an image processing unit 22, a treatment instrument image extraction unit 33, an image composition unit 44, and a display control unit. 51 and a display unit 52.
- three-dimensional data (indicated by a in FIG. 1) of a region including blood vessels and an X-ray image (indicated by d in FIG. 1) of a blood vessel as a two-dimensional image are acquired. .
- 3D data (volume data) of a region including a blood vessel is acquired by a medical diagnostic apparatus (for example, an X-ray CT apparatus).
- the three-dimensional data can be read from a storage device on the Internet (including a storage device of a medical diagnostic device). Note that three-dimensional data may be stored in the storage device of the image processing display device.
- An X-ray image of a blood vessel is acquired by an X-ray angiography examination.
- a medical diagnostic apparatus for example, an X-ray imaging apparatus
- a part containing the contrast agent is obtained by pouring a contrast agent that is difficult to transmit X-rays into a target blood vessel and then performing X-ray imaging. It clearly shows the shape of the blood vessels.
- An X-ray image of a blood vessel acquired by this examination can be read from a storage device (including a buffer) of the medical diagnostic apparatus.
- the X-ray image of the blood vessel may be stored in a storage device on the Internet or a storage device of an image processing display device, and may be readable from those storage devices.
- the plane coordinates of the pixel of the blood vessel X-ray image d Becomes (x1, y1).
- the plane coordinates of the pixels of the blood vessel X-ray image d are associated with the plane coordinates of the memory address.
- the blood vessel running information creation unit 13 extracts a three-dimensional image b representing a blood vessel based on the three-dimensional data a.
- the extracted three-dimensional image b of the blood vessel is stored in the storage unit 14.
- the spatial coordinates are ( x2, y2, z2).
- the spatial coordinates of the voxel of the three-dimensional image b of the blood vessel and the spatial coordinates of the memory address are made to correspond one-to-one.
- the blood vessel core processing unit 15 includes a blood vessel core extraction unit 16 that extracts a three-dimensional blood vessel core image (c shown in FIG. 1) representing the blood vessel core.
- a blood vessel core extraction unit 16 that extracts a three-dimensional blood vessel core image (c shown in FIG. 1) representing the blood vessel core.
- Various methods have been proposed for extracting the blood vessel three-dimensional image b and the blood vessel core image c, but any known method may be employed in the present embodiment.
- the three-dimensional image b of the blood vessel may be referred to as blood vessel running information.
- the blood vessel core image c is included in the blood vessel travel information.
- a region including a blood vessel is fluoroscopically transmitted through a medical diagnostic apparatus (for example, a diagnostic X-ray system), X-ray fluoroscopic data is acquired, and an X-ray fluoroscopic image (see FIG. 1 is indicated by f).
- the X-ray fluoroscopic image f may be stored in the storage device of the image processing display device.
- the X-ray imaging direction when creating the X-ray fluoroscopic image f and the X-ray imaging direction when acquiring the X-ray image d of the blood vessel in the X-ray angiography examination are set to be the same.
- the image processing unit 22 includes an alignment processing unit 23, a position calculation unit 26, and an overlay image creation unit 42.
- the alignment processing unit 23 aligns the three-dimensional image b of the blood vessel with the two-dimensional blood vessel X-ray image d, thereby matching the three-dimensional image b of the blood vessel with the two-dimensional blood vessel X-ray image d. Find the positional relationship. The reason is that the front and back positions of two objects displayed so as to overlap in the X-ray fluoroscopic image f cannot be determined only by the X-ray image d of the blood vessel.
- the coordinates (x2, y2, z2) of the three-dimensional image b of the blood vessel are transformed (inverted, enlarged, reduced, translated). By doing. Conversion of the coordinates (x2, y2, z2) of the three-dimensional image b of the blood vessel is performed by a three-dimensional coordinate conversion means (not shown).
- the x2 axis and y2 axis are aligned with the x1 axis and y1 axis of the plane coordinates (x1, y1) of the blood vessel. .
- the axes after the alignment are x2 ', y2', and z2 '.
- the coordinates (x2 ′, y2 ′, z2 ′) of the three-dimensional image b of the blood vessel so that the distances between the two predetermined points are equal to each other. Zoom in and out.
- the coordinates of the three-dimensional image of the blood vessel are translated in some cases.
- the coordinates of the three-dimensional image b of the blood vessel after being aligned with the coordinates (x1, y1) of the blood vessel X-ray image d are described as (x2 ′, y2 ′, z2 ′). To do.
- the coefficient matrix vector is used in the affine transformation.
- coordinate transformation such as rotation, inversion, enlargement, reduction, and translation can be performed.
- the affine transformation is expressed by the following equation.
- a and B are expressed as follows.
- a vector A that is rotated at an angle ⁇ in the positive direction from the z axis with the y axis as the rotation axis is expressed by the following equation.
- the vector B is as follows.
- the values of the vectors A and B are controlled, and the coordinates (x2, y2, z2) of the three-dimensional image of the blood vessel are rotated, inverted, enlarged, reduced, and moved horizontally, thereby moving the X-ray image of the blood vessel. It is possible to align the three-dimensional image b of the blood vessel with respect to d. Thereby, the corresponding positional relationship (positioning information) of the three-dimensional image of the blood vessel with respect to the X-ray image of the blood vessel can be obtained.
- the alignment information (vectors A and B) is indicated by e in FIG.
- any position on the coordinates of the blood vessel three-dimensional image b can be associated with any position on the coordinates of the blood vessel X-ray image d.
- the therapeutic instrument image extraction unit 33 extracts a therapeutic instrument image (indicated by g in FIG. 1) representing the therapeutic instrument inserted in the bypass operation based on the fluoroscopic image f.
- a therapeutic instrument image (indicated by g in FIG. 1) representing the therapeutic instrument inserted in the bypass operation based on the fluoroscopic image f.
- Various methods have been proposed for extracting the therapeutic instrument image g, but any known method may be employed in the present embodiment.
- the therapeutic instrument image g is extracted as an image of the contour of the therapeutic instrument (see FIG. 2).
- the position calculation unit 26 obtains the position and traveling direction of the distal end portion of the catheter.
- the fluoroscopic image f is used, the blood vessel core image c, the alignment information e, the treatment instrument image g, and the operation information related to the catheter (in FIG. May be used).
- the operation information related to the catheter refers to the amount of movement of the catheter that has been advanced by the operation of the operator.
- a sensor for detecting the amount of movement of the catheter is provided at the insertion position of the catheter into the subject.
- the value obtained based on the detection result is hereinafter simply referred to as “operation information”.
- the position calculation unit 26 is an example of “means for obtaining the position of the distal end portion of the catheter”.
- the position calculation unit 26 reads out two X-ray fluoroscopic images f taken at a predetermined time and calculates the difference between them, so that the distal end portion of the catheter can be detected from the movement of the shadow of the catheter reflected in the images f. Find the position and direction of travel.
- the position calculating unit 26 uses the images f so that the catheter The position of the tip can be determined.
- the position calculation unit 26 uses the X-ray fluoroscopic image f and determines that the shadow overlaps X Instead of using the fluoroscopic image f, the position or the like of the distal end portion of the catheter is obtained using the blood vessel core image c or the like.
- the internal memory of the position calculation unit 26 includes the position p10 (shown in FIG. 2) of the distal end of the catheter before the shadow of the catheter overlaps the treatment instrument image g, and the amount of movement s of the catheter from that position. Some operation information h is stored.
- the position p10 is shown as a point on the coordinates (x1, y1) of the blood vessel X-ray image d.
- the movement amount s is indicated as the movement amount along the blood vessel core line in the coordinates (x2 ′, y2 ′, z2 ′) of the three-dimensional image b of the blood vessel.
- the overlay image creation unit 42 creates an image in which the image of the line segment L (shown in FIG. 2) overlaps the treatment instrument image g based on the position information i and the treatment instrument image g.
- This overlapping image is a two-dimensional image (indicated by j in FIG. 1) of the distal end portion of the catheter.
- a two-dimensional image j of the distal end portion of the catheter is shown by a broken line in FIG.
- the image combining unit 44 combines the X-ray fluoroscopic image f and the two-dimensional image j of the distal end portion of the catheter, and outputs the combined image k to the display control unit 51.
- the display control unit 51 causes the display unit 52 to display the synthesized image k.
- the two-dimensional image j of the distal end portion of the catheter is displayed on the X-ray fluoroscopic image f so as to be hindered. It is possible to prevent this.
- FIG. 3 is a flowchart showing a series of flow of image processing display in the hybrid treatment.
- Step 101 previous stage
- a three-dimensional image b of the blood vessel is stored in advance in the storage means 14 at the pre-stage or the initial stage of the hybrid treatment.
- Step 102 previous stage Furthermore, an X-ray image d of the blood vessel is acquired in the previous stage or initial stage of the hybrid treatment.
- Step 103 blood vessel core line processing
- the blood vessel core line extraction unit 16 extracts a three-dimensional blood vessel core image c representing the blood vessel core line based on the blood vessel three-dimensional data a.
- Step 104 Creation of X-ray fluoroscopic image
- An X-ray fluoroscopic image f is created based on the X-ray fluoroscopic data. Note that the X-ray imaging direction when creating the X-ray fluoroscopic image f and the X-ray imaging direction when acquiring the X-ray image d of the blood vessel are set to be the same. Furthermore, a therapeutic instrument image g representing a therapeutic instrument is extracted based on the fluoroscopic image f.
- Step 105 alignment processing
- the alignment processing unit 23 aligns the blood vessel three-dimensional image b with the blood vessel X-ray image d. Thereby, the alignment information e is obtained.
- Step 106 position calculation
- the position calculation unit 26 obtains the position and traveling direction of the distal end portion of the catheter based on the blood vessel core image c, the operation information h, the alignment information e, the X-ray fluoroscopic image f, and the treatment instrument image g.
- the position calculating unit 26 obtains the position and traveling direction of the distal end portion of the catheter based on the fluoroscopic images f.
- the position and the traveling direction of the distal end portion of the catheter are obtained based on the blood vessel core image c, the operation information h, the alignment information e, and the treatment instrument image g.
- Step 107 Create overlay image
- the overlay image creation unit 42 creates an image in which the image of the line segment L overlaps with the treatment instrument image g based on the position information i and the treatment instrument image g.
- Step 108 Image composition
- the image combining unit 44 combines the X-ray fluoroscopic image f and the two-dimensional image j of the distal end portion of the catheter.
- Step 109 Display
- the display control unit 51 displays the two-dimensional image j of the distal end portion of the catheter so as to overlap the X-ray fluoroscopic image f.
- the relative positional relationship (positioning information e) of the blood vessel three-dimensional image b with respect to the blood vessel X-ray image d is obtained in the positioning process of step 105. This is because the alignment information e with higher accuracy can be obtained by comparing blood vessel information with each other. However, if high accuracy is not required, the three-dimensional blood vessel with respect to the fluoroscopic image f is obtained. The alignment information of the image b may be obtained.
- the position of the distal end portion of the catheter is obtained using the blood vessel core image c and the operation information h related to the catheter, for example, some signal is generated from the distal end portion of the catheter. Based on the signal, means such as determining the position of the distal end of the catheter is not necessary, and catheter treatment can be performed without using a device equipped with such means. It becomes possible to prevent the enlargement.
- the distal end portion of the catheter in the X-ray imaging direction, is located behind the treatment instrument, and the distal end portion of the catheter cannot be imaged. Is used to output the position information i of the distal end of the catheter to the overlay image creating unit 42, and the overlay image creating unit 42 can create the image j of the distal end of the catheter.
- FIG. 4 is a functional block diagram of the image processing unit according to the second embodiment. As shown in FIG. 4, an overlay determination processing unit 45 is added to the image processing unit 25.
- the overlay determination processing unit 45 Upon receiving the position information i from the position calculation unit 26, the overlay determination processing unit 45 outputs an X-ray re-imaging instruction (indicated by l in FIG. 4) to the X-ray imaging apparatus.
- X-ray imaging is performed by directly facing the distal end of the catheter by changing the angle of the X-ray projection direction (X-ray re-imaging).
- the position of the distal end portion of the catheter is obtained using an X-ray fluoroscopic image newly acquired by X-ray re-imaging.
- FIG. 5 is a schematic diagram of the subject P, the treatment instrument image g, and the shadow m of the catheter.
- the angle ⁇ in the X-ray imaging direction refers to an angle rotated in the positive direction from the z1 axis with the y1 axis as a rotation axis.
- the position calculation unit 26 determines whether the X-ray imaging apparatus (medical diagnosis apparatus) An instruction for X-ray re-imaging is given.
- the X-ray re-imaging instruction includes information on the angle ⁇ 1 of the X-ray projection direction to be used at the time of X-ray re-imaging.
- the position calculation unit 26 obtains an angle ⁇ 1 in the X-ray projection direction at the time of X-ray re-imaging.
- the position U of the treatment instrument on the coordinates (x1, z1) is (xu1, zu1), and the position on the coordinates (x1, z1) where the shadow m of the catheter overlaps the treatment instrument image g which is the outline of the treatment instrument.
- V is represented by (xv1, zv1).
- intersection W between the circle represented by the above formula and the straight line L1 connecting the two positions U (xu1, zu1) and V (xv1, zv1) is obtained as (xw, zw).
- the angle ⁇ 1 formed by the straight line connecting the intersection W (xw, zw) and the center O (0, 0) and the z1 axis is obtained.
- the X-ray fluoroscopic image f ′ is newly acquired by changing the angle ⁇ in the X-ray projection direction from 0 to ⁇ 1 and performing X-ray re-imaging.
- FIG. 8 is a diagram showing the order of obtaining the position of the distal end portion of the catheter.
- the coordinates (x1, y1) of the blood vessel X-ray image d and the coordinates (x2 ′, y2 ′, z2 ′) of the three-dimensional image b of the blood vessel are aligned. It shall be. Note that the alignment information at this time is e.
- the coordinates transformed from the coordinates (x1, y1) of the X-ray image d ′ of the blood vessel are (x1 ′, y1 ′), and the coordinates of the blood vessel 3 are aligned with the coordinates (x1 ′, y1 ′).
- the coordinates of the dimensional image b ′ are indicated by (x2 ′′, y2 ′′, z2 ′′).
- the conversion information from the coordinates (x1, y1) to the coordinates (x1 ′, y1 ′) is the alignment information e ′, and the coordinates (x1 ′, y1 ′) and the coordinates (x2 ′′, y2 ′′, z2 ′).
- the alignment information when ') is aligned is e ′′, and the conversion information from the coordinates (x2 ′′, y2 ′′, z2 ′′) to the coordinates (x2 ′, y2 ′, z2 ′) is positioned.
- the combined information is e ′ ′′.
- the position calculation unit 26 obtains a position p11 ′ on the coordinates (x1 ′, y1 ′) corresponding to the position P11 on the coordinates (x1, y1) based on the fluoroscopic image f ′ and the alignment information e ′. Further, the position calculation unit 26 obtains a position p21 ′′ on coordinates (x2 ′′, y2 ′′, z2 ′′) corresponding to the position p11 ′ based on the alignment information e ′′. Further, the position calculation unit 26 obtains a position p21 'on the coordinates (x2', y2 ', z2') with respect to the position P21 ".
- the position calculation unit 26 obtains a position p11 ′′ on the coordinates (x1, y1) of the blood vessel X-ray image d associated with the position p21 ′ based on the alignment information e.
- the positions P11, P11 ′, P11 ′′, P21 ′, and P21 ′′ indicate the position of the distal end portion of the catheter on each coordinate.
- the position p11 ′′ on (x1, y1) is sent to the overlay image creation unit 42 as the position information i ′ of the distal end portion of the catheter.
- the overlay image creation unit 42 creates a two-dimensional image j of the distal end portion of the catheter based on the position information i ′ and the treatment instrument image g.
- FIG. 9 is a functional block diagram of the image processing unit. As shown in FIG. 9, a blood vessel branch determination processing unit 28 is added to the image processing unit 25.
- the blood vessel branch determination processing unit 28 receives the position information i from the position calculation unit 26 and creates a two-dimensional image (indicated by n in FIG. 9) of the blood vessel branch associated with the fluoroscopic image.
- the creation of the two-dimensional image n of the blood vessel branch is basically the same as the method in which the position calculation unit 26 calculates the position information i of the distal end portion of the catheter in the first embodiment.
- the position calculation unit 26 uses the X-ray fluoroscopic image f, the blood vessel core image c, the alignment information e, the treatment instrument image g, and the operation information h related to the catheter, thereby
- the position calculation unit 26 uses the X-ray fluoroscopic image f, the blood vessel core image c, the alignment information e, and the treatment instrument image g to obtain a two-dimensional image of the blood vessel branch. Find n.
- the overlay image creating unit 42 creates an overlapping image n ′ of the blood vessel branch in which the two-dimensional image n of the blood vessel branch overlaps the therapeutic device image g based on the therapeutic device image g and the two-dimensional image n of the blood vessel branch.
- the catheter can be operated without any trouble. Is possible.
- FIG. 10 is a functional block diagram of the blood vessel core wire processing unit. As shown in FIG. 10, the blood vessel core processing unit 15 is provided with a blood vessel core calculation unit 16 a instead of the blood vessel core extraction unit 16.
- the blood vessel core line processing unit 15 includes the blood vessel core line extraction unit 16 that extracts the blood vessel core line image c using the blood vessel three-dimensional data a.
- the blood vessel core image c is calculated without using the dimension data a.
- the blood vessel core calculation unit 16a calculates a blood vessel core image c using two or more blood vessel X-ray images d taken from different X-ray imaging directions. X-ray images d of two or more blood vessels are acquired by the X-ray angiography examination described above.
- the fourth embodiment it is possible to obtain a blood vessel core image c without using the blood vessel three-dimensional data a.
- whether or not the two-dimensional image j of the distal end portion of the catheter is sent from the overlay image creating unit 12 is determined every predetermined time. If the two-dimensional image j is not sent, the image synthesizing unit 44 performs X-ray fluoroscopy. The image f is output to the display control unit 51 as the synthesized image k.
- whether the two-dimensional image j of the distal end portion of the catheter is synthesized based on the result of the position calculation unit 26 determining whether the shadow of the catheter overlaps the treatment instrument image g. It is configured to instruct the image composition unit 44 whether or not.
- the case where the shadow of the catheter overlaps the therapeutic instrument image f may be referred to as “when the distal end of the catheter is within the region where the therapeutic instrument is present on the fluoroscopic image”.
- the case where the shadow of the catheter does not overlap the therapeutic instrument image f may be referred to as “when the tip of the catheter is outside the region where the therapeutic instrument is present on the fluoroscopic image”.
- FIG. 11 is a functional block diagram.
- the result determined by the position calculation unit 26 is indicated by “m”, and a signal indicating whether or not the two-dimensional image j of the distal end portion of the catheter is combined with the fluoroscopic image f is indicated by “n”. .
- the position calculation unit 26 receives the result m of the determination by the position calculation unit 26 that the distal end portion of the catheter is outside the region where the treatment instrument exists on the fluoroscopic image f.
- a signal n is output so as not to synthesize the image j representing the position of the tip of the catheter into the fluoroscopic image f, and the result m of the determination that the tip of the catheter is within the region is received,
- Display switching means 53 is provided for outputting a signal n to the image synthesizing unit 44 so as to synthesize an image j representing the position of the distal end of the catheter with an X-ray fluoroscopic image f.
- the display switching unit 53 clearly displays the distal end portion of the catheter as a part of the X-ray fluoroscopic image f, and as an image j representing the position of the distal end portion of the catheter, Since the information is clearly displayed, it is possible to prevent troubles in catheter treatment.
- the position calculation unit 26 indirectly obtains the position of the distal end portion of the catheter using the blood vessel core image c and the operation information h related to the catheter.
- the position of the distal end portion of the catheter is directly measured.
- FIG. 12 is a functional block diagram.
- information on the position of the distal end portion of the catheter is indicated by “n”. These pieces of position information replace the operation information h.
- the image processing display device includes a signal output unit 61 and a signal detection unit 62.
- the signal output unit 61 is, for example, a permanent magnet and is provided at the distal end of the catheter.
- FIG. 12 shows the magnetic field strength (magnetic signal) generated by the permanent magnet as “n”.
- the signal detector 62 is, for example, a three-dimensional magnetic sensor, and receives a magnetic field generated by a permanent magnet.
- a three-dimensional magnetic sensor for example, a magnetic sensor board on which a three-dimensional input magnetic sensor described in JP-A-8-152955 is mounted is used.
- the position detector 26 obtains the three-dimensional position information of the distal end portion of the catheter based on the magnetic signal “n” received by the three-dimensional magnetic sensor.
- the position detection unit 26 may refer to the blood vessel core image c and / or the operation information h in order to improve the position accuracy when obtaining the three-dimensional position information of the distal end portion of the catheter.
- the three-dimensional position information of the distal end portion of the catheter is obtained based on the magnetic signal, but is not limited to the magnetic signal.
- the position of the distal end portion of the catheter can be directly obtained based on the magnetic signal.
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Abstract
Description
この画像処理表示装置の第1の実施形態について各図を参照して説明する。ここでは、画像処理表示装置が、小切開冠動脈バイパス術とカテーテル治療が同時に行われるハイブリッド治療に適用される場合を説明する。
血管走行情報作成部13は、3次元データaに基づいて血管を表す3次元画像bを抽出する。抽出された血管の3次元画像bは、記憶手段14に記憶される。
血管芯線処理部15は、血管芯線を表す3次元の血管芯線画像(図1に示すc)を抽出する血管芯線抽出部16を有している。なお、血管の3次元画像bや血管芯線画像cの抽出については、種々の方法が提案されているが、本実施形態では、公知のいずれの方法を採用してもよい。なお、血管の3次元画像bを血管走行情報という場合もある。また、血管芯線画像cを血管走行情報に含めて説明する場合がある。
画像処理部22は、位置合わせ処理部23、位置算出部26、及び、オーバーレイ画像作成部42を有している。
位置合わせ処理部23は、2次元の血管のX線画像dに対して血管の3次元画像bを位置合わせすることにより、2次元の血管のX線画像dに対する血管の3次元画像bの対応位置関係を求める。その理由は、血管のX線画像dだけでは、X線透視画像fにおいて、重なるように表示された2つの物の前後位置を判断することがきないからである。
ここで、A、Bは次のように表される。
例えば、y軸を回転軸としてz軸から正の方向に角度θで回転させるベクトルAは、次の式で表される。
このとき、平行移動がないとすれば、
ベクトルBは、次の式となる。
位置算出部26は、カテーテルの先端部の位置及び進行方向を求める。カテーテルの先端部の位置等を求めるには、X線透視画像fが用いられる場合と、血管芯線画像c、位置合わせ情報e、治療器具画像g、及びカテーテルに係る操作情報(図1にhで示す)が用いられる場合とがある。ここで、カテーテルに係る操作情報とは、術者の操作により進められたカテーテルの移動量をいい、例えば、カテーテルの被検体への挿入位置にカテーテルの移動量を検出するためのセンサを設けて、その検出結果に基づいて求めた値であり、以下、単に「操作情報」という。なお、位置算出部26が、「カテーテルの先端部の位置を求める手段」の一例である。
オーバーレイ画像作成部42は、位置情報i及び治療器具画像gに基づき、線分Lの画像(図2に示す)が治療器具画像gと重なる画像を作成する。この重なる画像が、カテーテルの先端部の2次元画像(図1にjで示す)となる。カテーテルの先端部の2次元画像jを図2に破線で示す。
画像合成部44は、X線透視画像fとカテーテルの先端部の2次元画像jとを合成し、合成した画像kを表示制御部51に出力する。表示制御部51は、合成された画像kを表示部52に表示させる。
図3に示すように、ハイブリッド治療の前段階あるいは初期段階において、血管の3次元画像bが記憶手段14に予め記憶される。
さらに、ハイブリッド治療の前段階あるいは初期段階において、血管のX線画像dを取得しておく。
血管芯線抽出部16は、血管の3次元データaに基づいて、血管芯線を表す3次元の血管芯線画像cを抽出する。
X線透視データに基づいてX線透視画像fを作成する。なお、X線透視画像fを作成するときのX線撮影方向と、血管のX線画像dを取得するときのX線撮影方向とを同じに設定する。さらに、X線透視画像fに基づいて治療器具を表す治療器具画像gを抽出する。
位置合わせ処理部23は、血管のX線画像dに対して血管の3次元画像bを位置合わせする。それにより、位置合わせ情報eを求める。
位置算出部26は、血管芯線画像c、操作情報h、位置合わせ情報e、X線透視画像f及び治療器具画像gに基づいて、カテーテルの先端部の位置及び進行方向を求める。
オーバーレイ画像作成部42は、位置情報i及び治療器具画像gに基づき、線分Lの画像が治療器具画像gと重なる画像を作成する。
画像合成部44は、X線透視画像fとカテーテルの先端部の2次元画像jとを合成する。
表示制御部51は、X線透視画像f上にカテーテルの先端部の2次元画像jを重ねて表示させる。
次に、画像処理表示装置の第2の実施形態について図4~図7を参照して説明する。
第2の実施形態において、第1の実施形態の構成と同じものについては同一番号を付してその説明を省略する。
以上により、X線源1の回転軌跡は次の式で表わされる。
x12 +z12 =R
次に、画像処理表示装置の第3の実施形態について図9を参照して説明する。
第3の実施形態において、第1の実施形態の構成と同じものについては同一番号を付してその説明を省略する。
次に、画像処理表示装置の第4の実施形態について図10を参照して説明する。
第4の実施形態において、第1の実施形態の構成と同じものについては同一番号を付してその説明を省略する。
次に、画像処理表示装置の第5の実施形態について図11を参照して説明する。
次に、画像処理表示装置の第6の実施形態について図12を参照して説明する。
2 X線検出器
13 血管走行情報作成部
14 記憶手段
15 血管芯線処理部
16 血管芯線抽出部
16a 血管芯線算出部
22 画像処理部
23 位置合わせ処理部
25 画像処理部
26 位置算出部
28 血管分岐判断処理部
33 治療器具画像抽出部
42 オーバーレイ画像作成部
44 画像合成部
45 オーバーレイ判断処理部
51 表示制御部
52 表示部
61 信号出力部
62 信号検出部
Claims (11)
- 治療中に血管を含む領域をX線透視することにより取得されるX線透視画像を表示する画像処理表示装置において、
前記X線透視画像に基づいて、X線を吸収する性質を有する治療器具を表す治療器具画像を抽出する治療器具画像抽出手段と、
カテーテル先端部の位置を求め、前記X線透視画像上の前記治療器具が存在する領域に、前記求めたカテーテルの先端部の位置を表す画像を重畳して表示させる画像処理手段と、
を有する
ことを特徴とする画像処理表示装置。 - 前記求められたカテーテルの先端部の位置を表す画像を、前記X線透視画像上の前記治療器具が存在する領域の外に前記カテーテルの先端部があるとき、表示させず、前記領域の内に前記カテーテルの先端があるとき、前記重畳して表示させる表示切替手段をさらに有する
ことを特徴とする請求項1に記載の画像処理表示装置。 - 前記カテーテル先端部に設けられ、信号を出力する手段と、
前記出力された信号を受信する手段と、
をさらに有し、
前記画像処理手段は、
前記受信された信号に基づきカテーテルの先端部の位置を求める位置算出部を有する
ことを特徴とする請求項1または2に記載の画像処理表示装置。 - 予め取得された3次元の血管走行情報を記憶する記憶手段をさらに有し、
前記画像処理手段は、
前記血管走行情報及びカテーテルに係る操作情報に基づきカテーテルの先端部の位置を求める位置算出部を有し、
求められたカテーテルの先端部の位置をさらに参照して、カテーテルの先端部の2次元画像を作成する
ことを特徴とする請求項1または2に記載の画像処理表示装置。 - 前記画像処理手段には、血管のX線画像が入力され、
前記画像処理手段は、入力された血管のX線画像と前記血管走行情報との位置合わせに基づき前記対応位置関係を求める
ことを特徴とする請求項4に記載の画像処理表示装置。 - 前記画像処理手段は、
前記X線透視画像に基づいて、治療器具の背後にあるカテーテルの先端部を直接臨んで撮影できるX線の撮影方向の角度を求めるオーバーレイ判断処理手段を有し、
カテーテルの先端部の2次元画像を作成するとき、前記X線の撮影方向の角度でX線撮影することにより取得されたX線撮影データに基づき求められたカテーテルの先端部の位置をさらに参照する
ことを特徴とする請求項4に記載の画像処理表示装置。 - 前記血管走行情報は、血管分岐の3次元画像を含み、
前記画像処理手段は、治療器具の背後に前記血管分岐が位置するかどうかを判断し、前記血管分岐が位置するとき、前記X線透視画像と対応付けられた血管分岐の2次元画像を作成する
ことを特徴とする請求項4に記載の画像処理表示装置。 - 前記血管走行情報は、血管芯線を表す3次元の血管芯線画像を含む
ことを特徴とする請求項4に記載の画像処理表示装置。 - 前記血管走行情報は、血管を含む領域の3次元データに基づいて作成され、
前記3次元データに基づいて前記血管芯線画像を抽出する血管芯線抽出手段をさらに有する
ことを特徴とする請求項8に記載の画像処理表示装置。 - 複数時相のX線透視画像から作成された血管のX線画像に基づき、造影像の変化を基に血流の走行情報を解析することにより、前記血管芯線画像を算出する血管芯線算出手段をさらに有する
ことを特徴とする請求項8に記載の画像処理表示装置。 - 血管を含む領域の3次元データに基づいて作成された血管の3次元画像を予め記憶しておくステップと、
血管のX線画像を取得しておくステップと、
前記3次元データに基づいて血管芯線を表す3次元の血管芯線画像を抽出するステップと、
X線透視データに基づいてX線透視画像を作成するステップと、
前記X線透視画像に基づいて治療器具を表す治療器具画像を抽出するステップと、
前記血管のX線画像に対する前記血管の3次元画像の対応位置関係である位置合わせ情報を求めるステップと、
前記血管芯線画像、カテーテルに係る操作情報、前記位置合わせ情報及び前記治療器具画像に基づいてカテーテルの先端部の位置を求めるステップと、
前記カテーテルの先端部の位置及び前記治療器具画像に基づき、前記治療器具画像と重なるカテーテルの先端部の2次元画像を作成するステップと、
前記X線透視画像上に前記カテーテルの先端部の2次元画像及び前記治療器具画像を重ねて表示させるステップと、
をコンピュータに処理させる
ことを特徴とする画像処理表示プログラム。
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CN114259272A (zh) * | 2021-12-15 | 2022-04-01 | 中国人民解放军火箭军特色医学中心 | 一种体外可视的介入止血装置和方法 |
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Also Published As
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CN103379862A (zh) | 2013-10-30 |
JP2013039274A (ja) | 2013-02-28 |
JP5989312B2 (ja) | 2016-09-07 |
US20130287282A1 (en) | 2013-10-31 |
CN103379862B (zh) | 2015-12-09 |
US9659366B2 (en) | 2017-05-23 |
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