WO2013042231A1 - Dispositif pour quantifier la forme de section transversale d'un vaisseau sanguin et procédé pour quantifier la forme de section transversale d'un vaisseau sanguin utilisant celui-ci - Google Patents

Dispositif pour quantifier la forme de section transversale d'un vaisseau sanguin et procédé pour quantifier la forme de section transversale d'un vaisseau sanguin utilisant celui-ci Download PDF

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Publication number
WO2013042231A1
WO2013042231A1 PCT/JP2011/071507 JP2011071507W WO2013042231A1 WO 2013042231 A1 WO2013042231 A1 WO 2013042231A1 JP 2011071507 W JP2011071507 W JP 2011071507W WO 2013042231 A1 WO2013042231 A1 WO 2013042231A1
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WO
WIPO (PCT)
Prior art keywords
blood vessel
sectional shape
shape
cross
intima
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PCT/JP2011/071507
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English (en)
Japanese (ja)
Inventor
賢哉 那須
栗田　哲郎
泰郎 栗田
大介 横田
Original Assignee
医療法人澄心会豊橋ハートセンター
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Application filed by 医療法人澄心会豊橋ハートセンター filed Critical 医療法人澄心会豊橋ハートセンター
Priority to PCT/JP2011/071507 priority Critical patent/WO2013042231A1/fr
Priority to JP2013534534A priority patent/JP6153169B2/ja
Publication of WO2013042231A1 publication Critical patent/WO2013042231A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062—Arrangements for scanning
    • A61B5/0066—Optical coherence imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1079—Measuring physical dimensions, e.g. size of the entire body or parts thereof using optical or photographic means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters

Definitions

  • the present invention relates to a blood vessel cross-sectional shape digitizing apparatus and a blood vessel cross-sectional shape digitizing method using the same, which are used to quantify the shape of the blood vessel intima in the cross-sectional shape of the blood vessel intima after the stent is inserted into the blood vessel.
  • a blood vessel cross-sectional shape digitizing apparatus and a blood vessel cross-sectional shape digitizing method using the same, which are used to quantify the shape of the blood vessel intima in the cross-sectional shape of the blood vessel intima after the stent is inserted into the blood vessel.
  • the arterial system which is the path of blood in the human body, is constantly exposed to high blood pressure in order to maintain the homeostasis of the human body and to maintain blood circulation. Therefore, stenosis and occlusion lesions are exhibited in blood vessels due to arteriosclerosis and inflammation.
  • a coronary artery supplying oxygen or nutrients to the heart exhibits stenosis or occlusion, it becomes angina and myocardial infarction, causing cardiogenic shock and fatal arrhythmia, which is a fatal disease.
  • a treatment method using a stent in the shape of a net-like tube mainly composed of a plurality of stainless steel stent struts ST is known (for example, see Non-Patent Document 1). ).
  • a coronary artery for supplying oxygen and nutrients is provided by placing a folded stent S on a balloon catheter, putting blood into the muscle of the heart h of the patient M, and supplying oxygen and nutrients.
  • the balloon S is inserted into a narrowed portion of the blood vessel 150 and the balloon is expanded, and the balloon catheter is withdrawn while the stent S is left in the lumen 110 of the blood vessel 150.
  • the indwelled stent S is fixed in the blood vessel 150 with the blood vessel 150 expanded from the inside, so that a sufficient lumen 110 can be secured in the blood vessel 150 in which the stent S is indwelled. Stage restenosis can be reduced.
  • Patients who have undergone treatment using a stent enter a stable period after one month from placement of the stent in the blood vessel, but when half a year has passed since placement, the neointima is placed on the intimal layer of the placed blood vessel. A layer may form and the blood vessel may restenosis.
  • stents there are two types of stents: metal stents and drug-eluting stents that have a drug applied to the metal stent (functional stents that promote cell proliferation, contain anticancer agents, etc.).
  • the shape of the blood vessel lumen formed by the above tends to maintain a state close to a perfect circle.
  • a drug-eluting stent when used, the shape of the intima of the blood vessel becomes uneven (a shape similar to the outer periphery of confetti) under the influence of the drug applied to the drug-eluting stent after placement of the stent. There is a case.
  • the shape of the intima of the blood vessel becomes uneven, the blood flowing through the lumen of the blood vessel becomes a turbulent state, which may promote the tendency of thrombus formation.
  • OCT Optical Coherence Tomography
  • the diagnostic imaging system can observe in detail the three-layer structure of an artery such as the intima, media and adventitia of blood vessels.
  • Stent treatment is new, and various shapes of stents and drug types have been devised.
  • shape of the vascular intima is quantified. It became important.
  • an object of the present invention is to provide a blood vessel cross-sectional shape digitizing apparatus that digitizes the shape of the intima of a blood vessel in the cross-sectional shape of the blood vessel after the stent is inserted into the lumen of the blood vessel, and a blood vessel cross-sectional shape numerical value using the device. It is to provide a conversion method.
  • the present invention is a blood vessel cross-sectional shape digitizing device that digitizes the shape of the intima of a blood vessel in the cross-sectional shape of the blood vessel after the stent is inserted into the lumen of the blood vessel.
  • the blood vessel cross-sectional shape digitizing apparatus obtains a plurality of coordinates on the boundary between the intima and the lumen of the blood vessel in an image representing the cross-sectional shape of the blood vessel in a state where a blood cell component is not substantially present inside.
  • Shape digitizing means for digitizing the shape of the intima based on a plurality of coordinates acquired by the coordinate acquiring means.
  • a blood vessel cross-sectional shape digitizing device and a blood vessel cross-sectional shape digitizing method using the same for quantifying the shape of the blood vessel intima in the cross-sectional shape of the blood vessel after the stent is inserted into the lumen of the blood vessel can be provided.
  • FIG. 5 It is a conceptual diagram of the blood vessel cross-sectional shape digitizing apparatus according to the present invention. It is a partially broken view of a blood vessel in a state where a stent is placed. It is a flowchart which shows the procedure of the blood vessel cross-sectional shape digitization method using the blood vessel cross-sectional shape digitization apparatus which concerns on this invention. It is sectional drawing of the blood vessel displayed on the blood vessel cross-sectional shape digitization apparatus shown in FIG. 5 is a screen that displays the coordinates of the intima of the blood vessel in the cross section of the blood vessel shown in FIG. 4. It is the screen which displayed the ellipse approximated to the coordinate shown in FIG.
  • FIG. 1 It is sectional drawing of another blood vessel displayed on the blood vessel cross-sectional shape digitization apparatus shown in FIG. It is the screen which displayed the coordinate of the intima of the blood vessel in the cross section of the blood vessel shown in FIG. It is the screen which displayed the ellipse approximated to the coordinate shown in FIG.
  • the blood vessel cross-sectional shape digitizing apparatus 10 includes a CPU 20, a monitor 30, and a mouse 40 which is an example of an input unit, and the blood vessel after inserting the stent S into the lumen 110 of the blood vessel 150.
  • This is a device that digitizes the shape of the intima 120 of the blood vessel 150 in 150 cross-sectional shapes.
  • the blood vessel cross-sectional shape digitizing device 10 is a general personal computer (registered trademark).
  • the CPU 20 functions as a coordinate acquisition unit and a shape digitization unit to be described later by a coordinate acquisition unit program and a shape digitization program stored in a storage unit (not shown) of the blood vessel cross-sectional shape digitization device 10, respectively.
  • the coordinate acquisition unit program and the shape digitization unit program stored in the storage unit will be described as different programs.
  • the program is stored in the storage unit.
  • the program may be composed of a coordinate acquisition / shape digitizing program including a coordinate acquisition program and a shape digitizing program.
  • a CPU other than the CPU 20 may be provided inside or outside the blood vessel cross-sectional shape digitizing apparatus 10, and the other CPU may be caused to execute the program for coordinate acquisition means.
  • the monitor 30 is a general display, and displays an image G in accordance with an image signal output from the CPU 20.
  • the mouse 40 is a general point input system, and is used to specify the coordinates of the image G displayed by the monitor 30.
  • the diagnostic imaging system 200 includes an image wire 220 that emits near-infrared light and the like, is inserted into a blood vessel, a probe interface unit (PIU), and a system main body 230.
  • the system main body 230 includes image output means for outputting the measured image to the blood vessel sectional shape digitizing apparatus 10.
  • the image output means outputs an image measured via a USB memory, a wired LAN, a wireless LAN, or the like to the blood vessel cross-sectional shape digitizing device 10.
  • image output means for outputting from the system main body 230 to the blood vessel cross-sectional shape digitizing device 10 is performed via the wired cable 240.
  • the doctor inserts the image wire 220 into the inside of the cylindrical stent S inserted into the lumen 110 of the blood vessel 150.
  • the blood flow in the blood vessel 150 is temporarily blocked, and the blood in the blood vessel 150 is removed with lactated Ringer's solution, reproductive saline, or the like.
  • the blood cell component is not substantially present inside the blood vessel 150.
  • the doctor images the cross-sectional shape of the blood vessel 150 using the diagnostic imaging system 200.
  • the cross-sectional shape of the intima 120 of the blood vessel 150 and the cross-sectional shape of the stent strut ST of the stent S are photographed in the image captured by the diagnostic imaging system 200.
  • the doctor operates the operation unit of the blood vessel cross-sectional shape digitizing apparatus 10 so that the image acquired by the diagnostic imaging system 200 is displayed on the monitor 30.
  • the CPU 20 causes the monitor 30 to display the image taken by the diagnostic imaging system 200 in accordance with the operation of the operation unit of the doctor (display process: step S11 in FIG. 3).
  • the monitor 30 displays an image G1 captured by the diagnostic imaging system 200.
  • the image G220 captures an image wire 220 and an artery wall 140.
  • the artery wall 140 includes a lumen 110, The cross-sectional shapes of the intima 120 of the blood vessel 150, the neointima 130 proliferated in the blood vessel 150, and the stent strut ST embedded in the neointima 130 are photographed.
  • the doctor operates the mouse 40 while observing the image displayed on the monitor 30 to position the inner membrane 120 of the blood vessel 150, that is, on the boundary between the inner membrane 120 of the blood vessel 150 and the lumen 110. Enter the position of as a coordinate.
  • the CPU 20 acquires the position on the boundary between the intima 120 of the blood vessel 150 and the lumen 110 as coordinates in accordance with the operation of the mouse 40 by the doctor (input reception process: step S12 in FIG. 3). Therefore, the CPU 20 acquires a plurality of coordinates on the boundary between the blood vessel 150, the intima 120, and the lumen 110 in the image representing the cross-sectional shape of the blood vessel in a state where the blood cell component is not substantially present inside. Acts as an acquisition means.
  • the coordinates input in this way are displayed as a plurality of coordinates P1 on the screen G11 of the monitor 30, as shown in FIG.
  • the doctor can determine whether or not a number of coordinates that can sufficiently specify the shape of the boundary between the intima 120 and the lumen 110 of the blood vessel 150 have been input by looking at the screen G11.
  • the doctor performs an operation of causing the CPU 20 to calculate an ellipse formula, a flat rate, and a gold flat rate based on the plurality of input coordinates P1.
  • the flatness ratio is a value representing how flat the obtained ellipse is compared to a circle.
  • the major radius of the ellipse is a and the minor radius is b, it is represented by 1- (b / a).
  • the flatness becomes 0, and the flatness approaches 1 as it collapses.
  • the flatness may be simply expressed as (b / a) (in this case, the flatness becomes 1 in a perfect circle, and the flatness approaches 0 as it is crushed).
  • the gold flat rate is a value (r 2 ) representing how far the coordinate P1 deviates from the line of the ellipse Q1 by comparing the obtained equation of the ellipse Q1 with a plurality of coordinates P1.
  • Is a value representing the degree of unevenness of the shape of the intima 120 based on the value calculated based on the sum of the squares of the plurality of residuals, which is the distance between the ellipse and each coordinate.
  • the CPU 20 calculates an ellipse formula, a flattening rate, and a flattening rate based on the input coordinates in accordance with a doctor's operation (a step for obtaining an ellipse, a step for obtaining a flattening rate, and a step for obtaining a flattening rate: FIG. Steps S13, S14, S15).
  • the CPU 20 obtains an ellipse equation that best fits the input plurality of coordinates by the method of least squares. Specifically, first, the center of gravity of the input coordinates is obtained. Next, the coordinates input to the polar coordinate system having the center of gravity as the origin are coordinate-transformed. Next, the equation of the ellipse is determined by the nonlinear least square method using the following parameter display as the equation of the ellipse.
  • x a ⁇ cos ⁇ cos ⁇ b ⁇ sin ⁇ sin ⁇ + x0
  • y a ⁇ sin ⁇ cos ⁇ b ⁇ cos ⁇ sin ⁇ + y0
  • ⁇ rotation angle of the ellipse
  • the CPU 20 causes the monitor 30 to display the calculated flattening rate and gold flattening rate, and displays it on the screen G12 based on the input coordinates P1 and the obtained ellipse formula as shown in FIG.
  • An ellipse Q1 is displayed. Since the shape of the ellipse Q1 is close to the shape of a slightly collapsed circle and there is a slight difference between the major radius and the minor radius, the CPU 20 calculates a flatness ratio (b / a) away from 1. In addition, since all of the plurality of coordinates P1 are close to the ellipse Q1, the CPU 20 calculates a high value of the flatness (indicating that a high value of flatness is not an uneven shape).
  • the CPU 20 acts as a shape digitizing unit that digitizes the shape of the intima 120 based on the plurality of coordinates P1.
  • the shape of the inner membrane 120 shown in FIG. 4 is close to a slightly collapsed ellipse, but is a smooth shape (not an uneven shape).
  • the image acquired by the diagnostic imaging system 200 is displayed on the monitor 30 as follows.
  • an image G ⁇ b> 2 photographed by the diagnostic imaging system 200 is displayed on the monitor 30, and the cross-sectional shape of the uneven inner membrane 120 is photographed on the image G ⁇ b> 2.
  • the CPU 20 displays a screen G21 representing a plurality of coordinates P2 input by the doctor on the monitor 30 (input reception step: step S12 in FIG. 3).
  • the CPU 20 calculates a flatness ratio (b / a) close to 1. Further, since the CPU 20 has coordinates close to the ellipse Q2 and coordinates apart from the ellipse Q2, among the plurality of coordinates P2, the CPU 20 has a low value of flatness (a low value of flatness indicates that the uneven shape is remarkable. ) Is calculated. Thereby, it can be said that the shape of the inner membrane 120 shown in FIG.
  • the blood vessel cross-sectional shape digitizing apparatus can digitize the shape of the intima of the blood vessel with the flatness and the gold flatness in the cross-sectional shape of the blood vessel after the stent is inserted into the lumen of the blood vessel.
  • the CPU 20 has a plurality of coordinates on the boundary between the intima and the lumen of the blood vessel in the image representing the cross-sectional shape of the blood vessel in a state where the blood cell component is not substantially present inside.
  • the coordinate acquisition means may be provided in an apparatus (for example, another computer) provided with another CPU other than the CPU 20.
  • Blood vessel cross-sectional shape digitizing device 20 CPU 30 monitor 40 mouse 110 lumen 120 intima 130 neointima 140 arterial wall 150 blood vessel 200 diagnostic imaging system 210 catheter 220 image wire 230 system main body 240 wired cable

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Abstract

La présente invention concerne un dispositif (10) pour quantifier la forme de section transversale d'un vaisseau sanguin qui quantifie la forme de l'intima (120) d'un vaisseau sanguin dans la forme de section transversale du vaisseau sanguin après insertion d'une endoprothèse (S) dans la lumière (110) du vaisseau sanguin. Le dispositif (10) pour quantifier la forme de section transversale du vaisseau sanguin est pourvu de moyens de quantification de forme qui quantifient la forme de l'intima (120) sur la base d'une pluralité de coordonnées qui sont acquises par des moyens d'acquisition de coordonnées qui acquièrent les coordonnées sur une limite entre l'intima (120) et la lumière (110) du vaisseau sanguin dans une image représentant la forme de section transversale du vaisseau sanguin, ledit vaisseau sanguin étant dans un état dans lequel il ne contient sensiblement pas de composant de cellules sanguines dans celui-ci. Selon la présente invention, un dispositif pour quantifier la forme de section transversale de vaisseau sanguin, qui quantifie la forme d'une intima d'un vaisseau sanguin dans la forme de section transversale du vaisseau sanguin après insertion d'une endoprothèse dans la lumière du vaisseau sanguin, et un procédé pour quantifier la forme de section transversale de vaisseau sanguin utilisant ledit dispositif ci-dessus peuvent être obtenus.
PCT/JP2011/071507 2011-09-21 2011-09-21 Dispositif pour quantifier la forme de section transversale d'un vaisseau sanguin et procédé pour quantifier la forme de section transversale d'un vaisseau sanguin utilisant celui-ci WO2013042231A1 (fr)

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PCT/JP2011/071507 WO2013042231A1 (fr) 2011-09-21 2011-09-21 Dispositif pour quantifier la forme de section transversale d'un vaisseau sanguin et procédé pour quantifier la forme de section transversale d'un vaisseau sanguin utilisant celui-ci
JP2013534534A JP6153169B2 (ja) 2011-09-21 2011-09-21 血管断面形状数値化装置

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PCT/JP2011/071507 WO2013042231A1 (fr) 2011-09-21 2011-09-21 Dispositif pour quantifier la forme de section transversale d'un vaisseau sanguin et procédé pour quantifier la forme de section transversale d'un vaisseau sanguin utilisant celui-ci

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WO2015044987A1 (fr) * 2013-09-30 2015-04-02 テルモ株式会社 Dispositif de diagnostic d'image et procédé de support de détermination de voie d'accès de fil-guide
JPWO2016136579A1 (ja) * 2015-02-25 2017-11-30 テルモ株式会社 画像診断装置、その作動方法、プログラム及びコンピュータ可読記憶媒体
JP2020114423A (ja) * 2014-07-24 2020-07-30 ライトラボ・イメージング・インコーポレーテッド ステント及び血管の可視化及び診断のシステム、装置、及び方法

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JP2009240359A (ja) * 2008-03-28 2009-10-22 Kazunori Urasawa 画像解析装置及び画像解析方法
JP2011072598A (ja) * 2009-09-30 2011-04-14 Terumo Corp 光干渉断層像形成装置及びその制御方法

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015044987A1 (fr) * 2013-09-30 2015-04-02 テルモ株式会社 Dispositif de diagnostic d'image et procédé de support de détermination de voie d'accès de fil-guide
JP2020114423A (ja) * 2014-07-24 2020-07-30 ライトラボ・イメージング・インコーポレーテッド ステント及び血管の可視化及び診断のシステム、装置、及び方法
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JPWO2016136579A1 (ja) * 2015-02-25 2017-11-30 テルモ株式会社 画像診断装置、その作動方法、プログラム及びコンピュータ可読記憶媒体

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