WO2014091999A1 - Dispositif et procédé d'imagerie acoustique - Google Patents

Dispositif et procédé d'imagerie acoustique Download PDF

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Publication number
WO2014091999A1
WO2014091999A1 PCT/JP2013/082719 JP2013082719W WO2014091999A1 WO 2014091999 A1 WO2014091999 A1 WO 2014091999A1 JP 2013082719 W JP2013082719 W JP 2013082719W WO 2014091999 A1 WO2014091999 A1 WO 2014091999A1
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Prior art keywords
elliptical shape
ultrasonic imaging
imaging apparatus
unit
blood vessel
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PCT/JP2013/082719
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English (en)
Japanese (ja)
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田中　智彦
岡田　孝
川畑　健一
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日立アロカメディカル株式会社
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Publication of WO2014091999A1 publication Critical patent/WO2014091999A1/fr

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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
    • A61B8/04—Measuring blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • 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
    • A61B8/0891—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
    • 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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/13—Tomography
    • A61B8/14—Echo-tomography
    • 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
    • A61B8/483—Diagnostic techniques involving the acquisition of a 3D volume of data
    • 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
    • A61B8/523—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for generating planar views from image data in a user selectable plane not corresponding to the acquisition plane

Definitions

  • the present invention relates to a medical ultrasonic imaging apparatus, and more particularly to an ultrasonic imaging apparatus and method for simultaneously measuring a blood vessel pulse wave and a blood vessel cross-sectional area desired by an examiner and calculating a blood pressure waveform.
  • the efficiency and form of blood circulation are closely related to cardiovascular diseases.
  • an inefficient circulatory system places a burden on the heart and increases the risk of heart failure. Since the efficiency of blood circulation depends on various factors such as vascular blood pressure and blood vessel properties, a method for easily measuring these factors is desired.
  • Non-Patent Document 1 As a technique for estimating arterial pressure using ultrasound, a technique is known in which a shear wave that travels on the surface of an artery is detected from an ultrasound image, a temporal variation in the diameter of a blood vessel is measured, and the blood pressure is converted into blood pressure.
  • Non-Patent Document 1 In this method, in order to detect a shear wave, an ultrasonic image (longitudinal cut image) of a cross section along the running direction of a blood vessel of an artery is acquired and a change in blood vessel diameter is measured.
  • a hemodynamic measurement technique using ultrasonic waves a technique for calculating a pulse wave velocity based on a temporal differentiation of blood flow velocity and a differentiation of local blood pressure has also been proposed (Patent Document 1).
  • Non-Patent Document 1 it is necessary to image a blood vessel longitudinally in order to detect a shear wave. It is necessary to image the largest cross section of the blood vessel through the center.
  • the ultrasonic beam passes through the center of the blood vessel, and the artery vibrates due to the pulsation of the artery, so that the blood vessel center easily deviates from the ultrasonic imaging surface. is there.
  • an object of the present invention is to provide an ultrasonic imaging apparatus capable of solving the above-mentioned problems and measuring changes in pulse wave and blood vessel cross-sectional area simultaneously and simply, thereby providing a highly reliable artery. It is to calculate blood pressure.
  • An ultrasonic imaging apparatus that solves the above-described problems is performed by obliquely irradiating an ultrasonic beam with respect to a blood vessel traveling direction so that a blood vessel cross-sectional shape becomes an elliptical shape, and a blood vessel characterized by an elliptical shape.
  • a blood vessel cross-sectional shape becomes an elliptical shape
  • a blood vessel characterized by an elliptical shape By performing analysis specialized for the cross section, changes in the pulse wave and the cross-sectional area of the blood vessel are measured simultaneously and simply to calculate arterial blood pressure.
  • the ultrasonic imaging apparatus of the present invention includes an ultrasonic probe that transmits ultrasonic waves to an inspection target and receives an ultrasonic echo reflected from the inspection target, and an echo received by the ultrasonic probe.
  • An ultrasonic imaging apparatus including a signal processing unit that processes a signal and a display unit that displays a processing result of the signal processing unit, wherein the signal processing unit is an ellipse included in the inspection target from the echo signal.
  • An elliptical shape detecting unit that detects a shape
  • an elliptical shape calculating unit that calculates biological information of a tissue specified by the elliptical shape based on the elliptical shape detected by the elliptical shape detecting unit. .
  • the ultrasonic imaging apparatus of the present invention is suitable for blood vessel imaging, and when targeting blood vessels, the elliptical shape detection unit extracts the blood vessel wall position from the echo signal, and from the blood vessel wall position, the blood vessel diameter and its time change, The blood vessel cross-sectional area and its change over time are calculated.
  • the elliptical shape calculation unit calculates the pulse wave velocity, the arterial variation pressure and the absolute pressure, and various quantities that are diagnostic information using the blood vessel diameter and the cross-sectional area of the blood vessel detected by the elliptical shape detection unit.
  • the diagnostic information is displayed on the display unit.
  • the technique dependency (the measurement result depends on the skill of the examiner), which is a problem in the method of measuring the time variation of the blood vessel diameter, is greatly reduced by a simple method. .
  • the reliability of the calculation results of the pulse wave velocity, arterial pressure and various quantities derived from them is improved.
  • FIG. 1 is a block diagram showing a device configuration of an ultrasonic imaging apparatus according to an embodiment of the present invention.
  • the flowchart which shows operation
  • FIGS. 4A and 4B are explanatory diagrams when calculating the characteristics of an ellipse.
  • FIG. 4A shows the relationship between the ellipse obtained by fitting and the coordinate system of the image, and FIG. 4B shows the tilt angle of the ultrasonic beam.
  • (A)-(c) is a figure which shows the example of a display, respectively.
  • (A), (b) is a figure which shows the example of a display of an ellipse imaging guide, respectively.
  • (A)-(d) is a figure which shows the example of guidance displayed on a guidance display part.
  • the ultrasonic imaging apparatus transmits an ultrasonic wave to an inspection target and receives an ultrasonic echo reflected from the inspection target, and an echo signal received by the ultrasonic probe.
  • a signal processing unit for processing and a display unit for displaying a processing result by the signal processing unit are provided.
  • the signal processing unit calculates the biological information of the tissue specified by the elliptical shape based on the elliptical shape detecting unit that detects the elliptical shape included in the examination target from the echo signal and the elliptical shape detected by the elliptical shape detecting unit. And an elliptical shape calculation unit.
  • the signal processing unit further includes a tissue position extracting unit that extracts an elliptical tissue position in the imaging section from the echo signal.
  • the ellipse shape detection unit performs ellipse approximation on the detected ellipse shape and calculates a shape parameter for specifying the ellipse shape.
  • the shape parameter calculated by the elliptical shape detection unit includes, for example, a major axis diameter and a minor axis diameter, or a ratio (aspect ratio) between the major axis diameter and the minor axis diameter.
  • the shape parameter calculated by the elliptical shape detection unit includes the tilt angle of the ultrasonic beam with respect to the blood vessel, and the elliptical shape detection unit uses the shape parameter to determine the blood vessel diameter and its time. Any one or more of calculation of change and calculation of blood vessel cross-sectional area and its time change are performed.
  • the ultrasonic imaging apparatus includes a period information acquisition unit that acquires biological period information of a test target, and the ellipse shape detection unit uses the period information from the period information acquisition unit to detect the ellipse in a specific time range. Detect shape change over time.
  • the elliptical shape calculation unit of the present embodiment calculates velocity information of the fluid flowing in the tissue specified by the elliptical shape using the elliptical time change information.
  • the pressure fluctuation in the tissue specified by the elliptical shape is calculated using the information on the time variation of the elliptical shape.
  • an index relating to the hardness of the tissue specified by the elliptical shape is calculated based on the pressure fluctuation.
  • the elliptical shape calculation unit calculates the moving speed (pulse wave speed) of the pulse wave propagating through the blood vessel wall from the time change of the blood vessel cross-sectional area or the time change of the blood vessel diameter. Also, the hardness of the blood vessel is calculated using the pulse wave velocity. Further, the arterial peak pressure waveform is calculated using the temporal change of the pulse wave velocity and the blood vessel cross-sectional area.
  • the ultrasonic imaging apparatus can further include a correction pressure input unit that inputs an external correction pressure, and the elliptical shape calculation unit corrects the arterial peak pressure waveform using the external correction pressure, and the arterial blood pressure waveform. May be calculated.
  • the ultrasonic imaging apparatus of the present embodiment can include a blood flow velocity measurement unit, and the elliptical shape calculation unit performs an examination using the blood flow velocity measured by the blood flow velocity measurement unit and the pulse wave velocity. The blood flow volume flowing through the subject may be calculated.
  • FIG. 1 is a block diagram showing an apparatus configuration example of an ultrasonic imaging apparatus according to the present invention.
  • the ultrasonic imaging apparatus of the present embodiment includes an apparatus main body 1 and an ultrasonic probe 2.
  • the apparatus main body 1 generates an ultrasonic image while controlling the ultrasonic probe 2, and includes an input unit 10, a control unit 11, an ultrasonic signal transmission / reception unit 12, a display unit 14, and a signal processing unit 15. ing.
  • the ultrasonic probe 2 is in contact with the living body (subject) 3 according to the signal generated by the ultrasonic signal transmitting / receiving unit 12 and irradiates the irradiation area 30 in the living body with ultrasonic waves. A reflected wave echo signal is received.
  • the ultrasonic probe 2 generates a continuous wave or a pulse wave according to the scanning method.
  • a linear probe that performs linear scanning is used as the ultrasonic probe 2, but the type of the probe is not particularly limited, and in addition to a linear probe, a convex probe, a sector A probe or the like may be used.
  • the input unit 10 includes a keyboard and a pointing device for an operator operating the ultrasonic imaging apparatus to set operating conditions of the ultrasonic imaging apparatus with respect to the control unit 11 and measures biological information other than the ultrasonic imaging apparatus such as an electrocardiogram. When the device is used, it also functions as a signal input unit for inputting signals from these biological information measuring devices.
  • the control unit 11 controls the ultrasonic signal transmitting / receiving unit 12, the display unit 14, and the signal processing unit 15 based on the operating conditions of the ultrasonic imaging apparatus set by the input unit 10, and is, for example, a CPU of a computer system.
  • the ultrasonic signal transmitting / receiving unit 12 includes an oscillator that generates a signal having a predetermined frequency, and sends a drive signal to the ultrasonic probe 2.
  • the ultrasonic signal transmission / reception unit 12 performs signal processing such as amplification and phasing on the reflected echo signal received by the ultrasonic probe 2.
  • the ultrasonic signal transmitting / receiving unit 12 includes a known receiving circuit, envelope detection means, and Log compression means.
  • the display unit 14 outputs information obtained by the signal processing unit 15, for example, an ultrasound image such as a B mode image or an M mode image, and biological information (numerical value) calculated by the signal processing unit 15.
  • the signal processing unit 15 has a function of generating an ultrasound image from the reflected echo signal from the ultrasound probe 2. Details thereof will be described later.
  • the apparatus main body 1 includes a scan converter and an A / D converter.
  • the scan converter may be included in the ultrasonic signal transmitting / receiving unit 12 or may be provided in the subsequent stage of the signal processing unit 15.
  • the ultrasonic signal transmitting / receiving unit 12 includes a scan converter, there is an advantage that the amount of data handled by the signal processing unit 15 is reduced. Further, when the scan converter is not included in the ultrasonic signal transmitting / receiving unit 12, a large amount of data can be handled by the signal processing unit 15, and a highly accurate measuring device can be realized.
  • the A / D converter is provided before the signal processing unit 15.
  • the ultrasonic imaging apparatus of the present embodiment includes a blood pressure correction unit (correction pressure input unit) 41 that corrects blood pressure and a period information acquisition unit 42 as external input devices.
  • the blood pressure correction unit 41 is used to input information for correcting information related to blood pressure (such as fluctuating pressure) calculated by the signal processing unit 15.
  • a cuff sphygmomanometer that acquires blood pressure data represented by upper arm blood pressure Can be used. If blood pressure data can be input to the main body 1 via the input unit 10, it is not essential to connect the blood pressure correction unit 41 as an external input device.
  • the cycle information acquisition unit 42 acquires information indicating the heartbeat time phase of the heart.
  • the heartbeat time phase is used for timing determination at the time of synchronous imaging for obtaining time series data at predetermined time intervals. Note that the synchronous imaging timing determination includes a case where it is performed after the echo signal analysis.
  • the period information acquisition unit 42 may be, for example, an electrocardiogram or a heart sound diagram.
  • region 30) in this embodiment is the whole artery, it demonstrates taking the carotid artery as an example in the following description.
  • the signal processing unit 15 includes, as main elements, a tomographic image forming unit 151, a blood flow velocity measuring unit 152, an elliptical shape detecting unit 153 that detects an elliptical shape, an elliptical shape calculating unit 154 that performs calculations based on the elliptical shape, and a display A display image forming unit 156 that creates display content on the unit 14 is provided.
  • the signal processing unit 15 includes a memory unit (not shown), and the tomographic image forming unit 151, the blood flow velocity measuring unit 152, the elliptical shape detecting unit 153, the elliptical shape calculating unit 154, and the display image forming unit 156 are respectively input or Stores data to be output and data obtained during the processing.
  • the memory unit may be provided anywhere in the signal processing unit 15 as long as it can appropriately read out data necessary for calculation and display. In the present embodiment, various types of data are stored using the data stored in the memory unit. It is assumed that it is in the elliptical shape calculation unit 154 that calculates biological information.
  • the tomographic image forming unit 151 receives the reflected echo signal output from the ultrasonic signal transmitting / receiving unit 12 and, for example, a B-mode image, that is, a two-dimensional tissue recording image using a planar imaging method of an ultrasonic irradiation target or A three-dimensional tissue shape image using a stereoscopic imaging method is formed.
  • the tomographic image forming unit 151 includes a tissue position extracting unit 155 that extracts tissue position information from the tissue shape image.
  • the blood flow velocity measurement unit 152 receives the reflected echo signal output from the ultrasonic signal transmission / reception unit 12 and, for example, two-dimensional or three-dimensional using a color Doppler mode, that is, a planar imaging method of an ultrasonic irradiation target. Three-dimensional Doppler blood flow velocity information using an imaging method is extracted.
  • the elliptical shape detection unit 153 identifies an elliptical shape with respect to the elliptical shape of the tissue set by the examiner.
  • the elliptical shape calculation unit 154 performs calculation based on the elliptical shape specified by the elliptical shape detection unit 153.
  • the memory unit stores the reflected echo signal and information held by the tomographic image forming unit 151, the blood flow velocity measuring unit 152, the elliptical shape detecting unit 153, and the elliptical shape calculating unit 154.
  • the ultrasonic diagnostic apparatus is roughly divided into a process (step S1) for performing imaging (hereinafter referred to as elliptical imaging) to obtain an imaging cross section in which an elliptical blood vessel is depicted, and an echo signal obtained by elliptical imaging.
  • elliptical imaging an imaging cross section in which an elliptical blood vessel is depicted
  • an echo signal obtained by elliptical imaging.
  • steps S2 and S3 steps used to extract and determine the elliptical shape of the blood vessel
  • steps S4 and S5 Processing for calculating useful diagnostic information by further utilizing pulse wave information (steps S6 to S9), and processing for providing the examiner with the results of the processing and the obtained diagnostic information (S10).
  • the ultrasonic diagnostic apparatus according to the present embodiment is characterized in that blood vessel information is obtained using an elliptical property, and some of the steps described in FIG. 2 can be omitted. It is also possible to add steps not described in.
  • imaging is performed to obtain form information (B-mode image) of the irradiation area.
  • the ultrasonic frequency during B-mode imaging is in the range of 1 MHz to 20 MHz that allows imaging.
  • the frame rate when imaging tissue that varies with the heartbeat is set to 10 Hz or more, which is a range in which the motion of the heart can be captured.
  • the tomographic image forming unit 151 uses the reflected echo output from the ultrasonic signal transmitting / receiving unit 12 to obtain a B-mode image, that is, a two-dimensional ultrasonic biological image or stereoscopic imaging using a planar imaging method of an ultrasonic irradiation target. A three-dimensional ultrasonic biological image using the method is formed. Imaging is performed continuously for a predetermined time, and ultrasonic biological image data is acquired in time series.
  • a tomographic image in which a cross section from which an elliptical shape of a blood vessel can be extracted is formed.
  • two-dimensional imaging irradiation in which the target blood vessel is traveling so that the transducer array direction of the ultrasound probe 2 has an angle of less than 90 degrees with respect to the traveling direction of the blood vessel, preferably about 60 degrees.
  • FIG. 3B shows a general structure in which a blood vessel wall 32 is present outside the oval arterial section 31 and a blood vessel endothelium 33 is present inside the blood vessel wall 32.
  • an elliptical tomographic image may be extracted by software processing.
  • the examiner may designate the angle, or the tomographic image may be created by setting the angle of the imaging surface and the blood vessel running in advance to a predetermined angle, for example, 60 degrees.
  • the tissue position information of the blood vessel is acquired from the ultrasonic biological image formed in step S1.
  • a method of detecting the tissue inner wall by image processing or a method of acquiring position information by the examiner specifying the tissue inner wall via the input unit 10 can be adopted.
  • a tissue (inner wall) in an ultrasonic image is recognized as a high luminance value, and the high luminance value portion is a blood vessel tissue, and the high luminance value portion is two-dimensional or three-dimensional.
  • the position is acquired as the tissue position.
  • the position designated by the examiner is acquired as a vascular tissue position via a pointing device provided in the input unit 10.
  • an arbitrary position such as a tissue inner wall or an outer wall, which is a boundary surface between blood and tissue, an intermediate point between the inner wall and the outer wall, or an inner part or the outer side of the endothelium can be designated as the tissue position.
  • the tissue position that defines the elliptical shape is extracted.
  • the elliptical shape can be extracted when the RF signal (echo signal) is detected from the image instead of the image by the envelope detection means.
  • ⁇ Step S3> various amounts (shape parameters) representing the properties of the elliptical shape are calculated using the elliptical position obtained by the tomographic image forming unit 151.
  • the shape parameters representing the properties of the ellipse include the major axis diameter and minor axis diameter of the ellipse, the ratio of the ellipticity, and the elliptical cross-sectional area. Time change is also included. Further, the blood vessel direction and the angle of ultrasonic beam irradiation are calculated from the calculated ellipticity. It is not always necessary to calculate all of these shape parameters depending on the content of vascular dynamic information calculated thereafter.
  • the major axis diameter, minor axis diameter, or ellipticity which is the shape parameter of the ellipse, can be obtained by ellipse approximation.
  • the ellipse approximation can be realized, for example, by fitting the measured blood vessel cross-sectional position (xi, yi) using the ellipse equation shown in Expression (1). Note that the subscript i is the number of the measured blood vessel cross-sectional position.
  • (x 0 , y 0 ) is the ellipse center position
  • r l is the major axis diameter
  • r s is the minor axis diameter
  • ⁇ is the inclination angle of the ellipse (the angle of the major axis with respect to the X axis of the cross-sectional image)
  • a known method such as a least square method or a cross correlation method can be employed.
  • FIG. 4 (a) shows an ellipse approximation.
  • FIG. 4A shows an elliptical shape obtained by fitting the blood vessel position indicated by a white circle (position obtained in step S2) in the coordinate system (X, Y) of the cross-sectional image.
  • the major axis direction of this ellipse is the traveling direction of the blood vessel, and the inclination angle ⁇ of the ellipse is the angle of the traveling direction of the blood vessel with respect to the X axis.
  • the major axis diameter and the minor axis diameter were obtained as unknowns, but the combination of unknowns was replaced with a set of major axis diameters and minor axis diameters.
  • the ellipse center position (x 0 , y 0 ) may be calculated not by fitting but by obtaining the blood vessel cross-sectional area from the blood vessel cross-sectional position and calculating the center of gravity of the blood vessel cross-sectional area. In this case, the number of unknowns obtained by fitting is reduced, so that the fitting calculation can be simplified.
  • the blood vessel cross-sectional area may be calculated using the major axis diameter and the minor axis diameter, or may be calculated from the number of pixels existing inside the ellipse defined in step S2.
  • the ultrasonic beam tilt angle ⁇ is an angle of the imaging surface of the ultrasonic beam with respect to the traveling direction of the blood vessel.
  • step S3 shape parameters representing the above-described elliptical properties are calculated for each tomographic image data obtained in time series within a frame at a predetermined time.
  • the various quantities obtained in step S3 are obtained as a function of time changing according to time and time phase.
  • the elliptical shape detection unit 153 calculates the time change of the blood vessel diameter using the various amounts obtained as a function of time as described above.
  • the time change of the blood vessel diameter is obtained by, for example, calculating the time change of the blood vessel cross-sectional area, the major axis diameter, or the minor axis diameter.
  • Vascular cross sectional area changes it is possible to calculate the blood vessel cross-sectional area of the diastolic upon the A d, by the formula (3) as the time changes K (t) of the blood vessel cross-sectional area ratio thereto.
  • Vascular sectional area A d of the diastole, to the smallest value may be A d of the blood vessel cross-sectional area of each heartbeat time phase, when the period information acquisition unit 42 for example can obtain the time information of the ECG diastolic may the cross sectional area at that time as a d.
  • the minor axis diameter and the major axis diameter are determined by the ultrasonic beam angle with respect to the blood vessel traveling direction of the imaging surface, that is, the tilt angle ⁇ , if the tilt angle ⁇ is constant, the blood vessel cross-sectional area and the major axis diameter obtained as described above are used.
  • the time changes K (t), Kl (t), and Ks (t) of the minor axis diameter should show almost the same value.
  • the change in blood vessel diameter may be obtained as in equation (5) using the short axis diameter as a reliable index.
  • the elliptical shape calculation unit 154 measures the amount of movement of the pulse wave using the RF signal of the reflected echo output from the ultrasonic signal transmission / reception unit 12.
  • This RF signal is an RF signal for imaging performed in order to acquire an elliptical shape in step S1.
  • FIG. 5 is used to explain the relationship between pulse wave movement and RF signals.
  • FIG. 5A is an explanatory diagram of a pulse wave
  • FIG. 5B is a diagram illustrating a pulse wave that appears on an imaging section at different times
  • FIG. 5C is a diagram illustrating an RF signal used to create the imaging section in FIG. It is.
  • a horizontal direction is the transducer arrangement direction of an ultrasonic probe
  • each signal is a signal which each transducer receives.
  • the vertical direction is the time axis and corresponds to the beam depth direction.
  • the pulse wave is a shear wave propagating through the blood vessel, and the shear wave propagates from the blood vessel close to the heart to the terminal blood vessel.
  • the shear wave traveling from the end to the heart is referred to as a reflected wave.
  • the progress of the wave can be detected by tracking the displacement amount in the radial direction of the blood vessel.
  • the pulse wave velocity is very fast, about 1 m / s to 10 m / s, in order to track this, it is necessary to perform imaging at a high frame rate or repetition frequency on the order of kHz.
  • Such imaging at a high frame rate can be realized by performing a plurality of receptions for one transmission and reducing the number of ultrasonic beams.
  • the transmission beam shape may be a thin linear beam, or may be a two-dimensional planar beam or a three-dimensional volume beam in order to widen the target area for each beam.
  • FIG. 5B shows changes in the pulse wave that appeared in the tomographic images after ⁇ t and 2 ⁇ t after time t1. As shown in the figure, it is possible to capture a pulse wave propagating through an elliptical blood vessel wall from imaging sections at different times.
  • the tomogram in FIG. 5B is equivalent to the RF signal envelope shown in FIG. 5C, and is directly (without creating a tomogram) from the envelope of the RF signal. It is also possible to capture the pulse wave that propagates through.
  • FIG. 6 shows a detailed procedure for measuring the amount of movement of the pulse wave using RF signals or tomographic images (both are collectively referred to as time series data) measured at different times in step S4.
  • Step S4 is a step S41 for correcting body motion changes in those measurement periods for time series data, a step S42 for setting a time width (time gate) for analyzing a pulse wave, and a range of blood vessel positions used for calculation.
  • Step S43 for setting (space gate), step S44 for calculating the displacement of the blood vessel position set by the space gate, and step S45 for calculating the pulse wave movement amount using the time information and displacement of the time series data. Details of each step will be described below.
  • the calculation of the amount of movement of the pulse wave can be performed using either an RF signal or a tomographic image, but in the following description, a case where a tomographic image is used will be described.
  • step S41 the elliptical shape calculation unit 154 corrects the body motion change in order to correspond to the body motion to be examined within the time when the time series data is obtained. Specifically, the blood vessel centroid (ellipse center position) calculated in step S3 is tracked, and the coordinates are rearranged so that the blood vessel centroid at a predetermined time is the reference point and the blood vessel centroid at another time is the reference point. This makes it possible to correct body movement changes. If there is almost no influence of the body movement on the measurement site and the body movement can be ignored, this step S41 can be omitted.
  • the elliptical shape calculation unit 154 sets a time gate for analysis.
  • the width of the time gate is a time required for at least the pulse wave to move from one end to the other end of the vascular tomographic image, and is several times larger when adding.
  • the start time of the pulse wave to be observed is set.
  • the pulse wave start time varies depending on the location of the artery and the condition of the patient. For example, using the electrocardiogram, the pulse wave start time or after a certain delay time has elapsed is set as the pulse wave start time, and then the pulse wave start time is determined from that time.
  • the time gate may be set by the operator via the input unit or may be set in advance by default.
  • the elliptical shape calculation unit 154 sets a space gate as an area for observing the displacement of the blood vessel position.
  • the space gate is set as a predetermined width including the reference blood vessel position when the data used for calculating the movement amount of the pulse wave is a blood vessel tomogram.
  • the reference vascular position is, for example, the vascular position in the vascular tomographic image that is time-averaged after body motion correction is performed in step S41 on a plurality of vascular tomographic images created from the RF signal acquired in the time gate in step S42. can do.
  • FIG. 7 shows a state in which a spatial gate is set in the vascular tomogram.
  • the left side shows RF signals 75 acquired at different times (t1, t1 + ⁇ t, t1 + 2 ⁇ t), and obtained by averaging the tomographic images after correction of body motion formed from these RF signals 75.
  • a tomographic image 70 is shown on the right side.
  • the blood vessel position of the blood vessel tomographic image 70 becomes the reference blood vessel position.
  • the RF signal 75 corresponds to N elements constituting the transducer array, and is composed of signals having signal numbers 1 to N. Each signal number corresponds to a position in the X-axis direction of the vascular tomographic image 70. .
  • Spatial gates are set at a plurality of blood vessel positions corresponding to these signal numbers 1 to N, respectively.
  • the displacement of the shear wave of the pulse wave appears as a displacement in the minor axis direction of the elliptical shape of the blood vessel, but in the ellipse image where the beam angle is not 90 °, the displacement amount includes the Y axis direction component.
  • the displacement of the shear wave can be measured.
  • the setting of the space gate and the measurement of the displacement are performed for each, and the displacement amount is calculated using both.
  • the width of the space gate is not particularly limited, but is, for example, about 20% of the minor axis diameter. This value may be set in advance, or may be set / changed by the operator.
  • the displacement amount of the shear wave of the pulse wave can be calculated as the displacement of the blood vessel position with respect to the reference blood vessel position thus set in each blood vessel image having different acquisition times.
  • FIG. 7 shows an embodiment in which a spatial gate is set for a vascular tomogram, it is also possible to calculate the amount of movement of a pulse wave directly from an RF signal.
  • the depth direction of the signal 75 is set.
  • step S44 the elliptical shape calculation unit 154 calculates the displacement amount of the blood vessel wall due to the pulse wave based on the reference blood vessel position set in step 43.
  • the amount of movement of the pulse wave it is only necessary to obtain the distance that the location displaced with respect to the reference blood vessel position moves in the time axis direction, so the amount of displacement may be accurate enough to determine the presence or absence of displacement.
  • the difference between each blood vessel position (position in the minor axis direction of the ellipse) and the reference blood vessel position (position in the minor axis direction of the ellipse) may be calculated in the tomographic images having different acquisition times.
  • a position where the difference calculated for each blood vessel position becomes the maximum or a position where the difference is equal to or greater than a predetermined threshold value can be set as the position where the displacement has occurred.
  • pattern matching calculation may be performed between a vascular tomogram with different acquisition times and a reference vascular tomogram (time-averaged vascular tomogram).
  • a known method such as cross-correlation or SAD (sum of absolute difference) can be employed as a pattern matching calculation method.
  • FIG. 6 shows a case where correlation processing is performed in step S44.
  • step S45 the elliptical shape calculation unit 154 calculates the pulse wave movement amount.
  • FIG. 8A shows a plot of changes in displacement at each position of the blood vessel.
  • the blood vessel position in the elliptical blood vessel is indicated by the corresponding signal number (signal numbers 1, j, N), and the vertical axis represents the amount of displacement obtained in step S44, and the horizontal axis represents the time gate. Is the elapsed time. From this graph, it can be seen that the pulse wave is transmitted through the blood vessel position corresponding to the signal number.
  • FIG. 8B shows a plot of the signal number of the position where the pulse wave has reached and the pulse wave arrival time.
  • the moving speed of the pulse wave can be obtained. That is, if the signal number on the vertical axis in FIG. 8B is converted into the distance between each ultrasonic beam, the slope of the straight line fitted in FIG. 8 becomes the pulse wave moving speed.
  • the propagation velocity V p of the pulse wave in the imaging plane when the took Delta] t p time to move from the signal number 1 to N by the formula (6) Can be represented.
  • the displacement amount is calculated using both the displacement of the blood vessel wall closer to the ultrasonic beam and the displacement of the blood vessel wall farther from the ultrasonic beam in step S44, and the pulse wave velocity is calculated in step S45.
  • the displacement of the blood vessel wall closer to the ultrasonic beam and the displacement of the blood vessel wall farther from the ultrasonic beam may be obtained, and the pulse wave velocity may be calculated from each displacement in step S45 and averaged. .
  • step S ⁇ b> 5 the elliptical shape calculation unit 154 performs angle correction according to the imaging angle with respect to the speed obtained in step S ⁇ b> 4.
  • the velocity V p obtained by the expression (6) in step S45 is calculated based on the distance between the beams, that is, the distance in the X-axis direction of the tomographic image, but the traveling direction of the blood vessel is actually X of the tomographic image. It has an inclination angle ⁇ (FIG. 4A) with respect to the axis, and has a tilt angle ⁇ with respect to the imaging surface.
  • the angle correction is performed according to Equation (7) using information on the inclination angle ⁇ and the tilt angle ⁇ of the elliptical shape calculated in step S3. That is, the pulse wave propagation velocity V can be expressed by equation (7).
  • information from the external information input unit is used as necessary, and various clinically important physical quantities are calculated in the following steps S6 to S8.
  • the physical quantity there are a blood vessel wall hardness (blood vessel elastic modulus), a temporal change in arterial peak pressure, a temporal change in arterial pressure, and the like.
  • step S6 the elliptical shape calculation unit 154 calculates the blood vessel elastic modulus E according to equation (8) based on the pulse wave velocity calculated in step S5.
  • the calculated vascular elasticity E is an index for estimating the hardness of the blood vessel.
  • ⁇ is the density of the vascular tissue, and is a constant between 1000 [kg / m 3 ] and 1100 [kg / m 3 ].
  • the device automatically sets what is stored in the memory unit in advance. Alternatively, it may be set manually by the examiner.
  • step S7 the elliptical shape calculation unit 154 uses the elliptical blood vessel area ratio K (time change), the density ⁇ , and the pulse wave velocity V obtained in step S3 to change the artery according to equation (9) or equation (10).
  • the pressure P p is calculated.
  • the area ratio of blood vessels is a function of time, and fluctuations in arterial pressure can be grasped. Since the relationship between the pressure and the area varies depending on the location and diameter of the blood vessel, the model represented by the equation (9) and the model represented by the equation (10) can be properly used depending on the target blood vessel. It is also possible to use models other than Equation (9) and Equation (10).
  • step S8 the ellipse shape calculation unit 154 estimates the absolute value (absolute pressure) of the arterial pressure.
  • the change in pressure can only be grasped and the absolute pressure of the arterial pressure cannot be known, but the absolute pressure can be estimated by using biological information taken in via an external input device.
  • the arterial pressure (absolute pressure) P is described as shown in Expression (11) using the blood pressure correction information acquired in the blood pressure correction unit 41, for example, the diastolic blood pressure Pd obtained by the cuff sphygmomanometer. Can do.
  • the arterial pressure is simply obtained by acquiring an elliptical cross section image and performing the above-described analysis. Can be requested.
  • Step S9 the elliptical shape calculation unit 154 calculates various diagnostic indices based on the physical quantities obtained in steps S2 to S8.
  • diagnostic indices that can be calculated by the elliptical shape calculating unit 154 include information on singular points of blood pressure waveforms, velocity profiles, pressure-flow curves (PQ curves) indicating the relationship between blood pressure and blood flow, blood pressure and heart volume. Pressure-volume relationship curves, end-diastolic pressure-volume relationship curves, and indices obtained from these curves.
  • PQ curves pressure-flow curves
  • FIG. 9 shows an arterial pressure waveform for one heartbeat.
  • the blood pressure rises at a predetermined increase width P1 during the systole and falls during the diastole.
  • the diastolic blood pressure Pd (the minimum blood pressure in the waveform), the blood pressure increase width P1, the second blood pressure increase width P2, and the systolic blood pressure width P3 are important indicators for diagnosing the degree of blood vessel hardness and arteriosclerosis.
  • these singular points are calculated based on the blood pressure waveform, and the pressure information and time information (time width) at the singular points are calculated as indices.
  • the singular point can be extracted using the maximum value, minimum value, time differentiation, inflection point, etc. of the waveform. Further, from the ratio of P1 and P2, AI (Augmentation Index), which is an index of blood vessel hardness, can be calculated.
  • the elliptical shape calculation unit 154 calculates the velocity distribution and flow rate in the blood vessel by using the velocity distribution information (Doppler waveform) obtained by the blood flow velocity measurement unit (Doppler velocity calculation unit) 152.
  • the blood flow velocity measurement unit 152 can use a color Doppler method, which is a general-purpose method, as a method for acquiring a Doppler waveform, and can obtain all or part of the blood flow site in the ultrasonic irradiation unit. When performing Doppler measurement, it is preferable to irradiate the beam obliquely, thereby enabling more accurate measurement.
  • the ellipse shape calculation unit 154 corrects the angle of the Doppler velocity profile using Equation (12) and The profile U (r) is calculated.
  • FIG. 10 shows the velocity profile on the minor axis of the elliptical shape determined in step S3. Since the minor axis passes through the center of the ellipse, the velocity profile of the entire tube can be estimated by approximating the circular tube to the profile on the minor axis calculated as described above.
  • the flow rate Q can be obtained from the equation (13) using the angle corrected velocity U (r) calculated by the equation (12).
  • equation (13) Since actual calculation of equation (13) involves discretization, the location of the kth velocity profile measurement point is defined as in equation (14), and the flow rate using the 0th to nth profiles is represented by equation (14). 15).
  • the flow rate is a function of time, and can be calculated as a flow rate per heart beat by integrating, ie, summing, one heart beat.
  • each of the plurality of loops corresponds to one cycle of the heartbeat, and shows a case where measurement is performed under different physical conditions.
  • the different conditions are an exercise load test, a positive pressure load test, a drug load test, or the like that indirectly applies a load to the cardiovascular system, and any of them may be used. In this way, examination can be performed under different conditions, and the change in the loop can be seen to contribute to the diagnosis of cardiac function.
  • the loop inclination or the like may be obtained as an index.
  • the pressure-flow relationship curve and the index obtained from it are diagnostic indices that could not be presented by conventional ultrasonic angiography, but in this embodiment, the absolute pressure can be calculated. Can be presented to the person.
  • the left ventricle shape image is taken for a certain time separately from step S1, and the volume of the left ventricle at a plurality of times is calculated from the left ventricle shape image formed by the tomographic image forming unit 151.
  • the volume calculation may be performed by, for example, the elliptical shape calculation unit 154, or a shape detection unit and a calculation unit having functions similar to the elliptical shape detection unit 153 and the elliptical shape calculation unit 154 are provided in the signal processing unit 15. May be.
  • the volume can be calculated by a Pombo method, a Teiholz method, or the like obtained from the inner diameter of the left ventricle obtained from a two-dimensional captured image. Or it is also possible to measure directly by imaging the shape of the heart three-dimensionally.
  • a pressure-volume relationship diagram representing the relationship between the calculated left ventricular volume V at a plurality of times and the absolute pressure P at the plurality of times calculated in step S8 is created.
  • An example of the pressure-volume relationship diagram is shown in FIG.
  • the curve of a plurality of looped, pressure, measured at different physical conditions for the test object - is the volume relationship curve C PV, shows one of the loop in one heartbeat.
  • the different physical conditions include the exercise load test, the positive pressure load test, or the drug load test described above, and any of them may be used.
  • the elliptical shape calculation unit 154 calculates dP / dt, which is a physical quantity indicating a temporal differential value, and the time constant ⁇ when the left ventricular relaxation state is approximated by an exponential function from the absolute pressure calculated in step S8. You can also.
  • Step S10> The values obtained in the above-described steps S2 to S9 are important diagnostic indexes indicating the state of the heart to be examined, and are converted into display data that can be displayed on the display unit 14 in the display image forming unit 156. It is presented to the examiner via the display unit 14.
  • the display can take various forms such as displaying together with the ultrasound image, displaying the diagnostic index as a table, and displaying the desired diagnostic index selected by the examiner from the display menu.
  • FIG. 12 shows a display example displayed on the display unit 14.
  • FIG. 12A displays the ellipse shape obtained in step S1
  • the ellipse index display unit 121 displays the properties of the ellipse obtained in step S3 such as the ellipse center position (x 0 , y 0 ), the long axis.
  • FIGS. 12B and 12C show a case where the physical quantity and the diagnostic index calculated in Step 6 to Step 9 are displayed together with the tomographic image formed by the tomographic image forming unit 151.
  • FIG. 12B and 12C for example, the arterial pressure graph shown in FIG. 9 and the pressure-volume relationship diagrams and pressures shown in FIGS. 11A and 11B are displayed.
  • -Flow rate relationship diagram can be displayed as an image.
  • an index obtained in step S9 for example, display of AI, blood vessel hardness, and pulse wave velocity may be added.
  • pressure at systole end - is the slope of the volume relationship E max, end-diastolic pressure showing the relationship between end-diastolic pressure and volume - volume relationship curve C PV ED may be displayed.
  • FIG. 12 shows a display example, and is not limited to the display example of FIG. 12, and various changes can be made.
  • the information displayed on the diagnostic index display unit 122 can be displayed alone or in combination as appropriate, separately from the tomographic image.
  • the ultrasonic imaging apparatus performs imaging in which a target blood vessel has an elliptical shape.
  • a feature is that imaging is performed to obtain a cross-section, and the moving speed of the pulse wave and the arterial pressure are obtained based on the elliptical shape of the blood vessel.
  • the functional block diagram in the signal processing unit shown in FIG. 1 shows the functions of the signal processing unit of this embodiment as a block, and the signal processing unit may include functional elements not shown. .
  • the ultrasonic imaging apparatus of this embodiment by using time-series information of an elliptical blood vessel cross section, blood flow dynamics such as pulse wave velocity and blood pressure can be accurately obtained regardless of the skill of the examiner's imaging technique. And it can obtain
  • FIG. 16 shows a functional block diagram of the signal processing unit of the present embodiment.
  • the same elements as those in FIG. 1 are denoted by the same reference numerals, and description thereof is omitted.
  • the signal processing unit 15 is provided with an elliptical imaging guide unit 157 that realizes an elliptical imaging guide function.
  • the ellipse imaging guide unit 157 causes the display unit 14 to display a parameter or an ellipse model that is an index of imaging accuracy calculated by the ellipse shape calculation unit 154.
  • step S3 for calculating the properties of the elliptical shape
  • step S3 it is determined whether the elliptical shape is an appropriate shape for the subsequent calculation, and information that serves as a guide for the examiner regarding the appropriate shape is obtained. It is characterized by including steps S31 and S32 to be presented.
  • step S31 when the elliptical shape of the blood vessel included in the tomographic image is calculated in step S3 by the elliptical shape detection unit 153, the elliptical shape calculation unit 154, for example, uses the short axis diameter and the long axis diameter obtained in step S3. From this information, it is determined whether or not the subsequent calculation is performed.
  • the determination parameter may be, for example, the ratio of the time change Kl of the major axis diameter r l and minor axis diameter r s determined by equation (4) in step S3 (t), Ks (t) .
  • the elliptical shape calculation unit 154 calculates the ratio Kr (t) according to the equation (16).
  • Kl (t) and Ks (t) should be the same value if the imaging cross section is constant. However, when the imaging cross section is blurred, these values are also shifted. . Therefore, when the change in Kr (t) is large, it means that the change in the blood vessel diameter or the cross-sectional area is not accurately captured. Therefore, the imaging accuracy sufficient for the calculation of the blood flow dynamics is not obtained. The examiner is informed that it is necessary to redo the imaging of S1 (change of the imaging section when imaging is continued).
  • the time change J of the ellipticity shown in Expression (17) may be used. Also good.
  • the time change J of the ellipticity may be a value normalized by a certain time phase, for example, a diastolic blood vessel diameter, using the equation (18). The smaller this change, the more appropriate the cross section.
  • FIG. 14A and 14B show the display screen 140 of the display unit 14, and FIG. 14A shows an image display unit 141 that displays the tomographic image of the elliptical blood vessel acquired in step S1 as the display region. And a guidance display unit 142 are provided. (B) has shown the display screen as which the image which displays the shape of the blood vessel wall extracted by step S2 was displayed on the image display part 141. FIG. These screens (a) and (b) may be switched as the flow shown in FIG. 2 progresses.
  • FIGS. (A) shows the numerical values of the parameters, and the values of Kr (t) and J described above are displayed.
  • (B) in FIG. 15 is a plot of time changes in ellipticity J and Jd
  • (c) is a graph in which a predetermined threshold is set for the parameter, and the elliptical shape is set using the set threshold.
  • Appropriateness i.e., imaging accuracy with which blood flow dynamics can be extracted
  • the accuracy of imaging with which blood flow dynamics can be extracted is one measure that the short-axis blood vessel diameter can be measured with high accuracy. Therefore, it can be used as a guide whether the value represented by Equation (19) can be sufficiently resolved. . For example, if 5% of this value is allowed, the threshold th can be expressed by the equation (20).
  • the rate of change J of the ellipse can be classified as follows, and a color can be assigned to each classification. Green: 1-th ⁇ Jd (t) ⁇ 1 + th Yellow: 1-2th ⁇ Jd (t) ⁇ 1 + 2th Red: 1-3th ⁇ Jd (t) ⁇ 1 + 3th
  • a parameter serving as an index of imaging accuracy is calculated, and the parameter or information obtained by further processing the parameter is presented.
  • an optimal elliptic model may be shown as guidance. The examiner can confirm whether or not the imaging section is appropriate by comparing the elliptical shape of the blood vessel actually imaged with the elliptic model.
  • FIGS. 15A to 15D only one may be displayed, but may be displayed in combination with other guidance.
  • the examiner uses such an ellipse imaging guide function to image an appropriate imaging section while adjusting the tilt angle. As a result, it is possible to prevent blood flow dynamic information from being calculated based on a low-accuracy imaging result, and to provide accurate blood flow dynamic information.
  • the present invention has been described according to the embodiment for imaging a blood vessel, but the present invention can also be applied to a biological tissue other than a blood vessel, such as a heart.
  • an ultrasonic imaging apparatus capable of presenting accurate blood flow dynamics information regardless of the imaging technique of the examiner.
  • SYMBOLS 1 Apparatus main body, 2 ... Ultrasonic probe, 10 ... Input part, 11 ... Control part, 12 ... Ultrasonic signal transmission / reception part, 14 ... Display part, 15 * ..Signal processing unit, 152 ... Tomographic image forming unit, 152 ... Blood flow velocity measuring unit, 153 ... Ellipse shape detection unit, 154 ... Ellipse shape calculation unit, 155 ... Tissue position extraction Part, 157... Ellipse imaging guide part.

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Abstract

La présente invention se rapporte à un dispositif d'imagerie acoustique qui détecte, pendant une imagerie acoustique, des changements de forme périodiques dans un tissu vivant et, à partir des informations de changement, mesure précisément les informations de débit concernant le fluide qui circule à l'intérieur du tissu vivant ainsi qu'une fluctuation de pression et une pression absolue dans le tissu vivant. Une unité de traitement de signal dans un dispositif de diagnostic par ultrasons comprend : une unité de détection de forme elliptique qui détecte des données de détection concernant des formes elliptiques présentes dans une cible d'inspection ; et une unité de calcul arithmétique de forme elliptique qui effectue des calculs arithmétiques sur la base des formes elliptiques. L'unité de détection de forme elliptique : analyse les formes elliptiques sur la base des données d'imagerie chronologiques extraites comme présentant une forme elliptique du tissu vivant, par exemple par capture de la section transversale en diagonale d'un vaisseau sanguin ; et calcule des changements temporels de son axe long et de son axe court, des changements temporels du rapport de forme ou des changements temporels de l'aire en coupe transversale du vaisseau sanguin, etc. L'unité de calcul arithmétique de forme elliptique : utilise ces changements temporels de forme elliptique ou, si nécessaire, des informations de correction provenant de l'extérieur ; calcule la vitesse des ondes pulsées propagées à travers les vaisseaux sanguins, les changements de la pression artérielle et la pression artérielle ; et affiche ces informations comme d'autres informations de diagnostic traitées sur une unité d'affichage.
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