WO2015044982A1 - Dispositif de diagnostic d'image et son procédé de commande - Google Patents

Dispositif de diagnostic d'image et son procédé de commande Download PDF

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Publication number
WO2015044982A1
WO2015044982A1 PCT/JP2013/005779 JP2013005779W WO2015044982A1 WO 2015044982 A1 WO2015044982 A1 WO 2015044982A1 JP 2013005779 W JP2013005779 W JP 2013005779W WO 2015044982 A1 WO2015044982 A1 WO 2015044982A1
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Prior art keywords
image
cross
representative
sectional
ray
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PCT/JP2013/005779
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English (en)
Japanese (ja)
Inventor
淳也 古市
耕一 井上
聖 衛藤
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テルモ株式会社
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Priority to JP2015538638A priority Critical patent/JP6100911B2/ja
Priority to PCT/JP2013/005779 priority patent/WO2015044982A1/fr
Publication of WO2015044982A1 publication Critical patent/WO2015044982A1/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
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
    • A61B5/0035—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography
    • 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
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • 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
    • 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
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4417—Constructional features of apparatus for radiation diagnosis related to combined acquisition of different diagnostic modalities
    • 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
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient

Definitions

  • the present invention relates to an image diagnostic apparatus and a control method thereof, and more particularly to a technique for generating a cross-sectional image of a biological tissue using ultrasonic waves or light.
  • an image diagnostic apparatus such as an optical coherence tomography diagnostic device (OCT: Optical Coherence Tomography) or an intravascular ultrasound diagnostic device (IVUS: IntraVascular Ultra Sound) is used. It is becoming common.
  • OCT optical coherence tomography diagnostic device
  • IVUS IntraVascular Ultra Sound
  • diagnostic imaging apparatuses are used when determining the necessity of treatment of a blood vessel site from information (for example, stenosis rate) obtained as a result of diagnosis, or for example, the adhesion rate of a stent to a blood vessel immediately after treatment. Used for confirmation of procedures such as evaluation.
  • Patent Document 1 discloses a configuration in which an X-ray image and a corresponding IVUS image are simultaneously displayed as a reference image at the time of catheter operation.
  • the function of displaying the cross-sectional images of the treatment target part before and after treatment side by side and reproducing them synchronously is very useful for diagnosis of treatment.
  • the cross-sectional image scans the blood vessel wall direction from the inside of the blood vessel, the rotation direction and position of the image have only relative information from the probe position and the rotation direction at the start of tomographic image acquisition.
  • the entire coronary artery as a target is recognized from an X-ray image or the like, and the positional relationship of the treatment site with respect to the whole is recognized.
  • the intravascular diagnostic device states that “the doctor recognizes the treatment target site in the absolute coordinate system of the entire coronary artery, whereas the displayed cross-sectional image has position information in the absolute coordinate system. There is a fundamental problem that it is not included.
  • a structure such as a branch that is displayed on both the cross-sectional image and the image on which the entire coronary artery such as an X-ray image is displayed is displayed.
  • alignment between the pre-treatment and post-treatment cross-sectional images is performed while comparing the X-ray image (Angio image) with the cross-sectional images.
  • the first problem is that it takes time to determine the landmarks.
  • a blood vessel with relatively few branches such as the right coronary artery
  • the present invention has been made in view of the above problems, and a diagnostic image to be compared can be compared and displayed under the same conditions with a simple operation.
  • an image diagnostic apparatus comprises the following arrangement. That is, An image diagnostic apparatus for comparing and displaying diagnostic images to be compared, An input means for inputting an X-ray image including the catheter inserted into the blood vessel in a catheter for obtaining a cross-sectional image of the blood vessel; Acquiring means for acquiring a cross-sectional image along with the movement of the drive shaft movably inserted into the catheter; In one diagnosis, a storage unit that associates a series of X-ray images input by the input unit with a series of cross-sectional images acquired by the acquisition unit, and stores them in a storage medium as diagnostic information for each diagnosis; Selecting means for selecting at least two pieces of diagnostic information including first diagnostic information and second diagnostic information from diagnostic information for each diagnosis stored in the storage means; A first representative cross-sectional image, a corresponding first representative X-ray image, a second representative cross-sectional image, and a first representative cross-sectional image included in each of the first diagnostic information and the second diagnostic information
  • the display control means detects the contrast display by the first representative cross-sectional image, the second representative cross-sectional image, the first representative X-ray image, and the second representative X-ray image on the display device. The corresponding frame detected by the means is displayed.
  • the diagnostic image to be compared is displayed in comparison with the same condition with a simple operation.
  • FIG. 1 is a diagram illustrating an external configuration of an image diagnostic apparatus (an image diagnostic apparatus having an OCT function as an example) 100.
  • the diagnostic imaging apparatus 100 includes a probe unit 101, a scanner and pullback unit 102, and an operation control device 103.
  • the scanner / pullback unit 102 and the operation control device 103 are connected by a signal line 104 so that various signals can be transmitted.
  • An imaging core 220 (FIG. 2) is inserted in the probe unit 101 which is a component of the catheter.
  • the imaging core 220 includes an optical transceiver that is inserted directly into a blood vessel and continuously transmits transmitted light (measurement light) into the blood vessel and continuously receives reflected light from the blood vessel. .
  • transmitted light measurement light
  • reflected light from the blood vessel.
  • the scanner and pullback unit 102 is detachably attached to the probe unit 101, and operates in the axial direction and rotational direction in the blood vessel of the imaging core 220 inserted into the probe unit 101 by driving a built-in motor. Is stipulated. Further, the scanner and pullback unit 102 acquires the reflected light received by the optical transmission / reception unit, and transmits it to the operation control device 103.
  • the operation control device 103 performs a function of inputting various set values and processes data obtained by the measurement, and displays a cross-sectional image (transverse cross-sectional image and axial cross-sectional image) in the blood vessel. It has the function to do.
  • the cross-sectional image in the transverse direction is a cross-sectional image when the blood vessel is cut in a plane perpendicular to the traveling direction of the blood vessel (the central axis of the blood vessel)
  • the axial sectional image is the traveling direction of the blood vessel ( It is a cross-sectional image when a blood vessel is cut along a plane parallel to the central axis of the blood vessel.
  • the main body control unit 111 In the operation control device 103, the main body control unit 111 generates interference light data by causing interference between the reflected light obtained by measurement and the reference light obtained by separating the light from the light source, and the interference By processing the line data generated based on the optical data, an optical cross-sectional image is generated.
  • the printer and DVD recorder 111-1 prints the processing result in the main body control unit 111 or stores it as data.
  • the operation panel 112 inputs various setting values and instructions from the user.
  • the display device 113 is realized by an LCD monitor, for example, and displays a cross-sectional image generated by the main body control unit 111.
  • the main body control unit 111 includes an input unit (not shown) for inputting an X-ray image (for example, an Angio image) of a patient imaged by an X-ray imaging apparatus (FIG. 3).
  • the diagnostic imaging apparatus 100 uses this X-ray image to acquire catheter travel information (two-dimensional or three-dimensional position information) and blood vessel travel information (two-dimensional or three-dimensional position information). Can do.
  • the probe unit 101 includes a long catheter sheath 201 that is inserted into a blood vessel, and a connector that is disposed on the user's hand side without being inserted into the blood vessel to be operated by the user.
  • Part 202 A guide wire lumen tube 203 constituting a guide wire lumen is provided at the distal end of the catheter sheath 201.
  • the catheter sheath 201 forms a continuous lumen from a connection portion with the guide wire lumen tube 203 to a connection portion with the connector portion 202.
  • a transmission / reception unit 221 in which an optical transmission / reception unit for transmitting and receiving light is arranged, and an optical fiber cable are provided.
  • An imaging core 220 including a coiled drive shaft 222 that transmits a rotational driving force for rotating the optical fiber cable is inserted through the catheter sheath 201 over almost the entire length of the catheter sheath 201. .
  • the connector portion 202 includes a sheath connector 202a configured integrally with the proximal end of the catheter sheath 201, and a drive shaft connector 202b configured by rotatably fixing the drive shaft 222 to the proximal end of the drive shaft 222.
  • a kink protector 211 is provided at the boundary between the sheath connector 202a and the catheter sheath 201. Thereby, predetermined rigidity is maintained, and bending (kink) due to a sudden change in physical properties can be prevented.
  • the base end of the drive shaft connector 202b is detachably attached to the scanner and the pullback unit 102.
  • an imaging core 220 including a housing 223 in which a transmission / reception unit 221 is disposed and a drive shaft 222 is inserted through almost the entire length, thereby forming a probe unit 101.
  • the drive shaft 222 is capable of rotating and axially moving the transmission / reception unit 221 with respect to the catheter sheath 201.
  • the drive shaft 222 is made of a metal wire such as stainless steel that is flexible and capable of transmitting rotation well. It is composed of multiple multilayer close-contact coils.
  • An optical fiber cable (single mode optical fiber cable) is disposed inside.
  • the housing 223 has a shape having a notch in a part of a short cylindrical metal pipe, and is formed by cutting out from a metal lump or MIM (metal powder injection molding). Further, a short coil-shaped elastic member 231 is provided on the tip side.
  • MIM metal powder injection molding
  • the elastic member 231 is a stainless steel wire formed in a coil shape, and the elastic member 231 is arranged on the distal end side to prevent the catheter core 201 from being caught when the imaging core 220 is moved back and forth. .
  • the reinforcing coil 232 is provided for the purpose of preventing sharp bending of the distal end portion of the catheter sheath 201.
  • the guide wire lumen tube 203 has a guide wire lumen into which a guide wire can be inserted.
  • the guide wire lumen tube 203 is used to receive a guide wire previously inserted into a blood vessel and guide the catheter sheath 201 to the affected area with the guide wire.
  • FIG. 3 is a diagram illustrating a functional configuration of an image diagnostic apparatus 100 having an OCT function (here, as an example, SS-OCT) function (optical image diagnostic apparatus using wavelength sweeping). Note that the diagnostic imaging apparatus combining the IVUS function and the other OCT functions also has the same functional configuration, and thus the description thereof is omitted here.
  • OCT function here, as an example, SS-OCT
  • SS-OCT optical image diagnostic apparatus using wavelength sweeping
  • reference numeral 428 denotes a signal processing unit that controls the entire diagnostic imaging apparatus 100, and includes a microprocessor and several other circuits.
  • Reference numeral 210 denotes a non-volatile storage device represented by a hard disk, which stores various programs and data files executed by the signal processing unit 428.
  • Reference numeral 430 denotes a memory (RAM) provided in the signal processing unit 428.
  • a wavelength sweep light source 408 is a light source that repeatedly generates light having a wavelength that changes within a preset range along the time axis.
  • the signal processing unit 428 generates a three-dimensional image of the blood vessel using the generated plurality of optical cross-sectional images and an X-ray image (for example, an Angio image) separately input from the X-ray imaging device 470. can do. Further, the signal processing unit 428 can generate an optical cross-sectional image at the specified position of interest in the three-dimensional image and output the generated image to the display device 113.
  • an X-ray image for example, an Angio image
  • various processes in the signal processing unit 428 and image processing related to a user interface for performing various operations on the diagnostic imaging apparatus 100 are realized by executing a predetermined program in the signal processing unit 428 by a computer.
  • the light output from the wavelength swept light source 408 is incident on one end of the first single mode fiber 271 and transmitted toward the distal end side.
  • the first single mode fiber 271 is optically coupled to the fourth single mode fiber 275 at an intermediate optical fiber coupler 272.
  • the light emitted from the tip side of the optical fiber coupler 272 in the first single mode fiber 271 is guided to the second single mode fiber 273 via the connector 105.
  • the other end of the second single mode fiber 273 is connected to the optical rotary joint 230 in the scanner and pullback unit 102.
  • the probe unit 101 has an adapter 101a for connecting to the scanner and the pullback unit 102. Then, by connecting the probe unit 101 to the scanner and pullback unit 102 by the adapter 101a, the probe unit 101 is stably held by the scanner and pullback unit 102. Furthermore, the end of the third single mode fiber 274 that is rotatably accommodated in the probe unit 101 is connected to the optical rotary joint 230. As a result, the second single mode fiber 273 and the third single mode fiber 274 are optically coupled. At the other end of the third single-mode fiber 274 (the leading portion side of the probe unit 101), an imaging core 220 is provided that mounts a mirror and a lens that emits light in a direction substantially perpendicular to the rotation axis. .
  • the light emitted from the wavelength swept light source 408 passes through the first single mode fiber 271, the second single mode fiber 273, and the third single mode fiber 274 to the end of the third single mode fiber 274. Guided to the provided imaging core 220.
  • the image core 220 emits this light in a direction perpendicular to the axis of the fiber, receives the reflected light, and the received reflected light is led backwards and returned to the operation control device 103.
  • an optical path length adjustment mechanism 250 for finely adjusting the optical path length of the reference light is provided at the opposite end of the fourth single mode fiber 275 coupled to the optical fiber coupler 272.
  • the optical path length varying mechanism 250 is an optical path length changing unit that changes the optical path length corresponding to the variation in length so that the variation in length of each probe unit 101 can be absorbed when the probe unit 101 is replaced. Function. Therefore, a collimating lens 255 located at the end of the fourth single mode fiber 275 is provided on a movable single-axis stage 254 as indicated by an arrow 256 in the optical axis direction.
  • the uniaxial stage 254 functions as an optical path length changing unit having a variable range of the optical path length that can absorb the variation in the optical path length of the probe unit 101. Further, the uniaxial stage 254 also has a function as an adjustment unit for adjusting the offset. For example, even when the tip of the probe unit 101 is not in close contact with the surface of the living tissue, the optical path length is minutely changed by the uniaxial stage so as to interfere with the reflected light from the surface position of the living tissue. Is possible.
  • the optical path length is finely adjusted by the uniaxial stage 254, and the light reflected by the mirror 253 via the grating 251 and the lens 252 is again guided to the fourth single mode fiber 275, and is then reflected by the optical fiber coupler 272.
  • the light obtained from the single mode fiber 271 side is mixed and received by the photodiode 204 as interference light.
  • the interference light received by the photodiode 204 is photoelectrically converted, amplified by the amplifier 205, and then input to the demodulator 206.
  • the demodulator 206 performs demodulation processing for extracting only the signal portion of the interfered light, and its output is input to the A / D converter 207 as an interference light signal.
  • the A / D converter 207 samples the interference light signal for 2048 points at 180 MHz, for example, and generates one line of digital data (interference light data).
  • the sampling frequency of 90 MHz is based on the assumption that about 90% of the wavelength sweep period (12.5 ⁇ sec) is extracted as 2048 digital data when the wavelength sweep repetition frequency is 80 kHz.
  • the present invention is not limited to this.
  • the line-by-line interference light data generated by the A / D converter 207 is input to the signal processing unit 428 and temporarily stored in the memory 430.
  • the interference light data is frequency-resolved by FFT (Fast Fourier Transform) to generate data in the depth direction (line data), and this is coordinate-converted to obtain data at each position in the blood vessel.
  • FFT Fast Fourier Transform
  • An optical cross-sectional image is constructed and output to the display device 113 at a predetermined frame rate.
  • the signal processing unit 428 is further connected to the optical path length adjustment driving unit 209 and the communication unit 208.
  • the signal processing unit 428 controls the position of the uniaxial stage 254 (optical path length control) via the optical path length adjustment driving unit 209.
  • the signal processing unit 428 is connected to the motor control circuit 429 and receives a video synchronization signal from the motor control circuit 429.
  • the signal processing unit 428 generates a cross-sectional image in synchronization with the received video synchronization signal.
  • the video synchronization signal of the motor control circuit 429 is also transmitted to the rotation drive device 240, and the rotation drive device 240 outputs a drive signal synchronized with the video synchronization signal.
  • the communication unit 208 incorporates several drive circuits and communicates with the scanner and the pullback unit 102 under the control of the signal processing unit 428. Specifically, an encoder unit for supplying a drive signal to a radial scanning motor for rotating the third single-mode fiber by an optical rotary joint in the scanner and pull-back unit 102, and detecting a rotational position of the radial motor. Signal reception from 242 and supply of a drive signal to the linear drive unit 243 for pulling the third single mode fiber 274 at a predetermined speed.
  • the above processing in the signal processing unit 428 is also realized by a predetermined program being executed by a computer.
  • a transparent flush solution (usually physiological saline or contrast medium) is supplied into the blood vessel from the probe tip by the user's operation. Release. This is to exclude the influence of blood.
  • the signal processing unit 428 drives the wavelength sweep light source 408 to drive the radial scanning motor 241 and the linear drive unit 243 (hereinafter, the radial scanning motor 241 and the linear drive unit). (Light irradiation and light reception processing by driving 243 is called scanning).
  • the wavelength swept light is supplied from the wavelength swept light source 408 to the imaging core 220 through the path as described above.
  • the imaging core 220 at the distal end position of the probe unit 101 rotates and moves along the rotation axis
  • the imaging core 220 rotates while moving along the blood vessel axis. The light is emitted to the blood vessel lumen surface and the reflected light is received.
  • a display control process is executed in which the synchronization position of the cross-sectional image to be displayed for comparison is input from the X-ray image and cross-sectional image display under the same condition (same position) is enabled.
  • processing described below may be realized using dedicated hardware, or the function of each unit may be realized by software (by a computer executing a program).
  • the signal processing unit 428 includes a control unit 605 that controls various processes of the signal processing unit 428.
  • a control unit 605 Connected to the control unit 605 are a cross-sectional image processing unit 601, an X-ray image analysis processing unit 602, a display frame number determination processing unit 603, a display control unit 604, an X-ray image processing unit 606, and a user interface device 215, respectively. To control the operation.
  • the interference light data generated by the A / D converter 207 is scanned in the line memory unit 601a of the cross-sectional image processing unit 601 using the signal of the encoder unit 242 of the radial scanning motor 241 output from the motor control circuit 429. Processing is performed so that the number of lines per rotation of the motor 241 is a predetermined number (for example, 512).
  • the cross-sectional image processing unit 601 performs line addition averaging processing, filter processing, logarithmic conversion processing, and the like on the interference light data, and stores line data that is interference light intensity data in the depth direction of the living tissue on the line memory unit 601a. Generate. Further, the cross-sectional image processing unit 601 performs contrast adjustment, brightness adjustment, gamma correction, frame correlation, sharpness processing, and the like on the generated line data, and converts the cross-sectional image data into a polar coordinate line data string by R ⁇ conversion. Generate. In this embodiment, as an example, a blood vessel cross-sectional image is generated from 512 lines. However, the number of lines is not limited to this.
  • the X-ray image processing unit 606 extracts a vertical synchronization signal from the X-ray image data input from the X-ray imaging device 470, and executes X-ray image data capturing control in synchronization with the rotation period signal of the radial scanning motor 241. .
  • the X-ray image processing unit 606 stores the acquired X-ray image data in the line memory unit 601a.
  • the X-ray image data may include X-ray image data (a front image and a side image of a patient) captured from a plurality of angles, and three-dimensional X-ray image data may be constructed from these. Furthermore, it may be X-ray image data of a moving image.
  • the X-ray image analysis processing unit 602 detects the travel position of the probe unit 101 of the catheter from the X-ray image data stored in the line memory unit 601a.
  • the probe unit 101 exists in the X-ray image displayed on the user interface device 215 at the position closest to the position (observation target site) specified by the display position specifying unit 611.
  • the number of frames of the blood vessel cross-sectional image to be calculated is calculated, and the number of frames of X image data synchronized with the calculated blood vessel cross-sectional image is also calculated at the same time.
  • the X-ray image data in which the probe unit 101 exists is detected using the X-ray opaque marker of the probe unit 101.
  • the X-ray opaque marker a portion where the position of the probe unit 101 such as the tip portion of the drive shaft 222 can be specified can be used.
  • the designation of the position (observation target site) is performed only for one of the X-ray images before and after the treatment, and the corresponding other blood vessel
  • the number of frames of the cross-sectional image and the X-ray image is calculated from information on the observation attention site that has already been specified.
  • an instruction of the observation attention site is received for each of the X-ray images before and after the treatment.
  • the “arm angle” refers to the incident angle of X-rays by the X-ray imaging apparatus.
  • the C-arm is rotated around the body axis of the subject counterclockwise as viewed from the head side of the subject with respect to the direction and direction of the rotation axis. This is referred to as “LAO” (left anterior oblique), and conversely turning clockwise is referred to as “RAO” (right anterior oblique).
  • the C-arm turning the C-arm around the axis perpendicular to the body axis of the subject to the head side of the subject is referred to as “Cranial” (head-to-tail direction) and conversely turning to the foot side. It is called “Caudial” (caudal direction), and the arm angle is defined by these. If either RAO or LAO or “Cranial and Caudal” is selected, the arm angle can be defined in the form of “RAORA30 ° + caudal 20 °”, for example.
  • the determination as to whether the arm angles are the same is performed as follows.
  • the arm angle is numerically displayed on the Angio screen.
  • the position on the screen where the arm angle is described is detected (or the range is specified in advance), and the character string indicating the direction and the number of the angle are recognized by image processing (for example, pattern matching), and the character string If the combination of numbers is the same, the angle is recognized as the same angle before and after treatment, and if the numbers are different, the angle is recognized as a different angle.
  • the cross-sectional image data acquired before and after the treatment are appropriately stored in the image storage unit 602a.
  • the display frame number determination processing unit 603 calculates the number of frames of the cross-sectional image data corresponding to the number of frames of the X-ray image data calculated in the X-ray image data before and after the treatment. This is because the number of frames in the X-ray image data and the number of frames in the cross-sectional image data are calculated, so that the display frame number determination processing unit 603 performs a sampling rate between the X-ray imaging apparatus 470 and the image diagnostic apparatus 100. This is to absorb the difference. Therefore, the display frame number determination processing unit 603, as necessary, at least one of the X-ray image data and the cross-sectional image data so that the number of frames is the same between the X-ray imaging apparatus 470 and the image diagnostic apparatus 100. , A process of generating an interpolated frame using adjacent frames is executed.
  • the display control unit 604 displays at least two cross-sectional images (for example, cross-sectional images before and after treatment) on the cross-sectional image display unit 610 of the user interface device 215. Further, X-ray images corresponding to the two cross-sectional images are displayed on the X-ray image display unit 607. As described above, the display control unit 604 can display the cross-sectional image data before and after the treatment and the corresponding X-ray image data before and after the treatment so that they can be compared in the same screen.
  • the cross-sectional image processing unit 601 generates line data and directly processes it, but the present invention is not limited to this.
  • the line data generated by the cross-sectional image processing unit 601 may be separately stored in a file unit in association with predetermined patient attribute information and measurement condition information in a storage unit (not shown).
  • the cross-sectional image processing unit 601 performs the above process by reading line data from the storage unit based on an instruction from the user.
  • this storage unit may be provided in the control unit 605 or may be provided outside the signal processing unit 428 (for example, the DVD recorder 111-1 may function as a storage unit).
  • the line memory unit 601a of the cross-sectional image processing unit 601 may function as a storage unit.
  • the user interface device 215 is provided with a display position designation unit 611, and an X-ray image displayed on the X-ray image display unit 607 is used to display the position of a cross-sectional image to be displayed as a diagnosis target on the cross-sectional image display unit 610. Can be specified.
  • Information regarding the position specified by the display position specifying unit 611 is input to the control unit 605 and transmitted to the X-ray image analysis processing unit 602.
  • the display control unit 604 reads cross-sectional image data corresponding to the position specified by the display position specifying unit 611 from the image storage unit 602a.
  • the display control unit 604 reads the cross-sectional image data at the designated position from the image storage unit 602a and displays it on the cross-sectional image display unit 610 of the user interface device 215.
  • FIG. 5 is a diagram illustrating an example of a user interface 500 displayed on the display device 113.
  • the user interface 500 is realized by the user interface device 215 shown in FIG.
  • the user interface 500 includes a cross-sectional image display area 510 that displays a cross-sectional image (cross-sectional cross section) generated by the signal processing unit 428, and an X-ray image display area 520 that displays an X-ray image.
  • the user interface 500 includes an operation area 530 for performing various operations on the cross-sectional image and the X-ray image displayed in the cross-sectional image display area 510 and the X-ray image display area 520, respectively.
  • the cross-sectional image display area 510 displays, for example, a pre-treatment cross-sectional image display area 511 for displaying a pre-treatment image (first cross-sectional image) and a post-treatment image (second cross-sectional image) as two types of diagnosis target images.
  • the post-treatment cross-sectional image display area 512 to be displayed is displayed.
  • the cross-sectional image displayed in the cross-sectional image display area 510 is generated based on the OCT cross-sectional image (optical cross-sectional image) generated using the OCT function in the case of the diagnostic imaging apparatus 100 illustrated in FIG. Use things.
  • the cross-sectional image display area 510 is configured to display a cross-sectional cross-sectional image.
  • an axial cross-sectional image generated based on a plurality of OCT cross-sectional images is displayed in the cross-sectional image display area 510. You may make it do.
  • the X-ray image display area 520 displays, for example, a pre-treatment X-ray image display area (first X-ray image) captured by the X-ray imaging apparatus 470 as two types of diagnosis target images. 521 and a post-treatment X-ray image area 522 for displaying a post-treatment X-ray image (second X-ray image).
  • a pre-treatment X-ray image display area first X-ray image
  • second X-ray image for displaying a post-treatment X-ray image
  • an arbitrary position on the X-ray image displayed in at least one of the pre-treatment X-ray image display area 521 and the post-treatment X-ray image area 522 can be designated by the instruction marker 523. it can.
  • a pre-treatment cross-sectional image and a post-treatment cross-sectional image corresponding to the position designated by the indication marker 523 are displayed in the pre-treatment cross-sectional image display region 511 and the post-treatment cross-sectional image display region 512, respectively.
  • the designation of the position by the instruction marker 523 is based on the designation of the position in one area of the pre-treatment X-ray image display area 521 or the post-treatment X-ray image area 522, and the corresponding position in the other area. It may be automatically detected and designated. Or you may make it designate separately the position which a user judges as the same position in each area
  • the cross-sectional image corresponding to the position designated on the X-ray image is read and displayed.
  • a three-dimensional image of a blood vessel may be generated using a plurality of generated cross-sectional images and an X-ray image (for example, an Angio image) separately input from the X-ray imaging device 470.
  • the indication marker 523 is defined horizontally with respect to the X-ray image in which the line segment passing through the tip is displayed, and the pre-treatment cross-sectional image cut out from the three-dimensional image by the horizontal line segment And it is good also as a structure which displays a cross-sectional image after a treatment.
  • the cross-sectional image is cut out and displayed vertically (90 degrees) from the designated position of the three-dimensional image.
  • the direction of the indication marker 523 may be rotated 360 degrees, and a pre-treatment cross-sectional image and a post-treatment cross-sectional image cut out from a three-dimensional image at an angle determined according to the direction may be displayed.
  • the operation area 530 includes an X-ray image operation area 550 for operating the X-ray image in the X-ray image display area 520. Further, the operation area 530 includes an image reproduction operation area 560 for continuously displaying (reproducing) each cross-sectional image in the cross-sectional image display area 510.
  • a position designation button 551 for displaying an instruction marker 523 in the X-ray image display area 520 is arranged.
  • an instruction marker 523 is displayed in the X-ray image display area 520.
  • the user uses an operation device such as a mouse or a trackball on the operation panel 112 to position the instruction marker 523 at any position in at least one of the pre-treatment X-ray image display area 521 and the post-treatment X-ray image display area 522. Move to.
  • the pre-treatment cross-sectional image and the post-treatment cross-sectional image corresponding to the position indicated by the indication marker 523 are displayed in the pre-treatment cross-sectional image display region 511 and the post-treatment cross-sectional image display region 512 of the cross-sectional image display region 510, respectively. Is possible.
  • a rewind button 561, a stop button 562, and a playback button 563 are arranged.
  • the rewind button 561 is pressed, the cross-sectional images displayed in the cross-sectional image display area 510 are sequentially switched to cross-sectional images having an old generation order. That is, the cross-sectional images when proceeding in the direction opposite to the axial direction in the blood vessel are continuously displayed.
  • the indication marker 523 corresponds to the left direction of the user interface 500 in synchronization with the display switching of the cross-sectional cross-sectional image.
  • the indication line indicating the position moves to the position where the movement is to be performed.
  • the cross-sectional images displayed in the cross-sectional image display area 510 are sequentially switched to new cross-sectional images in the generation order at the specified playback rate. That is, the cross-sectional images when proceeding in the axial direction are continuously displayed.
  • the indication marker 523 is displayed in the right direction of the user interface 500 in synchronization with the display switching of the cross-sectional cross-sectional image. The indication line indicating the position moves to the position where the movement is to be performed.
  • FIG. 6A and 6B are flowcharts showing details of display control processing in the signal processing unit 428 of the diagnostic imaging apparatus 100.
  • FIG. This processing may be executed in parallel during diagnosis by the image diagnostic apparatus 100, for example. Or you may perform according to the execution instruction input from the user interface apparatus 215 at arbitrary timings.
  • the line memory unit 601a stores at least two diagnosed blood vessel cross-sectional image groups and corresponding X-ray images for each diagnosis.
  • step S701a with the X-ray imaging apparatus 470 connected to the image diagnostic apparatus 100 before or immediately after the treatment, the X-ray image processing unit 606 displays the X-ray image of the diagnosis target part of the patient on the X-ray imaging apparatus 470. Get in.
  • step S701b the cross-sectional image processing unit 601 generates a blood vessel cross-sectional image.
  • step S701c the acquired X-ray image is associated with the acquired blood vessel cross-sectional image and stored in the line memory unit 601a as diagnostic information.
  • step S702a with the X-ray imaging apparatus 470 connected to the image diagnostic apparatus 100 immediately after treatment or at a later date, the X-ray image processing unit 606 displays an X-ray image of the diagnosis target part of the patient as an X-ray image. Obtained by the line imaging device 470.
  • step S702b the cross-sectional image processing unit 601 generates a blood vessel cross-sectional image.
  • step S702c in one diagnosis operation, a series of X-ray images acquired together with a series of sequentially acquired blood vessel cross-sectional images are associated with each other and stored as diagnostic information in a storage medium (line memory unit 601a).
  • the frame rates of images processed by the X-ray imaging apparatus 470 and the diagnostic imaging apparatus 100 are synchronized and can be matched.
  • the sampling rate of the diagnostic imaging apparatus 100 is higher than the sampling rate of the X-ray imaging apparatus 470.
  • the X-ray imaging apparatus 470 may have a sampling rate that can grasp the running state of the catheter and the running state of the blood vessel, the sampling rates of the two do not necessarily match. Therefore, if necessary, the sampling rate of the diagnostic imaging apparatus 100 may be down-sampled so as to match the sampling rate of the X-ray imaging apparatus 470.
  • the signal processing unit 428 selects a cross-sectional image, which is diagnostic information to be compared, based on an instruction from the user interface device 215. This selection is made via an image selection screen displayed on the display device 113.
  • the image selection screen includes, for example, a list of representative cross-sectional images and corresponding representative X-ray images included in the diagnosis information in each diagnosis, arranged in time series and for each diagnosis.
  • the user can select at least two cross-sectional images to be compared from the list on the image selection screen via the operation panel 112.
  • An X-ray image corresponding to each selected cross-sectional image is also selected.
  • a corresponding X-ray image may be selected instead of the cross-sectional image to determine the cross-sectional image to be compared.
  • step S704 the display control unit 604 selects the selected cross-sectional images to be compared (for example, representative cross-sectional images of the pre-treatment cross-sectional image and the post-treatment cross-sectional image) and X-ray images (representative X-ray images) corresponding to the respective cross-sectional images.
  • the representative cross-sectional image and the representative X-ray image may be an arbitrary frame belonging to a series of input cross-sectional images and a series of X-ray images in one diagnosis, but in the initial state, for example, a series of cross-sectional images and a series of X-ray images. Let the first frame of each X-ray image be a representative cross-sectional image and a representative X-ray image.
  • step S705 the display position designating unit 611 displays at least one of the two X-ray images displayed on the display device 113 based on the operation (user input) of the pointing marker 523 (FIG. 5). Specify the observation target region at.
  • the X-ray image analysis processing unit 602 determines whether the imaging parameters at the time of imaging of the two X-ray images displayed on the display device 113 are the same.
  • the imaging parameters are imaging conditions such as an X-ray image arm angle and an imaging direction, for example.
  • the imaging parameters are the same, the two X-ray images are regarded as X-ray images under the same imaging condition, and the position of the observation target region is designated in one X-ray image. The corresponding position on the other X-ray image is automatically designated as the position of the other observation target region.
  • step S706 If the imaging parameters of the X-ray image are the same as a result of the determination (YES in step S706), the process proceeds to step S708.
  • step S707 the display position designation unit 611 is displayed on the display device 113 based on the operation of the instruction marker 523 (FIG. 5).
  • the observation target region in the other X-ray image is designated.
  • a message screen (not shown) indicating that the imaging parameters of the X-ray image are not the same can be displayed, and the user can be prompted to specify the observation target region in the other X-ray image.
  • step S708 for each of the X-ray images before and after treatment, the X-ray image analysis processing unit 602 performs a frame from the frame corresponding to the designated observation target region to the frame where the X-ray opaque marker of the nearest probe exists. Detect numbers. By detecting a frame in which the X-ray opaque marker (landmark) of this probe exists, the cross-sectional image before and after the treatment at the specified position (same position) in the blood vessel and the frame of the X-ray image are detected and displayed. It becomes possible.
  • step S709 the display frame number determination processing unit 603 calculates the number of frames of the cross-sectional image data corresponding to the number of frames of the X-ray image data detected in each of the X-ray images before and after the treatment.
  • step S710 the display control unit 604 detects and updates the display frames of the X-ray image and the cross-sectional image before and after treatment by detecting and updating the frames detected or calculated in the respective images. Redisplay on.
  • step S711 when the playback button 563 is pressed, the display control unit 604 executes a synchronous display process in which the currently displayed X-ray images before and after the treatment and the cross-sectional images are displayed in synchronization.
  • the cross-sectional images corresponding to the respective positions on the travel locus are arranged around the center of gravity of the catheter travel locus image detected from the X-ray image.
  • a dimensional image can be constructed. That is, the signal processing unit 428 can generate a three-dimensional image that reproduces the traveling state of the blood vessel by arranging the cross-sectional image data along the traveling locus. When such a three-dimensional image is constructed, the signal processing unit 428 designates the three-dimensional image data before and after the two treatments (the first three-dimensional image and the second three-dimensional image).
  • two two-dimensional images Data (first reconstructed cross-sectional image and second reconstructed cross-sectional image) can be reconstructed.
  • the display control unit 604 displays the reconstructed two-dimensional image data (first reconstructed cross-sectional image and second reconstructed cross-sectional image) according to the position specified by the display position specifying unit 611. Can be displayed in parallel on the display device 113. In FIG. 5, two different cross-sectional images are displayed in parallel so that they can be compared, but the same display control may be performed for three or more cross-sectional images.
  • the signal processing unit 428 can generate a reconstructed cross-sectional image according to the designated angle.
  • the play button 563 is pressed, the signal processing unit 428 sequentially cuts out the cross-sectional images from the three-dimensional image at the designated angle at the designated position at the designated reproduction rate. Can be displayed on the display device 113.
  • the cross-sectional images to be compared can be compared and displayed under the same conditions with a simple operation.

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Abstract

Selon l'invention, une série d'images radiologiques qui ont été entrées et une série d'images de coupe transversale qui ont été acquises sont associées les unes aux autres et sont mémorisées en tant qu'informations de diagnostic. À partir desdites informations de diagnostic, deux éléments d'informations de diagnostic comprenant des premières informations de diagnostic et des secondes informations de diagnostic sont sélectionnés. Soit une première image de coupe transversale représentative et une première image radiologique représentative correspondant à cette dernière, qui sont comprises dans les premières informations de diagnostic sélectionnées, soit une seconde image de coupe transversale représentative et une seconde image radiologique représentative correspondant à cette dernière, qui sont comprises dans les secondes informations de diagnostic sélectionnées, sont affichées. Dans la première image radiologique représentative et la seconde image radiologique représentative affichées, la position d'un site de point d'observation est désignée. Des trames correspondant à la position désignée dans un vaisseau sanguin sont détectées à partir de chacune de la série d'images de coupe transversale comprenant la première image de coupe transversale représentative, de la série d'images radiologiques comprenant la première image radiologique représentative, de la série d'images de coupe transversale comprenant la seconde image de coupe transversale représentative, et de la série d'images radiologiques comprenant la seconde image radiologique représentative. Un affichage comparatif de la première image de coupe transversale représentative, de la seconde image de coupe transversale représentative, de la première image radiologique représentative et de la seconde image radiologique représentative est affiché par les trames correspondantes qui ont été détectées.
PCT/JP2013/005779 2013-09-27 2013-09-27 Dispositif de diagnostic d'image et son procédé de commande WO2015044982A1 (fr)

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US10631718B2 (en) 2015-08-31 2020-04-28 Gentuity, Llc Imaging system includes imaging probe and delivery devices
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