WO2015044983A1 - 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
WO2015044983A1
WO2015044983A1 PCT/JP2013/005782 JP2013005782W WO2015044983A1 WO 2015044983 A1 WO2015044983 A1 WO 2015044983A1 JP 2013005782 W JP2013005782 W JP 2013005782W WO 2015044983 A1 WO2015044983 A1 WO 2015044983A1
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WIPO (PCT)
Prior art keywords
image
cross
catheter
sectional
unit
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PCT/JP2013/005782
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English (en)
Japanese (ja)
Inventor
淳也 古市
耕一 井上
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テルモ株式会社
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Priority to PCT/JP2013/005782 priority Critical patent/WO2015044983A1/fr
Priority to JP2015538639A priority patent/JP6284944B2/ja
Publication of WO2015044983A1 publication Critical patent/WO2015044983A1/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
    • 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
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • 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
    • A61B8/42—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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display

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 a wave signal such as ultrasonic waves or light.
  • OCT Optical Coherence Tomography
  • IVUS IntraVascular Ultra Sound
  • SS-OCT Swept-source Optical coherence Tomography
  • diagnostic imaging apparatuses are used when determining the necessity of treatment of an intravascular target site from information (for example, stenosis rate) obtained by the apparatus, or, for example, the adhesion rate of a stent to a blood vessel immediately after treatment. Used for confirmation of procedures such as evaluation.
  • restenosis can be evaluated by acquiring a cross-sectional image of the treated site using a diagnostic imaging device after a certain period of time after treatment.
  • the pre-treatment and post-treatment cross-sectional images for the treatment target region are displayed side by side, and the display of the cross-sectional images reproduced synchronously prevents a doctor's judgment error and the like, and Shortening of procedure time is also expected.
  • 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 diagnostic imaging apparatus acquires information on a vascular tissue that intersects with a scanning line (for example, an ultrasonic wave or near-infrared light) irradiated from a probe while rotating in the longitudinal direction of the blood vessel, and the blood vessel acquired in one rotation
  • the tissue information is displayed as a cross-sectional image. That is, in principle, the cross-sectional image is merely a visualization of vascular tissue information existing on the trajectory of the spiral motion drawn by the intersection of the scanning line and the vascular tissue (FIG. 8). Further, since the direction of the scanning line irradiated from the probe depends on the position and angle of the probe in the blood vessel, the scanning line does not necessarily run perpendicular to the blood vessel (FIG. 8).
  • the acquired cross-sectional images cannot necessarily compare tomographic images of the same cross section depending on the position and angle of the probe at the time of image acquisition. Absent.
  • doctors are required to confirm changes before and after treatment on the same section and use them for diagnosis.
  • an object of the present invention is to provide an image diagnostic technique that can process a plurality of images acquired in different measurement states as diagnostic images of the same scale.
  • an image diagnostic apparatus comprises the following arrangement. That is, An image diagnostic apparatus for generating a diagnostic image, An input means for inputting an X-ray image including the catheter inserted into the blood vessel in a catheter for acquiring a cross-sectional image of the blood vessel;
  • the catheter has a transmission / reception unit for transmitting / receiving a wave signal, and acquisition means for sequentially acquiring the wave signal received by the transmission / reception unit at a predetermined sampling rate; From the X-ray image input by the input means, detection means for detecting the placement state of the catheter and the position of the transmission / reception unit;
  • Generating means for generating a three-dimensional image.
  • an image diagnostic technique capable of processing a plurality of images acquired in different measurement states as diagnostic images of the same scale.
  • 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 transmission / reception unit that is directly inserted 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 can acquire catheter position information (three-dimensional position information) and blood vessel position information (three-dimensional position information) using the X-ray image.
  • 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. Further, an imaging core 220 including a coiled drive shaft 222 that transmits a rotational driving force for rotating the optical fiber cable is inserted into the lumen of the catheter sheath 201 over almost the entire length of the catheter sheath 201. Yes.
  • 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 in the probe unit 101 moves along the rotation axis while rotating. Therefore, the imaging core 220 rotates while moving along the blood vessel axis. The light is emitted to the cavity surface and the reflected light is received.
  • the diagnostic imaging apparatus 100 generates volume data from cross-sectional image data groups (A-Line data groups) sequentially acquired in consideration of the spiral motion, and constructs a three-dimensional image.
  • A-Line data groups cross-sectional image data groups sequentially acquired in consideration of the spiral motion.
  • the diagnostic imaging apparatus 100 converts the position into coordinates on the three-dimensional image, and is arbitrarily specified for the blood vessel in the vicinity of the converted coordinates.
  • Luminance data existing on a surface in a direction (for example, a vertical direction) is calculated.
  • the diagnostic imaging apparatus 100 regenerates a two-dimensional image (cross-sectional image) on which the luminance data is projected and displays it on the display device 113.
  • each unit may be realized by software installed in a general-purpose computer based on data obtained by the diagnostic imaging apparatus (by the computer executing a program).
  • the signal processing unit 428 includes a control unit 605 that controls various processes of the signal processing unit 428.
  • the control unit 605 is connected with a cross-sectional image processing unit 601, a three-dimensional image construction unit 602, a display position extraction unit 603, a display control unit 604, an X-ray image processing unit 606, and a user interface device 215, and performs each operation. Control.
  • 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 three-dimensional image construction unit 602 detects the position of the probe unit 101 of the catheter from the X-ray image data stored in the line memory unit 601a, and generates cross-sectional image data using the position of the probe unit 101 as the center of the image. Volume data is generated by arranging In this embodiment, in order to compare and display the cross-sectional images before and after the treatment, the cross-sectional image data acquired before and after the treatment are appropriately stored in the image storage unit 602a.
  • the X-ray image display unit 607 in the X-ray image displayed on the user interface device 215, the X-ray image in which the X-ray opaque marker of the probe unit 101 is closest to the position specified by the display position specifying unit 611. The number of frames is calculated, and the number of frames of cross-sectional image data synchronized with the number of frames is calculated. In addition, the part which can pinpoint the position of the probe part 101, such as the front-end
  • the display position extraction unit 603 sets an arbitrary surface with respect to the direction of the specific blood vessel wall from the calculated coordinates, and reconstructs the cross-sectional image data existing on the surface using a volume rendering technique.
  • the display control unit 604 displays the reconstructed cross-sectional image on the cross-sectional image display unit 610 of the user interface device 215.
  • the display control unit 604 can display the cross-sectional image data before and after the treatment reconstructed at different timings and the 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 display position extracting unit 603.
  • the display position extraction unit 603 extracts cross-sectional image data corresponding to the position designated by the display position designation unit 611 from the image storage unit 602a from the three-dimensional image.
  • the display position extraction unit 603 displays the cross-sectional image data at the specified position extracted from the image storage unit 602a 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 a pre-treatment cross-sectional image display area 511 for displaying a pre-treatment image and a post-treatment cross-sectional image display area 512 for displaying a post-treatment image as two types of diagnosis target images. Note that 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.
  • 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 includes a pre-treatment X-ray image display area 521 that displays, for example, a pre-treatment X-ray image (first X-ray image) captured by the X-ray imaging device 470 as two types of diagnosis target images.
  • a post-treatment X-ray image area 522 for displaying a post-treatment X-ray image (second X-ray image) is displayed.
  • 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. .
  • a pre-treatment cross-sectional image and a post-treatment cross-sectional image cut out from the three-dimensional image at the position specified by the indication marker 523 are respectively displayed in the pre-treatment cross-sectional image display region 511 and the post-treatment cross-sectional image display region 512. Is displayed.
  • 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 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 section cut out from the three-dimensional image by the horizontal line segment.
  • An image and a cross-sectional image after treatment are displayed.
  • the cross-sectional image is cut out and displayed vertically (90 degrees) from the specified position of the three-dimensional image, but the present invention is not limited to this.
  • 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.
  • This processing is performed in order to grasp the blood vessel cross-sectional image group arranged in chronological order acquired from the catheter (probe unit 101) of the diagnostic imaging apparatus 100 and the traveling state (running locus) of the catheter and blood vessels by the X-ray imaging device 470.
  • a three-dimensional image of the blood vessel is generated using the X-ray image. More specifically, a blood vessel cross-sectional image group is arranged in a direction perpendicular to the central axis of the catheter in the running direction of the catheter to generate a three-dimensional image of the blood vessel.
  • FIG. 6 is a flowchart showing details of image generation processing in the signal processing unit 428 of the diagnostic imaging apparatus 100. This process 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. In this case, it goes without saying that the line memory unit 601a stores at least a blood vessel cross-sectional image group and a corresponding X-ray image for one diagnosis, which are to be processed.
  • step S701 in a state where the X-ray imaging apparatus 470 is connected to the image diagnostic apparatus 100, the X-ray image processing unit 606 acquires an X-ray image of the diagnosis target part of the patient with the X-ray imaging apparatus 470, and a cross-sectional image.
  • the processing unit 601a generates a blood vessel cross-sectional image. Note that the frame rates of the images processed by the X-ray imaging apparatus 470 and the diagnostic imaging apparatus 100 are synchronized and can be matched. However, generally, 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 arrangement state of the catheter and the arrangement 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.
  • step S702 the X-ray image processing unit 606 detects the arrangement state (catheter position information) of the catheter from the acquired X-ray image.
  • the arrangement state catheter position information
  • three-dimensional positional information can be detected as an arrangement
  • step S703 the X-ray image processing unit 606 detects a blood vessel arrangement state (blood vessel position information) from the acquired X-ray image.
  • a blood vessel arrangement state blood vessel position information
  • three-dimensional positional information can be detected as an arrangement
  • step S704 the three-dimensional image construction unit 602 sets the catheter trajectory indicated by the placement state of the catheter as the center of gravity of the three-dimensional image data, and arranges each cross-sectional image data in a direction perpendicular to the catheter trajectory from the center of gravity. , Construct 3D image data of blood vessels.
  • FIG. 7 an example of a three-dimensional image is shown in FIG.
  • FIG. 7 a three-dimensional image is constructed in which cross-sectional images 800a to 800e corresponding to the positions on the trajectory are arranged around the center of gravity of the trajectory image 801 of the catheter.
  • a three-dimensional image reproducing the arrangement state of the blood vessel can be generated.
  • step S705 the three-dimensional image construction unit 602 compares the cross-sectional image data to be compared with the three-dimensional image data (first three-dimensional image) constructed in step S704. 2nd 3D image) is constructed.
  • the X-ray image display unit 607 becomes at least a reference position for cutting out the cross-sectional image data from the two constructed three-dimensional image data (the first three-dimensional image and the second three-dimensional image).
  • the landmark positions of one landmark are designated respectively.
  • a feature point for example, a branch of a blood vessel
  • the three-dimensional image data may be extracted by image analysis and automatically specified as a landmark position.
  • step S707 the display position extraction unit 603 performs the specified landmark (the first landmark and the second landmark) on the two three-dimensional image data (the first three-dimensional image and the second three-dimensional image).
  • the data of the position (for example, vertical in the figure) in an arbitrary direction designated with respect to the blood vessel traveling indicated by the blood vessel position information is resampled at equal intervals from the landmark.
  • the display position extraction unit 603 reconstructs two two-dimensional image data (a first reconstructed cross-sectional image and a second reconstructed cross-sectional image).
  • step S708 the display control unit 604 places the reconstructed two-dimensional image data (first reconstructed cross-sectional image and second reconstructed cross-sectional image) at the position specified by the display position specifying unit 611. In response, the images are displayed in parallel on the display device 113. At this time, as described with reference to FIG. 5, the display control unit 604 may display corresponding three-dimensional image data (first three-dimensional image and second three-dimensional image) 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 display position extraction unit 603 when an angle is designated by the direction of the indication marker 523, the display position extraction unit 603 generates a reconstructed cross-sectional image according to the designated angle.
  • the play button 563 When the play button 563 is pressed, the cross-sectional images are sequentially cut out from the three-dimensional image at the designated angle at the designated position and displayed on the display device at the designated reproduction rate. .
  • an X-ray image captured by an X-ray imaging apparatus (an arrangement state of the catheter and the blood vessel (the catheter) By using the trajectory)), it is possible to construct a three-dimensional image of blood vessels composed of cross-sectional images in the original blood vessel arrangement state.

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Abstract

L'invention concerne un cathéter dans lequel, pour acquérir des images transversales d'un vaisseau sanguin, une image radiologique, qui comprend le cathéter introduit dans le vaisseau sanguin, est saisie. Le cathéter comprend une unité d'émission/réception pour émettre/recevoir des signaux d'onde et acquiert successivement, à un taux d'échantillonnage prédéterminé, les signaux d'onde reçus avec l'unité d'émission/réception. À partir de l'image radiologique qui a été saisie, l'état d'agencement du cathéter et la position de l'unité d'émission/réception sont détectés. Une image tridimensionnelle du vaisseau sanguin est créée en alignant les images transversales acquises successivement à des emplacements correspondant au trajet pris par l'unité d'émission/réception, qui est indiqué par l'état d'agencement détecté du cathéter, et perpendiculairement audit trajet.
PCT/JP2013/005782 2013-09-27 2013-09-27 Dispositif de diagnostic d'image et son procédé de commande WO2015044983A1 (fr)

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WO2021200295A1 (fr) * 2020-03-31 2021-10-07 テルモ株式会社 Dispositif de traitement d'image, système de traitement d'image, procédé d'affichage d'image et programme de traitement d'image
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US11278206B2 (en) 2015-04-16 2022-03-22 Gentuity, Llc Micro-optic probes for neurology
US10631718B2 (en) 2015-08-31 2020-04-28 Gentuity, Llc Imaging system includes imaging probe and delivery devices
US11064873B2 (en) 2015-08-31 2021-07-20 Gentuity, Llc Imaging system includes imaging probe and delivery devices
US11583172B2 (en) 2015-08-31 2023-02-21 Gentuity, Llc Imaging system includes imaging probe and delivery devices
US11937786B2 (en) 2015-08-31 2024-03-26 Gentuity, Llc Imaging system includes imaging probe and delivery devices
JP2019522529A (ja) * 2016-06-22 2019-08-15 エスワイエヌシー−アールエックス、リミテッド 内腔に沿った管腔内デバイスの管腔内経路の推定
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JP2020500665A (ja) * 2017-06-30 2020-01-16 シェンチェン ユニバーシティー 冠状血管３次元再構築の方法、装置、設備及び記憶媒体
US11684242B2 (en) 2017-11-28 2023-06-27 Gentuity, Llc Imaging system
WO2021200295A1 (fr) * 2020-03-31 2021-10-07 テルモ株式会社 Dispositif de traitement d'image, système de traitement d'image, procédé d'affichage d'image et programme de traitement d'image

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