WO2018129737A1 - 超声图像中参数测量的方法和超声成像系统 - Google Patents

超声图像中参数测量的方法和超声成像系统 Download PDF

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Publication number
WO2018129737A1
WO2018129737A1 PCT/CN2017/071277 CN2017071277W WO2018129737A1 WO 2018129737 A1 WO2018129737 A1 WO 2018129737A1 CN 2017071277 W CN2017071277 W CN 2017071277W WO 2018129737 A1 WO2018129737 A1 WO 2018129737A1
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Prior art keywords
measurement
pubic symphysis
ultrasound image
image
ultrasound
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PCT/CN2017/071277
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English (en)
French (fr)
Inventor
王慧芳
赖勇铨
邹耀贤
林穆清
陈志杰
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Shenzhen Mindray Bio Medical Electronics Co Ltd
Shenzhen Second Peoples Hospital
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Shenzhen Mindray Bio Medical Electronics Co Ltd
Shenzhen Second Peoples Hospital
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Application filed by Shenzhen Mindray Bio Medical Electronics Co Ltd, Shenzhen Second Peoples Hospital filed Critical Shenzhen Mindray Bio Medical Electronics Co Ltd
Priority to CN201780079237.5A priority Critical patent/CN110177504B/zh
Priority to CN202111217743.0A priority patent/CN114343715B/zh
Priority to US16/478,094 priority patent/US11826194B2/en
Priority to PCT/CN2017/071277 priority patent/WO2018129737A1/zh
Priority to CN202111217742.6A priority patent/CN114027880B/zh
Publication of WO2018129737A1 publication Critical patent/WO2018129737A1/zh
Anticipated expiration legal-status Critical
Priority to US17/544,203 priority patent/US12150808B2/en
Priority to US17/544,276 priority patent/US11744540B2/en
Priority to US17/544,330 priority patent/US11744541B2/en
Priority to US18/244,220 priority patent/US12318246B2/en
Priority to US19/212,391 priority patent/US20250275746A1/en
Priority to US19/212,330 priority patent/US20250281149A1/en
Priority to US19/212,431 priority patent/US20250281150A1/en
Ceased legal-status Critical Current

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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
    • A61B8/08—Clinical applications
    • A61B8/0833—Clinical applications involving detecting or locating foreign bodies or organic structures
    • A61B8/085—Clinical applications involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A61B5/7267—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems involving training the classification device
    • 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
    • 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
    • A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/48—Diagnostic techniques
    • A61B8/483—Diagnostic techniques involving the acquisition of a 3D volume of data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/48—Diagnostic techniques
    • A61B8/485—Diagnostic techniques involving measuring strain or elastic properties
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/48—Diagnostic techniques
    • A61B8/486—Diagnostic techniques involving arbitrary m-mode
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/48—Diagnostic techniques
    • A61B8/488—Diagnostic techniques involving Doppler signals

Definitions

  • the present invention relates to an ultrasound imaging apparatus, and more particularly to a method and system for performing parameter measurements in an ultrasound imaging image.
  • the ultrasound imaging apparatus is used to image the interior of the target tissue and to make measurements on the images obtained by the ultrasound imaging based on the characteristics of some medical parameters, thereby enabling the physician to obtain the actual anatomical structural parameters of the target tissue of the patient being tested.
  • Pelvic Floor Ultrasound refers to a discipline that scans the female pelvic floor with medical ultrasound equipment and plays an important role in the diagnosis of gynecological urology and other pelvic floor dysfunction.
  • PFU has the advantages of low cost, non-invasive, convenient and quick inspection, and gradually becomes the main means to diagnose female pelvic floor dysfunction.
  • a method of parameter measurement in an ultrasound image comprising:
  • an ultrasound image comprising target tissue, the ultrasound image obtained by receiving an ultrasound signal from a target tissue using an ultrasound probe;
  • the calculation result is output.
  • an ultrasound imaging system that includes:
  • a transmitting circuit and a receiving circuit configured to excite the probe to emit an ultrasonic beam to the target tissue, receive an ultrasonic echo of the ultrasonic beam, and obtain an ultrasonic echo signal
  • An image processing module configured to obtain an ultrasound image according to the ultrasonic echo signal
  • the image processing module is further configured to obtain a measurement instruction based on the ultrasound image, calculate a measurement item related to the target tissue according to the measurement instruction, obtain a calculation result, and output the calculation result.
  • FIG. 1 is a schematic diagram of a system architecture of an ultrasound imaging system in accordance with some embodiments
  • FIG. 2 is a schematic flow chart of a method of an embodiment
  • Figure 3 (a) and Figure 3 (b) shows the probe placement method (a) through the labia / transfemoral ultrasound and the obtained median sagittal view (b);
  • Figure 4 is a schematic diagram of the measurement of the levator sac of the axial plane (Axial Plane);
  • Figure 5 is a schematic view of the posterior horn of the bladder or the retroveal angle (RVA);
  • 6(a) and 6(b) are schematic views showing two calculation methods of the urethral tilt angle (UTA);
  • Figure 7 (a) and Figure 7 (b) are schematic views of the measurement of the pubic urethral angle and the pubic bladder angle;
  • Figure 8 is a schematic flow chart of a pelvic measurement scheme in one embodiment
  • FIG. 9 is a schematic flow chart of a pelvic measurement scheme in another embodiment.
  • Figure 10 is a schematic view showing the anatomy of the target tissue
  • Figure 11 is a schematic diagram of a reference coordinate system
  • Figure 12 and Figure 13 show the various measurement diagrams of the pelvic floor
  • Figure 17 shows an example of bladder contour segmentation
  • Fig. 18 shows a measurement example of RVA
  • Fig. 19 shows a measurement example of NI
  • Fig. 20 and Fig. 21 show measurement examples of PVA, PVD
  • Fig. 23 and Fig. 24 show measurement examples of PUA, BSD;
  • Figure 22 shows the detection of the lowest point of the posterior edge of the bladder and the calculation of the PVD
  • Figure 25 is a schematic view showing the positioning of the lower edge and the central axis of the pubic symphysis
  • Figure 26 is a schematic view showing the manner in which the pubic symphysis central axis feature is extracted
  • Figure 27 shows an example of the detection range of the lower edge of the pubic symphysis.
  • the ultrasound imaging system shown in FIG. 1 includes a probe 101, a transmitting circuit 101, a transmit/receive selection switch 102, a receiving circuit 104, a beam combining module 105, a signal processing module 116, and an image processing module 126.
  • the transmitting circuit 101 transmits a delayed-focused transmission pulse having a certain amplitude and polarity to the probe 101 through the transmission/reception selection switch 102.
  • the probe 101 is excited by a transmitting pulse to transmit ultrasonic waves to a target tissue (for example, organs, tissues, blood vessels, etc. in the human body or an animal body, not shown), and receives a reflection from the target area after a certain delay.
  • a target tissue for example, organs, tissues, blood vessels, etc. in the human body or an animal body, not shown
  • the receiving circuit 104 receives the electrical signals generated by the conversion of the probe 101, obtains ultrasonic echo signals, and sends the ultrasonic echo signals to the beam combining module 105.
  • the beam synthesis module 105 performs processing such as focus delay, weighting, and channel summation on the ultrasonic echo signals, and then sends the ultrasonic echo signals to the signal processing module 116 for related signal processing.
  • the ultrasonic echo signals processed by the signal processing module 116 are sent to the image processing module 126.
  • the image processing module 126 performs different processing on the signals according to different imaging modes required by the user, obtains ultrasonic image data of different modes, and then forms ultrasonic images of different modes through logarithmic compression, dynamic range adjustment, digital scan conversion, and the like.
  • the elastic image can be obtained by detecting the shear wave characteristic inside the target tissue by transmitting ultrasonic waves, or can also be obtained by detecting the deformation of the target tissue due to an external force by transmitting ultrasonic waves, wherein the shear wave can be obtained by external force vibration, or The generation is stimulated by transmitting ultrasonic waves to the target tissue.
  • the signal processing module 116 and the image processing module 126 may be integrated on one motherboard 106, or one or more of the modules (including the number herein above) integrated in one processor/ Implemented on the controller chip.
  • the above ultrasonic imaging system further includes an external input/output port 108, and the external input/output port 108 is disposed on the main board 106.
  • the above-mentioned ultrasonic imaging system may be connected to an external input/output device through an external input/output port 108 for receiving a command signal input through an external input/output device through an external input/output port 108, the command signal including a control command for an ultrasonic transmission and reception timing,
  • the operation of inputting an instruction to edit, label, etc. the ultrasonic image, and an output instruction such as a reminder to the user may also include other instruction types.
  • the operation instructions obtained when the user inputs, edits, etc.
  • the external input and output device may include a keyboard, a mouse, a scroll wheel, a trackball, and a combination of one or more of a mobile input device (a mobile device with a touch display screen, a mobile phone, etc.), etc., and accordingly, corresponding
  • the external input/output port 108 may be a wireless communication module, a wired communication module, or a combination of both.
  • the external input and output port 108 can also be implemented based on USB, a bus protocol such as CAN, and/or a wired network protocol or the like.
  • the ultrasound imaging system can also include a display 107 for displaying ultrasound image data from the image processing module.
  • Display 107 can be a touch screen display.
  • the ultrasound imaging system can also be connected to another display through an external input and output port to implement a dual display system.
  • the display in this embodiment may include one display, and may also include multiple displays, and the number of displays is not limited in this embodiment.
  • the displayed ultrasonic image data (ultrasound image) may be displayed on one display or may be displayed on multiple displays at the same time.
  • the portions of the ultrasonic image may be separately displayed on the plurality of displays, in this embodiment. There are no restrictions.
  • FIG. 2 a flowchart of a method for parameter measurement in an ultrasound image is provided.
  • the method for performing parameter measurement in the present embodiment will be described in detail below with reference to FIG.
  • the image processing module 126 in the ultrasound imaging system acquires an ultrasound image containing the target tissue.
  • the ultrasound image can obtain an ultrasound image by receiving an ultrasound signal from the target tissue using the ultrasound probe 101.
  • the ultrasonic signal in the present embodiment is not limited to the ultrasonic echo signal explained in the foregoing with reference to Fig. 1, but may be an ultrasonic signal generated in the target tissue by, for example, photoacoustic imaging.
  • the target tissue herein includes, but is not limited to, pelvic floor tissue, including one or more anatomical structures within the female pelvis, such as the uterus, labia, perineum, pelvis, pubic symphysis, and the like.
  • Ultrasound images including pelvic floor tissue include, but are not limited to, a anterior pelvic ultrasound image and a posterior pelvic ultrasound image, and may also include a mid-pelvic ultrasound image.
  • the commonly used measurement items for pelvic floor ultrasound are divided into three parts: the anterior pelvic cavity, the middle pelvic cavity and the posterior pelvic cavity.
  • the parameters based on the anterior pelvic ultrasound image and the middle pelvic ultrasound image are mainly measured by the translabial or transperineal probe.
  • the obtained human body is completed on the median sagittal plane (as shown in Fig. 3(a) and Fig. 3(b), the probe placement method through the labia/transperine ultrasound (Fig. 3(a)) and the obtained median vector Figure (Fig. 3(b))).
  • Parametric measurements based on posterior pelvic ultrasound images can be performed using Endoanal probes, or more conveniently using Transperineal probes or transvaginal probes to acquire static 3D images or 4D images on the axis plane.
  • the cut surface is correlated.
  • the description of the present embodiment is based on the second case described above, that is, the posterior pelvic ultrasound image obtained by image acquisition via a perineal or transvaginal probe.
  • step S220 the image processing module 126 in the ultrasound imaging system outputs the ultrasound image to A display for displaying an ultrasound image. See the description of display 107 above.
  • the manner of displaying the ultrasonic image in the embodiment is not limited, for example, it may be displayed on multiple displays at the same time, or may be displayed on only one display, or may be displayed in multiple parts synchronously on multiple displays, thereby expanding The viewing angle of the ultrasound image.
  • image processing module 126 can transmit the ultrasound image to the display by wireless or by wire.
  • the display can be a touch display on a mobile device.
  • the ultrasound image is displayed on a first level that is a software interface layer other than for displaying non-image data such as annotations, annotations, text, cursors, and the like.
  • the software interface layer for displaying non-image data such as annotations, annotations, texts, cursors, etc. is referred to as a second level, and the second layer is set to a transparent attribute in an area overlapping the first level, which may not block the ultrasound. Image, enhanced visibility, and user-friendliness. Further, the second layer is set to a transparent layer.
  • step S230 a measurement instruction is obtained based on the ultrasound image image processing module.
  • step S240 the image processing module calculates a measurement item related to the target tissue according to the measurement instruction, and obtains a calculation result.
  • the measurement instruction may be automatically determined by the system according to the ultrasound image, or may be based on the user's measurement operation on the ultrasound image, or may be based on the user's operation input on the ultrasound image according to the system prompt.
  • the measurement instruction is obtained by calculating the measurement items related to the target organization.
  • the medical meaning of some measurement items is explained in detail below.
  • Urethral Tilt Angle (UTA or Urethral Inclination, UI), as shown in Fig. 6(a) and Fig. 6(b), two calculation methods of urethral tilt angle (UTA).
  • Figure 6(b) shows the calculation of Maglinte et al. The angles obtained by the two methods are complementary to each other.
  • UTA urethral rotation angle
  • PuboUrethral Angle as shown in Fig. 7(a) is the pubic urethral angle PUA, which is the angle between the pubic symphysis central axis and the pubic symphysis lower edge and the bladder neck line.
  • BSD Bladder Neck–Symphyseal Distance
  • PED PuboUrethral Distance
  • PuboVesical Angle as shown in Figure 7(b) is the pubic bladder angle (PVA), which is the clip between the pubic symphysis central axis and the lower edge of the pubic symphysis and the lowest point of the posterior wall of the bladder. angle.
  • Bladder neck drop distance or bladder neck mobility (Bladder Neck Descend, BND). as well as
  • BSD and PVD require a unified reference to the position of the pubic symphysis and its central axis, depending on the establishment of a reference coordinate system with the pubic symphysis central axis as the X axis.
  • the second static frame can be selected for measurement.
  • the system displays the second frame measurement result in real time, and simultaneously calculates in real time.
  • the amount of change in some measurements relative to the first frame for example:
  • the amount of dynamic change as shown above will also be updated in real time.
  • URA, BND, and BWD are obtained by dynamic changes in UTA, BSD, and PVD, respectively; PUA and BSD, PVA, and PVD rely on the same input information, respectively; UTA/UR and PUA/BSD are both dependent on the determination of UVJ points.
  • the current ultrasound equipment is applied to the pelvic floor measurement, the existence of the above various correlations is not taken into consideration, and it is usually summarized by the sonographer after separately measuring each item, which inevitably increases the burden on the doctor.
  • individual measurement of the item will inevitably lead to measurement inconsistency and error.
  • UTA, PUA, and BSD share UVJ points.
  • the operator needs to select the position of the UVJ point three times; the difference between these three choices will lead to inconsistency in measurement results.
  • Measurements based on posterior pelvic ultrasound images are primarily used to assess pelvic organ prolapse and Fecal incontinence. Commonly used measurement items are related to the levator ani muscle group, for example (see Figure 4).
  • the measurement items a to d mentioned above mainly relate to the tracing of the levator ani muscle and the selection of the urethra.
  • Ultrasound doctors typically use a trackball to trace along the direction of the levator ani muscle, which is time consuming and error prone.
  • a new pelvic measurement scheme is proposed in one of the embodiments.
  • the scheme maximizes the correlation between measurement items and the repeatability of input information, inputs the necessary measurement point positions item by item in a programmable order, and updates and displays available measurement results in real time as input information increases. .
  • the program is also very good
  • the automatic comprehensive summary of the two measurement results saves the operator's own inconvenience and possible errors.
  • the measurement based on the anterior pelvic ultrasound image will be described in detail below as an example.
  • Measurements based on the anterior pelvic ultrasound image can be performed on a two-dimensional median sagittal plane.
  • the measurement process of the front pelvis is more complicated, involving more measurement items, and it is usually necessary to compare the measurement results of two frames. It is obtained by collecting the median sagittal image of the human body through the perineal or transvaginal probe when the subject is relaxed, and is also called a Rest frame.
  • the second frame is acquired under the maximum force of the pelvic cavity of the subject, also known as the Valsalva frame, for calculating the movement performance of the pelvic organs such as the bladder and the urethra relative to the resting frame ( Mobility).
  • the amount of change of the Valsalva frame relative to the resting frame is calculated using the resting frame as the reference image.
  • step S230 (based on the ultrasonic image image processing module obtaining the measurement instruction), the following process may be adopted. achieve.
  • Step 91 Receive at least one measurement item from the user input by using an external input/output device (such as a keyboard, a mouse, a trackball, a touch screen display, etc.), each measurement item associated with at least one anatomical structure position.
  • an external input/output device such as a keyboard, a mouse, a trackball, a touch screen display, etc.
  • One measurement item corresponds to a parameter that measures a target tissue, and one measurement item can be calculated based on at least two anatomical structure positions.
  • the anatomical structure position herein refers to a specific position associated with a measurement item when medically defining a measurement item of a target tissue, such as a proximal urethra and a posterior fluorosis of the bladder, and a posterior urinary tract of the bladder, and a urethral tilt
  • a target tissue such as a proximal urethra and a posterior fluorosis of the bladder, and a posterior urinary tract of the bladder, and a urethral tilt
  • the lower edge of the pubic symphysis and the lowest point of the posterior wall of the bladder, the urethral bladder junction, etc., can
  • the anatomical structure location can be an anatomical location that is physically present on the target tissue, or an anatomical reference line or reference location that is artificially defined to achieve measurement of the target tissue.
  • the relevant anatomical structure position can identify the corresponding image position on the ultrasonic image, and the image position can be a pixel point, or a block area or a line area composed of a plurality of pixel points, or a certain pixel point The neighborhood range.
  • Step 92 Obtain at least one anatomical structure position associated with the measurement item according to the input measurement item, to form a position set, to obtain the above measurement instruction.
  • the set of locations in this embodiment may be a collection of anatomical structure locations in one of the embodiments.
  • the elements in the set have three characteristics: 1. determinism (the elements in the set must be deterministic); 2. the dissimilarity (the elements in the set are different from each other); 3. the disorder (the elements in the set have no succession) Minute).
  • the set of positions is automatically measured by the system based on the input The item is obtained.
  • Step 93 Determine each anatomical structure position in the location set according to the location set, thereby obtaining the above measurement instruction.
  • the user may obtain the above measurement instruction by clicking on each of the anatomical structure positions in the position set by clicking on the ultrasonic image; and the position concentration may be automatically recognized by the system.
  • Each anatomical structure is positioned to obtain the above measurement instructions.
  • the measurement instruction mentioned herein includes the coordinate position of one or more anatomical structure positions in the position set. Confirmation information.
  • step 94 confirmation of the location of the centralized anatomical structure of the location is completed.
  • step 97 the measurement results are summarized.
  • step 95 may also be included to display an anatomical schematic for prompting the set of locations. Or you can use a text display to prompt the location set. Whether it is an anatomical schematic or a textual reminder, it can be used to prompt the user to click on the ultrasound image to determine the location of each anatomical structure.
  • step 96 may also be included to display the available measurement values, that is, to display the calculation results of the measurement items obtained according to the measurement instructions.
  • the manner of display will be described in detail below, and will not be described here.
  • step S230 (based on the ultrasound image image processing module obtaining measurement instructions), the following process may also be employed.
  • Step 12 Receive at least one measurement item from the user input by using an external input/output device (such as a keyboard, a mouse, a trackball, etc.), each measurement item associated with at least one anatomical structure position.
  • an external input/output device such as a keyboard, a mouse, a trackball, etc.
  • Step 14 Obtain at least one anatomical structure position associated with the measurement item according to the input measurement item, form a position set, and determine, according to the position set, an execution order of the at least one anatomical structure position when the measurement item is executed, combined
  • the set of positions and the execution order generate a measurement sequence.
  • the set of locations in this embodiment may be a collection of anatomical structure locations in one of the embodiments.
  • the measurement sequence is automatically implemented by the system.
  • each anatomical structure position in the position set is sequentially determined, thereby obtaining the above measurement instruction.
  • the user may obtain the above-mentioned measurement instruction by sequentially clicking on the ultrasonic image according to the measurement sequence to obtain the above-mentioned measurement position; or may automatically identify by the system.
  • Each anatomical structure position in the sequence is measured to obtain the above measurement instructions.
  • the measurement command mentioned herein contains information for confirming the coordinate position of one or more anatomical structure positions in the position set.
  • step 16 confirmation of the location of the anatomical structure in the measurement sequence is completed.
  • step 17 the measurement result is summarized.
  • step 13 may also be included to display an anatomical schematic for prompting a set of locations. Or you can use a text display to prompt the location set. Whether it is an anatomical schematic or a textual reminder, it can be used to prompt the user to click on the ultrasound image to determine the location of each anatomical structure.
  • step 15 may also be included to display the available measurement values, that is to say display the calculation results of the measurement items obtained according to the measurement instructions.
  • the manner of display will be described in detail below, and will not be described here.
  • the first way is that the receiving user confirms one or more anatomical structure positions in the position set on the ultrasonic image through the external input and output device (which may include a keyboard, a mouse, a trackball or a touch display screen), according to
  • the confirmation operation input by the user sequentially obtains a measurement instruction; wherein the order in which the user performs the confirmation operation is an ordered operation according to the above measurement sequence. Ordered operations are done according to the order of execution in the measurement sequence.
  • the second way is that the receiving user sequentially confirms one or more anatomical structure positions in the position set on the ultrasonic image through the external input and output device, and obtains a measurement instruction according to the confirmation operation sequentially input by the user; wherein, the user
  • the order in which the confirmation operations are performed is an operation in which an arbitrary order can be performed, and the operations in which the arbitrary order can be performed herein can also be understood as a confirmation operation that the user performs when there is no anatomical structure position confirmation order in the system or manual manual.
  • the confirmation operation in the previous section is used to clarify the position of each anatomical structure position in the ultrasound image.
  • the set of locations obtained in FIG. 8 is prompted, or the sequence of locations obtained in FIG. 9 is prompted.
  • the location set or measurement sequence can be prompted in the following ways:
  • anatomical structure diagram can be displayed in super Outside the area of the acoustic image, it can also be superimposed on the ultrasound image.
  • an anatomical schematic is shown on the aforementioned second level.
  • the position of the anatomical structure where the position is concentrated is marked on the anatomical structure diagram (as shown in the left diagram of FIG. 10, the black point indicates the position of the anatomical structure), or the above measurement sequence is marked (as shown in the right diagram of FIG. 10).
  • the above-mentioned measurement sequence is marked to include an anatomical structure position in which the marker position is concentrated on the anatomical structure diagram, and a confirmation operation execution order in which the marker position is concentrated in each anatomical structure position (for example, the number in the right diagram of FIG. 10 indicates a black dot The anatomical structure position of the representation, the corresponding execution order).
  • the anatomical position currently to be confirmed can be scrolled through the screen for prompting.
  • the manner of scrolling the display through the screen includes sequentially displaying the position of the anatomical structure currently to be confirmed in the position set in an arbitrary order or an execution order.
  • the determining the location of each anatomical structure position to obtain the measurement instruction further includes: determining, according to the measurement sequence, an execution order corresponding to a plurality of anatomical structure positions when performing the measurement item, and passing The text scrolling mode of the screen scrolls to prompt the user with multiple anatomical structure locations.
  • the method for parameter measurement in a new ultrasound image further includes:
  • a reference coordinate system is determined, the reference coordinate system is at least a first rectangular coordinate system established with the lower edge of the pubic symphysis as the origin and the central axis of the pubic symphysis as the second quadrant 45, with the pubic symphysis lower edge as the origin and the pubic symphysis
  • the central axis is a second rectangular coordinate system established by the X axis, and one of a third rectangular coordinate system established by the horizontal direction being the X axis and the vertical direction being the Y axis;
  • step S240 based on the determined reference coordinate system, the measurement item is calculated according to the measurement instruction.
  • This embodiment can be compatible with the establishment of at least three reference coordinate systems, as shown in FIG. 11, A is a rectangular coordinate system established with the lower edge of the pubic symphysis as the origin, and the central axis of the pubic symphysis is a 45 degree angle of the second quadrant, B is Taking the lower edge of the pubic symphysis as the origin, the central axis of the pubic symphysis is the Cartesian coordinate system established by the x-axis.
  • C is a Cartesian coordinate system established with the lower edge of the pubic symphysis as the origin, the horizontal direction is the x-axis, and the vertical direction is the y-axis.
  • the calculation method of BSD/PVD can select the following different BSD/PVD calculation methods for users in two different coordinate systems.
  • the reference coordinate system is determined by one of the following ways:
  • the pubic symphysis lower edge and the pubic symphysis central axis in the ultrasound image are automatically detected, and a first Cartesian coordinate system, a second Cartesian coordinate system or a third Cartesian coordinate system is established.
  • the following manner may be adopted.
  • an option of at least three reference coordinate systems may be presented, and the reference coordinate system may be selected from the first rectangular coordinate system, the second rectangular coordinate system, or the third rectangular coordinate system according to customer requirements.
  • a selection instruction about the reference coordinate system input by the user is received, and the reference coordinate system is determined according to the selection instruction.
  • the first straight coordinate system, the second coordinate system, and the third rectangular coordinate system may be obtained by using the first method described above, or may be obtained by the second method.
  • the lower edge of the pubic symphysis and its central axis are related to the establishment of the coordinate system, so the user needs to input the pubic symphysis.
  • the lower edge and its central axis provide two manual input schemes for receiving the pubic symphysis lower edge and the pubic symphysis central axis input by the user on the ultrasound image, as follows:
  • the user first inputs the pubic symphysis 182 lower edge position information 181, as shown in the left diagram of FIG. Then, as shown in the right diagram of Fig. 16, an input device (such as a trackball) is operated to determine the position 183 of the central axis. For example, in one embodiment, receiving a click input determines a lower edge of the pubic symphysis, the candidate central axis following the movement of the trackball or mouse or touch contact with the display screen; detecting the stop of the movement, at the stop The candidate central axis is displayed at the location to determine the input of the pubic symphysis central axis.
  • an input device such as a trackball
  • the position of the central axis does not have to be related to the absolute position of the cursor, and even the system does not need to display the mouse cursor.
  • an input device such as a mouse or a trackball moves
  • the candidate central axis moves, until the operator notifies the system to complete the selection of the central axis position by clicking or the like.
  • the user can also directly input the position of the two points to determine the position of the pubic symphysis central axis.
  • the two points entered can also be automatically recognized by the system.
  • a scheme for automatically determining a coordinate system is proposed, that is, the pubic symphysis lower edge and the pubic symphysis central axis are automatically detected by the pattern recognition method, thereby determining the position of the coordinate system. Below Do not describe how to detect these two angular cut positions.
  • pattern recognition is used to detect the lower edge of the pubic symphysis.
  • the positive sample of the image marked with the lower edge of the pubic symphysis and the negative sample of the image not including the lower edge of the pubic symphysis are input into the detector for training; the recognition model is obtained based on the training result; and the recognition model is automatically detected.
  • This embodiment is not limited to the type of detector, but rather the detector is part of the automatic measurement frame.
  • the training method is different.
  • this scheme uses a mobile window-based search method (as shown in Figure 27).
  • the detection area of the pubic symphysis is concentrated in a certain possible region (for example, in the region of 0.1w to 0.5w, 0.1h to 0.9h), and the detection method is stepwise by a certain step by pixel at different scales. Window scan and select the most likely area from it.
  • the scanning method is from left to right, from top to bottom for window scanning, and the most likely area is selected from it.
  • the pubic symphysis region was selected from a large number of images including the pubic symphysis region as a positive sample for training the detector. When the image is flipped or mirrored, the detection area should be adjusted accordingly.
  • the pubic symphysis lower edge is determined to determine the starting point of the pubic symphysis central axis, and the remaining only needs to detect the direction of the pubic symphysis central axis.
  • the method is described below.
  • the process of automatically detecting the pubic symphysis lower edge and the pubic symphysis central axis in the ultrasound image based on pattern recognition includes:
  • the starting point of the pubic symphysis central axis is determined according to the lower edge of the pubic symphysis. Then, the candidate ray representing the central axis of the pubic symphysis is determined with the starting point as the origin. The candidate ray has an initial deflection angle, and the predetermined range is deflected with the initial deflection angle as a center and is predetermined by the interval. The angle is scanned to obtain a plurality of candidate rays.
  • a certain angle of the pubic symphysis (such as 135 degrees) is deflected to the left and right by a certain angle as the scanning range and scanned at a certain angle, and the most likely is selected.
  • the direction is the direction of the pubic symphysis central axis, as shown in Figure 25.
  • the detection area should be adjusted accordingly.
  • the ray sc represents the initial deflection angle of the pubic symphysis central axis
  • the broken line represents a plurality of candidate rays.
  • point S is detected by a detector such as a cascaded adaboost classifier.
  • the ray SC is obtained by searching for a specific range of angles (for example, in the rectangular coordinate system of the natural image, the angle is shifted by 30 degrees around 135 degrees, and the feature is taken at intervals of 1 degree, and the most probable angle is selected therefrom).
  • the X-axis is obtained by rotating the SC beam 135 degrees clockwise around the S point (coordinate system C1) or directly as the X-axis (coordinate system C).
  • the pixel features of the plurality of candidate ray are extracted, and the pubic symphysis central axis is determined from one of the plurality of candidate ray according to the pixel characteristic. For example, for each candidate ray, features associated with the ray are extracted, for example, pixel values along the normal to the two sides of the normal direction along the ray direction are taken as features (as shown in FIG. 26). The extracted features are input to a pre-trained detector for scoring, a set of scores (corresponding to a set of candidate rays), and finally the highest scored candidate rays are selected as the direction of the pubic symphysis central axis.
  • a variety of detectors can be used to detect the pubic symphysis central axis, such as likelihood detectors based on Gaussian distribution, detectors based on (linear, polynomial, logistic, etc.) regression models, and the like.
  • the inputs to these detectors are features that are equivalent to the features entered during the training phase, and the output is a continuous real value representation of the input.
  • the user pre-defines the measurement items (such as BSD, UTA, etc.) included in the measurement requirements, and the ultrasound imaging system calculates the anatomical structure position points to be input according to the measurement requirements, and automatically arranges the input order.
  • the anatomical structure diagram may be further displayed on the screen to prompt the user how to perform a semi-automatic measurement operation flow according to the anatomical structure position point automatically determined by the system; the process of confirming the input operation of the anatomical structure position according to the anatomical structure diagram of the user
  • the system displays the currently available measurement results in real time. It can be seen that, unlike the traditional distributed measurement scheme, this embodiment proposes an integrated intelligent manual measurement scheme (see FIGS. 8 and 9). Based on the flow described in Figure 9, the following example illustrates how to perform intelligent manual measurements.
  • the user defines the following measurement items in the step 12 in FIG. 9 through a preset menu:
  • the ultrasound imaging system can automatically calculate the pelvic floor anatomical position information of the required input according to the logical relationship between the measurement items, that is, determine the position set of the anatomical structure position, and generate a default ordering.
  • the measurement sequence is as follows, see Figure 14:
  • Figure 12 shows a schematic diagram of various measurements of the pelvic floor, including the pubic urethral angle PUA, the posterior horn of the bladder urethra, the urethral tilt angle UTA, and the distance BSD from the pubic symphysis to the x-axis.
  • Figure 13 shows a schematic diagram of various measurements of the pelvic floor, including the pubic bladder angle PVA, the posterior horn of the bladder urethra, the urethral tilt angle UTA, and the distance from the pubic symphysis to the x-axis PVD.
  • Two steps a) and b) are used to determine the coordinate system.
  • the user can sort these inputs according to their personal habits, or they can choose not to change them.
  • the user inputs the above information through the input device in a predetermined order (as shown in FIG. 14). As the user's input increases, the system will gradually update the measurement until the measurement is completed.
  • the input order of the information items a to f is set in advance, and can also be deleted as needed.
  • the definitions of a to f and 1 to 6 are as shown above. As shown in Fig.
  • the measurement item (1) the angle between the pubic symphysis and the UVJ PUA and (2) the distance from the UVJ to the X axis BSD can be displayed; After the position of the proximal end of the urethra, the measurement item (3) the urethral tilt angle UTA can be displayed; after confirming (e) the position of the proximal edge of the posterior bladder, the measurement item (4) the posterior angle of the bladder RVA can be displayed; After the position of the posterior edge of the bladder, the measurement item (5) pubic bladder angle PVA and (6) the distance from the lowest point of the posterior wall of the bladder to the X-axis PVD can be displayed.
  • the user can choose not to measure the angle PVA and the distance PVD, and the measurement demand will be simplified to:
  • the measurement items (1) the angle between the pubic symphysis and UVJ and the distance BSD of the UVJ to the X axis can be displayed; the position of the proximal end of the urethra is confirmed (d) After that, the measurement item (3) urethral tilt angle UTA can be displayed; after confirming (e) the position of the proximal edge of the posterior bladder, the measurement item (4) the posterior angle of the bladder RVA can be displayed.
  • the above-described concentration of positions includes at least the pubic symphysis lower edge and the pubic symphysis central axis.
  • the first two anatomical structural positions in the above measurement sequence are the pubic symphysis lower edge and the pubic symphysis central axis, thereby directly adding the process of the reference coordinate system to the measurement operation flow, thereby simplifying the flow operation, and similarly,
  • the relevant position of the reference coordinate system is first determined according to the position set and/or the measurement sequence, and then the calculation of the specific measurement item is performed.
  • the foregoing process of calculating a target organization-related measurement item according to the measurement instruction, and obtaining the calculation result includes:
  • the image processing module determines a reference coordinate system based on the first two anatomical structure locations in the measurement sequence.
  • the first two anatomical structures may be the pubic symphysis lower edge and the pubic symphysis central axis.
  • the measurement items to be calculated are calculated, and the corresponding calculation results are obtained.
  • the image processing module determines the reference coordinate system according to the positions of the first two anatomical structures in the measurement sequence, and the reference coordinate system can be determined by the following two methods mentioned in the foregoing. Specifically:
  • the pubic symphysis lower edge and the pubic symphysis central axis in the ultrasound image are automatically detected, and a first Cartesian coordinate system, a second Cartesian coordinate system or a third coordinate system is established.
  • a first Cartesian coordinate system, a second Cartesian coordinate system or a third coordinate system is established.
  • the calculation result corresponding to each measurement item can be calculated.
  • the measurement sequence automatically generated by the system shown in Figure 9 can enter the edit mode to update the measurement item or measurement result.
  • the combining position set and the execution order generating measurement sequence include:
  • the image processing module automatically generates a preset measurement sequence in combination with the position set and execution order mentioned above.
  • the preset measurement sequence is automatically generated based on the measurement items input by the user in step 12 in FIG.
  • the preset measurement sequence is then displayed using the display.
  • the way to display can be a text list or a prompt box.
  • the input and output device is used to receive an edit instruction input by the user, and the edit command may be an adjustment of the measurement item or an adjustment of the position or execution order of the anatomical structure.
  • the preset measurement sequence is updated to obtain the above-mentioned measurement sequence for sequentially determining each anatomical structure position in the position set to obtain the above measurement instruction.
  • the user can select to enter the editing mode; when the user edits the inputs, the measurement result is updated in real time; when the user inputs or edits the second frame, the system not only displays in real time.
  • the second frame measurement result will also calculate the change of some measured values with respect to the first frame in real time, such as the relative change amount BND of BSD, the relative change amount URA of UTA, and the like.
  • the editing instruction in the above embodiment includes at least one of the following operations: 1. adding or subtracting an anatomical position of a positional concentration in a preset measurement sequence, 2. adjusting an execution order in a preset measurement sequence, 3. measuring a measurement item Increase or decrease.
  • the user's input to the measurement item is mentioned in the embodiment shown in FIG. 8 and FIG. 9 and other various embodiments.
  • “receiving at least one measurement item from the user input” is not limited to the user item.
  • the manner of inputting the measurement item may also include the input manner of one or more measurement items obtained when the user selects the measurement mode preset by the system or the measurement process.
  • the present embodiment also proposes a fully automatic measurement scheme, which can automatically determine the bladder urethral junction (UVJ), the proximal urethra, the posterior end of the bladder, and the lowest point of the posterior edge of the bladder.
  • Anatomical location The examination of these anatomical locations is based on the segmentation tracking of the bladder. The following is an example of the detection of several special anatomical positions.
  • the bladder is segmented to make additional anatomical junctions using the contour location information of the bladder.
  • Fruit detection FIG 17 shows an example of bladder contour segmentation.
  • a closed curve box indicates the divided bladder region.
  • Common detection methods include level set, active contour model, graph cut, and the like. For dynamic continuous image sequences, tracking methods can be employed to improve accuracy and reduce the complexity of frame-by-frame calculations.
  • Figure 20 shows a schematic view of the detection of the bladder urethral junction (bladder neck).
  • a portion of the bladder contour near the direction of the probe (shown as a yellow thick portion (a thick line portion) in the figure) is sampled at a certain interval.
  • search for the possibility of urethra in different directions within a certain range select the best position as the position of the urethra, and return the position of the urethra and bladder contour as the position of the bladder neck.
  • the detection method used in the present embodiment is as follows: a portion of the bladder contour near the direction of the probe (shown as a yellow thick portion (a thick line portion) in the figure) is sampled at a certain interval.
  • the method of determining the optimal candidate position is similar to the determination of the pubic symphysis central axis direction, as described below.
  • features associated with the urethral structure are extracted, for example, pixel values along the normal to the two sides of the normal direction are characterized as a feature along the urethral direction.
  • the extracted features are input to a pre-trained detector for scoring, a set of scores is obtained, and finally the candidate position with the highest score is selected as the optimal urethral position.
  • the posterior edge of the bladder refers to the closest point on the right bladder contour of the bladder-urethral junction from the X-axis (or the origin of the coordinate system, depending on how the PVD is calculated). Since the bladder contour has been positioned, it is only necessary to traverse a particular region on the contour of the bladder to find the closest point to the X-axis, as shown in FIG. Figure 22 shows the detection of the lowest point of the posterior edge of the bladder and the calculation of PVD. The position of the X-axis and the Y-axis can be determined by the detected S point and direction SC (the case where the first rectangular coordinate system A is used is shown).
  • the position V of the trailing edge of the bladder i.e., the yellow thick portion in the figure
  • the Y coordinate of the V point is the value of PVD.
  • the proximal end of the urethra is also detected at the same time, that is, a section of the urethra (for example, 2 cm) closer to the UVJ is taken.
  • the posterior end of the bladder is obtained by the position of the bladder contour and the junction of the bladder and urethra, that is, a point close to the bladder urethral junction (for example, within 2 cm) is selected as the proximal end of the bladder posterior edge.
  • the measurement of RVA is shown in Figure 18.
  • the system automatically tracks the contour of the paracrine using a level set or similar (and can also only track the lower half of the contour of the paracrine).
  • the system automatically detects the position of the urethra (the yellow line in the figure) using a machine learning algorithm. Combined with the urethra and bladder contours, the system automatically derives the RVA angle from three points N, U and R.
  • NI The calculation of NI is shown in Figure 19, which gives a schematic diagram of the automatic measurement of the NI angle.
  • the position of the X-axis can be determined by the two points of C and S detected, thereby obtaining the direction of the straight line I perpendicular thereto.
  • the NI angle is the angle formed by the urethra represented by the ray UN and the straight line I.
  • Fig. 20 and Fig. 21, and Fig. 21 shows a schematic diagram of PVA measurement. Schematic diagram of PVA angle measurement.
  • the value of PVA can be determined by the detected S point and direction SC and V point (as indicated by the red arrow in the figure).
  • the size of the PVA is independent of the coordinate system (i.e., applicable to the first and second Cartesian coordinate systems described above).
  • FIG. 23 shows a schematic diagram of BSD automatic measurement.
  • the U point is the bladder neck that is automatically detected.
  • the position of the X-axis and the Y-axis can be determined by the detected S point and direction SC (the case where the first rectangular coordinate system is used is shown).
  • the Y coordinate of the U point is the value of BSD.
  • Figure 24 shows a schematic diagram of the PUA angle measurement.
  • the value of PUA can be determined by the detected S point and direction SC and the U point (as indicated by the red arrow in the figure).
  • the size of the PUA is independent of the coordinate system (i.e., applicable to the first and second Cartesian coordinate systems described above).
  • the ultrasound image displayed above includes the first frame image and the second frame image. Therefore, the image processing module performs a process of obtaining a measurement instruction based on the ultrasound image, and calculating a measurement item related to the target tissue according to the measurement instruction, and the process of obtaining the calculation result may be adopted.
  • the image processing module obtains a measurement instruction based on the first frame image, and calculates a measurement item related to the target tissue according to the measurement instruction, to obtain a first calculation result;
  • the image processing module obtains a measurement instruction based on the second frame image, calculates a measurement item related to the target tissue according to the measurement instruction, and obtains a second calculation result;
  • the image processing module calculates a change result of the second calculation result relative to the first calculation result
  • the display When the display displays the multi-frame ultrasound image, the user's selection instruction is received, and the ultrasound image is obtained according to the user's selection instruction, and the ultrasound image includes the first frame image and the second frame image.
  • the two frame images are a resting frame image and a Watt frame image.
  • the process of obtaining the first calculation result for the first frame image and obtaining the second calculation result for the second frame image may refer to the process of obtaining the calculation result based on the ultrasound image in the foregoing, and the method and the steps may be partially the same or similar, or may be All the same or similar. For example, by replacing the above-mentioned "ultrasound image" appearing in the process of step S230 and step S240 with "first frame image" and "second image", it is obtained that the first calculation result is obtained for the first frame image, and The process of obtaining the second calculation result by the two-frame image.
  • the user can also choose to enter the editing mode; when the user edits these inputs, the measurement result is updated in real time; when the user inputs or edits the second frame image, the system not only displays the second frame measurement result in real time,
  • the change of the measured value relative to the first frame such as the relative change in BSD (ie, the drop distance BND of the bladder neck), the relative change in UTA (corresponding to the urethral rotation angle URA), PVD will also be calculated in real time.
  • Relative change ie, the falling distance of the posterior wall of the bladder, BWD.
  • the ultrasonic imaging system supports fully automatic measurement, that is, all anatomical structures are automatically calculated by an algorithm, and the values of all the measurement items are automatically obtained according to the position information of the anatomical structure. If the single-frame ultrasound image is a parameter measurement obtained by a fully automatic method, the result of the dynamic measurement can also be automatically obtained accordingly.
  • the evaluation of the pelvic floor function can be performed to obtain an evaluation level.
  • the International Society for Urinary Control (ICS) has a quantitative rating system for pelvic prolapse procedures, referred to as the POP-Q system.
  • the system divides the pelvic floor prolapse method into five levels from 0 degrees to IV degrees by means of surgical examination.
  • the prolapse of the pelvic floor organ is quantitatively analyzed and measured by means of ultrasonic examination.
  • the system can obtain a score based on the formula and comprehensively combine the measurement results, showing the degree or grade of pelvic floor dysfunction. This score can be converted to an equivalent ICS POP-Q score.
  • the following methods can be provided for the user to select in the embodiment.
  • the system provides a default evaluation rule, which is mapped by maximizing the value of PVD under Va l sa va, ie
  • the equivalent POP-Q is 3 or more.
  • an evaluation level is obtained based on a calculation result corresponding to the measurement item based on a default evaluation rule, where the default evaluation rule is obtained by maximizing a calculation result mapping corresponding to a specific measurement item calculated on a specific frame.
  • Specific frames include Valsalva frames
  • specific measurement items include PVD.
  • users can customize the scoring rules and formulas with reference to the default rating method.
  • the results of BSD and PVD can be combined, or the threshold of judgment can be changed.
  • the evaluation level is obtained and output according to the values of BSD and PVD in the above calculation results.
  • the image processing module receives an adjustment of the evaluation rule by the user, the evaluation rule is used to determine an evaluation level, and based on the adjusted evaluation rule, the evaluation result obtained according to the above method is used to determine the evaluation level, and output .
  • the system provides a machine learning-based method to automatically achieve a comprehensive scoring of the degree of prolapse, as described below:
  • the system will automatically analyze the doctor's score and the measurement results and images to establish a relationship.
  • methods of analysis such as linear regression, Kalman filtering, Gaussian process regression, support vector regression and other regression analysis methods, or deep neural networks.
  • the system can give a rating score based on the combined measurement results. If the operation is objectionable to the rating, the rating can be modified by hand. After the system gets feedback, the relationship will be further refined to get a score that is more in line with the operator's expectations.
  • the ultrasonic imaging system can input a plurality of sample images and calculation results of the measurement items calculated on the sample image, and corresponding evaluation levels, and input them into the detector for mathematical correlation analysis. The machine model is obtained, and the evaluation level is automatically obtained by using the machine model based on the calculation result actually obtained on the ultrasonic image.
  • the evaluation levels mentioned herein may be numerical expressions such as 0-100, percentage representations, or quantified stage indices (eg 1, 2, 3, etc.) and the like.
  • step S250 the image processing module outputs a calculation result corresponding to the calculated measurement item. It can be output by printing or by the display.
  • the system calculates the measurement results item by item and displays it in real time.
  • the system additionally calculates the change result of the measurement parameter of the second frame relative to the first frame image in the same coordinate system and displays it in real time.
  • a convenient and quick parameter measurement scheme based on two-dimensional or three-dimensional ultrasound is proposed, which can be applied to the measurement of the pelvic floor parameters.
  • the scheme automatically establishes the measurement coordinate system and utilizes the correlation between the various measurement items at the pelvic floor to minimize the measurement input, improve measurement efficiency and reduce measurement error.
  • the solution can also calculate the relative change amount of the corresponding measurement items between the two frames according to the user's needs, and automatically calculate the subject dysfunction score or level by synthesizing the measurement items and their relative change amount information.
  • the program also supports online or offline learning users' scoring methods for automatic scoring.
  • the technical solution of the present invention which is essential or contributes to the prior art, may be embodied in the form of a software product carried on a non-transitory computer readable storage carrier (eg ROM, disk, optical disk, hard disk, server cloud space), comprising a plurality of instructions for causing a terminal device (which may be a mobile phone, a computer, a server, a network device, etc.) to execute the system structure and method of various embodiments of the present invention .
  • a terminal device which may be a mobile phone, a computer, a server, a network device, etc.

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Abstract

一种超声图像中参数测量的方法，包括：获取超声图像，该图像包含目标组织，超声探头通过接收来自目标组织的超声信号获得超声图像；显示该超声图像；基于该超声图像获得测量指令；根据测量指令计算目标组织相关测量项，获得计算结果；输出计算结果。还提供了一种超声图像中参数测量的系统。该方法和系统解决了超声图像测量操作不便的问题。

Description

超声图像中参数测量的方法和超声成像系统 技术领域
本发明涉及一种超声成像设备，特别涉及在超声成像图像中进行参数测量的方法和系统。
背景技术
超声成像设备用于对目标组织的内部进行成像，并基于一些医学参数的特点在超声成像获得的图像上进行测量，从而使医生获得被检测病人的目标组织的实际解剖学结构参数。例如，盆底超声(Pelvic Floor Ultrasound,PFU)是指对女性盆底采用医学超声设备进行扫查成像的一门学科，对妇科泌尿学和其它盆底功能障碍的诊断起到重要作用。相比其它成像方式如MRI和膀胱尿道造影，PFU具有成本低，无创，检查方便快捷等优点，逐渐成为诊断女性盆底功能障碍的主要手段。
盆底超声的检查项目众多，医生通常需要针对每个测量项在图中分别进行描点测量。这种方式增加了额外的工作量。另外，一些测量项之间的变化量和相对关系需要额外计算，也给操作者带来了很多的不便。
当然，对于同一个目标组织存在一些测量项时通常都采用描点测量的方式，从而带来了操作不便的问题。
发明内容
基于此，有必要针对现有技术中存在的操作不便问题，提供一种超声图像中参数测量的方法和系统。
在其中一个实施例中，提供了一种超声图像中参数测量的方法，其包括：
获取超声图像,所述超声图像包含目标组织,所述超声图像通过利用超声探头接收来自目标组织的超声信号而获得所述超声图像；
显示所述超声图像；
基于所述超声图像获得测量指令；
根据所述测量指令计算目标组织相关的测量项，获得计算结果；和
输出所述计算结果。
在其中一个实施例中，提供了一种超声成像系统，其包括：
探头，
发射电路和接收电路，用于激励所述探头向目标组织发射超声波束，接收所述超声波束的超声回波，获得超声回波信号；
图像处理模块，用于根据所述超声回波信号，获得超声图像；
显示器，用于显示所述超声图像；其中，
所述图像处理模块还用于基于所述超声图像获得测量指令，根据所述测量指令计算目标组织相关的测量项，获得计算结果，输出所述计算结果。
附图说明
图1为提供了依照一些实施例的超声成像系统的系统架构示意图；
图2为一个实施例的方法流程示意图；
图3(a)和图3(b)为经阴唇/经会阴超声的探头摆放方式(a)及所得到的正中矢状面图(b)；
图4为轴平面(Axial Plane)肛提肌裂孔测量示意图；
图5为膀胱尿道后角或膀胱后角(RetroVesical Angle,RVA)的示意图；
图6(a)和图6(b)为尿道倾斜角(UTA)的两种计算方式的示意图；
图7(a)和图7(b)为耻骨尿道角和耻骨膀胱角的测量方式示意图；
图8为一个实施例中盆腔测量方案的流程示意图；
图9为另一个实施例中盆腔测量方案的流程示意图；
图10为目标组织的解剖结构示意图；
图11为参考坐标系的示意图；
图12和图13给出了盆底各项测量示意图；
图14和图15分别为两个实施例的流程示意图；
图17显示了一个膀胱轮廓分割的例子；
图18显示了RVA的测量实例；图19显示了NI的测量实例；图20和图21给出了PVA，PVD的测量实例；图23和图24给出了PUA,BSD的测量实例；
图22给出了膀胱后沿最低点的检测以及PVD的计算示意图；
图25给出了耻骨联合下缘和中轴线定位示意图；
图26给出了耻骨联合中轴线特征提取方式的示意图；
图27给出了耻骨联合下缘的检测范围实例。
具体实施方式
图1所示的超声成像系统包括：探头101、发射电路101、发射/接收选择开关102、接收电路104、波束合成模块105、信号处理模块116、图像处理模块126。在超声成像过程中，发射电路101将经过延迟聚焦的具有一定幅度和极性的发射脉冲通过发射/接收选择开关102发送到探头101。探头101受发射脉冲的激励，向目标组织(例如，人体或者动物体内的器官、组织、血管等等，图中未示出)发射超声波，经一定延时后接收从目标区域反射回来的带有目标组织的信息的超声回波，并将此超声回波重新转换为电信号。接收电路104接收探头101转换生成的电信号，获得超声回波信号，并将这些超声回波信号送入波束合成模块105。波束合成模块105对超声回波信号进行聚焦延时、加权和通道求和等处理，然后将超声回波信号送入信号处理模块116进行相关的信号处理。经过信号处理模块116处理的超声回波信号送入图像处理模块126。图像处理模块126根据用户所需成像模式的不同，对信号进行不同的处理，获得不同模式的超声图像数据，然后经对数压缩、动态范围调整、数字扫描变换等处理形成不同模式的超声图像，如B图像，C图像，D图像，多普勒血流图像，包含组织弹性特性的弹性图像等等，或者其他类型的二维超声图像或三维超声图像。弹性图像可以通过发射超声波检测目标组织内部的剪切波特性来获得，或者还可以通过发射超声波检测目标组织因外力发生的形变来获得，其中，剪切波可以通过外力振动来获得，也可以通过向目标组织发射超声波来激发产生。
在本发明的其中一些实施例中，信号处理模块116和图像处理模块126可以集成在一个主板106上，或者其中的一个或两个以上(本文中以上包括本数)的模块集成在一个处理器/控制器芯片上实现。
其次，上述超声成像系统还包括外部输入输出端口108，外部输入输出端口108设置在主板106上。上述超声成像系统可以通过外部输入输出端口108与外部输入输出设备连接，用于通过外部输入输出端口108接收通过外部输入输出设备输入的指令信号，该指令信号包括对超声波发射接收时序的控制指令、对超声图像进行编辑、标注等的操作输入指令，对用户进行提醒等输出指令，或者还可以包括其他指令类型。通常用户对超声图像进行编辑、标注等操作输入时所获得的操作指令用于关于目标组织的测量。外部输入输出设备可以包括键盘、鼠标、滚轮、轨迹球、和移动式输入设备(带触摸显示屏的移动设备、手机等等)等等其中之一或者多个的结合，因此，相应的 外部输入输出端口108可以是无线通信模块，也可以是有线通信模块，或者两者的组合。外部输入输出端口108也可基于USB、如CAN等总线协议、和/或有线网络协议等来实现。
此外，超声成像系统还可以包括显示器107，该显示器用于显示来自于图像处理模块的超声图像数据。显示器107可以是触摸屏显示器。当然，超声成像系统还可以通过外部输入输出端口连接另一个显示器，实现双屏显示系统。此外，本实施例中的显示器可以包括一个显示器，也可以包括多个显示器，本实施例中不限制显示器的数量。显示的超声图像数据(超声图像)可以是显示在一个显示器上，也可以同时显示在多个显示器上，当然也可以是将超声图像的部分分别同步显示在多个显示器上，在此本实施例也不作限制。
如图2所示，提供了一种超声图像中参数测量的方法的流程图，以下将结合图1详细说明本实施例中参数测量的方法执行过程。
在步骤S210中,超声成像系统中的图像处理模块126获取超声图像,超声图像包含目标组织。如图1所示,超声图像可以通过利用超声探头101接收来自目标组织的超声信号而获得超声图像。本实施例中的超声信号不限于是前文中参照图1解释的超声回波信号，还可以是采用如光声成像方式在目标组织内产生的超声信号。此外，这里的目标组织包括但不限于盆底组织，盆底组织包括女性盆腔内的一个或多个解剖学组织结构，例如，子宫、阴唇、会阴、盆骨、耻骨联合等等。包含盆底组织的超声图像包括但不限于前盆腔超声图像和后盆腔超声图像，还可以包括中盆腔超声图像。盆底超声常用的测量项分为前盆腔、中盆腔和后盆腔三部分，其中基于前盆腔超声图像和中盆腔超声图像的参数测量主要在通过采用经阴唇(Translabial)或经会阴(Transperineal)探头得到的人体正中矢状面图上完成(如图3(a)和图3(b)所示，经阴唇/经会阴超声的探头摆放方式(图3(a))及所得到的正中矢状面图(图3(b)))。基于后盆腔超声图像的参数测量可采用腔内(Endoanal)探头采集图像，或者更方便地采用经会阴(Transperineal)探头或经阴道(Transvaginal)探头采集静态三维图像或四维图像在轴平面上选择适当的切面进行相关测量。基于后盆腔超声图像的参数测量，本实施例的说明书基于上述第二种情况,即采用经会阴或经阴道探头进行图像采集获得的后盆腔超声图像。
在步骤S220中，超声成像系统中的图像处理模块126将超声图像输出至 显示器，用于显示超声图像。参见前文中有关显示107的说明。本实施例中的对显示超声图像的方式并不做限定，例如，可以是同时显示在多个显示器上，或者仅显示在一个显示器上，还可以是分部分同步显示在多个显示器，从而扩大超声图像的观察视角。更进一步地，在其中一个实施例中，图像处理模块126可以通过无线或有线的方式来传送超声图像至显示器。显示器可以是移动设备上的触摸显示屏。更进一步地，在其中一个实施例中，超声图像被显示在第一层面上，该第一层面为除用于显示批注、标注、文本、光标等非图像数据之外的软件界面层。相应地，用于显示批注、标注、文本、光标等非图像数据的软件界面层称之为第二层面，该第二层面在与第一层面重叠的区域被设置为透明属性，可以不遮挡超声图像，增强可视性，以及界面友好性。更进一步地，第二层面全层设置为透明属性。
在步骤S230中，基于超声图像图像处理模块获得测量指令。在步骤S240中，图像处理模块根据测量指令计算目标组织相关的测量项，获得计算结果。
在本实施例中，测量指令可以是系统根据超声图像自动确定的，也可以是基于用户在超声图像上的测量操作，还可以是基于用户根据系统提示在超声图像上的操作输入。
测量指令的获得在于计算目标组织相关的测量项，以下详细说明部分测量项的医学含义。
学术和临床上关于前盆腔超声图像的测量较多，这些测量大多与诊断前盆腔脱垂(Pelvic Organ Prolapsed,POP)和尿失禁(Urinary Incontinence)相关。本实施例中可能涉及的测量项包括以下几项，但也不限于以下几项：
1)膀胱尿道后角或膀胱后角(RetroVesical Angle,RVA),如图5所示，图像中标记的白色粗实线角，RVA角即近端尿道和膀胱三角区后端之间的夹角。
2)尿道倾斜角(Urethral Tilt Angle,UTA或Urethral Inclination，UI),如图6(a)和图6(b)所示，尿道倾斜角(UTA)的两种计算方式。图6(b)为Maglinte et al计算方式。两种方式得到的角度互为余角。当UTA的计算最终用于计算尿道旋转角(URA)时，两种计算方式等效。
3)耻骨尿道角(PuboUrethral Angle,PUA)，如图7(a)显示的是耻骨尿道角PUA,即耻骨联合中轴线与耻骨联合下缘和膀胱颈连线之间的夹角。
4)膀胱颈距离(Bladder Neck–Symphyseal Distance,BSD)或称为耻骨尿道距离(PuboUrethral Distance，PUD)。
5)耻骨膀胱角(PuboVesical Angle,PVA)，如图7(b)显示的是耻骨膀胱角(PVA),即耻骨联合中轴线与耻骨联合下缘和膀胱后壁最低点连线之间的夹角。
6)耻骨膀胱距离(PuboVesical Distance,PVD)或称膀胱下降距离(BL Desc.Max)。
7)尿道旋转角(Urethral Rotation Angle,URA)。
8)膀胱颈下降距离或称膀胱颈移动度(Bladder Neck Descend,BND)。以及
9)膀胱壁下降距离(Bladder Wall Descend,BWD)等。
这些测量项很大一部分依赖于如何建立适当的参考坐标系。例如BSD和PVD需要统一参考耻骨联合及其中轴线的位置，依赖于以耻骨联合中轴线为X轴的参考坐标系的建立。
同时，这些测量项相互之间存在关联。参见图3(b)和下表的名词解释。
Figure PCTCN2017071277-appb-000001
Figure PCTCN2017071277-appb-000002
动态变化量的测量，用户在一个静态帧上完成测量流程后，可以选择第二个静态帧进行测量，此时系统实时显示第二帧测量结果，同时实时计算出 某些测量值的相对于第一帧的变化量，例如：
1)BSD的相对变化，即膀胱颈的下降距离BND,
2)PVD的相对变化，即膀胱后壁的下降距离BWD,和
3)UI的相对变化，对应为尿道旋转角UR。
当第二帧测量完成时，如果用户编辑第一帧的输入，则如上所示的动态变化量也将实时更新显示。
例如，URA,BND和BWD分别通过UTA,BSD和PVD的动态变化得到；PUA和BSD，PVA和PVD分别依赖于同样的输入信息；UTA/UR与PUA/BSD均依赖于UVJ点的确定。当前的超声设备应用于盆底测量时，并未考虑到以上种种关联的存在，而通常是由超声医生分别单独测量各项后汇总，此时必然增加了医生的负担。不仅如此，由于测量项之间存在共用信息，分项单独测量必然带来测量的不一致性(Inconsistent)和误差。例如，UTA，PUA，BSD三者共用UVJ点，分开测量时，操作者需要三次选择UVJ点的位置；这三次选择之间的差异将带来测量结果的不一致。
基于后盆腔超声图像的测量主要用于评估盆底脏器脱垂和大便失禁(Fecal incontinence)相关。常用的测量项均与肛提肌群相关，例如(见图4)
a)肛提肌裂孔面积(Levator Hiatus area,LH Area)，图4中的41，
b)肛提肌裂孔周长(Levator Hiatus circumference,LH Circ),图4中的42，
c)肛提肌前后径(Levator Hiatus AP,LH AP，图4中的44)和左右径(Levator Hiatus Lateral Diam,LH Lateral Diam，图4中的43)的长度，以及
d)肛提肌-尿道间隙(左右侧)(Levator urethra gap,LUG，图4中的45)等。
上面提到的测量项a到d主要涉及肛提肌裂孔的描迹和尿道的选点。超声医生通常使用轨迹球沿着肛提肌的方向进行曲线描迹，既费时又容易误操作。另外，不同操作者之间(Interoperator)以及同一操作者不同次测量之间(Intraoperator)存在较大差异。这些差异无疑将影响盆底肌肉撕裂程度的评估，甚至可能造成漏诊或误诊。
为了减轻医生的负担，提高测量效率和降低测量误差，在其中一个实施例中提出了一种新的盆腔测量方案。该方案最大化地利用了测量项之间的关联性和输入信息的重复性，按可编程的顺序逐项输入必要的测量点位置，并且随着输入信息的增加实时更新和显示可用的测量结果。该方案还很好地支 持了两次测量结果的自动综合汇总,省去了操作者自行计算的不便和可能带来的错误。以下以基于前盆腔超声图像的测量为例进行详细说明。
基于前盆腔超声图像的测量可以在二维正中矢状面上进行。前盆腔的测量流程较为复杂，涉及了较多的测量项，同时通常需要对比两帧的测量结果。在受检者放松状态下利用经会阴或经阴道探头采集人体正中矢状面图像得到，又称为静息(Rest)帧。第二帧是在受检者盆腔向下最大程度发力的情况下采集得到，又称为瓦氏(Valsalva)帧，用于计算盆底器官如膀光和尿道相对于静息帧的移动性能(Mobility)。以静息帧作为基准图像，计算Valsalva帧相对于静息帧的变化量。
与传统的分散测量方案不同，本实施例中提出新的盆腔测量方案更为一体化，如图8所示，在步骤S230(基于超声图像图像处理模块获得测量指令)中，可以采用以下过程来实现。
步骤91，利用外部输入输出设备(例如键盘、鼠标、轨迹球、触摸显示屏等人机交互设备)接收来自于用户输入的至少一个测量项，每个测量项关联对应至少一个解剖学结构位置。本实施例中的测量项可参见前文相关说明。一个测量项对应测量一个目标组织的参数，一个测量项可以基于至少两个解剖学结构位置来计算。本文的解剖学结构位置是指医学上定义目标组织的测量项时与测量项关联的特定位置，例如与膀胱尿道后角或膀胱后角关联的近端尿道和膀胱三角区后端，与尿道倾斜角关联的近端尿道和人体中轴线，与耻骨尿道角关联的耻骨联合中轴线、耻骨联合下缘和膀胱颈，与膀胱颈距离关联的尿道膀胱结合处，与耻骨膀胱角耻骨联合中轴线、耻骨联合下缘和膀胱后壁最低点，尿道膀胱结合处，等等，具体可参见前文相关说明，在此不进行穷举。解剖学结构位置可以是目标组织上实际存在的解剖学位置，也可以是为了实现对目标组织测量而人为定义的解剖学参考线或者参考位置。相关的解剖学结构位置均可在超声图像上识别到相应的图像位置，该图像位置可以是一个像素点，或者是多个像素点构成的块状区域或者线条区域，还可以是某个像素点的邻域范围。
步骤92，根据输入的测量项，获得与测量项相关联的至少一个解剖学结构位置，形成位置集，用以获得上述测量指令。本实施例中的位置集在其中一个实施例中可以为解剖学结构位置的集合。集合中的元素有三个特征：1.确定性(集合中的元素必须是确定的)；2.互异性(集合中的元素互不相同)；3.无序性(集合中的元素没有先后之分)。位置集由系统自动根据输入的测量 项获得。
步骤93，根据位置集，确定位置集中每个解剖学结构位置，从而获得上述测量指令。本步骤中的确定位置集中每个解剖学结构位置的步骤中，可以通过用户在超声图像上点击确定位置集中的每个解剖学结构位置，从而获得上述测量指令；也可以通过系统自动识别位置集中的每个解剖学结构位置，从而获得上述测量指令。当每个解剖学结构位置被确定后，则对应在测量用的坐标系中对应一个坐标位置，因此，本文中提到的测量指令包含对位置集中的一个或多个解剖学结构位置的坐标位置进行确认的信息。
步骤94，完成位置集中解剖学结构位置的确认。
步骤97，汇总测量计算结果。
在其中一个实施例中，还可以包括步骤95，显示解剖结构示意图用于提示位置集。或者还可以采用文本显示的方式提示位置集。无论是解剖结构示意图或是文本提示的方式，都可以用于提示用户在超声图像上点击确定每个解剖学结构位置。
在其中一个实施例中，还可以包括步骤96，显示可用测量值，也就是说显示根据测量指令获得的测量项的计算结果。下文将详细说明显示的方式，在此不累述。
参见图9，在另一个实施例中，在步骤S230(基于超声图像图像处理模块获得测量指令)中，还可以采用以下过程来实现。
步骤12，利用外部输入输出设备(例如键盘、鼠标、轨迹球等人机交互设备)接收来自于用户输入的至少一个测量项，每个测量项关联对应至少一个解剖学结构位置。本步骤同前文步骤92。
步骤14，根据输入的测量项，获得与测量项相关联的至少一个解剖学结构位置，形成位置集，根据位置集，确定至少一个解剖学结构位置在执行所述测量项时的执行次序，结合位置集和执行次序生成测量序列。本实施例中的位置集在其中一个实施例中可以为解剖学结构位置的集合。测量序列由系统自动实现。
步骤16，根据测量序列，依次确定位置集中每个解剖学结构位置，从而获得上述测量指令。本步骤中的依次确定位置集中每个解剖学结构位置的步骤中，可以通过用户根据测量序列在超声图像上依次点击确定每个解剖学结构位置，从而获得上述测量指令；也可以通过系统自动识别测量序列中每个解剖学结构位置，从而获得上述测量指令。当每个解剖学结构位置被确定后， 则对应在测量用的坐标系中对应一个坐标位置，因此，本文中提到的测量指令包含对位置集中的一个或多个解剖学结构位置的坐标位置进行确认的信息。
步骤16，完成测量序列中解剖学结构位置的确认。
步骤17，汇总测量计算结果。
在其中一个实施例中，还可以包括步骤13，显示解剖结构示意图用于提示位置集。或者还可以采用文本显示的方式提示位置集。无论是解剖结构示意图或是文本提示的方式，都可以用于提示用户在超声图像上点击确定每个解剖学结构位置。
在其中一个实施例中，还可以包括步骤15，显示可用测量值，也就是说显示根据测量指令获得的测量项的计算结果。下文将详细说明显示的方式，在此不累述。
上述各个实施例中无论是根据位置集，确定位置集中每个解剖学结构位置，从而获得上述测量指令；还是根据测量序列，依次确定位置集中每个解剖学结构位置，从而获得上述测量指令的过程中，还可以采用以下方式之一来确定位置集中每个解剖学结构位置获得所述测量指令：
第一种方式是，接收用户通过外部输入输出设备(可以包括键盘、鼠标、轨迹球或者触摸显示屏)依次在超声图像上对位置集中1个或多个解剖学结构位置进行的确认操作，根据用户依次输入的确认操作，获得测量指令；其中，用户进行确认操作的顺序为根据上述测量序列进行的有序操作。有序操作依据测量序列中的执行次序来完成。
第二种方式是，接收用户通过外部输入输出设备依次在超声图像上对位置集中1个或多个解剖学结构位置进行的确认操作，根据用户依次输入的确认操作，获得测量指令；其中，用户进行确认操作的顺序为可执行任意次序的操作，这里的可执行任意次序的操作还可以理解为，用户在没有系统或手册说明书中给予解剖学结构位置确认顺序时完成的确认操作。
前文中的确认操作用于明确每个解剖学结构位置在超声图像中的位置。
在其中一个实施例中，提示图8获得的位置集，或者提示图9获得的位置序列。可以采用以下方式提示位置集或测量序列：
首先，基于组织解剖学知识，生成目标组织的解剖结构示意图，如图10所示。
然后，利用显示器显示解剖结构示意图。解剖结构示意图可以显示在超 声图像的区域之外，也可以叠加显示在超声图像上。在其中一个实施例中，解剖结构示意图显示在前述第二层面上。
其次，在解剖结构示意图上标记位置集中的解剖学结构位置(如图10的左图，黑色点表示解剖学结构位置)，或者标记上述测量序列(如图10的右图)。本实施例中标记上述测量序列包括在解剖结构示意图上标记位置集中的解剖学结构位置，和标记标记位置集中各个解剖学结构位置的确认操作执行次序(例如图10右图中的数字表示黑点表征的解剖学结构位置，对应的执行次序)。当然除了图10中采用数字标记执行次序之外，还可以通过屏幕上滚动显示当前待确认的解剖学位置，用以进行提示。在其中一个实施例中，在通过屏幕滚动显示的方式包括：按照任意顺序或者执行次序依次显示位置集中当前待确认的解剖学结构位置。
更进一步地，所述确定位置集中每个解剖学结构位置获得所述测量指令的方式中还包括：根据上述测量序列，确定在执行测量项时多个解剖学结构位置对应的执行次序，并通过屏幕滚动的文本提示方式来依次向用户提示多个解剖学结构位置。
由于盆底检测需要比较两次采集图像中脏器的移动性，因此在测量之前需要寻找两次测量中的固定点建立适当的参考坐标系。在其中一个实施例中，新的超声图像中参数测量的方法还包括：
首先，确定参考坐标系，所述参考坐标系至少为以耻骨联合下缘为原点、耻骨联合中轴线为第二象限45角建立的第一直角坐标系，以耻骨联合下缘为原点、耻骨联合中轴线为X轴建立的第二直角坐标系，和以水平方向为X轴、竖直方向为Y轴建立的第三直角坐标系中其中之一；
然后，在步骤S240中，基于确定的参考坐标系，根据测量指令计算测量项。
本实施例可以兼容至少三种参考坐标系的建立方式，如图11所示，A为以耻骨联合下缘为原点，耻骨联合中轴线为第二象限45度角建立的直角坐标系，B为以耻骨联合下缘为原点，耻骨联合中轴线为x轴建立的直角坐标系。C为以耻骨联合下缘为原点，水平方向为x轴、竖直方向为y轴建立的直角坐标系。
BSD/PVD的计算方式，针对两种不同坐标系下用户均可以选择以下不同的BSD/PVD计算方式。
1)测量点到坐标系X轴的距离，或
2)测量点到坐标系Y轴的距离，或
3)测量点到坐标系原点的距离。
注:可参考图12显示了第1种计算方式。
用户可以在系统预设选项中选择这三种坐标系中的一种。例如，在其中一个实施例中，通过以下方式之一确定参考坐标系：
第一，接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线，根据用户输入建立第一直角坐标系或第二直角坐标系或第三直角坐标系；和，
第二，基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线，并建立第一直角坐标系、第二直角坐标系或第三直角坐标系。
或者还可以采用以下方式，首先，呈现至少三种参考坐标系的选择项，参考坐标系可以根据客户需求从上述第一直角坐标系、上述第二直角坐标系或上述第三直角坐标系中选择；然后，接收用户输入的关于参考坐标系的选择指令，根据选择指令确定参考坐标系。第一直角坐标系、第二坐标系和第三直角坐标系可以是采用上述第一种方式获得的，也可以是采用第二种方式获得的。
基于第一种方式建立坐标系时，不论是作为坐标系第二象限45度角又或是直接作为X轴，耻骨联合下缘及其中轴线都与坐标系的建立有关，因此用户需要输入耻骨联合下缘及其中轴线，本实施例中提供两种手动输入方案来实现接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线，具体如下：
1)用户首先输入耻骨联合182下缘位置信息181，如图16左图所示。然后，图16右图所示，操作输入设备(如轨迹球)，确定中轴线的位置183。例如，在其中一个实施例中，接收点击输入确定耻骨联合下缘，当轨迹球或鼠标或与显示屏的触摸接触发生移动时，候选中轴线跟着移动；检测所述移动的停止，在停止的位置处显示候选中轴线，用以确定耻骨联合中轴线的输入。值得注意的是，中轴线的位置不一定要与光标的绝对位置相关，甚至系统不需要显示鼠标光标。当鼠标或轨迹球等输入设备发生移动时，候选中轴线跟着移动，直至操作者通过单击等操作通知系统完成中轴线位置的选择。
2)用户也可以直接输入两个点的位置确定耻骨联合中轴线的位置。
基于第二种方式建立坐标系时，输入的两个点也可通过系统自动识别。在本实施例中提出了一种自动确定坐标系的方案，即通过模式识别的方法自动检测出耻骨联合下缘和耻骨联合中轴线，从而确定坐标系的位置。下面分 别描述如何检测这两个角剖位置。
在耻骨联合下缘的自动检测中，采用模式识别的方法检测耻骨联合下缘。在其中一个实施例中，将标记有耻骨联合下缘的图像正样本和不包含耻骨联合下缘的图像负样本，输入到检测器中进行训练；基于训练结果获得识别模型；利用识别模型自动检测超声图像中的耻骨联合下缘。例如，首先，从经过平滑去噪预处理后的若干图像序列中收集耻骨联合下缘图像方块(patch)，对其进行必要的大小归一化后作为正样本备用。然后收集不包含耻骨联合下缘的图像序列作为背景图像，这些背景图像中任一位置作意大小的图像方块都是一个负样本。最后，利用这些正样本和背景图像训练特定的检测器用于检测骨联合下缘。例如，这些特定的检测器包括但不限于以下经典的检测器：
1)采用Haar特征的级联adaBoost检测器
2)采用LBP特征的级联adaBoost检测器
3)支持向量机(Latent SVM)检测器
4)基于神经网络的检测器
本实施例不局限于检测器的类型，而是将检测器作为自动测量框架的一部分。根据检测器不同，其训练方式也不一样。对于检测方式，本方案采用的是基于移动窗口的搜索方法(如图27所示)。为了提高检测的效率，耻骨联合的检测区域集中在某个可能的区域(例如在0.1w至0.5w,0.1h至0.9h的区域),检测方式为以不同尺度按像素以一定步长逐步进行窗口式扫描，并从中选择最可能的区域。扫描方式为从左到右，从上到下进行窗口式的扫描，并从中选择最可能的区域。从大量包括耻骨联合区域的图像中选择耻骨联合区域作为正样本用于训练检测器。当图像经过翻转或镜像时，检测区域应作出相应的调整。
在耻骨联合中轴线的自动检测过程中，耻骨联合下缘确定后便确定了耻骨联合中轴线的起点，余下只需检测耻骨联合中轴线的方向，方法描述如下。在其中一个实施例中，基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线的过程包括：
首先，根据耻骨联合下缘确定耻骨联合中轴线的起点，然后，以起点为原点确定表征耻骨联合中轴线的候选射线，候选射线具有初始偏转角度，以初始偏转角为中心偏转预定范围并间隔预定角度进行扫描，获得多条候选射线。例如，在自然图像直角坐标系中以某个耻骨联合常见角度(如135度)为中心左右偏转一定角度为扫描范围并间隔一定角度进行扫描，选择最可能的 方向作为耻骨联合中轴线的方向，如图25所示。当图像经过翻转或镜像时，检测区域应作出相应的调整。图25中射线sc表示耻骨联合中轴线的初始偏转角度，虚线表示多条候选射线。如图25所示，S点通过检测器(如级联的adaboost分类器)检测得到。射线SC则是通过特定范围的角度搜索得到(如在自然图像直角坐标系中以135度为中心左右偏移30度，并且间隔1度进行取特征，从中选取最可能的角度)。在确定了射线SC后，X轴则由SC射线以S点为中心顺时针旋转135度得到(坐标系C1)或者以射线SC直接作为X轴(坐标系C)。
其次，提取多条候选射线的像素特征，根据像素特征，从多条候选射线中择一确定耻骨联合中轴线。例如，对于每条候选射线，提取与该射线相关的特征,例如沿着射线方向每间隔一段距离向两边法线方向选取法线上的像素值作为特征(如图26)所示。提取到的特征输入到预先训练好的检测器进行评分，得到一组得分(对应一组候选射线)，最后选取评分最高候选射线作为耻骨联合中轴线的方向。
有多种检测器可以用于检测耻骨联合中轴线，例如基于高斯分布的似然度检测器，基于(线性，多项式，logistic等)回归模型的检测器等。这些检测器的输入是与训练阶段所输入特征等价的特征，输出是连续的实数值表示对该输入的评分。
在确定了参考坐标系之后，用户预先定义测量需求中包含的测量项(如BSD,UTA等)，超声成像系统会根据这些测量需求计算出需要输入的解剖学结构位置点，以及自动安排输入顺序，还可以进一步地在屏幕上显示解剖结构示意图提示用户如何按照系统自动确定的解剖学结构位置点进行半自动化的测量操作流程；在用户根据解剖结构示意图进行解剖学结构位置的确认操作输入的过程中，系统实时显示当前可用的测量结果。可见，与传统的分散测量方案不同，本实施例提出了一种一体化的智能手动测量方案(见图8和图9)。基于图9所述的流程，以下举例说明如何进行智能化的手动测量。
在其中一个实施例中，用户在图9中的步骤12中，通过预设菜单定义如下的测量项目：
(1)耻骨联合和UVJ的夹角PUA，
(2)UVJ到X轴的距离BSD
(3)尿道倾斜角UTA,
(4)膀胱后角RVA，
(5)耻骨膀胱角PVA，和
(6)膀胱后壁最低点到X轴的距离PVD。
则在步骤14中，超声成像系统会根据这些测量项目之间的逻辑关系可以自动计算出所需输入的盆底解剖结构位置信息，即确定解剖学结构位置的位置集，并生成一个默认排序的测量序列，具体如下所示，参见图14所示：
(a)耻骨联合下缘(Lower boarder of SP)，
(b)耻骨联合中轴线(Central axis of SP)，
(c)膀胱尿道联接处(Urethrovesical junction,UVJ)，
(d)尿道近端(Proximal end of urethra)，
(e)膀胱后沿近端(Proximal end of posterior vesical wall)和
(f)膀胱后沿最低点(Lowest point of posterior vesical wall)。
以上输入项的解剖结构如图12和图13所示。图12给出了盆底各项测量示意图，图中包含了耻骨尿道角PUA,膀胱尿道后角RVA,尿道倾斜角UTA,耻骨联合到x轴的距离BSD。
图13给出了盆底各项测量示意图，图中包含了耻骨膀胱角PVA,膀胱尿道后角RVA,尿道倾斜角UTA,耻骨联合到x轴的距离PVD。其中a)和b)两步用于确定坐标系。此时用户可以按照个人习惯对这些输入进行排序，也可以选择不作更改。当采集到新的合格图像时，用户按预先定义的顺序(如图14所示)，通过输入设备分别输入如上的信息。随着用户的输入增加，系统将逐步更新测量结果直到完成测量。
随着输入的信息项增加，测量结果也将实时增加。信息项a到f的输入顺序按预先设定，也可按需进行删减。a到f以及1到6项的定义见前文所示。如图14所示，确认完(c)膀胱尿道联接处的位置后，可显示测量项(1)耻骨联合和UVJ的夹角PUA和(2)UVJ到X轴的距离BSD；确认完(d)尿道近端的位置后，可显示测量项(3)尿道倾斜角UTA；确认完(e)膀胱后沿近端的位置后，可显示测量项(4)膀胱后角RVA；确认完(f)膀胱后沿最低点的位置后，可显示测量项(5)耻骨膀胱角PVA和(6)膀胱后壁最低点到X轴的距离PVD。
在上述实施例的基础上，用户可以选择不测量角度PVA和距离PVD，此时测量需求将简化为：
(1)耻骨联合和UVJ夹角PUA，
(2)UVJ到X轴的距离BSD，
(3)尿道倾斜角UTA和
(4)膀胱后角RVA。
此时，位置集中所需输入的盆底解剖结构位置信息也发生了变化，并生成一个默认排序的测量序列，具体如下所示，参见图15所示：
(a)耻骨联合下缘(Lower boarder of SP)，
(b)耻骨联合中轴线(Central axis of SP)，
(c)膀胱尿道联接处(UrethroVesical Junction,UVJ)，
(d)尿道近端(Proximal end of urethra)，以及
(e)膀胱后沿近端(Proximal end of posterior vesical wall)。
整个简化的测量流程如图15所示。确认完(c)膀胱尿道联接处的位置后，可显示测量项(1)耻骨联合和UVJ的夹角PUA和(2)UVJ到X轴的距离BSD；确认完(d)尿道近端的位置后，可显示测量项(3)尿道倾斜角UTA；确认完(e)膀胱后沿近端的位置后，可显示测量项(4)膀胱后角RVA。
为了更加简化手动测量时的操作流程，或降低自动化测量时的计算量，则在其中一个实施例中，上述位置集中至少包括耻骨联合下缘和耻骨联合中轴线。更进一步地，上述测量序列中前两个解剖学结构位置为耻骨联合下缘和耻骨联合中轴线，从而将参考坐标系的过程直接加入到测量操作流中，从而简化的流程操作，同样的，在基于位置集和/或测量序列进行系统自动识别和计算时，同样依据位置集和/或测量序列首先确定参考坐标系的相关位置后，再进行具体测量项的计算。具体地，在其中一个实施例中，上述根据测量指令计算目标组织相关的测量项，获得计算结果的过程包括：
首先，图像处理模块根据测量序列中前两个解剖学结构位置确定参考坐标系。前两个解剖学结构位置可以为耻骨联合下缘和耻骨联合中轴线。
然后，依次根据测量序列中剩余的解剖学结构位置，并基于确定的参考坐标系，计算待计算的测量项，并获得相应的计算结果。
上述图像处理模块根据测量序列中前两个解剖学结构位置确定参考坐标系，可以采用前文中提到的以下两种方式来确定参考坐标系。具体为：
第一，接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线，根据用户输入建立第一直角坐标系、第二直角坐标系或第三坐标系；和，
第二，基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线，并建立第一直角坐标系、第二直角坐标系或第三坐标系。具体识别方式可参见前文中的相关说明，在此不作累述。
基于参考坐标系，根据图12和图13中各个测量项的相应关系，可以计算获得各个测量项对应的计算结果。
图9所示的系统自动生成的测量序列，可以进入编辑模式，来对测量项或测量结果进行更新。例如，在其中一个实施例中，上述结合位置集和执行次序生成测量序列包括：
首先，图像处理模块结合前文提到的位置集和执行次序，自动生成预置测量序列。基于图9中的步骤12中利用用户输入的测量项来自动生成预置测量序列。
然后，利用显示器显示预置测量序列。显示的方式可以是文本列表或者提示框的方式。
其次，利用输入输出设备接收用户输入的编辑指令，该编辑指令可以是对测量项的调整，也可以是对解剖学结构位置或执行次序的调整。
最后，根据上述编辑指令，更新预置测量序列，获得上述提到的测量序列，用以进行依次确定位置集中每个解剖学结构位置，获得上述测量指令。
在上述实施例中提供的编辑模式中，完成输入后，用户可选择进入编辑模式；当用户编辑这些输入时，测量结果实时更新；当用户进行第二帧的输入或编辑时，系统不仅实时显示第二帧测量结果，还将实时计算出某些测量值的相对于第一帧的变化，如BSD的相对变化量BND，UTA的相对变化量URA等。上述实施例中的编辑指令至少包含以下操作之一：1、对预置测量序列中位置集中解剖学位置的添加或减少，2、对预置测量序列中执行次序的调整，3、对测量项目的增加或删减。
前文中图8和图9所示的实施例和其他各个实施例中均提到了用户对测量项的输入，本文中“接收来自于用户输入的至少一个测量项”不局限于用户一项一项输入测量项的方式，还可以包括用户选择系统预置的测量模式或测量流程时而得到的一个或多个测量项的输入方式。
根据前文提到的各个实施例，可以基于位置集和/或测量序列，实现全自动测量。因此，在其中一个实施例中，本实施例还提出了一种全自动测量的方案，可以自动确定膀胱尿道联接处(UVJ)，尿道近端，膀胱后沿近端和膀胱后沿最低点等解剖结构位置。这些解剖结构位置的检则是在膀胱分割跟踪的基础上进行的。以下以几个特殊的解剖结构位置的检测为例进行说明。
1、膀胱分割跟踪
首先，对膀胱进行分割，以便利用膀胱的轮廓位置信息进行其它解剖结 果的检测。图17显示了一个膀胱轮廓分割的例子。图17中，封闭曲线框表示分割得到的膀胱区域。常用的检测方法包括水平集(level set),主动轮廓模型(active contour model)，图分割(Graph cut)等。对于动态的连续图像序列，可以采用跟踪的方法以提高准确度和降低逐帧计算的复杂度。
2、膀胱尿道联接处
图20显示了膀胱尿道联接处(膀胱颈)的检测示意图。如图20所示，对靠近探头方向的膀胱轮廓部分(如图中黄色加粗部分(粗线框部分)所示)按照一定间隔采样进行搜索。对于每个采样的位置，在一定范围内搜索不同的方向存在尿道的可能性，选取最佳的位置作为尿道的位置，同时将尿道与膀胱轮廓的位置作为膀胱颈的位值返回。本实施例所用的检测方法如下：对靠近探头方向的膀胱轮廓部分(如图中黄色加粗部分(粗线框部分)所示)按照一定间隔采样进行搜索。对于每个采样的位置，在一定范围内搜索不同的方向存在尿道的可能性，选取最佳的位置作为尿道的位置，同时将尿道与膀胱轮廓的位置作为膀胱颈的位值。对于每个候选尿道位置，确定最佳候选位置的方法与耻骨联合中轴线方向的确定类似，描述如下。
对于每个候选尿道位置，提取与该尿道结构相关的特征,例如沿着尿道方向每间隔一段距离向两边法线方向选取法线上的像素值作为特征。提取到的特征输入到预先训练好的检测器进行评分，得到一组得分，最后选取评分最高的候选位置作为最佳尿道位置。
3、膀胱后沿最低点
膀胱后沿是指膀胱尿道联接处右侧膀胱轮廓上离X轴(或坐标系原点，取决于PVD的计算方式)最接近的一个点。由于已经对膀胱轮廓进行定位，因此只需要在膀胱轮廓上的特定区域遍历找到离X轴最近的点即可，如图22所示。图22给出了膀胱后沿最低点的检测以及PVD的计算示意图。通过检测到的S点和方向SC即可确定X轴和Y轴的位置(图中所示为采用第一直角坐标系A时的情况)。通过膀胱轮廓的跟踪结果以及膀胱颈的检测结果可以得到膀胱后沿(即图中黄色加粗部分)离X轴最接近的点的位置V。此时，V点的Y坐标即为PVD的值。
4、尿道近端
在得到膀胱尿道联接处(UVJ)的同时，尿道的近端也同时被检测到，即截取离UVJ较近的一段尿道(例如2cm)。
5、膀胱后沿近端
膀胱后沿近端由膀胱轮廓和膀胱尿道联接处的位置共同得到，即选取膀胱轮廓后沿接近膀胱尿道联接处(例如2cm以内)的一点作为膀胱后沿近端点。
各测量项的计算
在自动检测到主要解剖结构后，各测量项的计算则简单明了。
RVA的测量如图18所示。系统采用水平集(level set)或类似方法自动跟踪旁胱的轮廓(也可以只跟踪旁胱的轮廓的下半部分)。同时，系统采用机器学习算法自动检测出尿道的位置(图中的黄色直线)。结合尿道和膀胱轮廓，系统从三个点N,U和R可以自动推算出RVA角。
NI的计算如图19所示，给出了NI角自动测量示意图。通过检测到的C,S两点可以确定X轴的位置，从而得到与其垂直的直线I的方向。NI角即射线UN所代表的尿道与直线I形成的夹角。
PVA，PVD的计算如图20和图21所示，图21给出了PVA测量示意图。PVA角度测量示意图。通过检测到的S点和方向SC以及V点即可确定PVA的值(如图中红色箭头所示)。PVA的大小与坐标系无关(即适用于上述第一和第二直角坐标系的情况)。
PUA,BSD的测量如图23和图24所示。图23给出了BSD自动测量示意图。图中U点为自动检测得到的膀胱颈，通过检测到的S点和方向SC即可确定X轴轴和Y轴的位置(图中所示为采用第一直角坐标系时的情况)。此时，U点的Y坐标即为BSD的值。图24给出了PUA角度测量示意图。通过检测到的S点和方向SC以及U点即可确定PUA的值(如图中红色箭头所示)。PUA的大小与坐标系无关(即适用于上述第一和第二直角坐标系的情况)。
在本发明的其中一个实施例中还可以用于两帧图像的对比测量，用于获得动态变化的测量结果。具体方案如下所示：
上述显示的超声图像包括第一帧图像和第二帧图像，因此，图像处理模块在执行基于所述超声图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得计算结果的过程可以采用以下方式：
图像处理模块基于第一帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第一计算结果；
图像处理模块基于第二帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第二计算结果；
图像处理模块计算第二计算结果相对第一计算结果的变化结果，
图像处理模块在输出计算结果时，一并输出变化结果。
这两帧图像可以采用以下方式来获得：
在显示器显示多帧超声图像时，接收用户的选择指令，根据用户的选择指令获得所述超声图像，该超声图像包括上述第一帧图像和上述第二帧图像。在其中一个实施例中，这两帧图像为静息帧图像和瓦氏帧图像。
上述针对第一帧图像获得第一计算结果，以及针对第二帧图像获得第二计算结果的过程可以参见前文中基于超声图像获得计算结果的过程，方法和步骤可部分相同或相近似，也可以全部相同或相近似。例如将上述针对步骤S230和步骤S240的过程中出现的“超声图像”替换为“第一帧图像”和“第二图像”，即可获得针对第一帧图像获得第一计算结果，以及针对第二帧图像获得第二计算结果的过程。
此外，在完成输入后，用户还可以选择进入编辑模式；当用户编辑这些输入时，测量结果实时更新；当用户进行第二帧图像的输入或编辑时，系统不仅实时显示第二帧测量结果，还将实时计算出某些测量值的相对于第一帧的变化，如BSD的相对变化量(即膀胱颈的下降距离BND)，UTA的相对变化量(对应为尿道旋转角URA)，PVD的相对变化(即膀胱后壁的下降距离BWD)等。当第二帧测量完成时，如果用户编辑第一帧的输入，则如上所示的动态变化量也将实时更新显示。
上述各个实施例中，除了智能化辅助手动测量外，超声成像系统还支持全自动测量，即所有解剖结构通过算法自动计算得到，所有测量项的值根据解剖结构的位置信息自动得到。如果对单帧超声图像是通过全自动方式得到的参数测量结果，则动态测量的变化结果也可以相应地自动得到。
此外，在另一个实施例中，基于上述获得盆底组织的计算结果，可以进行盆底功能的评估，获得评估等级。国际尿控协会(ICS)对盆底脱垂的程序有定量的评级体系，简称为POP-Q体系。该体系通过外科检查的方式将盆底脱垂方式分为0度到IV度共五个级别。本实施例中采用超声检查的方式对盆底器官的脱垂进行定量分析测量。在测量完成后，系统可以根据公式并综合各项测量结果得到一个评分，显示盆底功能障碍的程度或等级。该评分可转换成等价ICS POP-Q评分。
针对盆底功能的评估，在本实施例中可以提供如下几种方式供用户选择。
第一种，系统提供一个默认的评估规则，该方式由最大化Va l sa l va下PVD的值映射而来,即
当PVD＝1cm时，等价的POP-Q为1级。
当-2cm<PVD<1cm时，等价的POP-Q为2级。
当PVD<-2cm时，等价的POP-Q为3级以上。
例如，在其中一个实施例中，根据测量项对应的计算结果，基于默认的评估规则，获得评估等级，此处的默认的评估规则由最大化特定帧上计算的特定测量项对应的计算结果映射获得。特定帧包括瓦氏(Valsalva)帧，特定测量项包括PVD。
第二种，用户可以参考默认的评级方式自定义评分规则和公式。例如可以综合BSD和PVD的结果，又或者更改评判门限等。例如，在其中一个实施例中，根据上述计算结果中的BSD和PVD的值，获得评估等级，并输出。此外，在其中一个实施例中，图像处理模块接收用户对评估规则的调整，该评估规则用于确定评估等级，基于调整后的评估规则，依据上述方法获得的计算结果来确定评估等级，并输出。
第三种，系统提供一种基于机器学习的方法自动实现对脱垂程度的综合评分定级，描述如下：
(a)离线和在线收集一些二维测量图像作为样本及样本的测量结果和医生手动评分；
(b)系统自动将将医生的评分与测量结果以及图像进行数学关联分析，建立关联关系。分析的方法有很多，例如线性回归，卡尔曼滤波，高斯过程回归，支持向量回归等回归分析方法，又或者是深度神经网络等方法。
(c)建立好关联后，系统可综合测量结果给出一个评级分数。如果操作得对评级有异议，可以用手修改该评分。系统得到反馈后将进一步修进关联关系，以得到更加符合操作者预期的评分。总之，超声成系统在执行上述基于机器学习的方法时，可以利用多个样本图像和该样本图像上计算的测量项的计算结果、以及对应的评估等级，输入至检测器中进行数学关联性分析，获得机器模型，根据在超声图像上实际获得的计算结果利用该机器模型，自动获得评估等级。本文提到的评估等级，可以采用诸如0-100的数值表现形式、百分比表现形式、或者量化的阶段性指数(如1、2、3等等)等等。
在步骤S250中，图像处理模块输出计算测量项对应的计算结果。可以通过打印方式输出，或者通过显示器显示计算结果。
在其中一个实施例中，当计算完一个测量项，获得一个测量项对应的计算结果后，立即显示该计算结果。测量结果的计算和显示随着用户输入的增 加，系统逐项计算测量结果并实时显示。用户对第二帧图像进行测量时，系统额外计算在同一坐标系下第二帧的测量参数相对第一帧图像的变化结果并实时显示。
上述实施例中提出一种方便快捷的基于二维或三维超声的参数测量方案，可以适用于盆底参数的测量。该方案自动建立测量坐标系并利用了盆底各个测量项之间的关联性最大化地减少测量输入，提高测量效率和降低测量误差。该方案还能根据用户需求，计算两帧图像之间对应测量项的相对变化量，并且通过综合这些测量项及其相对变化量信息自动计算出受检者功能障碍评分或等级。方案还支持在线或离线学习用户的评分方式用于自动评分。
通过以上的实施方式的描述，本领域的技术人员可以清楚地了解到上述实施例方法可借助软件加必需的通用硬件平台的方式来实现，当然也可以通过硬件，但很多情况下前者是更佳的实施方式。基于这样的理解，本发明的技术方案本质上或者说对现有技术做出贡献的部分可以以软件产品的形式体现出来，该计算机软件产品承载在一个非易失性计算机可读存储载体(如ROM、磁碟、光盘、硬盘、服务器云空间)中，包括若干指令用以使得一台终端设备(可以是手机，计算机，服务器，或者网络设备等)执行本发明各个实施例的系统结构和方法。
以上实施例仅表达了几种实施方式，其描述较为具体和详细，但并不能因此而理解为对本发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干变形和改进，这些都属于本发明的保护范围。因此，本发明专利的保护范围应以所附权利要求为准。

Claims (44)

  1. 一种超声图像中参数测量的方法，其包括：
    获取超声图像,所述超声图像包含目标组织,所述超声图像通过利用超声探头接收来自目标组织的超声信号而获得所述超声图像；
    显示所述超声图像；
    基于所述超声图像获得测量指令；
    根据所述测量指令计算目标组织相关的测量项，获得计算结果；和
    输出所述计算结果。
  2. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述目标组织包括盆底组织。
  3. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述超声图像包括前盆腔超声图像、中盆腔超声图像或后盆腔超声图像。
  4. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述基于所述超声图像获得测量指令包括：
    接收来自于用户输入的至少一个所述测量项，每个测量项关联对应至少一个解剖学结构位置；
    根据输入的测量项，获得与测量项相关联的至少一个解剖学结构位置，形成位置集，
    根据所述位置集，确定位置集中每个解剖学结构位置，获得所述测量指令。
  5. 根据权利要求4所述的超声图像中参数测量的方法，其特征在于，所述根据所述位置集，确定位置集中每个解剖学结构位置，获得所述测量指令包括：
    根据所述位置集，确定所述至少一个解剖学结构位置在执行所述测量项时的执行次序；
    结合所述位置集和执行次序生成测量序列；
    根据所述测量序列，依次确定位置集中每个解剖学结构位置，获得所述测量指令。
  6. 根据权利要求4或5所述的超声图像中参数测量的方法，其特征在于，所述位置集为解剖学结构位置的集合。
  7. 根据权利要求4或5所述的超声图像中参数测量的方法，其特征在于，通过以下方式来根据所述位置集，确定位置集中每个解剖学结构位置获得所 述测量指令：
    接收用户依次在所述超声图像上对所述位置集中1个或多个解剖学结构位置进行的确认操作；
    根据用户依次输入的确认操作，获得所述测量指令；其中，用户进行确认操作的顺序为根据所述测量序列进行的有序操作，或者为可执行任意次序的操作。
  8. 根据权利要求4或5所述的超声图像中参数测量的方法，其特征在于，所述超声图像中参数测量的方法还包括：提示所述位置集或所述测量序列。
  9. 根据权利要求8所述的超声图像中参数测量的方法，其特征在于，所述提示所述位置集或所述测量序列包括：
    基于组织解剖学知识，生成目标组织的解剖结构示意图，
    显示所述解剖结构示意图，并在解剖结构示意图上标记所述位置集中的解剖学结构位置或者标记所述测量序列；或者，
    通过滚动显示当前待确认的解剖学结构位置。
  10. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述输出所述计算结果包括：
    当计算完一个测量项，获得一个测量项对应的计算结果后，立即显示该计算结果。
  11. 根据权利要求7所述的超声图像中参数测量的方法，其特征在于，所述确定位置集中每个解剖学结构位置获得所述测量指令的方式中还包括：
    根据所述测量序列，确定在执行所述测量项时多个解剖学结构位置对应的执行次序；
    依次向用户提示多个解剖学结构位置。
  12. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述超声图像中参数测量的方法还包括：
    确定参考坐标系，所述参考坐标系至少为以耻骨联合下缘为原点、耻骨联合中轴线为第二象限45角建立的第一直角坐标系，以耻骨联合下缘为原点、耻骨联合中轴线为X轴建立的第二直角坐标系，和以水平方向为X轴、竖直方向为Y轴建立的第三直角坐标系中之一；
    所述根据所述测量指令计算目标组织相关的测量项获得计算结果中，基于确定的参考坐标系，根据所述测量指令计算所述测量项。
  13. 根据权利要求4或5所述的超声图像中参数测量的方法，其特征在 于，所述位置集中至少包括耻骨联合下缘和耻骨联合中轴线；和/或
    所述测量序列中前两个解剖学结构位置为耻骨联合下缘和耻骨联合中轴线。
  14. 根据权利要求5所述的超声图像中参数测量的方法，其特征在于，所述根据所述测量指令计算目标组织相关的测量项，获得计算结果包括：
    根据所述测量序列中前两个解剖学结构位置确定参考坐标系；和
    依次根据所述测量序列中剩余的解剖学结构位置，并基于确定的参考坐标系，计算所述测量项，获得所述计算结果。
  15. 根据权利要求5所述的超声图像中参数测量的方法，其特征在于，所述结合所述位置集和执行次序生成测量序列包括：
    结合所述位置集和执行次序，自动生成预置测量序列；
    显示预置测量序列；
    接收用户输入的编辑指令，和
    根据所述编辑指令，更新所述预置测量序列，获得所述测量序列。
  16. 根据权利要求12或14所述的超声图像中参数测量的方法，其特征在于，所述确定参考坐标系的步骤包括以下方式之一：
    接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线，根据用户输入建立第一直角坐标系、第二直角坐标系、或第三直角坐标系；和，
    基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线，并建立第一直角坐标系、第二直角坐标系、或第三直角坐标系。
  17. 根据权利要求16所述的超声图像中参数测量的方法，其特征在于，所述基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线包括：
    将标记有耻骨联合下缘的图像正样本和不包含耻骨联合下缘的图像负样本，输入到检测器中进行训练；
    基于训练结果获得识别模型；和
    利用识别模型自动检测所述超声图像中的耻骨联合下缘。
  18. 根据权利要求16所述的超声图像中参数测量的方法，其特征在于，所述基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线包括：
    根据耻骨联合下缘确定耻骨联合中轴线的起点，
    以所述起点为原点确定表征耻骨联合中轴线的候选射线，所述候选射线 具有初始偏转角度；
    以初始偏转角为中心偏转预定范围并间隔预定角度进行扫描，获得多条候选射线；
    提取所述多条候选射线的像素特征；和，
    根据所述像素特征，从所述多条候选射线中择一确定所述耻骨联合中轴线。
  19. 根据权利要求16所述的超声图像中参数测量的方法，其特征在于，所述接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线包括：
    接收点击输入确定耻骨联合下缘，
    当轨迹球或鼠标或与显示屏的触摸接触发生移动时，候选中轴线跟着移动；和
    检测所述移动的停止，在停止的位置处显示候选中轴线，用以确定耻骨联合中轴线的输入。
  20. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述超声图像至少包括：静息帧图像和瓦氏帧图像。
  21. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述超声图像包括第一帧图像和第二帧图像，所述基于所述超声图像获得测量指令，根据所述测量指令计算目标组织相关的测量项，获得计算结果中包括：
    基于第一帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第一计算结果；
    基于第二帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第二计算结果；
    计算第二计算结果相对第一计算结果的变化结果，和
    输出所述变化结果。
  22. 根据权利要求1所述的超声图像中参数测量的方法，其特征在于，所述超声图像中参数测量的方法还包括：
    根据所述计算结果，获得评估等级；
    输出所述评估等级。
  23. 根据权利要求22所述的超声图像中参数测量的方法，其特征在于，所述根据所述计算结果获得评估等级中至少采用以下方式之一执行：
    接收用户对评估规则的调整，该评估规则用于确定评估等级，基于调整 后的评估规则，依据所述计算结果确定评估等级；
    根据所述计算结果，基于默认的评估规则，获得评估等级，所述默认的评估规则由最大化特定帧上计算的特定测量项对应的计算结果映射获得；和，
    利用多个样本图像和该样本图像上计算的测量项的计算结果、以及对应的评估等级，输入至检测器中进行数学关联性分析，获得机器模型，根据所述计算结果利用所述机器模型，自动获得评估等级。
  24. 一种超声成像系统，其特征在于，包括：
    探头，
    发射电路和接收电路，用于激励所述探头向目标组织发射超声波束，接收所述超声波束的超声回波，获得超声回波信号；
    图像处理模块，用于根据所述超声回波信号，获得超声图像；
    显示器，用于显示所述超声图像；其中，
    所述图像处理模块还用于基于所述超声图像获得测量指令，根据所述测量指令计算目标组织相关的测量项，获得计算结果，输出所述计算结果。
  25. 根据权利要求24所述的超声成像系统，其特征在于，所述目标组织包括盆底组织。
  26. 根据权利要求24所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式基于所述超声图像获得测量指令：
    接收来自于用户输入的至少一个所述测量项，每个测量项关联对应至少一个解剖学结构位置，
    根据输入的测量项，获得与测量项相关联的至少一个解剖学结构位置，形成位置集，和
    根据所述位置集，确定位置集中每个解剖学结构位置，获得所述测量指令。
  27. 根据权利要求26所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式根据所述位置集，确定位置集中每个解剖学结构位置，获得所述测量指令包括：
    根据所述位置集，确定所述至少一个解剖学结构位置在执行所述测量项时的执行次序；
    结合所述位置集和执行次序生成测量序列；和
    根据所述测量序列，依次确定位置集中每个解剖学结构位置，获得所述 测量指令。
  28. 根据权利要求26或27所述的超声成像系统，其特征在于，所述位置集为解剖学结构位置的集合。
  29. 根据权利要求26或27所述的超声成像系统，其特征在于，所述图像处理模块通过以下方式来确定位置集中每个解剖学结构位置获得所述测量指令：
    接收用户依次在所述超声图像上对所述位置集中1个或多个解剖学结构位置进行的确认操作；和，
    根据用户依次输入的确认操作，获得所述测量指令；其中，用户进行确认操作的顺序为根据所述测量序列进行的有序操作，或者为可执行任意次序的操作。
  30. 根据权利要求26或27所述的超声成像系统，其特征在于，所述超声成像系统还包括：通过显示器提示所述位置集或所述测量序列。
  31. 根据权利要求30所述的超声成像系统，其特征在于，所述图像处理模块通过以下方式提示所述位置集或所述测量序列包括：
    基于组织剖学知识，生成目标组织的解剖结构示意图，
    通过显示器显示所述解剖结构示意图，并在解剖结构示意图上标记所述位置集中的解剖学结构位置或者标记所述测量序列；或者，
    通过显示器滚动显示当前待确认的解剖学结构位置。
  32. 根据权利要求24所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式输出所述计算结果包括：
    当计算完一个测量项，获得一个测量项对应的计算结果后，立即显示该计算结果。
  33. 根据权利要求24所述的超声成像系统，其特征在于，所述图像处理模块还用于：
    确定参考坐标系，所述参考坐标系至少为以耻骨联合下缘为原点、耻骨联合中轴线为第二象限45角建立的第一直角坐标系，以耻骨联合下缘为原点、耻骨联合中轴线为X轴建立的第二直角坐标系，和以水平方向为X轴、竖直方向为Y轴建立的第三直角坐标系中之一；
    所述根据所述测量指令计算目标组织相关的测量项获得计算结果中，基于确定的参考坐标系，根据所述测量指令计算所述测量项。
  34. 根据权利要求26或27所述的超声成像系统，其特征在于，所述位 置集中至少包括耻骨联合下缘和耻骨联合中轴线；和/或
    所述测量序列中前两个解剖学结构位置为耻骨联合下缘和耻骨联合中轴线。
  35. 根据权利要求27所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式根据所述测量指令计算目标组织相关的测量项，获得计算结果：
    根据所述测量序列中前两个解剖学结构位置确定参考坐标系；
    依次根据所述测量序列中剩余的解剖学结构位置，并基于确定的参考坐标系，计算所述测量项，获得所述计算结果。
  36. 根据权利要求27所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式结合所述位置集和执行次序生成测量序列：
    结合所述位置集和执行次序，自动生成预置测量序列；
    显示预置测量序列；
    接收用户输入的编辑指令，
    根据所述编辑指令，更新所述预置测量序列，获得所述测量序列。
  37. 根据权利要求32或34所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式确定参考坐标系的步骤包括以下方式之一：
    接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线，根据用户输入建立第一直角坐标系或第二直角坐标系；和，
    基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线，并建立第一直角坐标系或第二直角坐标系。
  38. 根据权利要求36所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线：
    将标记有耻骨联合下缘的图像正样本和不包含耻骨联合下缘的图像负样本，输入到检测器中进行训练；
    基于训练结果获得识别模型；和
    利用识别模型自动检测所述超声图像中的耻骨联合下缘。
  39. 根据权利要求36所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式基于模式识别自动检测超声图像中的耻骨联合下缘和耻骨联合中轴线：
    根据耻骨联合下缘确定耻骨联合中轴线的起点，
    以所述起点为原点确定表征耻骨联合中轴线的候选射线，所述候选射线具有初始偏转角度；
    以初始偏转角为中心偏转预定范围并间隔预定角度进行扫描，获得多条候选射线；
    提取所述多条候选射线的像素特征；和
    根据所述像素特征，从所述多条候选射线中择一确定所述耻骨联合中轴线。
  40. 根据权利要求36所述的超声成像系统，其特征在于，所述图像处理模块还通过以下方式接收用户在超声图像上输入的耻骨联合下缘和耻骨联合中轴线包括：
    接收点击输入确定耻骨联合下缘，
    当轨迹球或鼠标或与显示屏的触摸接触发生移动时，候选中轴线跟着移动；和
    检测所述移动的停止，在停止的位置处显示候选中轴线，用以确定耻骨联合中轴线的输入。
  41. 根据权利要求24所述的超声成像系统，其特征在于，所述超声图像至少包括：静息帧图像和瓦氏帧图像。
  42. 根据权利要求24所述的超声成像系统，其特征在于，所述超声图像包括第一帧图像和第二帧图像，所述图像处理模块还通过以下方式基于所述超声图像获得测量指令，根据所述测量指令计算目标组织相关的测量项，获得计算结果：
    基于第一帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第一计算结果；
    基于第二帧图像获得测量指令，根据测量指令计算目标组织相关的测量项，获得第二计算结果；
    计算第二计算结果相对第一计算结果的变化结果，和
    输出所述变化结果。
  43. 根据权利要求24所述的超声成像系统，其特征在于，所述图像处理模块还用于：
    根据所述计算结果，获得评估等级；和
    输出所述评估等级。
  44. 根据权利要求42所述的超声成像系统，其特征在于，所述图像处理 模块还至少采用以下方式之一根据所述计算结果，获得评估等级：
    接收用户对评估规则的调整，该评估规则用于确定评估等级，基于调整后的评估规则，依据所述计算结果确定评估等级；
    根据所述计算结果，基于默认的评估规则，获得评估等级，所述默认的评估规则由最大化特定帧上计算的特定测量项对应的计算结果映射获得；和，
    利用多个样本图像和该样本图像上计算的测量项的计算结果、以及对应的评估等级，输入至检测器中进行数学关联性分析，获得机器模型，根据所述计算结果利用所述机器模型，自动获得评估等级。
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