WO2019225605A1

WO2019225605A1 - Medical image processing device, medical image diagnostic device, and medical image processing program

Info

Publication number: WO2019225605A1
Application number: PCT/JP2019/020113
Authority: WO
Inventors: 昂彦西岡
Original assignee: キヤノンメディカルシステムズ株式会社
Priority date: 2018-05-21
Filing date: 2019-05-21
Publication date: 2019-11-28

Abstract

A medical image processing device (300) according to an embodiment has an extraction function (352), a measurement function (354), and a control function (351). The extraction function (352) extracts a plurality of valve leaflets of a heart valve from image data on a subject. The measurement function (354) measures the length of at least one of the plurality of valve leaflets in a predetermined reference direction in a region in which said valve leaflet contacts another valve leaflet. The control function (351) controls a display unit to display the length distribution of the valve leaflets in each of a plurality of positions.

Description

Medical image processing apparatus, medical image diagnostic apparatus, and medical image processing program

Embodiments described herein relate generally to a medical image processing apparatus, a medical image diagnostic apparatus, and a medical image processing program.

Conventionally, for example, an ultrasonic diagnostic apparatus is used in a preoperative examination for various diseases (for example, aortic regurgitation or mitral regurgitation) of valves (heart valves) such as an aortic valve and a mitral valve. Thus, confirmation of the backflow of blood is performed by a user such as a doctor.

Japanese Patent Laid-Open No. 2017-018305 Japanese Patent Laying-Open No. 2015-226693

The problem to be solved by the present invention is to make the user grasp the detailed state of the valve.

The medical image processing apparatus according to the embodiment includes an extraction unit, a measurement unit, and a display control unit. The extraction unit extracts a plurality of leaflets of the heart valve from the image data of the subject. A measurement part measures the length of a predetermined reference direction in the region where the valve leaf and the other leaflet are in contact with each other, regarding at least one of the plurality of leaflets. The display control unit controls the display unit to display the distribution of the length at each of the plurality of positions of the leaflets.

FIG. 1 is a diagram illustrating an example of a configuration of a medical image processing apparatus according to the first embodiment. FIG. 2 is a diagram illustrating an example of a plurality of leaflets extracted by the extraction function according to the first embodiment. FIG. 3 is a diagram illustrating an example of a plurality of leaflets extracted by the extraction function according to the first embodiment. FIG. 4 is a diagram for explaining an example of processing executed by the setting function according to the first embodiment. FIG. 5 is a diagram for explaining an example of processing executed by the setting function according to the first embodiment. FIG. 6 is a diagram for explaining an example of processing executed by the setting function according to the first embodiment. FIG. 7 is a diagram for explaining an example of processing executed by the setting function according to the first embodiment. FIG. 8 is a diagram illustrating an example of the arrangement of reference surfaces according to the first embodiment. FIG. 9 is a diagram for explaining an example of processing for setting a boundary line by the setting function according to the first embodiment. FIG. 10 is a diagram for explaining an example of processing for setting a boundary line by the setting function according to the first embodiment. FIG. 11 is a diagram for explaining an example of processing for setting a boundary line by the setting function according to the first embodiment. FIG. 12 is a diagram for explaining an example of processing for measuring the length of the contact region in the blood flow direction by the measurement function according to the first embodiment. FIG. 13 is a diagram for explaining an example of a process of generating graph image data and display image data by the generation function according to the first embodiment. FIG. 14 is an enlarged view of a part of the boundary line shown in FIG. FIG. 15 is a diagram for explaining an example of processing for generating image data of another graph and image data for other display by the generation function according to the first embodiment. FIG. 16 is a flowchart illustrating an example of a flow of processing executed by the processing circuit according to the first embodiment. FIG. 17 is a diagram for describing an example of processing executed according to the second modification and the third modification. FIG. 18 is a diagram for describing an example of processing executed according to the fourth modification and the fifth modification. FIG. 19 is a diagram for describing an example of processing executed according to the fourth modification. FIG. 20 is a diagram for explaining an example of processing executed according to the fifth modification. FIG. 21 is a diagram for explaining an example of processing executed according to the sixth modification. FIG. 22 is a diagram for explaining an example of processing executed according to the sixth modification. FIG. 23 is a diagram for describing an example of processing executed by the setting function according to the seventh modification example of the first embodiment. FIG. 24 is a diagram for describing an example of processing executed by the setting function according to the eighth modification example of the first embodiment. FIG. 25 is a diagram illustrating an example of a configuration of a medical image processing apparatus according to the second embodiment. FIG. 26 is a diagram illustrating an example of the configuration of the X-ray CT apparatus according to the third embodiment.

Hereinafter, embodiments of a medical image processing apparatus, a medical image diagnostic apparatus, and a medical image processing program will be described with reference to the drawings. Note that the content described in one embodiment or modification may be similarly applied to other embodiments or other modifications.

(First embodiment)
First, the first embodiment will be described. FIG. 1 is a diagram illustrating an example of a configuration of a medical image processing apparatus 300 according to the first embodiment. As shown in FIG. 1, the medical image processing apparatus 300 is connected to the medical image diagnostic apparatus 100 and the image storage apparatus 200 via a network 400. The configuration illustrated in FIG. 1 is merely an example, and various devices such as a terminal device may be connected to the network 400 in addition to the medical image diagnostic apparatus 100, the image storage apparatus 200, and the medical image processing apparatus 300 illustrated in the figure. Good.

The medical image diagnostic apparatus 100 is, for example, an X-ray CT (Computed Tomography) apparatus, an ultrasonic diagnostic apparatus, a magnetic resonance imaging apparatus (MRI (Magnetic Resonance Imaging) apparatus), or an X-ray diagnostic apparatus. The medical image diagnostic apparatus 100 is not limited to the above-described medical image diagnostic apparatus (X-ray CT apparatus, ultrasonic diagnostic apparatus, magnetic resonance imaging apparatus, and X-ray diagnostic apparatus), and is another medical image diagnostic apparatus. Also good. The medical image diagnostic apparatus 100 acquires three-dimensional image data including a heart valve (heart valve) of a subject. Note that the three-dimensional image data is also referred to as volume data.

When the medical image diagnostic apparatus 100 is an X-ray CT apparatus, the X-ray CT apparatus collects CT image data of the subject. For example, an X-ray CT apparatus rotates an X-ray tube and an X-ray detector around a subject, detects X-rays transmitted through the subject, and collects projection data. Then, the X-ray CT apparatus generates three-dimensional CT image data based on the collected projection data. For example, an X-ray CT apparatus collects projection data obtained by imaging a region including a heart valve of a subject, and generates three-dimensional CT image data based on the collected projection data. Then, the X-ray CT apparatus transmits the generated three-dimensional CT image data to the image storage apparatus 200 and the medical image processing apparatus 300.

Note that the X-ray CT apparatus collects four-dimensional CT image data including the heart valve of the subject and transmits the collected four-dimensional CT image data to the image storage apparatus 200 and the medical image processing apparatus 300. Good. Here, the four-dimensional CT image data including the heart valve is composed of, for example, a plurality of time-series three-dimensional CT image data. That is, the four-dimensional CT image data including the heart valve is composed of a plurality of three-dimensional CT image data having different imaging times (time phases). Each of the plurality of three-dimensional CT image data constituting the four-dimensional CT image data is generated based on projection data obtained by imaging a region including the heart valve of the subject. Note that the three-dimensional CT image data and the four-dimensional CT image data are examples of image data. Further, the three-dimensional CT image data and the four-dimensional CT image data may be simply referred to as “CT image data”.

Further, examples of the heart valve of the subject include a mitral valve, an aortic valve, a tricuspid valve, and a pulmonary valve. Hereinafter, a case where the medical image diagnostic apparatus 100 is an X-ray CT apparatus will be described as an example. However, the medical image diagnostic apparatus 100 may be an ultrasonic diagnostic apparatus or a magnetic resonance imaging apparatus. That is, the medical image processing apparatus 300 may perform the same processes as various processes described later on the image data collected by the ultrasonic diagnostic apparatus or the magnetic resonance imaging apparatus.

The image storage apparatus 200 stores CT image data collected by the medical image diagnostic apparatus 100 that is an X-ray CT apparatus. For example, the image storage device 200 is realized by a computer device such as a server device. The image storage apparatus 200 acquires CT image data from the medical image diagnostic apparatus 100 via the network 400, and stores the acquired CT image data in a memory such as a hard disk or an optical disk provided inside or outside the apparatus. For example, the image storage device 200 acquires three-dimensional CT image data or four-dimensional CT image data from the medical image diagnostic apparatus 100 that is an X-ray CT apparatus, and stores the acquired CT image data in a memory. The image storage apparatus 200 transmits CT image data stored in the memory to the medical image processing apparatus 300 in response to a request from the medical image processing apparatus 300.

The medical image processing apparatus 300 acquires CT image data from the medical image diagnostic apparatus 100 and the image storage apparatus 200 via the network 400, and processes the acquired CT image data. For example, the medical image processing apparatus 300 acquires 3D CT image data or 4D CT image data from the medical image diagnostic apparatus 100 or the image storage apparatus 200, and performs various types of image processing on the acquired CT image data. . Then, the medical image processing apparatus 300 displays an image after image processing (for example, a display image) or the like on the display 340.

As shown in FIG. 1, the medical image processing apparatus 300 includes a communication interface 310, a memory 320, an input interface 330, a display 340, and a processing circuit 350.

The communication interface 310 is connected to the processing circuit 350, transmits various data between the medical image diagnostic apparatus 100 and the image storage apparatus 200 connected via the network 400, and the medical image diagnostic apparatus 100 and the image. Controls communication performed with the storage device 200. For example, the communication interface 310 is realized by a network card, a network adapter, a NIC (Network Interface Controller), or the like. For example, the communication interface 310 receives 3D CT image data or 4D CT image data from the medical image diagnostic apparatus 100 or the image storage apparatus 200, and outputs the received CT image data to the processing circuit 350.

The memory 320 is connected to the processing circuit 350 and stores various data. For example, the memory 320 is realized by a RAM (Random Access Memory), a semiconductor memory element such as a flash memory, a hard disk, or an optical disk. In the present embodiment, the memory 320 stores 3D CT image data or 4D CT image data received from the medical image diagnostic apparatus 100 or the image storage apparatus 200.

Further, the memory 320 stores various information used for processing of the processing circuit 350, processing results by the processing circuit 350, and the like. For example, the memory 320 stores display image data generated by the processing circuit 350, a measurement result by a measurement function 354, which will be described later, and the like.

The input interface 330 is connected to the processing circuit 350, converts an input operation received from the operator into an electrical signal, and outputs the electrical signal to the processing circuit 350. In the present specification, the input interface 330 is not limited to one having physical operation components such as a mouse and a keyboard. For example, an example of the input interface includes an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electric signal to the control circuit.

For example, the input interface 330 includes a trackball for performing various settings, a switch button, a mouse, a keyboard, a touch pad for performing an input operation by touching an operation surface, a touch in which a display screen and a touch pad are integrated. It is realized by a screen, a non-contact input interface using an optical sensor, or a voice input interface.

The display 340 is connected to the processing circuit 350 and displays various information and various images output from the processing circuit 350. For example, the display 340 is realized by a liquid crystal monitor, a CRT (Cathode Ray Tube) monitor, or a touch panel. For example, the display 340 displays a GUI (Graphical User Interface) for receiving an instruction from the operator, various display images, and various processing results by the processing circuit 350. The display 340 is an example of a display unit.

The processing circuit 350 controls each component included in the medical image processing apparatus 300 in accordance with an input operation received from the operator via the input interface 330. For example, the processing circuit 350 is realized by a processor. In the present embodiment, the processing circuit 350 stores the three-dimensional CT image data or the four-dimensional CT image data output from the communication interface 310 in the memory 320. Further, the processing circuit 350 reads out the three-dimensional CT image data or the four-dimensional CT image data from the memory 320, and displays a display image indicated by the display image data generated from the read CT image data. The display 340 is controlled.

The overall configuration of the medical image processing apparatus according to this embodiment has been described above. Here, a case will be described in which an ultrasonic diagnostic apparatus is used in the preoperative examination, and confirmation of blood backflow in the heart valve of the subject is performed by a user such as a doctor. In this case, since the detailed state of the valve is not presented to the user, it is difficult for the user to grasp the detailed state of the valve. For this reason, for example, the user may decide on a valve operation method such as whether to perform mitral valve replacement surgery or to perform mitral valve repair surgery before surgery. Have difficulty.

Therefore, as described below, the medical image processing apparatus 300 according to the present embodiment is configured to allow the user to grasp the detailed state of the valve.

The processing circuit 350 according to the first embodiment includes a control function 351, an extraction function 352, a setting function 353, a measurement function 354, and a generation function 355, as shown in FIG. Here, for example, the processing functions of the control function 351, the extraction function 352, the setting function 353, the measurement function 354, and the generation function 355, which are components of the processing circuit 350 shown in FIG. Is recorded in the memory 320. The processing circuit 350 implements a function corresponding to each program by reading each program from the memory 320 and executing each read program. In other words, the processing circuit 350 in a state where each program is read has the functions shown in the processing circuit 350 of FIG.

Note that all processing functions of the control function 351, the extraction function 352, the setting function 353, the measurement function 354, and the generation function 355 may be recorded in the memory 320 in the form of one program that can be executed by a computer. For example, such a program is also referred to as a medical image processing program. In this case, the processing circuit 350 reads the medical image processing program from the memory 320 and executes the read medical image processing program to thereby control the control function 351, the extraction function 352, the setting function 353, and the measurement function corresponding to the medical image processing program. 354 and the generation function 355 are realized.

The control function 351 is an example of a display control unit. The extraction function 352 is an example of an extraction unit. The setting function 353 is an example of a setting unit. The measurement function 354 is an example of a measurement unit. The generation function 355 is an example of a generation unit.

The control function 351 executes overall control of the medical image processing apparatus 300. For example, the control function 351 acquires CT image data from the medical image diagnostic apparatus 100 or the image storage apparatus 200 via the communication interface 310. For example, the control function 351 acquires three-dimensional CT image data including a heart valve of the subject or four-dimensional CT image data including a heart valve of the subject. Then, the control function 351 stores the acquired CT image data in the memory 320. In addition, the control function 351 controls the display 340 so as to display a display image indicated by display image data generated from CT image data by various image processing. In addition, the control function 351 controls the display 340 so as to display the measurement result measured by the measurement function 354.

The extraction function 352 extracts a plurality of leaflets constituting the valve from CT image data including the valve of the subject. That is, the extraction function 352 extracts a plurality of leaflets of the heart valve from the image data of the subject. Hereinafter, an example of various processes executed by the extraction function 352 will be described. For example, the extraction function 352 first acquires 3D CT image data or 4D CT image data stored in the memory 320.

Here, the case where the CT image data acquired by the extraction function 352 is three-dimensional CT image data will be described. For example, the user obtains a three-dimensional CT image obtained by photographing the valve that the user wants to observe at the time phase that the user wants to observe on the medical image diagnostic apparatus 100 or the image storage apparatus 200 via the input interface 330. Send a request to send data. Then, the medical image diagnostic apparatus 100 or the image storage apparatus 200 that has received the transmission request transmits three-dimensional CT image data that satisfies the transmission request to the medical image processing apparatus 300. The three-dimensional CT image data transmitted in this way is the three-dimensional CT image data acquired by the extraction function 352.

The valve and time phase that the user wants to observe will be described with specific examples. For example, when the subject's heart is in a normal state, in the diastole, the aortic valve closes and the mitral valve opens, and blood flows from the left atrium into the left ventricle. Here, in mitral stenosis, the opening of the mitral valve is narrowed, and the amount of blood flowing from the left atrium into the left ventricle during diastole is reduced. Therefore, when the subject is suspected of having mitral stenosis, a user such as a doctor may want to know the detailed state of the mitral valve during diastole.

Also, in aortic regurgitation (aortic regurgitation), a part of blood flows back to the left ventricle because the aortic valve does not close sufficiently during diastole. Therefore, the user may want to grasp the detailed state of the aortic valve in the diastole.

In the normal state of the subject, in the systole, the mitral valve is closed and the aortic valve is opened, and blood is sent from the left ventricle to the aorta. Here, in mitral regurgitation (mitral regurgitation), when the left ventricle contracts during systole, the mitral valve does not close sufficiently so that a part of blood flows back to the left atrium. Therefore, when the subject is suspected of having mitral stenosis, the user may want to grasp the detailed state of the mitral valve during the systole.

In aortic stenosis, the opening of the aortic valve becomes narrow during the systole, and the amount of blood flowing from the left ventricle into the aorta during the systole decreases. Therefore, when the subject is suspected of having aortic stenosis, the user may want to grasp the detailed state of the aortic valve during the systole.

Next, the case where the CT image data acquired by the extraction function 352 is four-dimensional CT image data will be described. In this case, the extraction function 352 selects one time-phase three-dimensional CT image data designated by the user from a plurality of time-phase three-dimensional CT image data constituting the four-dimensional CT image data. To do. Then, the extraction function 352 acquires the selected three-dimensional CT image data.

Then, the extraction function 352 extracts each of a plurality of leaflets constituting the heart valve of the subject from the acquired three-dimensional CT image data. At this time, the extraction function 352 extracts leaflets one by one from the three-dimensional CT image data using various known techniques. For example, the memory 320 may store information indicating the standard shape of the leaflets, and the extraction function 352 may acquire information indicating the standard shape of the leaflets from the memory 320. Then, the extraction function 352 may detect a portion similar to the shape indicated by the acquired information from the three-dimensional CT image data, and extract the detected portion from the three-dimensional CT image data.

2 and 3 are diagrams illustrating an example of a plurality of leaflets extracted by the extraction function 352 according to the first embodiment. FIG. 2 is a view when the mitral valve 40 is viewed from the upstream side in the flow of blood passing through the mitral valve 40. FIG. 3 is a perspective view of the mitral valve 40.

As shown in FIGS. 2 and 3, the mitral valve 40 includes two

leaflets

40a and 40b extracted by the extraction function 352. In the example of FIG.2 and FIG.3, the area | region (contact area | region) 41 where the leaflet 40a and the leaflet 40b are contacting exists. Since the leaflet 40a and the leaflet 40b are in contact (joined) with each other, the contact region 41 is common to the

leaflets

40a and 40b. Note that the contact between the

leaflets

40a and 40b is also referred to as the leaflets 40a overlapping the leaflets 40b.

In the example of FIGS. 2 and 3, a part of the leaflets 40a and a part of the leaflets 40b are separated from each other, and a part of the leaflets 40a and the leaflets 40b that are separated from each other are separated. There is a region (separated region) 42 formed by a part of. That is, there is a separation region 42 that is a region between a part of the leaflets 40a and a part of the leaflets 40b that are separated from each other. Here, the range of the separation region 42 in the blood flow direction is, for example, the range from the upstream end of the contact region 41 in the blood flow direction to the downstream end of the contact region 41 in the blood flow direction. The downstream end of the contact region 41 in the blood flow direction is the position of the reference plane 50 set by the setting function 353 as will be described later. In addition, the separation region 42 may be a region that is less than a threshold value for considering that the leaflets 40a and the leaflets 40b are separated from each other, for example.

1, the setting function 353 sets reference planes related to a plurality of leaflets for the plurality of leaflets extracted by the extraction function 352. Hereinafter, an example of processing for setting the reference plane by the setting function 353 will be described by taking a case where the processing target is the mitral valve 40 as an example.

4, 5, 6, and 7 are diagrams for explaining an example of processing executed by the setting function 353 according to the first embodiment. For example, the setting function 353 sets a reference plane (first reference plane) 50 for the plurality of

leaflets

40a and 40b, as shown in FIGS.

Here, the setting function 353 sets the reference plane 50 so as to be orthogonal or substantially orthogonal to the blood flow direction. Thus, the setting function 353 sets the reference plane 50 that is perpendicular or substantially perpendicular to the blood flow direction. That is, the setting function 353 sets the reference plane 50 so as to intersect the blood flow direction. FIG. 6 shows a direction 40a_3 from the root portion 40a_1 of one of the two

leaflets

40a and 40b toward the distal end portion 40a_2. Here, the direction 40a_3 is a direction from the root portion 40a_1 toward the tip portion 40a_2 along the leaflet 40a. The direction 40a_3 at the distal end portion 40a_2 is considered to be the same direction as the blood flow direction or the direction in the substantially same direction.

Therefore, as shown in FIG. 6, the setting function 353 sets the reference plane 50 that is in contact with the tip portion 40a_2 and orthogonal to the direction 40a_3. Thereby, the reference plane 50 orthogonal or substantially orthogonal to the blood flow direction is set. The setting function 353 may perform the same process on the leaflets 40b instead of the leaflets 40a to set the reference plane 50 that is orthogonal or substantially orthogonal to the blood flow direction. That is, the setting function 353 sets the reference plane 50 that intersects the blood flow direction by performing the above-described processing on one of the plurality of leaflets constituting the valve.

It should be noted that the reference surface 50 may have a shape that follows the shape of the tip portion 40a_2. In this case, since the shape of the reference surface 50 depends on the shape of the tip end portion 40a_2, the reference surface 50 may be a curved surface or a flat surface.

In addition, the setting function 353 can move the set reference plane 50 along the normal direction or the blood flow direction of the reference plane 50 and place it within a predetermined range (arrangeable range). . When the reference plane 50 is moved within the possible arrangement range, an MPR image corresponding to the moved position is newly generated by the generation function 355 described later, and the new MPR image is displayed on the display by the control function 351 described later. Is displayed. For example, a new MPR image 76 (see FIG. 13) and a new MPR image 80 (see FIG. 15) are generated by the generation function 355, and a new MPR image 76 and a new MPR image 80 are displayed by the control function 351. Is done. Since the surface passing through the origin of the coronary artery is relatively coincident with the overlapping portion of the valves, it is conceivable to arrange the reference surface 50 so as to pass through the origin of the coronary artery.

Here, the arrangement range of the reference surface 50 is different between the case where the two leaflets 40a and the leaflets 40b are at least partially in contact with each other and the case where they are not in contact at all.

First, the arrangement range of the reference surface 50 when the two leaflets 40a and the leaflets 40b are in contact with each other at least partially will be described. For example, the setting function 353 is within the possible range from the upstream end in the blood flow direction of the contact area 41 shown in FIG. 5 to the downstream end in the blood flow direction of the contact area 41 shown in FIG. The surface 50 can be moved and arranged. A specific example will be described. When the setting function 353 receives the designation of the arrangement position of the reference plane 50 within the possible arrangement range from the user via the input interface 330, the setting function 353 moves the reference plane 50 to the designated arrangement position and arranges it.

Next, a case where the two

leaflets

40a and 40b are not in contact with each other will be described. In this case, for example, the setting function 353 moves and arranges the reference plane 50 within a predetermined arrangement possible range. FIG. 8 is a diagram illustrating an example of the arrangement of the reference surfaces 50 according to the first embodiment. For example, the setting function 353 arranges the reference plane 50 as shown in FIG. A center 52a on the reference plane 50 between the

leaflets

40a and 40b shown in FIG. 8 will be described later.

When the reference plane 50 is set (arranged), the setting function 353, as shown in FIGS. 4, 5, and 7, is orthogonal to the reference plane 50 and orthogonal to the line segment 40e ( (Second reference plane) 51 is set. The line segment 40e is a line segment connecting the commissure part 40c and the commissure part 40d of the mitral valve 40. The reference surface 51 is an example of a surface.

In the present embodiment, the reference surface 50 and the reference surface 51 are used in various processes described below. In addition, although the method for setting the reference surface 50 and the reference surface 51 for the mitral valve 40 configured by the two

leaflets

40a and 40b has been described, the setting function 353 uses the same method for the three leaflets. The reference plane 50 and the reference plane 51 can be set for the aortic valve, tricuspid valve, and pulmonary valve configured by

An example of a method of setting the reference surface 50 and the reference surface 51 on a valve (three-leaf valve) constituted by three leaflets will be described. For example, the setting function 353 sets the reference plane 50 for one valve leaf out of three leaflets constituting one three-leaflet valve by the same method as described above. The setting function 353 sets the reference plane 51 for each combination of two adjacent leaflets. That is, the setting function 353 sets one reference plane 50 and three reference planes 51 for the trilobe valve.

For example, when the three-leaf valve is completely closed, that is, when the three leaflets contact at one point (contact point), the setting function 353 is configured to connect the contact point to the three commissures of the three-leaf valve. Three line segments connecting each of the parts are derived. The setting function 353 sets a reference plane 51 that is orthogonal to the line segment and orthogonal to the reference plane 50 for each of the three line segments.

For example, the setting function 353 calculates the position of the center of gravity of the area surrounded by the three leaflets on the reference plane 50 when the three-leaflet valve is not completely closed. Then, the setting function 353 derives three line segments connecting the center of gravity and each of the three commissures of the trilobe valve. The setting function 353 sets a reference plane 51 that is orthogonal to the line segment and orthogonal to the reference plane 50 for each of the three line segments.

When the reference plane 50 and the reference plane 51 are set, the setting function 353 sets a boundary line between two adjacent leaflets. The boundary line indicates, for example, the boundary between two adjacent leaflets. The boundary line is an example of a line segment. Hereinafter, an example of processing for setting the boundary line by the setting function 353 will be described by taking the case where the processing target is the mitral valve 40 (see FIG. 9) and the aortic valve 60 (see FIGS. 10 and 11) as examples. .

FIG. 9 is a diagram for explaining an example of processing for setting the boundary line 55 by the setting function 353 according to the first embodiment. FIG. 9 shows a case where the processing target is the mitral valve 40. As illustrated in FIG. 9, the setting function 353 sets a boundary line 55 between the leaflets 40a and the leaflets 40b on the reference plane 50.

The boundary line 55 is a line in which one end of the boundary line 55a and one end of the temporary boundary line 55b are connected. For example, the setting function 353 sets the boundary line 55a on the reference surface 50 at a position where the reference surface 50 and the contact area 41 intersect. Further, the setting function 353 sets a temporary boundary line 55b that passes through the center 52a on the reference plane 50 between the

leaflets

40a and 40b as shown in FIG. Then, the setting function 353 generates the boundary line 55 by connecting one end of the boundary line 55a and one end of the temporary boundary line 55b. In this way, the boundary line 55 is set with respect to the reference plane 50.

10 and 11 are diagrams for explaining an example of processing for setting the boundary lines 64 to 66 by the setting function 353 according to the first embodiment. 10 and 11 show a case where the processing target is the aortic valve 60 composed of three

leaflets

60a, 60b, and 60c. However, FIG. 10 shows a case where the aortic valve 60 is completely closed, and FIG. 11 shows a case where the aortic valve 60 is not completely closed. That is, FIG. 11 shows a case where the

leaflets

60a and 60b are partially separated, the

leaflets

60b and 60c are partially separated, and the

leaflets

60c and 60a are partially separated.

As shown in FIG. 10, when the aortic valve 60 is completely closed, the setting function 353 sets a boundary line 64 between the leaflets 60c and the leaflets 60a on the reference plane 50. For example, the setting function 353 sets the boundary line 64 at a position where the reference surface 50 and the contact area 61 intersect on the reference surface 50. The contact area 61 is an area where the leaflet 60c and the leaflet 60a are in contact with each other.

Similarly, on the reference plane 50, the setting function 353 sets a boundary line 65 between the

leaflets

60a and 60b and sets a boundary line 66 between the

leaflets

60b and 60c. For example, the setting function 353 sets the boundary line 65 at a position where the reference surface 50 and the contact area 62 intersect on the reference surface 50. The setting function 353 sets a boundary line 66 at a position where the reference surface 50 and the contact area 63 intersect on the reference surface 50. The contact region 62 is a region where the

leaflets

60a and 60b are in contact, and the contact region 63 is a region where the

leaflets

60b and 60c are in contact.

On the other hand, as shown in FIG. 11, when the aortic valve 60 is not completely closed, the setting function 353 calculates the center of gravity 67 of the region surrounded by the three

leaflets

60a, 60b, 60c on the reference plane 50. To do. The region surrounded by the

leaflets

60a, 60b, and 60c is a non-contact region where the

leaflets

60a, 60b, and 60c are not in contact with each other, and is also a non-existing region where the

leaflets

60a, 60b, and 60c are not present.

Then, the setting function 353 sets a boundary line 68 between the leaflets 60c and the leaflets 60a on the reference plane 50. The boundary line 68 is a line in which one end of the boundary line 68a is connected to one end of the temporary boundary line 68b. For example, the setting function 353 sets the boundary line 68a on the reference plane 50 at the position where the contact area where the

leaflets

60c and 60a contact each other and the reference plane 50 intersect. The setting function 353 sets a temporary boundary line 68b passing through the center on the reference surface 50 between the leaflets 60c and the leaflets 60a in the non-contact region with respect to the reference surface 50. Then, the setting function 353 generates the boundary line 68 by connecting one end of the boundary line 68a and one end of the temporary boundary line 68b. Note that the other end of the temporary boundary line 68 b is connected to the center of gravity 67. That is, the position of the other end of the temporary boundary line 68 b is the same as the position of the center of gravity 67. In this way, the boundary line 68 is set with respect to the reference plane 50.

Similarly, on the reference plane 50, the setting function 353 sets a boundary line 69 between the

leaflets

60a and 60b, and sets a boundary line 70 between the

leaflets

60b and 60c. The boundary line 69 is a line in which one end of the boundary line 69a and one end of the temporary boundary line 69b are connected, and the boundary line 70 is connected to one end of the boundary line 70a and one end of the temporary boundary line 70b. Is a line. The other end of the temporary boundary line 69 b and the other end of the temporary boundary line 70 b are connected to the center of gravity 67.

For example, the setting function 353 sets the leaflet 60a and the leaflet 60b in the same manner as described above for setting the boundary line 68a and the temporary boundary line 68b on the reference surface 50 using the leaflet 60c and the leaflet 60a. The boundary line 69 is set by setting the boundary line 69 a and the temporary boundary line 69 b on the reference plane 50. In addition, the setting function 353 sets the boundary line 70 by setting the boundary line 70a and the temporary boundary line 70b on the reference plane 50 using the leaflets 60b and the leaflets 60c in the same manner.

Returning to the description of FIG. 1, the measurement function 354 is the length in the blood flow direction of the contact area where each of the leaflets is in contact with the other leaflets for each of the plurality of leaflets extracted by the extraction function 352. Measure the thickness. In other words, the measurement function 354 measures the length in the blood flow direction for each of the plurality of leaflets, in the contact area where the leaflets and other leaflets contact. This length is also an index indicating, for example, the degree of close contact of the contact area where the leaflet contacts another leaflet. Hereinafter, an example of the process of measuring the length of the contact region in the blood flow direction by the measurement function 354 will be described by taking a case where the processing target is the mitral valve 40 as an example.

FIG. 12 is a diagram for explaining an example of processing for measuring the length of the contact region 41 in the blood flow direction 74 by the measurement function 354 according to the first embodiment. FIG. 12 shows a case where the processing target is the mitral valve 40. As shown in FIG. 12, the measurement function 354 moves the reference plane 51 along the boundary line 71 in the direction 72 from one end of the boundary line 71 toward the other end of the boundary line 71, while on the boundary line 71. The length in the blood flow direction 74 of the contact region 41 is measured at a plurality of positions. The blood flow direction 74 is an example of a predetermined reference direction.

Note that the boundary line 71 is a line set between the

leaflets

40a and 40b. In the example of FIG. 12, one end of the boundary line 71 is the left end of the boundary line 71, and the other end of the boundary line 71 is the right end of the boundary line 71.

For example, the measurement function 354 moves the reference surface 51 and positions the reference surface 51 at each of a plurality of positions on the boundary line 71. Then, each time the reference surface 51 is positioned at each of a plurality of positions, the measurement function 354 contacts the length of the blood flow direction 74 on the reference surface 51 of the contact region 41 intersecting with the reference surface 51. The length of the region 41 in the blood flow direction 74 is measured. That is, the measurement function 354 measures the length of the contact region 41 in the direction intersecting the reference plane 50 as the length of the contact region 41 in the blood flow direction. More specifically, the measurement function 354 measures the length of the contact region 41 in the direction substantially perpendicular to the reference surface 50 as the length of the contact region 41 in the blood flow direction. In this way, the measurement function 354 measures the length of the contact region 41 in the blood flow direction. The measurement function 354 measures the length of the contact region 41 in the direction intersecting the boundary line 71 and in the direction intersecting the reference plane 50 as the length of the contact region 41 in the blood flow direction. For example, the measurement function 354 measures the length of the contact region 41 in the direction orthogonal to the boundary line 71 and in the direction orthogonal to the reference plane 50 as the length of the contact region 41 in the blood flow direction. Note that the measurement function 354 may measure the length of the contact region 41 intersecting the reference surface 51 on the reference surface 51 as the length of the contact region 41 in the blood flow direction 74. That is, the measurement function 354 may measure the length of the contact area 41 on the reference surface 51 as the length of the contact area 41 in the blood flow direction 74.

For example, the measurement function 354 has a length 73a and a length 73b in the blood flow direction 74 of the contact area 41 as shown in FIG. Measure. In this way, the measurement function 354 measures a plurality of lengths corresponding to a plurality of positions on the boundary line 71. That is, the measurement function 354 measures the length of the blood flow direction 74 of the contact region 41 at each position in the direction along the boundary line 71 that intersects the blood flow direction 74 of the contact region 41. Such a length is also referred to as “depth”. One end of the boundary line 71 is the origin (0), and the distance (position) on the boundary line 71 from the origin is also referred to as “width”. The direction along the boundary line 71 is an example of the second direction.

Here, since the measurement function 354 uses CT image data having a relatively high spatial resolution, the measurement function 354 can measure the length of the contact region 41 in the blood flow direction with relatively good accuracy.

The length 73a and the length 73b in the blood flow direction of the contact region 41 where the leaflets 40a and the leaflets 40b are in contact are information indicating the detailed state of the mitral valve 77, and are a doctor and the like. This information is useful as a judgment material when determining the operation method of the mitral valve 77.

In addition, although the case where the length of the blood flow direction 74 of the contact region 41 is measured with respect to one boundary line 71 in the mitral valve 40 in which one boundary line 71 is set, the setting function 353 is described. The length of the contact region in the blood flow direction may be calculated by performing the same process on the aortic valve, tricuspid valve, and pulmonary valve in which three boundary lines are set in the same manner. That is, in the case of an aortic valve, a tricuspid valve, and a pulmonary valve, the method described above for measuring the length of the blood flow direction 74 of the contact region 41 with respect to one boundary line 71 in each of the three boundary lines; By using the same method, three lengths corresponding to three boundary lines can be measured.

In addition, as shown in FIG. 12, when the region facing the reference surface 51 (opposite region) is not parallel to the reference surface 51 out of all the regions 42, the measurement function The inclination angle of the facing region with respect to the reference plane 51 may be measured by 354. Then, the control function 351 may control the display 340 so as to display the measured tilt angle.

1, the generation function 355 generates a graph indicating the length at each position (each of a plurality of positions) on the boundary line 71 measured by the measurement function 354. Such a graph shows the length distribution at each of a plurality of positions of the leaflets. The generation function 355 generates display image data in which a plurality of leaflets extracted by the extraction function 352 are depicted. Hereinafter, an example of processing for generating a graph and display image data by the generation function 355 will be described.

FIG. 13 is a diagram for explaining an example of processing for generating graph image data and display image data by the generation function 355 according to the first embodiment. As illustrated in FIG. 13, the generation function 355 generates image data indicating a graph 75 representing the length of each position on the boundary line 78. Note that the length of each position on the boundary line 78 is the length measured by the measurement function 354. The boundary line 78 is a line set between a plurality of leaflets 77a and leaflets 77b constituting the mitral valve 77. The mitral valve 77 is a valve configured by a plurality of leaflets 77a and leaflets 77b extracted by the extraction function 352.

In the generation function 355, the horizontal axis is the length (depth) [mm] in the blood flow direction of the contact area where the

leaflets

77a and 77b contact, and the vertical axis is the position (width) on the boundary line 78. In the graph [mm], a plurality of lengths corresponding to a plurality of positions on the boundary line 78 measured by the measurement function 354 are plotted, thereby generating image data indicating the graph 75.

Also, the generation function 355 generates image data indicating an MPR (Multi Planar Reconstruction) image (tomographic image) 76 of the cross section of the mitral valve 77 cut by the reference plane 50 as display image data. That is, the generation function 355 generates display image data including a plurality of

leaflets

77a and 77b from the three-dimensional CT image data. Such image data is an example of first image data for display. Such image data is an example of first tomographic image data. The MPR image 76 is an example of a first tomographic image. Then, the generation function 355 generates image data indicating the boundary line 78. Then, the generation function 355 generates image data indicating the MPR image 76 on which the boundary line 78 is superimposed by superimposing the boundary line 78 on the MPR image 76. That is, the generation function 355 has a boundary line 78 corresponding to a contact area where the two

leaflets

77a and 77b come into contact with each other in the MPR image 76 with respect to the MPR image 76 at a position substantially corresponding to the reference plane 50 in the CT image data. Is generated.

Here, since CT image data has a relatively high spatial resolution, a plurality of leaflets are extracted with relatively high accuracy by the extraction function 352. Therefore, for example, the generation function 355 makes the display mode in which the user can easily recognize the boundary between the leaflet 77a shown in FIG. 13 and the separation region between the leaflet 77a and the leaflet 77b. Similarly, the generation function 355 changes the boundary between the leaflet 77b shown in FIG. 13 and the separated area into a display mode that is easy for the user to recognize. For example, the generation function 355 generates red line image data superimposed on the boundary between the leaflet 77a and the leaflet 77b and the separation region, and the red line indicated by the generated image data is converted into the leaflet 77a. And it overlaps with the boundary between the leaflet 77b and the separation region.

Here, in FIG. 13, as indicated by a broken line in the graph 75, a threshold value for determining that the

leaflets

77 a and 77 b are separated from each other is set as 1 [mm]. In this case, even if the position on the boundary line 78 where the length in the blood flow direction of the contact region 41 is less than 1 [mm] is the contact region, the leaflet 77a and the leaflet 77b are separated from each other. It is thought that it is close to the state.

For this reason, the generation function 355 includes, in the graph 75, a portion of the curve that indicates the correspondence between the position (width) on the boundary line 78 and the length (depth) of the contact region in the blood flow direction, less than the threshold, Image data representing the graph 75 is generated so that the portion (display manner) is different from the portion of. For example, the generation function 355 may generate image data indicating the graph 75 so that the portion of the curve that is less than the threshold and the portion that is greater than or equal to the threshold have different colors.

The threshold value is not limited to 1 [mm] described above, and may be another value. In addition, when the generation function 355 receives an instruction to change the threshold value from the user via the input interface 330, the generation function 355 may change the threshold value based on the instruction.

FIG. 14 is an enlarged view of a part of the boundary line 78 shown in FIG. As illustrated in FIG. 14, the generation function 355 includes a portion 78a of the boundary line 78 where the length of the contact region in the blood flow direction is less than the threshold value, and a boundary line where the length of the contact region in the blood flow direction is equal to or greater than the threshold value. Image data indicating the boundary line 78 is generated so that the portion (part other than the portion 78a) of 78 has a different form (display form).

Here, as described above, the generation function 355 superimposes the boundary line 78 on the MPR image 76. That is, the generation function 355 is a boundary line 78 set between two

adjacent leaflets

77a and 77b, and the length of the contact region in the blood flow direction is equal to or greater than the threshold value (other than the portion 78a). The boundary line 78 having a different aspect between the portion 78 and the portion 78 a less than the threshold is superimposed on the MPR image 76.

Note that the generation function 355 may generate a boundary line that is more finely displayed according to the size of the length of the contact region in the blood flow direction using a plurality of threshold values instead of one threshold value.

FIG. 15 is a diagram for explaining an example of processing for generating image data of another graph and image data for other display by the generation function 355 according to the first embodiment. As shown in FIG. 15, the generation function 355 generates image data indicating an MPR image 80 of a cross section of the aortic valve 83 cut by the reference plane 50 as display image data. Here, the aortic valve 83 is a valve composed of a plurality of

leaflets

83a, 83b, 83c extracted by the extraction function 352. That is, the generation function 355 generates display image data including a plurality of

leaflets

83a, 83b, and 83c from the three-dimensional CT image data. Such image data is an example of first image data for display.

The generation function 355 generates image data indicating the boundary line 84a, image data indicating the boundary line 84b, and image data indicating the boundary line 84c. The boundary line 84a is a line set between the leaflet 83c and the leaflet 83a. The boundary line 84b is a line set between the leaflets 83a and the leaflets 83b. The boundary line 84c is a line set between the leaflets 83b and the leaflets 83c.

Further, the generation function 355 generates image data indicating the center of gravity mark 85. The center of gravity here is the center of gravity of the non-contact region (non-existing region) surrounded by the three leaflets 83a, leaflets 83b, and leaflets 83c on the reference plane 50.

Further, the generation function 355 generates image data indicating the mark 86a at the end opposite to the center of gravity of the boundary line 84a. The generation function 355 generates image data indicating the mark 86b at the end opposite to the center of gravity of the boundary line 84b. The generation function 355 generates image data indicating the mark 86c at the end opposite to the center of gravity of the boundary line 84c.

Further, the generation function 355 generates image data indicating the mark 87a that can move on the boundary line 84a. The generation function 355 generates image data indicating the mark 87b that can move on the boundary line 84b. The generation function 355 generates image data indicating the mark 87c that can move on the boundary line 84c.

The generation function 355 superimposes the boundary lines 84a to 84c, the

marks

85, 86a to 86c, and 87a to 87c on the MPR image 80. Accordingly, the generation function 355 generates image data indicating the MPR image 80 on which the boundary lines 84a to 84c, the

marks

85, 86a to 86c, and 87a to 87c are superimposed.

Further, the generation function 355 generates image data indicating the MPR image 81a of the cross section of the aortic valve 83 passing through the mark 87a on the boundary line 84a and orthogonal to the boundary line 84a. The generation function 355 generates image data indicating the MPR image 81b of the cross section of the aortic valve 83 that passes through the mark 87b on the boundary line 84b and is orthogonal to the boundary line 84b. The generation function 355 generates image data indicating the MPR image 81c of the cross section of the aortic valve 83 that passes through the mark 87c on the boundary line 84c and is orthogonal to the boundary line 84c.

As shown in FIG. 15, the MPR image 81a shows the contact state between the leaflets 83c and the leaflets 83a. Similarly, the MPR image 81b shows the contact state between the valve leaf 83a and the valve leaf 83b, and the MPR image 81c shows the contact state between the valve leaf 83b and the valve leaf 83c.

For example, the MPR image 81a shows a state where the leaflets 83c and the leaflets 83a are separated from each other. Further, the MPR image 81b shows a state where the leaflets 83a and the leaflets 83b are in contact with each other. Further, the MPR image 81c shows a state in which the leaflets 83b and the leaflets 83c are in contact with each other.

Further, the generation function 355 generates image data indicating a graph 82a representing the length of the contact region in the blood flow direction for each position on the boundary line 84a. In addition, the generation function 355 generates image data indicating a graph 82b representing the length in the blood flow direction of the contact region for each position on the boundary line 84b. In addition, the generation function 355 generates image data indicating a graph 82c representing the length in the blood flow direction of the contact region for each position on the boundary line 84c. The length in the blood flow direction of the contact area for each position on the boundary line 84a, the length in the blood flow direction of the contact area for each position on the boundary line 84b, and the blood in the contact area for each position on the boundary line 84c The length in the flow direction is measured by the measurement function 354.

A curve 99a in the graph 82a indicates a correspondence relationship between the position (width) on the boundary line 84a and the length (depth) in the blood flow direction of the contact region where the leaflets 83c and the leaflets 83a are in contact with each other. .

The mark 89a in the graph 82a corresponds to the mark 86a at the end of the boundary line 84a. That is, in the graph 82a, the mark 89a has a position (width; origin (0)) on the boundary line 84a of the mark 86a and a length (depth) corresponding to the position on the boundary line 84a of the mark 86a. 5 [mm]).

The mark 88 in the graph 82a corresponds to the mark 85 indicating the center of gravity. That is, in the graph 82a, the mark 88 is arranged at a position indicating a position (depth; 0 [mm]) corresponding to a position on the boundary line 84a of the center of gravity and a position on the boundary line 84a of the center of gravity. Has been.

Further, the mark 90a in the graph 82a corresponds to the mark 87a. That is, the mark 90a is arranged on the curve 99a so as to indicate the same position as the position of the mark 87a on the boundary line 84a.

The same applies to the curve 99b, the mark 89b, the mark 88, and the mark 90b in the graph 82b, and the curve 99c, the mark 89c, the mark 88, and the mark 90c in the graph 82c. That is, the curve 99b shows the correspondence between the position on the boundary line 84b and the length in the blood flow direction of the contact area where the leaflets 83a and the leaflets 83b are in contact. The mark 89b corresponds to the mark 86b at the end of the boundary line 84b. A mark 88 in the graph 82b indicates a position on the boundary line 84b of the center of gravity and a length (depth; 0 [mm]) corresponding to the position on the boundary line 84b of the center of gravity. The mark 90b corresponds to the mark 87b.

The curve 99c shows the correspondence between the position on the boundary line 84c and the length in the blood flow direction of the contact area where the leaflets 83b and the leaflets 83c are in contact. The mark 89c corresponds to the mark 86c at the end of the boundary line 84c. A mark 88 in the graph 82c indicates a position on the boundary line 84c of the center of gravity and a length (depth; 0 [mm]) corresponding to the position on the boundary line 84c of the center of gravity. The mark 90c corresponds to the mark 87c.

In the graph 82a, a threshold value 98 for setting the leaflet 83c and the leaflet 83a to be separated from each other is set as 1 [mm]. Therefore, the generation function 355 may generate image data indicating the graph 82a so that the portion of the curve 99a that is less than the threshold 98 is different from the portion that is equal to or greater than the threshold 98. The same applies to the graph 82b and the graph 82c.

In the example of FIG. 15 as well, the threshold value is not limited to 1 [mm] described above, and may be other values, as in the example of FIG. In addition, when the generation function 355 receives an instruction to change the threshold value from the user, the generation function 355 may change the threshold value based on the instruction.

Here, for example, when the image data indicating the graph 75 shown in FIG. 13 and the image data indicating the MPR image 76 on which the boundary line 78 is superimposed are generated by the generation function 355, the control function 351 displays the graph 75. The image data to be displayed and the image data to indicate the MPR image 76 on which the boundary line 78 is superimposed are transmitted to the display 340. Then, the control function 351 controls the display 340 to display the MPR image 76 on which the graph 75 and the boundary line 78 are superimposed, as shown in FIG.

That is, the control function 351 is a position in the contact region where the leaflet 77a and the leaflet 77b contact each other, and the blood flow direction of the contact region at each position in the direction along the boundary line 78 intersecting the blood flow direction. The display 340 is controlled to display the length of. Thus, the control function 351 causes the display 34 to display a graph of the length distribution at each of the plurality of positions of the boundary line 78. In addition, the control function 351 controls the display 340 so as to display the display MPR image 76 in which the plurality of leaflets 77a and leaflets 77b are drawn together with the length of the contact region in the blood flow direction. That is, the control function 351 causes the display 34 to display an image in which the boundary line 78 corresponding to the contact region where the two

leaflets

77a and 77b are in contact with the MPR image 76 is superimposed on the MPR image 76. The display MPR image 76 is an example of a first display image. The direction along the boundary line 78 is an example of the second direction.

Thus, the medical image processing apparatus 300 according to the first embodiment displays the length in the blood flow direction of the contact area where the

leaflets

77a and 77b contact. Here, the length in the blood flow direction of the contact area where the

leaflets

77a and 77b are in contact is information indicating the detailed state of the mitral valve 77, and for a user such as a doctor, the mitral valve This information is useful as a judgment material when determining 77 surgical methods. Therefore, according to the medical image processing apparatus 300, the user can grasp the detailed state of the mitral valve 77. Furthermore, as a result, according to the medical image processing apparatus 300, it is possible to assist the user in determining the operation method of the mitral valve 77. For example, the user can intuitively specify the portion of the mitral valve 77 that requires surgery. For this reason, the time required for planning the operation of the mitral valve 77 can be shortened.

Further, the medical image processing apparatus 300 superimposes on the MPR image 76 a boundary line 78 having different aspects in a portion (a portion other than the portion 78a) whose length in the blood flow direction of the contact region is greater than or equal to a threshold value and a portion 78a that is less than the threshold value. In this state, the image is displayed on the display 340. For this reason, according to the medical image processing apparatus 300, by setting the threshold value to be larger than 0, it is considered that the medical image processing apparatus 300 is close to the separated state as well as the separated region where the leaflet 77a and the leaflet 77b are separated. The user can easily grasp the contact area between the leaflet 77a and the leaflet 77b.

The generation function 355 generates a new MPR image 76 based on the position of the reference surface 50 after the movement when the reference surface 50 is moved by a user operation. Then, the control function 351 updates the MPR image 76 being displayed on the display 340 with the new MPR image 76.

Further, for example, the image data indicating the MPR image 80 on which the boundary lines 84a to 84c, the

marks

85, 86a to 86c, and 87a to 87c shown in FIG. 15 are superimposed, the image data of the MPR images 81a to 81c, and the graph 82a A case where each of the image data 82 to 82c is generated by the generation function 355 will be described. In this case, the control function 351 transmits these image data to the display 340. Then, as shown in FIG. 15, the control function 351 displays the MPR image 80, the MPR images 81a to 81c, and the graphs 82a to 82c on which the boundary lines 84a to 84c, the

marks

85, 86a to 86c, and 87a to 87c are superimposed. The display 340 is controlled as follows.

Here, the mark 87 a displayed on the display 340 can be moved on the boundary line 84 a by a user operation via the input interface 330. Similarly, the mark 87b can be moved on the boundary line 84b by the user's operation, and the mark 87c can be moved on the boundary line 84c. For example, the generation function 355 moves the

marks

87a, 87b, 87c to positions specified by the user.

Therefore, according to the position of the mark 87a after movement, the generation function 355 generates image data indicating a new MPR image 81a. Similarly, the generation function 355 generates image data indicating a new MPR image 81b according to the position of the moved mark 87b, and image data indicating the new MPR image 81c according to the position of the moved mark 87c. Is generated. That is, the generation function 355 generates image data indicating

new MPR images

81a, 81b, and 81c in conjunction with changes in the positions of the

marks

87a, 87b, and 87c.

As described above, the generation function 355 receives the designation of the position on the boundary line 84a, and includes the designated position, and the MPR image 81a for display in which the two adjacent leaflets 83c and the leaflets 83a are depicted. Display image data indicating the above is generated. Similarly, the generation function 355 accepts designation of a position on the boundary line 84b, and displays an MPR image 81b for display that includes the designated position and depicts two adjacent leaflets 83a and leaflets 83b. Display image data to be displayed is generated. Further, the generation function 355 accepts designation of a position on the boundary line 84c, and shows a display MPR image 81c that includes the designated position and depicts two adjacent leaflets 83b and leaflets 83c. Display image data is generated.

Note that the

MPR images

81a, 81b, and 81c are examples of the second display image. The

MPR images

81a, 81b, and 81c are examples of the second tomographic image. Each image data of the

MPR images

81a, 81b, 81c is an example of second image data for display. In addition, each image data of the

MPR images

81a, 81b, 81c is an example of second tomographic image data.

Then, the control function 351 controls the display 340 so as to display the MPR image 81a indicated by the image data of the MPR image 81a. Similarly, the control function 351 controls the display 340 so as to display the MPR image 81b indicated by the image data of the MPR image 81b. The control function 351 controls the display 340 so as to display the MPR image 81b indicated by the image data of the MPR image 81c. For example, the control function 351 controls the display 340 so as to update the

MPR images

81a, 81b, and 81c being displayed with the

new MPR images

81a, 81b, and 81c. As described above, the medical image processing apparatus 300 updates the displayed

MPR images

81a, 81b, and 81c in conjunction with changes in the positions of the

marks

87a, 87b, and 87c.

Therefore, the user simply moves the

marks

87a, 87b, 87c, the contact state between the

leaflets

83c and 83a, the contact state between the

leaflets

83a and 83b, and the leaflets 83b and valves at various positions. The contact state of the leaves 83c can be easily grasped.

Further, according to the position of the mark 87a after the movement, the generation function 355 displays an image showing a new graph 82a in which the position of the mark 90a on the curve 99a is changed to the same position as the position of the mark 87a after the movement. Generate data. Further, the generation function 355 displays an image showing a new graph 82b in which the position of the mark 90b on the curve 99b is changed to the same position as the position of the moved mark 87b according to the position of the moved mark 87b. Generate data. Further, the generation function 355 displays an image showing a new graph 82c in which the position of the mark 90c on the curve 99c is changed to the same position as the position of the moved mark 87c according to the position of the moved mark 87c. Generate data.

That is, the generation function 355 generates

new graphs

82a, 82b, and 82c in conjunction with changes in the positions of the

marks

87a, 87b, and 87c. Then, the control function 351 controls the display 340 so as to update the currently displayed

graphs

82a, 82b, and 82c with the

new graphs

82a, 82b, and 82c. As described above, the medical image processing apparatus 300 updates the displayed

graphs

82a, 82b, and 82c in conjunction with the change in the positions of the

marks

87a, 87b, and 87c.

Further, when the reference plane 50 is moved by a user operation, the generation function 355 generates a new MPR image 80 based on the position of the reference plane 50 after the movement. Then, the control function 351 updates the MPR image 80 being displayed on the display 340 with the new MPR image 80.

In the medical image processing apparatus 300 according to the first embodiment, the length in the blood flow direction of the contact region where the leaflets 83c and the leaflets 83a contact each other, the blood in the contact region where the leaflets 83a and the leaflets 83b contact each other. The length in the flow direction and the length in the blood flow direction of the contact area where the leaflets 83a and the leaflets 83b contact are displayed. Therefore, according to the medical image processing apparatus 300, the user can grasp the detailed state of the aortic valve 83. Further, according to the medical image processing apparatus 300, it is possible to assist the user in determining the operation method for the aortic valve 83.

FIG. 16 is a flowchart illustrating an example of a flow of processing executed by the processing circuit 350 according to the first embodiment. Such processing is executed by the functions 351 to 355 of the processing circuit 350 when, for example, an instruction for executing processing is received by the input interface 330.

As shown in FIG. 16, the extraction function 352 acquires 3D CT image data or 4D CT image data stored in the memory 320 (step S101). In addition, when the four-dimensional CT image data is acquired, the extraction function 352 selects one time phase 3 from a plurality of time-phase three-dimensional CT image data constituting the four-dimensional CT image data. Dimensional CT image data is acquired.

Then, the extraction function 352 extracts each of a plurality of leaflets constituting the heart valve of the subject from the three-dimensional CT image data (step S102). Then, the setting function 353 sets the reference plane 50 and the reference plane 51 related to the plurality of leaflets for the plurality of leaflets extracted by the extraction function 352 (step S103).

Then, the setting function 353 sets a boundary line between two adjacent leaflets (step S104). And the measurement function 354 measures the length of the blood flow direction of the contact area | region where each valve leaf and another valve leaf are contacting about each of several leaflets (step S105). And the production | generation function 355 produces | generates the image data which shows the graph showing the length of the blood flow direction of the contact area for every position on the boundary line set between the leaflets which comprise a valve (step S106).

Then, the generation function 355 generates image data indicating an MPR image of the cross section of the valve cut by the reference plane 50 as display image data (step S107). Then, the control function 351 controls the display 340 so as to display the graph and the display image (Step S108), and ends the process.

Steps S101 and S102 shown in FIG. 16 are steps corresponding to the extraction function 352. Steps S101 and S102 are steps in which the extraction function 352 is realized by the processing circuit 350 calling and executing a program corresponding to the extraction function 352 from the memory 320. Steps S103 and S104 are steps corresponding to the setting function 353. Steps S103 and S104 are steps in which the setting function 353 is realized by the processing circuit 350 calling and executing a program corresponding to the setting function 353 from the memory 320.

Step S105 is a step corresponding to the measurement function 354. Step S105 is a step in which the measurement function 354 is realized by the processing circuit 350 calling and executing a program corresponding to the measurement function 354 from the memory 320.

Steps S106 and S107 are steps corresponding to the generation function 355. Steps S106 and S107 are steps in which the generation function 355 is realized by the processing circuit 350 calling and executing a program corresponding to the generation function 355 from the memory 320. Step S108 is a step in which the control function 351 is realized by the processing circuit 350 calling and executing a program corresponding to the control function 351 from the memory 320.

The medical image processing apparatus 300 according to the first embodiment has been described above. According to the medical image processing apparatus 300, as described above, the user can grasp the detailed state of the valve.

(First modification of the first embodiment)
In the first embodiment, the setting function 353 is a reference plane 50 related to a plurality of leaflets and intersects with the blood flow direction with respect to the plurality of leaflets extracted by the extraction function 352. The case where 50 is set has been described. However, the setting function 353 sets, for at least one leaflet among the plurality of leaflets, a reference surface 50 related to the at least one leaflet and intersecting the blood flow direction. Also good.

Moreover, in 1st Embodiment, when the measurement function 354 measures the length of the blood flow direction of the contact area which each leaflet and other leaflets contact about each of several leaflets. Explained. However, the measurement function 354 may measure the length in the blood flow direction of the contact region where the valve leaf and another leaf leaf are in contact with each other for at least one of the plurality of leaflets.

(Second modification of the first embodiment)
The medical image processing apparatus 300 may measure information indicating the detailed state of the valve other than the length of the contact region in the blood flow direction. Therefore, a case where information indicating the detailed state of other valves is measured will be described. Hereinafter, five pieces of information indicating the detailed state of the valve other than the length of the contact region in the blood flow direction in the second to sixth modifications of the first embodiment will be described.

The medical image processing apparatus 300 according to each of the second to sixth modifications of the first embodiment performs the same processing as the medical image processing apparatus 300 according to the first embodiment described above. In addition, processing described below is further executed.

Note that, in the descriptions of the second to sixth modifications of the first embodiment, the same components as those in the first embodiment may be denoted by the same reference numerals and description thereof may be omitted. FIG. 17 is a diagram for describing an example of processing executed according to the second modification and the third modification.

First, a second modification example that measures information indicating the detailed state of the first valve will be described. As shown in FIG. 17, the measurement function 354 measures the length 91a of the boundary line 55a. That is, the measurement function 354 calculates the length 91a in the direction along the boundary line 55a of the contact region 41 where the

leaflets

40a and 40b are in contact. The direction along the boundary line 55a is an example of the second direction.

Note that the measurement function 354 is the length of the contact area where at least one of the plurality of leaflets extracted by the extraction function 352 is in contact with the other leaflets, and the boundary What is necessary is just to calculate the length of the direction along a line.

Then, the control function 351 controls the display 340 so as to display the length in the direction along the boundary line of the contact area measured by the measurement function 354. For example, the control function 351 controls the display 340 to display the length 91a in the direction along the boundary line 55a of the contact area 41.

(Third Modification of First Embodiment)
Next, a third modification for measuring information indicating the detailed state of the second valve will be described. As shown in FIG. 17, the measurement function 354 has a length in the direction along the boundary line 55 b of the separation region 42 between a part of the leaflets 40 a and a part of the other leaflets 40 b that are separated from each other. 91b is measured. The direction along the boundary line 55b is an example of the second direction.

Note that the measurement function 354 has, on at least one leaflet extracted from the plurality of leaflets extracted by the extraction function 352, a boundary line between the leaflets and the other leaflets that are separated from each other. What is necessary is just to calculate the length of the direction along.

Then, the control function 351 controls the display 340 so as to display the length in the direction along the boundary line of the separation area measured by the measurement function 354. For example, the control function 351 controls the display 340 so as to display the length 91 b in the direction along the boundary line 55 b of the separation region 42.

(Fourth modification of the first embodiment)
Next, a fourth modification for measuring information indicating the detailed state of the third valve will be described. FIG. 18 is a diagram for describing an example of processing executed according to the fourth modification and the fifth modification. As shown in FIG. 18, the measurement function 354 measures the contact area 41a in the contact region 41 where the

leaflets

40a and 40b are in contact. An example of a method for measuring the contact area 41a will be described. For example, the measurement function 354 integrates a plurality of lengths corresponding to a plurality of positions on the measured boundary line 71 (length in the blood flow direction of the contact region 41) in a direction along the boundary line 71. The obtained integrated value is measured as the contact area 41a.

Note that the measurement function 354 measures the contact area in the contact area where the valve leaf and the other leaflet are in contact with each other for at least one of the plurality of leaflets extracted by the extraction function 352. Good.

Then, the control function 351 controls the display 340 so as to display the contact area measured by the measurement function 354.

Here, the case where the measurement function 354 measures the contact area in one time phase using the three-dimensional CT image data of one time phase has been described. However, the measurement function 354 may measure the contact area in each of the plurality of time phases using each of the plurality of time-phase three-dimensional CT image data constituting the four-dimensional CT image data. FIG. 19 is a diagram for describing an example of processing executed according to the fourth modification. In this case, the generation function 355 uses a plurality of contact areas in a plurality of time phases measured by the measurement function 354, as shown in FIG. 19, the horizontal axis is time (time phase), and the vertical axis is the overlapping area. Image data indicating a graph representing a contact area for each time phase is generated.

Then, the control function 351 transmits the image data generated by the generation function 355 to the display 340, and controls the display 340 so as to display a graph indicated by the image data.

(Fifth modification of the first embodiment)
Next, a fifth modification for measuring information indicating the detailed state of the fourth valve will be described. As shown in FIG. 18, the measurement function 354 measures the area of “a part of the leaflet 40 a” that forms the separation region 42 as the separation area 42 a.

For example, the measurement function 354 moves the reference surface 51 along the boundary line 71 in the direction 72 from one end of the boundary line 71 toward the other end of the boundary line 71 in the separation area 42, while moving on the boundary line 71. The length on the reference plane 51 of the leaflet 40a intersecting with the reference plane 51 is measured at a plurality of positions.

For example, the measurement function 354 moves the reference surface 51 and positions the reference surface 51 at each of a plurality of positions on the boundary line 71 in the separation region 42. And the measurement function 354 measures the length on the reference surface 51 of the leaflet 40a intersecting the reference surface 51 in the separation region 42 when the reference surface 51 is positioned at each of a plurality of positions. To do.

The measurement function 354 is obtained by integrating a plurality of lengths corresponding to a plurality of positions on the boundary line 71 (lengths on the reference plane 51 of the leaflets 40a) in the direction along the boundary line 71. The integral value is measured as the separation area 42a. Then, the control function 351 controls the display 340 so as to display the separation area 42a measured by the measurement function 354.

Note that the measurement function 354 has a separation area in a separation region between the valve leaf and the other leaflets that are separated from each other with respect to at least one of the plurality of leaflets extracted by the extraction function 352. Just measure.

Here, the case where the measurement function 354 measures the separated area in one time phase using the three-dimensional CT image data of one time phase has been described. However, the measurement function 354 may measure the separation area in each of the plurality of time phases using each of the plurality of time-phase three-dimensional CT image data constituting the four-dimensional CT image data. FIG. 20 is a diagram for explaining an example of processing executed according to the fifth modification. In this case, the generation function 355 uses a plurality of separation areas in a plurality of time phases measured by the measurement function 354, and the horizontal axis is time (time phase) and the vertical axis is the deviation area, as shown in FIG. Image data indicating a graph indicating a separation area for each time phase is generated.

Note that the measurement function 354 may measure the area of the “part of the leaflet 40b” forming the separation region 42 as the separation area by the same method.

(Sixth Modification of First Embodiment)
Next, a sixth modification that measures information indicating the detailed state of the fifth valve will be described. FIG. 21 is a diagram for explaining an example of processing executed according to the sixth modification. As shown in FIG. 21, the measurement function 354 measures the distance 51b between the

leaflets

40a and 40b in the separation region 42. To explain with a specific example, the measurement function 354 measures the distance 51b between the

leaflets

40a and 40b in the separation region 42 on the reference surface 50 and on the reference surface 51. The distance 51b is also referred to as a gap (gap) width. Here, for example, the measurement function 354 measures the distance 51b at each of the plurality of positions of the reference surface 51 while moving the reference surface 51 along the boundary line 55b, and is the longest of the plurality of distances 51b. The distance 51b may be adopted as the distance between the

leaflets

40a and 40b in the separation region 42.

Note that the measurement function 354 has the leaflets in the separated region between the leaflets and the other leaflets that are separated from each other for at least one leaflet extracted from the plurality of leaflets extracted by the extraction function 352. What is necessary is just to measure the distance between and other leaflets.

Then, the control function 351 controls the display 340 so as to display the distance 51b measured by the measurement function 354.

Here, the case where the measurement function 354 measures the distance 51b in one time phase using the three-dimensional CT image data of one time phase has been described. However, the measurement function 354 may measure the distance 51b in each of the plurality of time phases by using each of the plurality of time-phase three-dimensional CT image data constituting the four-dimensional CT image data. FIG. 22 is a diagram for explaining an example of processing executed according to the sixth modification. In this case, the generation function 355 uses the plurality of distances 51b in the plurality of time phases measured by the measurement function 354, as shown in FIG. 22, the horizontal axis is time (time phase), and the vertical axis is the gap width. Image data indicating a graph representing the distance 51b for each time phase is generated.

Note that the control function 351 may control the display 340 so that various measurement results measured by the measurement function 354 are displayed by an indicator bar. Thereby, a user can grasp | ascertain quantitatively the length of the direction in alignment with the boundary line of the measured contact area | region.

(Seventh Modification of First Embodiment)
In the first embodiment and the first to sixth modifications described above, the setting function 353 is orthogonal to the reference plane 50 in the two-leaf valve such as the mitral valve 40 and the two-leaf valve. The case where the reference plane 51 orthogonal to the line segment connecting the two commissures is set has been described. However, the setting function 353 may set the reference plane 51 by another method. Therefore, such a modification will be described as a seventh modification of the first embodiment.

FIG. 23 is a diagram for explaining an example of processing executed by the setting function according to the seventh modification of the first embodiment. In the description of the seventh modification, differences from the above-described first embodiment and the first to sixth modifications will be mainly described. In the description of the seventh modification, the same reference numerals are given to the same configurations as those in the first embodiment and the first to sixth modifications described above, and the description may be omitted.

In the seventh modification, for example, the setting function 353 detects the long axis 40f of the heart included in the CT image data as shown in FIG. The long axis 40 f is an axis that connects the apex of the heart and the apex of the mitral valve 40. Then, the setting function 353 sets the reference plane 51 that is orthogonal to the line segment 40e and that extends along the long axis 40f. The setting function 353 may set a reference surface 51 that is orthogonal to the reference surface 50 and that extends along the long axis 40f.

For example, an example in which the setting function 353 sets the reference plane 51 for an aortic valve composed of three leaflets will be described. In this case, the setting function 353 extracts the core wire (not shown) of the aorta. The aorta is a blood vessel that carries blood that flows in via the aortic valve. Then, the setting function 353 sets the reference plane 51 that is orthogonal to the line segment that connects the contact point or the center of gravity and the commissure described above, and that is along the core line. The setting function 353 may set the reference surface 51 that is orthogonal to the reference surface 50 and that is along the core wire.

Further, for example, an example in which the setting function 353 sets the reference plane 51 for a pulmonary valve composed of three leaflets will be described. In this case, the setting function 353 extracts a pulmonary artery core wire (not shown). The pulmonary artery is a blood vessel that carries blood that has flowed in via the pulmonary valve. Then, the setting function 353 sets the reference plane 51 that is orthogonal to the line segment that connects the contact point or the center of gravity and the commissure described above, and that is along the core line. The setting function 353 may set the reference surface 51 that is orthogonal to the reference surface 50 and that is along the core wire.

(Eighth Modification of First Embodiment)
The measurement function 354 may measure the inclination angle of the leaflets and the length of the contact region in the inclination direction of the leaflets. Therefore, such a modification will be described as an eighth modification of the first embodiment.

FIG. 24 is a diagram for explaining an example of processing executed by the setting function according to the eighth modification of the first embodiment. In the description of the eighth modification, differences from the above-described first embodiment and the first to seventh modifications will be mainly described. In the description of the eighth modification, the same reference numerals are given to the same configurations as those in the first embodiment and the first to seventh modifications described above, and the description may be omitted.

24, the measurement function 354 derives the angle θ formed by the line segment 40g on the reference plane 51 and the leaflet 40a as the inclination angle of the leaflet 40a. Here, the line segment 40g is a line segment parallel to the line segment 40e. The line segment 40g may be a line segment parallel to the line segment where the reference plane 50 and the reference plane 51 intersect.

Then, the measurement function 354 specifies the direction in which the leaflet 40a extends (the direction indicated by the arrow 40i, the extending direction) from the inclination angle θ of the leaflet 40a. Then, the measurement function 354 measures the length of the contact area on the reference surface 51 in the extending direction. That is, the measurement function 354 measures the length of the contact area in the direction in which the leaflet 40a extends.

Note that the measurement function 354 may measure the length of the contact region intersecting the reference surface 51 on the reference surface 51 as the length of the contact region 41 in the extending direction.

(Ninth Modification of First Embodiment)
Note that the control function 351 may display other images on the display 340 in addition to the display in the first embodiment and the first to eighth modifications. Therefore, such a modification will be described as a ninth modification of the first embodiment.

The ninth modification will be described with reference to FIG. For example, the generation function 355 according to the ninth modification generates volume rendering image data in a predetermined range that passes through the mark 87a on the boundary line 84a shown in FIG. 15 and includes the leaflets 83c and the leaflets 83a. .

In this case, the generation function 355 generates volume rendering image data in which a predetermined color is assigned to a contact area where the leaflets 83c and the leaflets 83a are in contact with each other. As the predetermined color, for example, when a volume rendering image is displayed on the display 340, a color in which the contact area is conspicuous with respect to an area around the contact area is employed. For example, the predetermined color may be red.

Here, as described above, the mark 87 a can be moved on the boundary line 84 a by a user operation via the input interface 330. For example, the generation function 355 moves the

marks

87a, 87b, 87c to positions specified by the user. Therefore, the generation function 355 generates new volume rendering image data according to the position of the mark 87a after movement.

That is, the generation function 355 receives the designation of the position on the boundary line 84a, is volume rendering image data that includes the designated position and depicts two

adjacent leaflets

83c and 83a, Volume rendering image data in which a predetermined color is assigned to the contact area where the

leaflets

83c and 83a contact is generated.

Then, the control function 351 causes the display 340 to display a volume rendering image indicated by the volume rendering image data. As a result, the contact area is displayed in a three-dimensional manner in the volume rendering image that the user looks three-dimensional. In addition, since a conspicuous color is assigned to the contact area, the user can easily grasp the shape and position of the contact area.

Therefore, according to the ninth modification, the user can easily grasp the shape and position of the contact area.

(Second Embodiment)
Next, a medical image processing apparatus 300 according to the second embodiment will be described. FIG. 25 is a diagram illustrating an example of a configuration of a medical image processing apparatus 300 according to the second embodiment. The medical image processing apparatus 300 according to the second embodiment is different from the medical image processing apparatus 300 according to the first embodiment in that the processing circuit 350 further has an analysis function 356. In the description of the second embodiment, the same components as those in the first embodiment may be denoted by the same reference numerals and description thereof may be omitted.

The analysis function 356 according to the second embodiment executes various simulations using the measurement results obtained by the measurement function 354. For example, the analysis function 356 obtains the reverse flow rate of blood when the blood flowing through the valve flows backward in the valve constituted by a plurality of leaflets extracted by the extraction function 352 based on the measurement result by the measurement function 354. Run the simulation.

For example, the analysis function 356 is a time period during which the two lobules constituting the mitral valve are open during the systole when the mitral valve is completely closed if normal, and the separation region measured by the measurement function 354 during the systole. Using the length in the direction along the boundary line, the contraction speed of the left ventricle of the subject's heart, the heart rate discharge of the subject's heart, the back flow of blood when the blood flowing through the mitral valve flows back, and A fluid simulation for obtaining a backflow position and the like is executed.

Regarding the time during which the two leaflets constituting the mitral valve are open in the systole, the medical image processing apparatus 300 is obtained from four-dimensional CT image data including three-dimensional CT image data in the time phase of the systole. Is obtained. For example, the medical image processing apparatus 300 can calculate the time during which the two leaflets are open by measuring the length of the contact region in the blood flow direction in each time phase of the systole.

Further, the cardiac discharge amount of the subject's heart can also be obtained by the medical image processing apparatus 300 by a known technique using the four-dimensional CT image data. Further, the contraction speed of the left ventricle of the subject's heart is also obtained by the medical image processing apparatus 300 by a known technique using the four-dimensional CT image data.

The analysis function 356 is not the length in the direction along the boundary line of the separation region measured by the measurement function 354 when performing the fluid simulation described above, but the separation region in the valve after the plastic surgery assumed by the doctor. The fluid simulation may be executed using the length in the direction along the boundary line. Thereby, the simulation after the operation of the valve is performed, and the user can obtain a valve forming method suitable for the operation.

Further, the analysis function 356 may superimpose information indicating the reverse flow rate of blood obtained by the fluid simulation at a position where the leaflet and the leaflet are separated from each other on the MPR image. Examples of the MPR image here include an MPR image 76 shown in FIG. 13 and

MPR images

80, 81a to 81c shown in FIG.

The analysis function 356 replaces the subject valve in the valve replacement operation instead of the length in the direction along the boundary line of the separated region measured by the measurement function 354 when performing the fluid simulation described above. Fluid simulation may be executed using information on leaflets and annulus of a plurality of biological valves and mechanical valves that are candidates. Thereby, the user can discriminate | determine the optimal biological valve and mechanical valve which can suppress a backflow from several candidates.

(Third embodiment)
In the above-described embodiment, the case where the medical image processing apparatus 300 executes various processes has been described. However, the embodiment is not limited to this, and for example, various processes may be executed in the medical image diagnostic apparatus. Hereinafter, although the case where the medical image diagnostic apparatus which performs various processes is an X-ray CT apparatus is demonstrated, the medical image diagnostic apparatus which performs various processes is an ultrasonic diagnostic apparatus, a magnetic resonance imaging apparatus, or an X-ray diagnostic apparatus. There may be. FIG. 26 is a diagram illustrating an example of the configuration of the X-ray CT apparatus according to the third embodiment.

For example, as shown in FIG. 26, the X-ray CT apparatus 500 according to the third embodiment includes a gantry 10, a bed 20, and a console 30.

The gantry 10 is an apparatus that irradiates the subject P with X-rays and collects data related to the X-rays transmitted through the subject P. The gantry 10 includes an X-ray high-voltage device 11, an X-ray generator 12, and an X-ray detector. 13, a data collection circuit 14, a rotating frame 15, and a gantry control device 16. In the gantry 10, as shown in FIG. 26, an orthogonal coordinate system including an X axis, a Y axis, and a Z axis is defined. That is, the X axis indicates the horizontal direction, the Y axis indicates the vertical direction, and the Z axis indicates the direction of the rotation center axis of the rotating frame 15 when the gantry 10 is not tilted.

The rotating frame 15 supports the X-ray generator 12 and the X-ray detector 13 so as to face each other with the subject P interposed therebetween, and is fast at a circular orbit centered on the subject P by a gantry control device 16 described later. It is an annular frame that rotates in a circle.

The X-ray generator 12 is an apparatus that generates X-rays and irradiates the subject P with the generated X-rays. The X-ray generator 12 includes an X-ray tube 12a, a wedge 12b, and a collimator 12c.

The X-ray tube 12a is a vacuum tube that receives a high voltage from the X-ray high voltage device 11 and irradiates thermoelectrons from a cathode (sometimes referred to as a filament) to an anode (target). The X-ray beam is irradiated to the subject P with the rotation of. That is, the X-ray tube 12 a generates X-rays using the high voltage supplied from the X-ray high voltage device 11.

Also, the X-ray tube 12a generates an X-ray beam that spreads with a fan angle and a cone angle. For example, the X-ray tube 12a controls the X-ray high-voltage apparatus 11 to continuously expose X-rays around the subject P for full reconstruction or exposure that can be reconfigured for half reconstruction. It is possible to continuously expose X-rays in the irradiation range (180 degrees + fan angle). Further, the X-ray tube 12a can intermittently emit X-rays (pulse X-rays) at a preset position (tube position) under the control of the X-ray high voltage apparatus 11. Further, the X-ray high voltage apparatus 11 can also modulate the intensity of X-rays exposed from the X-ray tube 12a. For example, the X-ray high voltage apparatus 11 increases the intensity of X-rays emitted from the X-ray tube 12a at a specific tube position, and exposes from the X-ray tube 12a in a range other than the specific tube position. Reduce the intensity of the emitted X-rays.

The wedge 12b is an X-ray filter for adjusting the X-ray dose of X-rays exposed from the X-ray tube 12a. Specifically, the wedge 12b transmits the X-rays exposed from the X-ray tube 12a so that the X-rays irradiated from the X-ray tube 12a to the subject P have a predetermined distribution. Attenuating filter. For example, the wedge 12b is a filter obtained by processing aluminum so as to have a predetermined target angle or a predetermined thickness. The wedge is also called a wedge filter or a bow-tie filter.

The collimator 12c is composed of a lead plate or the like and has a slit in part. For example, the collimator 12c narrows down the X-ray irradiation range in which the X-ray dose is adjusted by the wedge 12b with the slits under the control of the X-ray high voltage apparatus 11 described later.

Note that the X-ray source of the X-ray generator 12 is not limited to the X-ray tube 12a. For example, in place of the X-ray tube 12a, the X-ray generator 12 collides with a focus coil that focuses an electron beam generated from an electron gun, a deflection coil that electromagnetically deflects, and an electron beam that deflects around a half circumference of the subject P. And a target ring that generates X-rays.

The X-ray high voltage device 11 is composed of an electric circuit such as a transformer and a rectifier, and has a function of generating a high voltage to be applied to the X-ray tube 12a, and the X-ray tube 12a emits light. An X-ray control device that controls the output voltage according to the X-ray to be performed. The high voltage generator may be a transformer system or an inverter system. For example, the X-ray high voltage apparatus 11 adjusts the X-ray dose irradiated to the subject P by adjusting the tube voltage and tube current supplied to the X-ray tube 12a. Further, the X-ray high voltage apparatus 11 receives control from the processing circuit 37 of the console 30.

The gantry control device 16 includes a processing circuit configured by a CPU (Central Processing Unit) and the like and a driving mechanism such as a motor and an actuator. The gantry control device 16 has a function of controlling the operation of the gantry 10 by receiving an input signal from the input interface 31 attached to the console 30 or the input interface attached to the gantry 10. For example, the gantry control device 16 receives the input signal and rotates the rotary frame 15 to rotate the X-ray tube 12a and the X-ray detector 13 on a circular orbit around the subject P. Control for tilting the gantry 10 and control for operating the bed 20 and the top plate 22 are performed. The gantry control device 16 receives control from the processing circuit 37 of the console 30.

Further, the gantry control device 16 monitors the position of the X-ray tube 12a, and when the X-ray tube 12a reaches a predetermined rotation angle (imaging angle), a timing at which data acquisition to the data acquisition circuit 14 is started. A view trigger signal indicating is output. For example, when the total number of views in rotational imaging is 2460 views, the gantry control device 16 outputs a view trigger signal every time the X-ray tube 12a moves about 0.15 degrees (= 360/2460) on a circular orbit. To do.

In the X-ray detector 13, for example, a plurality of X-ray detection elements (also referred to as “sensors” or simply “detection elements”) are arranged in the channel direction along one circular arc with the focal point of the X-ray tube 12a as the center. It is composed of a plurality of X-ray detection element arrays. The X-ray detector 13 has a structure in which a plurality of X-ray detection element arrays in which a plurality of X-ray detection elements are arranged in the channel direction are arranged in the slice direction. Each X-ray detection element of the X-ray detector 13 detects X-rays irradiated from the X-ray generator 12 and passed through the subject P, and outputs an electric signal (pulse) corresponding to the X-ray dose to the data collection circuit 14. To output.

Further, the X-ray detector 13 is an indirect conversion type detector composed of, for example, a grid, a scintillator array, and an optical sensor array. The scintillator array is composed of a plurality of scintillators, and the scintillator is composed of a scintillator crystal that outputs a photon amount of light corresponding to the incident X-ray dose. The grid is an X-ray shielding plate that is disposed on the surface on the X-ray incident side of the scintillator array and has a function of absorbing scattered X-rays. The photosensor array has a function of converting into an electrical signal corresponding to the amount of light from the scintillator, and is composed of a photosensor such as a photomultiplier tube, for example. Here, the optical sensor is, for example, a SiPM (Silicon photomultiplier).

It should be noted that the X-ray detector 13 may be a direct conversion type detector composed of a semiconductor element that converts incident X-rays into electrical signals.

The data acquisition circuit 14 (DAS: Data Acquisition System) includes an amplifier that performs amplification processing on an electric signal output from each X-ray detection element of the X-ray detector 13 and an A / A that converts the electric signal into a digital signal. It comprises at least a D (Analog-to-digital) converter and generates detection data using the detection signal of the X-ray detector 13.

The bed 20 is a device for placing and moving the subject P to be scanned, and includes a bed driving device 21, a top plate 22, a base 23, and a base (support frame) 24.

The top plate 22 is a plate on which the subject P is placed. The base 24 supports the top plate 22. The base 23 is a housing that supports the base 24 so as to be movable in the vertical direction. The couch driving device 21 is a motor or an actuator that moves the subject P into the rotary frame 15 by moving the top 22 on which the subject P is placed in the major axis direction of the top 22. The couch driving device 21 can move the top plate 22 also in the X-axis direction.

The top plate moving method may be a method of moving only the top plate 22 or a method of moving the base 24 of the bed 20 together. In the case of standing CT, a method of moving a patient moving mechanism corresponding to the top board 22 may be used.

Note that the gantry 10 executes a helical scan that scans the subject P in a spiral by rotating the rotating frame 15 while moving the top plate 22, for example. Alternatively, the gantry 10 performs a conventional scan in which the subject P is scanned in a circular orbit by rotating the rotating frame 15 while the position of the subject P is fixed after the top plate 22 is moved. In the following embodiment, a change in the relative position between the gantry 10 and the top plate 22 will be described as being realized by controlling the top plate 22, but the embodiment is not limited to this. For example, when the gantry 10 is self-propelled, a change in the relative position between the gantry 10 and the top plate 22 may be realized by controlling the traveling of the gantry 10. Further, the relative position of the gantry 10 and the top plate 22 may be changed by controlling the traveling of the gantry 10 and the top plate 22.

The console 30 is a device that accepts an operation of the medical image diagnostic apparatus 100 by an operator and reconstructs CT image data using projection data collected by the gantry 10. As shown in FIG. 26, the console 30 includes an input interface 31, a display 32, a memory 35, and a processing circuit 37.

The input interface 31 receives various input operations from the operator, converts the received input operations into electrical signals, and outputs them to the processing circuit 37. For example, the input interface 31 is used to set the conditions for collecting projection data, the reconstruction conditions for reconstructing CT image data, the image processing conditions for generating a post-processed image from CT image data, Accept from. For example, the input interface 31 is realized by a mouse, a keyboard, a trackball, a switch, a button, a joystick, or the like.

Display 32 displays various information. For example, the display 32 outputs a medical image (CT image) generated by the processing circuit 37, a GUI for receiving various operations from the operator, and the like. For example, the display 32 is configured by a liquid crystal display, a CRT display, or the like.

The memory 35 is realized by, for example, a semiconductor memory element such as a RAM or a flash memory, a hard disk, an optical disk, or the like. The memory 35 stores, for example, projection data and CT image data.

The processing circuit 37 executes, for example, a control function 37a, an extraction function 37b, a setting function 37c, a measurement function 37d, and a generation function 37e. Here, for example, each processing function executed by the control function 37a, the extraction function 37b, the setting function 37c, the measurement function 37d, and the generation function 37e, which are components of the processing circuit 37 shown in FIG. In the memory 35. The processing circuit 37 is, for example, a processor, and realizes a function corresponding to each read program by reading and executing each program from the memory 35. In other words, the processing circuit 37 in a state where each program is read has each function shown in the processing circuit 37 of FIG.

The control function 37a controls the entire medical image diagnostic apparatus 100. In addition, the control function 37a executes the same processing as the control function 351 described above. The extraction function 37b performs the same process as the extraction function 352 described above. The setting function 37c executes the same processing as the setting function 353 described above. The measurement function 37d performs the same process as the generation function 354 described above. The generation function 37e performs the same process as the generation function 355 described above.

Also, the generation function 37e generates three-dimensional CT image data based on the collected projection data. For example, the generation function 37e collects projection data obtained by imaging a region including the heart valve of the subject P, and generates three-dimensional CT image data based on the collected projection data. The generation function 37e can also collect projection data obtained by imaging a region including the heart valve of the subject P, and can generate four-dimensional CT image data based on the collected projection data. . In this way, the generation function 37e collects 3D CT image data and 4D CT image data. The generation function 37e is an example of a generation unit and a collection unit.

In the above-described embodiment, an example in which each processing function is realized by a single processing circuit (the processing circuit 350 and the processing circuit 37) has been described, but the embodiment is not limited thereto. For example, the processing circuit 350 and the processing circuit 37 may be configured by combining a plurality of independent processors, and each processing function may be realized by each processor executing each program. The processing functions of the processing circuit 350 and the processing circuit 37 may be realized by appropriately distributing or integrating the processing functions in a single or a plurality of processing circuits.

The term “processor” used in the description of each embodiment described above is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an application-specific integrated circuit (ASIC), or a programmable. Means circuits such as logic devices (for example, Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)) To do. Here, instead of storing the program in the memory, the program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit. In addition, each processor of the present embodiment is not limited to being configured as a single circuit for each processor, but may be configured as a single processor by combining a plurality of independent circuits to realize its function. Good.

Here, the program executed by the processor is provided by being incorporated in advance in a ROM (Read Only Memory) or a storage unit. This program is a file in a format that can be installed or executed on these devices. CD (Compact Disk) -ROM, FD (Flexible Disk), CD-R (Recordable), DVD (Digital Versatile Disk), etc. It may be provided by being recorded on a computer-readable storage medium. The program may be provided or distributed by being stored on a computer connected to a network such as the Internet and downloaded via the network. For example, this program is composed of modules including each functional unit. As actual hardware, the CPU reads a program from a storage medium such as a ROM and executes it, whereby each module is loaded on the main storage device and generated on the main storage device.

According to at least one embodiment described above, the detailed state of the valve can be grasped by the user.

Although several embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

Claims

An extraction unit for extracting a plurality of leaflets of the heart valve from the image data of the subject;
For at least one leaflet of the plurality of leaflets, a measurement unit that measures a length in a predetermined reference direction in a region where the leaflet and the other leaflets contact;
A display control unit for controlling the display unit to display the distribution of the length at each of the plurality of positions of the leaflets;
A medical image processing apparatus comprising:
A setting unit for setting a reference plane for the at least one leaflet with respect to the at least one leaflet;
The display control unit
An image in which a line segment corresponding to a region where two leaflets are in contact with each other in the first tomographic image is superimposed on the first tomographic image at a position substantially corresponding to the reference plane in the image data. Displaying on the display unit, and displaying the distribution of the length at each of the plurality of positions of the line segment on the display unit,
The medical image processing apparatus according to claim 1.
The medical image processing apparatus according to claim 2, wherein the measuring unit measures a length in a direction substantially perpendicular to the reference plane in the region as the length in the predetermined reference direction.
The medical image processing apparatus according to claim 1, wherein the measurement unit measures a length in a blood flow direction in the region as the length in the predetermined reference direction.
The medical image processing apparatus according to claim 1, wherein the measurement unit measures a length of the region in a direction in which the valve leaf extends as the length of the predetermined reference direction.
The extraction unit extracts two leaflets constituting the heart valve,
The said measurement part measures the length of the said area | region in the surface orthogonal to the said reference plane, and orthogonal to the line segment which connects the two commissure parts of the said heart valve. Medical image processing apparatus.
The extraction unit extracts two leaflets constituting the heart valve,
The medical image processing apparatus according to claim 2, wherein the measurement unit measures the length of the region in a plane orthogonal to the reference plane and along the long axis of the heart.
The extraction unit extracts two leaflets constituting the heart valve,
The medical image according to claim 2, wherein the measurement unit measures the length of the region in a plane that is orthogonal to a line segment that connects two commissural portions of the heart valve and is along the long axis of the heart. Processing equipment.
The extraction unit extracts three leaflets constituting the heart valve,
The measurement unit is a line segment that is orthogonal to the reference plane and connects the commissure of the heart valve and the point where the three leaflets intersect or the center of gravity of the region surrounded by the three leaflets. The medical image processing apparatus according to claim 2, wherein the length of the region in a plane orthogonal to the surface is measured.
The extraction unit extracts three leaflets constituting the heart valve,
The said measurement part measures the length of the said area | region in the surface which is orthogonal to the said reference plane, and follows the core line of the blood vessel which carries the blood flowed in via the said heart valve. Medical image processing apparatus.
The extraction unit extracts three leaflets constituting the heart valve,
The measurement unit is orthogonal to a line segment connecting the commissural portion of the heart valve and the point where the three leaflets intersect or the center of gravity of the region surrounded by the three leaflets, and the heart valve The medical image processing apparatus according to claim 2, wherein the length of the region on a surface along a core line of a blood vessel that carries blood that has flowed in is measured.
The medical image processing apparatus according to claim 2, wherein the measurement unit measures the length of the at least one leaflet in a direction intersecting the line segment and in a direction intersecting the reference plane. .
The measurement unit measures the length at each of the plurality of positions in a direction intersecting the predetermined reference direction of the region;
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display the distribution of the lengths at the plurality of positions.
A generator for generating first tomographic image data including the plurality of leaflets from the image data;
The medical image processing apparatus according to claim 2, wherein the display control unit controls the display unit to display the first tomographic image indicated by the first tomographic image data together with the distribution.
The generation unit superimposes the line segments having different aspects on the first tomographic image in a portion where the length is greater than or equal to a threshold and a portion less than the threshold,
The medical image processing apparatus according to claim 14, wherein the display control unit controls the display unit to display the first tomographic image on which the line segment is superimposed.
The line segment indicates the boundary between two adjacent leaflets,
The generation unit receives a designation of a position on the line segment, generates second tomographic image data including the designated position and in which the two adjacent leaflets are depicted,
The medical image processing apparatus according to claim 15, wherein the display control unit controls the display unit to display a second tomographic image indicated by the second tomographic image data.
The measurement unit measures, for at least one leaflet of the plurality of leaflets, a length in a direction intersecting the predetermined reference direction of the region where the leaflet and another leaflet are in contact with each other. And
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display a length of the region in a direction intersecting the predetermined reference direction.
The measurement unit has a length in a direction intersecting the predetermined reference direction of a separation region between the leaflets and the other leaflets that are separated from each other with respect to at least one leaflet of the plurality of leaflets. Measuring
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display a length of the separation area in a direction intersecting the predetermined reference direction.
The measurement unit measures a contact area in the region where the leaflet and another leaflet are in contact with each other for at least one leaflet of the plurality of leaflets,
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display the contact area.
The measurement unit measures a separation area in a separation region between the valve leaf and the other leaflets that are separated from each other with respect to at least one of the plurality of leaflets.
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display the separation area.
The measurement unit is configured such that, with respect to at least one of the plurality of leaflets, between the leaflets and the other leaflets in a separation region between the leaflets and the other leaflets that are separated from each other. Measure the distance of
The medical image processing apparatus according to claim 1, wherein the display control unit controls the display unit to display the distance.
Based on the length in the direction intersecting the predetermined reference direction of the separation region measured by the measurement unit, a simulation for obtaining a reverse flow rate of blood when the blood flowing through the heart valve flows backward in the heart valve The medical image processing apparatus according to claim 18, further comprising an analysis unit to be executed.
An extraction unit for extracting a plurality of leaflets of the heart valve from the image data of the subject;
For at least one leaflet of the plurality of leaflets, a measurement unit that measures an index indicating the degree of adhesion of a region where the leaflet and the other leaflets contact;
A display control unit that controls the display unit to display the index at each of a plurality of positions of the leaflets;
A medical image processing apparatus comprising:
The line segment indicates the boundary between two adjacent leaflets,
The generator is
It is volume rendering image data that accepts designation of a position on the line segment, includes the designated position, and depicts the two adjacent leaflets, and is in a contact region where the two leaflets contact each other. Generate volume rendering image data to which a predetermined color is assigned,
The medical image processing apparatus according to claim 15, wherein the display control unit controls the display unit to display a volume rendering image indicated by the volume rendering image data.
A collection unit for collecting image data of the subject;
An extraction unit for extracting a plurality of leaflets of the heart valve from the image data;
For at least one leaflet of the plurality of leaflets, a measurement unit that measures a length in a predetermined reference direction in a region where the leaflet and the other leaflets contact;
A display control unit for controlling the display unit to display the distribution of the length at each of the plurality of positions of the leaflets;
A medical image diagnostic apparatus comprising:
Extract multiple leaflets of the heart valve from the image data of the subject,
For at least one leaflet of the plurality of leaflets, measure a length in a predetermined reference direction in a region where the leaflet and another leaflet contact,
Controlling the display unit to display the distribution of the length at each of a plurality of positions of the leaflets;
A medical image processing program for causing a computer to execute each process.