Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/48—Diagnostic techniques
  • A61B6/481—Diagnostic techniques involving the use of contrast agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
  • A61B6/03—Computed tomography [CT]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
  • A61B6/03—Computed tomography [CT]
  • A61B6/032—Transmission computed tomography [CT]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/46—Arrangements for interfacing with the operator or the patient
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/46—Arrangements for interfacing with the operator or the patient
  • A61B6/461—Displaying means of special interest
  • A61B6/465—Displaying means of special interest adapted to display user selection data, e.g. graphical user interface, icons or menus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
  • A61B6/504—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of blood vessels, e.g. by angiography

Definitions

• the present invention relates to a control device for chemical injection, a chemical injection device, a computer program, and a processing method.
• CT Computer Tomography
• MRI Magnetic Resonance Imaging
• PET PET
• ultrasound diagnostic devices and angiography imaging devices.
• a contrast agent or saline solution hereinafter, simply referred to as "medicinal liquid"
• Various techniques have been proposed for injecting contrast agents to capture images.
• Patent Document 1 discloses a drug injection device that injects drug solutions under specified conditions to image normal myocardial areas and myocardial infarction areas with a contrast difference.
• the operator can set the injection protocol correctly so that the examination site of the myocardium can be well imaged in the delayed layer.
• the injection protocol may not be set correctly depending on the operator's operation, so there is room for improvement.
• the object of the present invention is to provide a liquid injection control device, a liquid injection device, a computer program, and a processing method that can properly set a liquid injection protocol for myocardial analysis.
• a control device for liquid injection is a control device for liquid injection that is connected to an injection head that delivers at least a contrast agent as a liquid drug toward a subject, and includes a control unit for operating the injection head under operating conditions corresponding to a set injection protocol, and a display device connected to the control unit, wherein the control unit has an input receiving unit that receives an operator's selection of an injection mode for myocardial analysis, a display processing unit that, when the injection mode for myocardial analysis is selected, causes the display device to display an injection protocol setting screen for the operator to set an injection protocol for myocardial analysis, and an injection protocol creation unit that modifies the injection protocol to create a modified injection protocol in response to input by the operator to the injection protocol setting screen, and the display processing unit determines the amount of contrast agent to be injected into the subject throughout the entire injection.
• An injection protocol setting screen including a total iodine amount display unit displaying a corresponding total iodine amount per body weight, a first display unit displaying a first iodine amount per body weight corresponding to the amount of contrast agent to be injected into the subject in a first contrast agent injection phase, and a second display unit displaying a second iodine amount per body weight corresponding to the amount of contrast agent to be injected into the subject in a second contrast agent injection phase performed with an interval time after the first contrast agent injection phase is displayed, and the input receiving unit receives a change to the total iodine amount per body weight or the first iodine amount per body weight by an operator through the injection protocol setting screen, and the injection protocol creation unit determines the difference between the total iodine amount per body weight after the change and the first iodine amount per body weight, or the difference between the total iodine amount per body weight and the first iodine amount per body weight after the change, as the second io
• the input receiving unit may be configured not to accept a change to the total iodine amount per body weight or the first iodine amount per body weight when the total iodine amount per body weight or the first iodine amount per body weight input by the operator exceeds an upper threshold or falls below a lower threshold.
• the display processing unit may be configured to display, on the injection protocol setting screen, a first display mode in which the first iodine amount per body weight in the first contrast agent injection phase is displayed as an iodine amount per body weight in which the injection amount per unit time is not specified, and a second display mode in which the iodine amount per body weight in which the injection amount per unit time is specified, and to switch between the first display mode and the second display mode in response to an input from an operator received by the input receiving unit.
• the display processing unit may be configured to display an injection protocol setting screen on the display device in a manner that prevents the operator from changing the value of the second amount of iodine per body weight.
• the injection rate of the contrast agent in the first contrast agent injection phase may be a variable rate that increases or decreases over the course of injection time.
• the liquid medicine injection control device may further include a memory unit that stores default values for the total iodine amount per body weight, the first iodine amount per body weight, and the second iodine amount per body weight as parameters of an injection protocol for myocardial analysis.
• a liquid medicine injection device includes the injection head that holds a syringe filled with a contrast agent, and a console that includes the liquid medicine injection control device described above.
• a computer program causes a computer to function as an input receiving unit that receives an operator's selection of an injection mode for myocardial analysis, a display processing unit that, when the injection mode for myocardial analysis is selected, causes a display device to display an injection protocol setting screen for the operator to set an injection protocol for myocardial analysis, and an injection protocol creation unit that modifies the injection protocol and creates a modified injection protocol in response to an input by the operator to the injection protocol setting screen, and the display processing unit includes a total iodine amount display unit that displays a total iodine amount per body weight corresponding to the amount of contrast agent to be injected into the subject throughout the entire injection, and a first contrast agent injection flow control unit that controls the first injection flow control unit.
• the input receiving unit receives a change to the total iodine amount per body weight or the first iodine amount per body weight
• the injection protocol creation unit determines the difference between the total iodine amount per body weight after the change and the first iodine amount per body weight, or the difference between the total iodine amount per body weight and the first iodine amount per body weight after the change, as the second iodine amount per body weight.
• the method includes an input receiving step of receiving that an operator has selected an injection mode for myocardial analysis, a display processing step of displaying an injection protocol setting screen on a display device for the operator to set an injection protocol for myocardial analysis when the injection mode for myocardial analysis is selected, and an injection protocol creating step of modifying the injection protocol to create a modified injection protocol in response to an input by the operator to the injection protocol setting screen, the display processing step including a total iodine amount display unit that displays a total iodine amount per body weight corresponding to the amount of contrast agent to be injected into the subject throughout the entire injection, and a first iodine amount per body weight display unit that displays a first iodine amount per body weight corresponding to the amount of contrast agent to be injected into the subject in a first contrast agent injection phase.
• the input receiving step includes receiving a change to the total iodine amount per body weight or the first iodine amount per body weight by an operator through the injection protocol setting screen
• the injection protocol creating step includes determining the difference between the total iodine amount per body weight after the change and the first iodine amount per body weight, or the difference between the total iodine amount per body weight and the first iodine amount per body weight after the change, as the second iodine amount per body weight.
• the step of processing the captured images of the subject that have been contrast-enhanced by injection of a contrast agent under the injection conditions created in the injection protocol creation step further includes an image processing step of generating a difference image between a coronary artery CT image obtained by imaging the left ventricle including the contrast-enhanced coronary artery with a CT device and a delayed contrast-enhanced CT image obtained by imaging after a predetermined delay time has elapsed since the acquisition of the coronary artery CT image, and the image processing step may include an acquisition step of acquiring the coronary artery CT image and the delayed contrast-enhanced CT image, an alignment step of aligning the coronary artery CT image and the delayed contrast-enhanced CT image, and a difference processing step of performing difference processing to subtract the coronary artery CT image from the delayed contrast-enhanced CT image.
• alignment may be performed by modifying the size or shape of one of the coronary artery CT image and the delayed contrast CT image.
• the coronary artery CT image may be deformed without deforming the delayed contrast CT image.
• the coronary artery CT image may be deformed so as to maintain the area of the myocardium in the coronary artery CT image.
• control device for injecting a liquid medicine
• the control device being connected to an injection head that delivers at least a contrast agent as a liquid medicine toward a subject, and comprising a control unit for operating the injection head under operating conditions corresponding to a set injection protocol, and a display device connected to the control unit, the control unit having an input receiving unit that receives an operator's selection of a predetermined injection mode, a display processing unit that, when the injection mode is selected, causes the display device to display an injection protocol setting screen for the operator to set an injection protocol corresponding to the injection mode, and an injection protocol creation unit that modifies the injection protocol to create a modified injection protocol in response to input by the operator to the injection protocol setting screen, the injection protocol comprising a first injection phase in which a liquid medicine is injected with liquid medicine parameters calculated by a first calculation method that determines liquid medicine parameters based on first biological information of the subject, and a second injection phase in which a liquid medicine is injected with a liquid medicine parameter calculated by a first calculation method that determines
• the present invention provides a liquid injection control device, a liquid injection device, a computer program, and a processing method that can properly set a liquid injection protocol for myocardial analysis.
• FIG. 1 is a block diagram showing a configuration of an imaging system.
• FIG. 1 is a perspective view showing a configuration example of a chemical liquid injector.
• FIG. 2 is a perspective view showing an injection head and a liquid syringe attached thereto.
• FIG. 2 is a block diagram for explaining the function of a control unit of the console.
• 13 is an example of an injection protocol setting screen for myocardial analysis.
• FIG. 1 shows an example of an injection protocol for myocardial analysis. This is a time density curve when a drug solution is injected according to the injection protocol of FIG. 6.
• FIG. 13 shows a state in which the display of the injection protocol setting screen has been partially switched.
• FIG. 1 is a block diagram showing a configuration of an image processing device.
• FIG. 1 is a block diagram showing a configuration of an image processing device.
• FIG. 13 is a schematic cross-sectional view of the left ventricle for explaining non-rigid deformation registration.
• 11 is a schematic cross-sectional view for explaining subtraction processing using a delayed contrast CT image and a coronary artery CT image.
• FIG. 1 is a flowchart of an example of an image processing method.
• Fig. 1 is a block diagram showing the configuration of an imaging system.
• Fig. 2 is a perspective view showing an example of the configuration of a liquid injection device.
• Fig. 3 is a perspective view showing an injection head and a liquid syringe attached thereto.
• the imaging system 1 includes an imaging device 300 and a liquid medicine injection device S100.
• the imaging device 300 and the liquid medicine injection device S100 are connected to each other so that they can communicate with each other.
• the imaging device 300 is a device that generates a fluoroscopic image of a subject.
• the imaging device 300 is, for example, an X-ray CT device.
• the imaging device 300 includes, for example, an imaging unit 303b that captures a fluoroscopic image of the subject, a bed 304 on which the subject rests, and a control unit 303a that controls the operations of the imaging unit 303b and the bed 304.
• the liquid injector S100 mainly comprises an injection head 110 and a console 150.
• the injection head 110 is a device that delivers at least a contrast agent as a medicinal liquid toward a subject.
• the injection head 110 is held on top of a movable stand 111.
• the injection head 110 holds a first syringe 200C and a second syringe 200P.
• the first syringe 200C and the second syringe 200P will not be distinguished from each other and will simply be referred to as syringes 200.
• the injection head 110 has a housing 120.
• the housing 120 has a shape that is elongated in the front-rear direction, for example.
• Two recesses 120a are formed on the top surface of the housing 120, on which the syringes 200 are placed.
• the recesses 120a function as syringe holders.
• a first syringe 200C and a second syringe 200P are placed on each recess 120a via a syringe adapter S121 and a syringe adapter S122.
• the functional configuration of the injection head 110 will be described later.
• Examples of the medicinal liquid filled in the syringe 200 include a contrast medium and physiological saline.
• the first syringe 200C is filled with, for example, a contrast medium.
• the second syringe 200P is filled with, for example, physiological saline.
• the syringe 200 has a cylinder member 221 and a piston member 222.
• the cylinder member 221 is formed in a cylindrical shape.
• a conduit portion 221b is formed at the tip of the cylinder member 221, and a flange portion 221a is formed at the rear end.
• the piston member 222 is inserted into the cylinder member 221 so as to be slidable.
• An extension tube 230 is connected to each syringe 200.
• the extension tube 230 has tubes 231a, 231b, and 231c.
• Tube 231a is connected to the conduit portion 221b of the first syringe 200C.
• Tube 231b is connected to the conduit portion of the second syringe 200P.
• Tube 231c extends toward the subject from a connector to which tubes 231a and 231b are connected.
• An injection needle (not shown) is connected to the end of tube 231c. The medicinal liquid is injected into the subject via the extension tube 230 and injection needle configured in this manner.
• an IC tag 225 (see FIG. 1) is attached to the syringe 200.
• the IC tag 225 stores information that can be read by an external device via wireless communication means.
• the IC tag 225 stores, for example, at least one of information about the syringe (syringe identification information, syringe pressure resistance, inner diameter of the cylinder member, stroke of the piston member, etc.) and information about the medicinal liquid filled in the syringe (name (e.g. product name), ingredient information such as amount of iodine, expiration date, medicinal liquid volume, etc.).
• the console 150 is electrically connected to the injection head 110, for example, by a cable 102.
• the console 150 is placed, for example, in an operation room adjacent to an examination room.
• the console 150 is a device that allows the operator to set the injection protocol for the medicinal liquid and check the injection result screen.
• injection head 110 has, as its main components, piston drive mechanism 130, control unit 144, and reader/writer 145.
• the piston drive mechanism 130 pushes the piston member 222 into the cylinder member 221.
• Two piston drive mechanisms 130 are provided, one for each syringe, and each mechanism operates independently. Each piston drive mechanism 130 may be driven simultaneously or at different times.
• the reader/writer 145 is a device that reads information from the IC tag 225 and writes information to the IC tag 225.
• the reader/writer 145 does not need to have the function of writing information to the IC tag 225.
• the control unit 144 is a computer including a CPU (Central Processing Unit).
• the control unit 144 controls the operation of the piston drive mechanism 130 by providing a control signal to the piston drive mechanism 130.
• the control unit 144 operates the piston drive mechanism 130 under operating conditions corresponding to the injection protocol set by the console 150.
• the control unit 144 also transmits information on the IC tag 225 read by the reader/writer 145 to the outside.
• the control unit 144 transmits information on the IC tag 225 to the console 150, for example.
• the console 150 has, as its main components, a display device 151, a switch box 152, a storage unit 154, and a control unit 155.
• the display device 151 is a display unit connected to the control unit 155, and is a display that displays characters, images, and the like.
• the display device 151 is, for example, a touch panel display.
• the display device 151 which is a touch panel display, also functions as an input means that accepts input from the operator.
• the switch box 152 is an input means operated by an operator. Although not shown in the figure, the switch box 152 has a main body and one or more buttons provided on the main body. The switch box 152 is electrically connected to the control unit 155.
• the storage unit 154 stores various types of data.
• the storage unit 154 stores data on the graphical user interface displayed on the display device 151, data on drug injection protocols, data on the operating conditions of the piston drive mechanism 130 associated with each injection protocol, computer programs, etc.
• the memory unit 154 stores default values for the total iodine amount per body weight, the first iodine amount per body weight, and the second iodine amount per body weight as parameters of the injection protocol for myocardial analysis (described in detail below). With this configuration, the parameters of the injection protocol for myocardial analysis that have been stored in advance can be used as default values, so that the operator does not need to manually set the conditions of the injection protocol for myocardial analysis.
• the control unit 155 is a computer including a CPU.
• the control unit 155 performs multiple functions as shown in FIG. 4 by reading a computer program stored in the memory unit 154.
• the control unit 155 cooperates with the control unit 144 of the injection head 110 to operate the injection head 110 under operating conditions corresponding to the injection protocol of the medicinal liquid.
• the control unit 155 is a control unit for operating the injection head 110.
• the control unit 155 and the display device 151 constitute a control device for medicinal liquid injection according to one embodiment of the present invention.
• the control unit 155 and the control unit 144 are provided, but one control unit may have the functions of the control unit 155 and the control unit 144.
• (Console control function) 4 is a block diagram for explaining the function of the control unit of the console.
• the control unit 155 of the console 150 has an input receiving unit 156, an injection protocol creating unit 157, a display processing unit 158, and an operation control unit 159.
• the input reception unit 156 receives various inputs (user inputs) to the console 150 by the operator. For example, the input reception unit 156 receives the operator's selection of an icon displayed on a user interface. Specifically, the input reception unit 156 receives the operator's selection of a specific injection mode via a user interface (for example, an injection protocol setting screen 601 described later with reference to FIG. 5) displayed on the display device 151. In this embodiment, the input reception unit 156 receives the operator's selection of an injection mode for myocardial analysis such as LIE (Late Iodine Enhancement) or ECV (Extracellular Volume) analysis. The input reception unit 156 also receives input of numerical values by the operator on the injection protocol setting screen 601. The input reception unit 156 receives changes to the total iodine amount per body weight or the first iodine amount per body weight (details below) by the operator through the injection protocol setting screen 601.
• LIE Lineate Iodine Enhancement
• ECV Extracellular Volume
• the input receiving unit 156 also receives input when the operator presses a button on the switch box 152.
• the button on the switch box 152 is pressed, for example, to start a second contrast injection phase of the injection protocol, which will be described later.
• the injection protocol creation unit 157 modifies the injection protocol and creates a modified injection protocol in response to inputs (details below) made by the operator to the injection protocol setting screen 601.
• the detailed functions of the injection protocol creation unit 157 will be described separately with reference to a specific example of the injection protocol setting screen 601.
• the display processing unit 158 causes the display device 151 to display an injection protocol template corresponding to the selected injection mode from among the injection protocol templates stored in the memory unit 154 in association with multiple injection modes.
• An "injection protocol template” is a template that includes some or all of the parameters, such as the injection rate of the medicinal liquid, the injection amount, the subject's weight, and the concentration of the contrast agent, that are preset, and at least one of these parameters is changeable.
• the display processing unit 158 causes the display device 151 to display an injection protocol setting screen 601 (see FIG. 5) that enables the operator to set an injection protocol.
• An injection protocol setting screen 601 is a screen for an operator to confirm and set an injection protocol for myocardial analysis.
• the injection protocol setting screen 601 mainly includes a human body image 610, an iodine concentration display section 621, a body weight display section 622, a total iodine amount per body weight display section 631, a first injection phase condition display section 632, a second injection phase condition display section 633, and an injection condition thumbnail display section 640.
• the human body image 610 is an icon including multiple imaging sections.
• the human body image 610 includes icons of, for example, a head 611, a chest 612, an abdomen 613, and a lower limb 614.
• the injection mode for myocardial analysis is set as one of multiple injection modes targeting the chest 612. As an example, the injection mode for myocardial analysis is selected by the operator choosing one of multiple injection modes displayed by selecting the chest 612.
• the iodine concentration display unit 621 is a display unit that shows the iodine concentration in the syringe 200 placed on the injection head 110. In this example, based on the information read from the IC tag 225, the iodine concentration display unit 621 shows "370 (mgI/mL)."
• the weight display unit 622 is a display unit that displays the subject's weight.
• the weight display unit 622 is displayed, for example, as an icon.
• the weight display unit 622 may be configured so that the operator can input an arbitrary weight or one of several weight candidates by touching the weight display unit 622. Specifically, the subject's weight may be input via a displayed numeric keypad.
• the total iodine amount display section 631 displays the total iodine amount per body weight, which corresponds to the amount of contrast agent to be injected into the subject throughout the entire injection in the injection mode of myocardial analysis.
• the entire injection refers to the period from the start of injection to the end of injection in a protocol in which contrast agent is injected multiple times as shown in FIG. 6.
• the total iodine amount display section 631 displays, for example, a predetermined default value set as a template for the injection mode of myocardial analysis. In this example, the total iodine amount display section 631 displays "550 mgI/kg.”
• the total iodine amount per body weight displayed in the total iodine amount display unit 631 is preferably within the range of 300 mgI/kg to 666 mgI/kg, and more preferably within the range of 500 mgI/kg to 600 mgI/kg.
• the total iodine amount display unit 631 is displayed as an icon.
• the total iodine amount display unit 631 may be configured so that the operator can input an arbitrary numerical value or one of several candidates by touching the total iodine amount display unit 631. With such a configuration, the operator can change the total iodine amount per body weight.
• the input receiving unit 156 (see FIG. 4) may be configured to receive input only when the numerical value manually input by the operator is within the above range.
• the first injection phase condition display section 632 includes an iodine amount display section 632a and a time display section 632b.
• the iodine amount display section 632a displays the first amount of iodine per body weight, which corresponds to the amount of contrast agent to be injected into the subject in the first contrast agent injection phase.
• the first injection phase condition display section 632 displays "450 mgI/kg”.
• the time display section 632b is the duration of the first contrast agent injection phase, and is displayed as "0:15 sec" as an example. These values are predetermined default values that have been set in advance.
• the iodine amount display section 632a is displayed, for example, as an icon.
• the input receiving section 156 may receive an arbitrary numerical value input by the operator via a numeric keypad or the like when the operator touches the iodine amount display section 632a, or an input selected from a number of options. With this configuration, the operator can change the first amount of iodine per body weight.
• the second injection phase condition display section 633 includes an iodine amount display section 633a and a time display section 633b.
• the iodine amount display section 633a displays the second amount of iodine per body weight.
• the iodine amount display section 633a specifically displays the amount of iodine per body weight corresponding to the amount of contrast agent to be injected into the subject in the second contrast agent injection phase. In this example, the iodine amount display section 633a displays "100 mgI/kg". This is the difference between "550 mgI/kg" and "450 mgI/kg”.
• the time display section 633b is the duration of the second contrast agent injection phase, and is displayed as "0:10 sec" as an example. These values are predetermined default values that have been set in advance.
• the injection condition thumbnail display section 640 is a display section that displays the injection conditions corresponding to the above injection conditions as thumbnail images.
• saline is injected after the injection of the contrast agent.
• FIG. 6 shows an example of an injection protocol for myocardial analysis.
• the injection protocol in FIG. 6 includes a first contrast agent injection phase, a first saline injection phase, an interval phase, a second contrast agent injection phase, and a second saline injection phase.
• This injection protocol is used when the CT device images a subject, and the contrast agent is administered in separate doses in the two phases.
• the specific values of the injection amount and injection speed in each injection phase are as shown in FIG. 5.
• injection head 110 injects contrast agent.
• injection head 110 injects an amount of contrast agent equivalent to an iodine amount of 450 mgI/kg of body weight for a period of 15 seconds.
• the injection is started when control unit 155 notifies control unit 144 of the start of operation, and control unit 144 controls piston drive mechanism 130.
• the start and end of drug injection are controlled by control unit 155 and control unit 144 in this way, but the operation of control unit 155 and control unit 144 will not be described below.
• the injection head 110 injects saline.
• the injection head 110 injects saline at a speed similar to that in the first contrast agent injection phase.
• the amount of saline injected is 25 mL, which is less than the amount of contrast agent injected in the first contrast agent injection phase.
• injection head 110 does not perform injection.
• the main role of the interval phase is to ensure that there is a sufficient amount of time between the first contrast agent injection phase and the second contrast agent injection phase.
• the interval phase continues, for example, until the operator inputs the start of injection.
• the interval phase may end when a predetermined time has elapsed, after which injection head 110 may automatically start injecting the drug solution for the second contrast agent injection phase.
• the "predetermined time” may be a time that has been set in advance, or may be any time input by the operator.
• the second contrast injection phase is performed with an interval after the injection of saline following the first contrast injection phase.
• the injection head 110 again injects contrast.
• the injection head 110 injects, for example, an amount of contrast that corresponds to 100 mgI of iodine per body weight for a period of 10 seconds.
• the injection head 110 injects saline. Specifically, the injection head 110 injects saline at the same speed as in the second contrast agent injection phase.
• the amount of saline injected is, for example, the same as in the first saline injection phase.
• FIG. 7 shows a time density curve (TDC) when a drug solution is injected according to the injection protocol of FIG. 6.
• the vertical axis of FIG. 7 is the CT value, and the horizontal axis is time.
• the time density curve shows the change over time of the contrast agent concentration or CT value of a region of interest (ROI) in a certain cross section of an image.
• ROI region of interest
• the shape of the time density curve changes depending on the injection conditions of the contrast agent, the target site, the circulatory dynamics of the subject, etc.
• the time density curve is also called a time enhancement curve (TEC).
• TEC time enhancement curve
• the solid curve shows the CT value in the aorta
• the dashed curve shows the CT value in the myocardium.
• the contrast agent injected into the subject flows through the systemic circulation to the heart, aorta, arteries, and capillaries.
• the contrast agent then flows to the veins, vena cava, and heart.
• the first contrast agent injection phase is followed by a first saline injection phase, so that the injection head 110 injects saline following the injection of the contrast agent.
• the contrast agent is boosted by the saline.
• the first contrast injection phase produces a contrast effect that makes it possible to perform coronary artery CT and whole-body contrast CT.
• the contrast agent reaches blood vessels such as the aorta, the CT value in the blood vessels increases, for example, as shown at time t1.
• the imaging device 300 performs the first imaging.
• technology for the imaging device 300 to automatically perform imaging in response to an increase in the CT value is well known in the art, so a description thereof will be omitted.
• the CT value in the blood vessel gradually decreases.
• the operator inputs the start of injection via the switch box 152, for example, at the timing of time t2. This causes the injection head 110 to inject the contrast agent and saline as the second contrast agent injection phase and the second saline injection phase.
• the contrast agent in the second contrast agent injection phase is injected for the purpose of delayed contrast.
• This injection of contrast agent causes the CT value in the blood vessels to rise again at time t3, a predetermined time after time t1.
• the contrast agent injected into the subject gradually permeates the myocardium, and the CT value in the myocardium also rises.
• the imaging device 300 may perform imaging at a timing around time t3.
• the imaging device 300 performs a second imaging at time t4, a predetermined time after time t3.
• the timing of imaging at this time t4 is changed as appropriate depending on the contents of the examination and the physical characteristics of the subject.
• the imaging timing is, for example, a timing when a time within a range of 3 to 15 minutes has elapsed after the start of injection of the contrast agent.
• the imaging timing may be a timing when a time within a range of 6 to 10 minutes has elapsed after the start of injection of the contrast agent.
• the contrast images captured by the imaging device 300 at time t1 and time t4 can be used to appropriately evaluate the LIE and ECV. Note that since conventionally known methods can be used to inspect the LIE and ECV, a description thereof will be omitted here.
• the operator can change the value of, for example, the iodine amount display section 632a on the injection protocol setting screen 601. As an example, the operator can change the first amount of iodine per body weight from the default value of "450 mgI/kg" to "400 mgI/kg.”
• the total iodine amount per body weight which corresponds to the amount of contrast agent to be injected into the subject throughout the entire injection, is set here to "550 mgI/kg.” Therefore, if the operator reduces the first iodine amount per body weight in this way, and the second iodine amount per body weight remains at "100 mgI/kg,” the amount of iodine per body weight injected in both phases will be "500 mgI/kg,” which falls short of the set amount.
• the liquid injector S100 of this embodiment is therefore configured to calculate the second amount of iodine per unit weight as follows. Below, we will explain an example in which the operator changes "450 mgI/kg” to "400 mgI/kg".
• the input reception unit 156 receives the operator's change from "450 mgI/kg” to "400 mgI/kg” via the injection protocol setting screen 601.
• the injection protocol creation unit 157 determines the difference between the total iodine amount per body weight of "550 mgI/kg” and the changed first iodine amount per body weight of "400 mgI/kg” as the second iodine amount per body weight of "150 mgI/kg.”
• the injection protocol creation unit 157 stores "400 mgI/kg” and "150 mgI/kg” in the memory unit 154 as conditions of the changed injection protocol.
• the display processing unit 158 displays the value "150 mgI/kg" calculated by the injection protocol creation unit 157 on the iodine amount display unit 633a. Note that in this embodiment, the calculated value is displayed, but the display processing unit 158 does not have to display the calculated value.
• the operation control unit 159 operates the injection head 110 according to the above conditions determined by the injection protocol creation unit 157, thereby injecting the medicinal liquid under the desired conditions.
• the second amount of iodine per body weight is calculated from the difference between the total amount of iodine per body weight and the first amount of iodine per body weight. This eliminates the need for the operator to manually input the second amount of iodine per body weight, and allows the injection protocol of the drug solution to be set appropriately. This prevents problems such as an insufficient total injection amount of contrast agent in myocardial analysis due to an operator setting error, for example.
• the injection protocol creation unit 157 recalculates the injection rate and injection time of each phase in response to changes in the amount of iodine per body weight between the first injection phase and the second injection phase. Calculations of the injection rate and injection time can be performed using conventionally known technology.
• the injection protocol creation unit 157 recalculates the injection rate, for example, to correspond to the changed value, resulting in an injection rate less than "2.0 ml/sec", for example.
• the injection rate of the contrast agent is less than a predetermined threshold, the desired contrast effect may not be obtained due to the influence of blood flow.
• the injection protocol creation unit 157 may set injection conditions for simultaneously injecting saline without changing the iodine amount per first body weight and the injection conditions of the contrast agent (i.e., the operating conditions of the piston drive mechanism on the first syringe containing the contrast agent). Specifically, the injection protocol creation unit 157 calculates the injection rate of saline so that the injection rate of the contrast agent diluted with saline exceeds a threshold (lower limit value), and stores the injection protocol including the injection conditions in the storage unit.
• a threshold lower limit value
• the injection protocol creation unit 157 may refer to the storage unit 154, which stores multiple examination contents and multiple injection rate thresholds (lower limit values) associated with each examination content, read the injection rate threshold value (lower limit value) corresponding to the currently set examination content, and perform the above processing based on the read value.
• the input receiving unit 156 may receive a change to the total amount of iodine per body weight from "550 mgI/kg” by the operator, and the injection protocol creation unit 157 may calculate the second amount of iodine per body weight from the difference between the changed total amount of iodine per body weight and the first amount of iodine per body weight.
• the default values of the total iodine amount per body weight and/or the first iodine amount per body weight are configured to be changeable, which is advantageous in that various injection conditions can be set according to the subject and the examination contents. However, if the changed value is not within a predetermined range, there is a risk that the desired imaging result will not be obtained.
• the input receiving unit 156 may be configured not to accept a change to the total iodine amount per body weight or the first iodine amount per body weight when the total iodine amount per body weight or the first iodine amount per body weight input by the operator exceeds a predetermined upper threshold or falls below a predetermined lower threshold.
• the upper threshold and the lower threshold may be set as values that produce a desired contrast effect required for myocardial analysis and stored in the storage unit 154.
• the iodine amount display section 632a displays the amount of iodine per body weight of "450 mgI/kg," making it difficult to intuitively understand the injection rate. Therefore, in this embodiment, the display processing section 158 (see FIG. 4) can display the first display mode and the second display mode, and may be configured to switch between them.
• FIG. 8 shows the state in which a portion of the display on the injection protocol setting screen has been switched.
• the iodine amount display section 632a' shows "30 mgI/kg/sec.”
• the display processing unit 158 may be capable of switching between a first display mode (see FIG. 5) in which the first iodine amount per body weight in the first contrast agent injection phase is displayed as a normal iodine amount per body weight (unit: mgI/kg) in which the injection amount per unit time is not specified, and a second display mode in which the iodine amount per body weight per unit time (unit: mgI/kg/sec, see FIG. 8) in which the injection amount per unit time is specified.
• a first display mode see FIG. 5
• the first iodine amount per body weight in the first contrast agent injection phase is displayed as a normal iodine amount per body weight (unit: mgI/kg) in which the injection amount per unit time is not specified
• a second display mode in which the iodine amount per body weight per unit time (unit: mgI/kg/sec, see FIG. 8) in which the injection amount per unit time is specified.
• the display processing unit 158 switches from the first display mode to the second display mode, or from the second display mode to the first display mode, in response to the input received by the input receiving unit 156 to switch the display from the operator.
• the input receiving unit 156 may receive, for example, that the operator has performed such a switch in the change mode of the environment settings of the console 150, and the display processing unit 158 may change the display accordingly.
• the input receiving unit 156 may receive such a switch input from the operator while the liquid injection device S100 is operating according to the injection protocol (including a state in which the piston drive mechanism is not moving but the series of injection protocols has not yet ended).
• the display processing unit 158 may be configured to be able to switch between the first display mode and the second display mode for the second contrast agent injection phase as well. In addition, the display processing unit 158 may be configured to be able to switch the display for the first contrast agent injection phase, but to display only the first display mode for the second contrast agent injection phase.
• the injection protocol creation unit 157 determines the difference between the total iodine amount per body weight after the input and the first iodine amount per body weight as the second iodine amount per body weight. Therefore, the operator does not need to manually input the second iodine amount per body weight, and the injection protocol for the liquid can be set satisfactorily.
• the display of the iodine amount display unit 632a can be switched between a first display mode and a second display mode, so that the injection conditions of the contrast agent can be displayed in a manner appropriate to the examination contents.
• the display processing unit 158 is configured to display the numerical value of the second iodine amount per body weight (e.g., 100 mgI/kg) in a manner that the operator cannot change, it is possible to prevent the operator from erroneously setting the numerical value of the second iodine amount per body weight.
• the input receiving unit 156 not to accept changes to the numerical value of the second iodine amount per body weight when the injection protocol setting screen 601 is displayed, it is possible to prevent erroneous setting of conditions.
• CT-LIE Long Iodine Enhancement
• MRI LGE Magnetic Reliable and Low-Reliable MRI
• This type of examination makes it possible to detect early cardiac amyloidosis, in which protein fibers called amyloid deposit in the heart and cause cardiac hypertrophy.
• drugs that prevent amyloid deposition in the heart have been put to practical use for cardiac amyloidosis, and administration of such drugs can prevent the subject's condition from worsening.
• the configuration of this embodiment makes it possible to provide a liquid injection control device and a liquid injection device that can be usefully used for such myocardial analysis.
• the injection speed of the contrast agent in the first injection phase does not have to be a constant speed.
• the injection speed of the contrast agent in the first injection phase may be a so-called variable speed in which the speed increases or decreases as the injection time elapses.
• variable constant the injection rate at the end of the phase divided by the injection rate at the start. For example, if the rate decreases over time from 3.0 ml/sec to 1.5 ml/sec, the variable constant is 0.5
• the variable constant may be 0.3 or more and less than 1.0, or 0.5 or more and less than 1.0.
• liquid injection device in which the injection head and the console are configured separately was shown.
• the present invention also covers a liquid injection device in which the injection head and the console are configured as an integrated unit.
• control unit 155 has the function of creating an injection protocol, and the control unit 144 controls the operation of the piston drive mechanism 130, but a single control unit may both create the injection protocol and control the operation of the piston drive mechanism 130.
• the liquid medicine injector may also include a mechanism for delivering the liquid medicine from a liquid medicine storage container other than a syringe.
• the liquid medicine storage container may be a flexible liquid medicine bag or a bottle.
• the liquid medicine injector may also be configured to have a tube pump instead of a piston drive mechanism, and to deliver the liquid medicine by pressurizing the liquid medicine in the tube with the tube pump.
• a “medicinal liquid” refers to, for example, a contrast medium, saline, or a mixture of these.
• An “injection protocol” refers to what kind of medicinal liquid is to be injected, in what amount, and at what speed.
• the phrase “same as,” when referring to a specific numerical value it includes not only the case where the value is completely the same as the numerical value, but also a certain numerical range obtained by adding or subtracting 10% of the numerical value to or from the numerical value.
• “same as 10” refers to a range of 10 ⁇ 1. In this specification, for example, "when an injection mode is selected” has the same meaning as "according to the selection of an injection mode.”
• Non-transitory computer readable media includes various types of tangible storage media.
• a control device for liquid injection comprising: a control unit (155) connected to an injection head that delivers at least a contrast agent as a liquid drug toward a subject, and operating the injection head under operating conditions corresponding to a set injection protocol, and a display device (151) connected to the control unit, wherein the control unit (155) has an input receiving unit (156) that receives an operator's selection of an injection mode for myocardial analysis, a display processing unit (158) that, when the injection mode for myocardial analysis is selected, causes the display device to display an injection protocol setting screen (601) for the operator to set an injection protocol for myocardial analysis, and an injection protocol creation unit (157) that modifies the injection protocol in response to an input by the operator to the injection protocol setting screen (601) to create a modified injection protocol, and the display processing unit (158) displays information on the injection protocol to be injected into the subject throughout the injection.
• a display unit displaying a total iodine amount per body weight (550 mgI/kg) corresponding to an amount of contrast agent, a display unit displaying a first iodine amount per body weight (450 mgI/kg) corresponding to an amount of contrast agent to be injected into the subject in a first contrast agent injection phase, and a display unit displaying a second iodine amount per body weight (100 mgI/kg) corresponding to an amount of contrast agent to be injected into the subject in a second contrast agent injection phase that is performed with an interval time after the first contrast agent injection phase, and an injection protocol creation unit (157) determines, when an operator inputs a numerical value of the total iodine amount per body weight (550 mgI/kg) or the first iodine amount per body weight (450 mgI/kg), as the second iodine amount per body weight.
• FIG. 9 is a block diagram showing the configuration of an image processing device.
• the image processing device 301 in FIG. 9 is, for example, a workstation.
• the image processing device 301 includes a storage unit 311, an input unit 312, a display unit 313, and a processing unit 310.
• the memory unit 311 stores an image processing program.
• the input unit 312 includes devices such as a keyboard and switches.
• the display unit 313 is a display that displays predetermined information.
• the processing unit 310 is a computer including a CPU, and realizes a predetermined function according to an image processing program stored in the storage unit 311.
• the processing unit 310 includes an acquisition unit 314, a discrimination unit 315, an extraction unit 316, a calculation unit 317, a position alignment unit 318, and a difference processing unit 319.
• the acquisition unit 314 acquires images, for example, from a CT device or an image storage server.
• the image storage server is, for example, a PACS (Picture Archiving and Communication Systems).
• the acquisition unit 314 acquires a "coronary artery CT image” and a "delayed contrast enhancement CT image.”
• a "coronary artery CT image” is an image acquired by a CT device by imaging the left ventricle including the contrast-enhanced coronary artery.
• the coronary artery is well-contrast-enhanced when 15 to 30 seconds have elapsed since the start of the injection of the contrast agent.
• a "coronary artery CT image” is an image acquired, for example, at the timing of time t1 in FIG. 7.
• a “delayed contrast enhancement CT image” is an image acquired by a CT device by imaging the left ventricle including the contrast-enhanced myocardial infarction after a predetermined delay time has elapsed since the acquisition of the coronary artery CT image.
• the "coronary artery CT image” is an image captured, for example, at time t4 in FIG. 7. This is the timing at which the difference in pixel values between normal myocardium and myocardial infarction becomes large.
• the discrimination unit 315 discriminates between the coronary artery CT image and the delayed contrast-enhanced CT image acquired by the acquisition unit 314.
• the discrimination unit 315 adds discrimination information (e.g., an ID indicating the type of image) to the CT image as necessary.
• the discrimination unit 315 discriminates between the coronary artery CT image and the delayed contrast-enhanced CT image based on the average pixel value in a region (e.g., a central region) including the left ventricle of the CT image or the average pixel value in the entire CT image.
• the discrimination unit 315 compares both CT images and discriminates that the image with the lower average pixel value is the delayed contrast-enhanced CT image. For example, the discrimination unit 315 adds discrimination information indicating that the delayed contrast-enhanced CT image is a delayed contrast-enhanced CT image to the delayed contrast-enhanced CT image.
• the extraction unit 316 extracts the outer contour of the left ventricle in the coronary artery CT image.
• the extraction unit 316 also extracts the outer contour of the left ventricle in the delayed contrast CT image.
• the outer contour corresponds to the contour of the epicardium.
• the inner contour corresponds to the contour of the endocardium.
• the extraction unit 316 extracts the heart region by binarizing the CT image using an arbitrary threshold value and extracting areas with large pixel values.
• the extraction unit 316 extracts the boundary between the extracted heart region and its outer region as the outer contour.
• the calculation unit 317 calculates the area of the myocardial part of the left ventricle in the coronary artery CT image. Specifically, the calculation unit 317 calculates the area of the myocardial part by calculating the area of the region between the inner contour and the outer contour. The calculation unit 317 also calculates the volume of the myocardial part by performing the same processing on multiple CT images included in the volume data acquired by the acquisition unit 314. The calculation unit 317 also calculates the ratio of the myocardial infarction part to the myocardial part, and the depth of the myocardial infarction part from the endocardium (myocardial wall part).
• the registration unit 318 performs registration between the coronary artery CT image and the delayed contrast enhancement CT image. Specifically, the registration unit 318 performs rigid body registration between the coronary artery CT image and the delayed contrast enhancement CT image. For example, the registration unit 318 identifies the center of gravity of the left ventricle in each of the coronary artery CT image and the delayed contrast enhancement CT image, and moves the coronary artery CT image and/or the delayed contrast enhancement CT image so that the centers of gravity coincide with each other. The registration unit 318 may perform rigid body registration so that the positional deviation between the outer contours of the left ventricle in the coronary artery CT image and the delayed contrast enhancement CT image is reduced.
• the registration unit 318 sets the control points on the outer contour as corresponding points among a plurality of control points set in a grid pattern in the CT image.
• the registration unit 318 then performs translation and rotation of the coronary artery CT image so that the positional deviation between the corresponding points in the coronary artery CT image and the corresponding points in the delayed contrast enhancement CT image is reduced.
• the registration unit 318 may perform non-rigid deformation registration between the coronary artery CT image and the delayed contrast CT image.
• the shape or size of the left ventricle in the coronary artery CT image may differ from that in the delayed contrast CT image due to heartbeat or body movement, etc. Therefore, in one embodiment, it is preferable to perform non-rigid deformation registration to generate an image that is more suitable for differential processing.
• the alignment unit 318 deforms the coronary artery CT image without deforming the delayed contrast CT image.
• a delayed contrast CT image the difference in pixel values between normal myocardium and myocardial infarction is greater than in a coronary artery CT image, making it easier to analyze the area of myocardial infarction. Therefore, by not deforming the delayed contrast CT image, the area of myocardial infarction can be accurately depicted even in the difference image obtained by subtraction processing.
• Non-rigid deformation alignment is performed, for example, by a method using a measure (similarity) based on the similarity of pixel values (for example, mutual information or correlation coefficient).
• the alignment unit 318 deforms the coronary artery CT image so that the similarity is maximized or equal to or greater than a predetermined threshold.
• FIG. 10 is a schematic cross-sectional view of the left ventricle to explain non-rigid deformation alignment.
• the coronary artery CT image and the delayed contrast CT image are aligned so that the centers of gravity of the left ventricle match.
• the left ventricle in the coronary artery CT image shown by the solid line is smaller than the left ventricle in the delayed contrast CT image shown by the dashed line.
• the shape of the inner contour in the coronary artery CT image is different from that in the delayed contrast CT image.
• the alignment unit 318 sets a control point on the outer contour of the coronary artery CT image as corresponding point C.
• the alignment unit 318 sets a control point on the outer contour of the delayed contrast CT image as corresponding point D.
• the alignment unit 318 moves the outer contour of the coronary artery CT image to the position shown by the dotted line in FIG. 10 so that the positions of corresponding point C and corresponding point D approximately coincide.
• the alignment unit 318 deforms the shape of the outer contour of the coronary artery CT image so that the similarity between both CT images is maximized or equal to or greater than a predetermined threshold.
• the alignment unit 318 deforms the shape of the inner contour of the coronary artery CT image so that the similarity between both CT images is maximized or equal to or greater than a predetermined threshold.
• the alignment unit 318 reduces the outer contour of the coronary artery CT image so that the positions of corresponding points C and D approximately coincide. Specifically, the alignment unit 318 deforms the shape of the outer contour of the coronary artery CT image so that the similarity between both CT images is maximized or equal to or greater than a predetermined threshold. The alignment unit 318 deforms the shape of the inner contour of the coronary artery CT image so that the similarity between both CT images is maximized or equal to or greater than a predetermined threshold.
• the alignment unit 318 may use the area or volume of the myocardium to deform the shape of the inner contour of the coronary artery CT image as follows.
• the calculation unit 317 calculates the area of the myocardial part of the left ventricle in the coronary artery CT image (the region indicated by diagonal lines in FIG. 10 ). In the coronary artery CT image, the difference in pixel values between the lumen and the myocardial part is large, so that the inner contour and the outer contour can be extracted.
• the calculation unit 317 calculates the area of the myocardial part by calculating the area of the region between the extracted inner contour and outer contour.
• the calculation unit 317 may also calculate the volume of the myocardial part by performing the same process on multiple CT images included in the volume data acquired by the acquisition unit 314.
• the alignment unit 318 deforms the coronary artery CT image (the inner contour of the coronary artery CT image) so as to maintain the calculated area or volume of the myocardial region. In this case, too, the alignment unit 318 deforms the coronary artery CT image so that the similarity between both CT images is maximized or equal to or exceeds a predetermined threshold. Normally, the coronary artery CT image and the delayed contrast CT image are captured in the same cardiac phase using electrocardiogram synchronization. Therefore, it can be assumed that the area and volume of both myocardial regions are approximately the same.
• the inner contour of the coronary artery CT image can be made to more closely resemble the actual size and shape. Note that the area or volume does not need to be perfectly consistent, and it can be considered that the area or volume has been maintained even if there is an error within a predetermined range.
• FIG. 11 is a schematic cross-sectional view for explaining the differential processing using a delayed contrast CT image and a coronary artery CT image.
• FIG. 11(a) is a delayed contrast CT image
• FIG. 11(b) is a coronary artery CT image
• FIG. 11(c) is an image after differential processing (difference image).
• the pixel value of the normal myocardium is 80HU
• the pixel value of the lumen is 100HU
• the pixel value of the myocardial infarction is 100HU.
• the pixel value of the normal myocardium is 50HU
• the pixel value of the lumen is 180HU
• the subtraction processing unit 319 performs subtraction processing to subtract the coronary artery CT image from the delayed contrast-enhanced CT image. This subtracts the pixel values of the coronary artery CT image from the delayed contrast-enhanced CT image, and the left ventricular lumen and inner contour are clearly depicted, as shown in FIG. 11(c). Specifically, the difference in pixel values between normal myocardium and myocardial infarction, which was 20 HU in the delayed contrast-enhanced CT image, becomes 50 HU in the subtraction image, making the difference clear.
• the myocardium can be depicted simply and clearly, as described above. This allows doctors to accurately and easily identify myocardial infarction.
• FIG. 12 is a flowchart of an example of an image processing method.
• the acquisition unit 314 of the image processing device 301 acquires a delayed contrast CT image and a coronary artery CT image. These images are temporarily stored in the storage unit 311.
• step S2 the discrimination unit 315 discriminates between delayed contrast CT images and coronary artery CT images.
• the extraction unit 316 extracts the myocardial area from the coronary artery CT image. Specifically, the extraction unit 316 extracts the shapes of the outer and inner contours of the myocardial area. This extraction is started, for example, when triggered by an instruction from an operator. In another processing example, the extraction unit 316 may automatically extract the shapes of the outer and inner contours without relying on instructions from the operator.
• step S4 it is determined whether to calculate the area in order to perform non-rigid deformation. If the area is to be calculated (YES in S4), the calculation unit 317 calculates the area of the myocardium in the coronary artery CT image in step S5.
• step S6 the extraction unit 316 extracts the shape of the outer contour of the delayed contrast-enhanced CT image determined by the discrimination unit 315.
• the display unit 313 displays this extraction result on the CT image, allowing the operator to modify the range of the outer contour and inner contour. Even if the area is not calculated (NO in S4), in step S6, the extraction unit 316 extracts the shape of the outer contour of the delayed contrast-enhanced CT image.
• the alignment unit 318 aligns the coronary artery CT image and the delayed contrast CT image.
• This alignment includes at least one of rigid alignment and non-rigid deformation alignment.
• the alignment unit 318 deforms the coronary artery CT image so as to maintain the calculated area of the myocardium.
• step S8 the subtraction processing unit 319 performs subtraction processing to subtract the coronary artery CT image from the delayed contrast CT image.
• the created subtraction image is temporarily stored in the storage unit 311, and the display unit 313 displays the subtraction image.
• the image processing device 301 transmits the subtraction image to the PACS for storage.
• Imaging using a CT device generally takes less time than MRI devices, and has the advantage of reducing the burden on the patient, who is the subject, when imaging the area of myocardial infarction.
• This specification discloses, for example, changing the default conditions on the injection protocol setting screen 601 in Fig. 5, injecting a liquid drug according to the changed injection protocol, acquiring coronary artery CT images and delayed contrast CT images generated by imaging with a CT device, and performing image processing based on the acquired images.
• it is not essential to change the default conditions on the injection protocol setting screen 601, and a default injection mode for myocardial analysis may be used.
• a processing method includes a step of processing an image of a subject that has been contrast-enhanced by injection of a contrast agent under the injection conditions created in the injection protocol creation step, and includes an image processing step of generating a difference image between a coronary artery CT image obtained by imaging the left ventricle including the contrast-enhanced coronary artery with a CT device and a delayed contrast-enhanced CT image obtained by imaging after a predetermined delay time has elapsed since the acquisition of the coronary artery CT image, and the image processing step may include an acquisition step of acquiring the coronary artery CT image and the delayed contrast-enhanced CT image, an alignment step of aligning the coronary artery CT image and the delayed contrast-enhanced CT image, and a difference processing step of performing difference processing to subtract the coronary artery CT image from the delayed contrast-enhanced CT image.
• a liquid injection control device includes a control unit connected to an injection head that delivers at least a contrast medium as a liquid toward a subject, for example, for operating the injection head under operating conditions corresponding to the set injection protocol, and a display device connected to the control unit.
• the control unit has an input receiving unit that receives the operator's selection of a predetermined injection mode.
• the control unit also has a display processing unit that, when an injection mode is selected, causes the display device to display an injection protocol setting screen for the operator to set an injection protocol corresponding to the injection mode.
• the control unit also has an injection protocol creation unit that creates a modified injection protocol by modifying the injection protocol in response to an input by the operator to the injection protocol setting screen.
• the "injection mode” is not limited to myocardial analysis, and may be a mode for various contrast examinations.
• an injection protocol may be used that includes a first injection phase and a second injection phase (three or more phases may be set), and the phases are performed continuously with or without intervals.
• the first injection phase and the second injection phase may not use a common method of calculating the amount of drug solution, such as "amount of iodine per body weight (mgI/Kg)". The reason for this is that, for example, the imaging purpose or object of the first injection phase is different from the imaging purpose or object of the second injection phase.
• the first injection phase is a phase for imaging blood vessels
• the second injection phase is a phase for imaging solid organs.
• the drug solution injected in the first injection phase is for imaging a specific area
• the total amount of drug solution injected in the first injection phase and the second injection phase is for imaging another area.
• the injection protocol in question here includes a first injection phase in which the drug solution is injected with drug solution parameters calculated by a first calculation method that determines the drug solution parameters based on first biological information of the subject (e.g., weight, but not limited to this), and a second injection phase in which the drug solution is injected with drug solution parameters calculated by a second calculation method that determines the drug solution parameters based on second biological information of the subject (e.g., weight, but not limited to this).
• the display processing unit displays an injection protocol setting screen including a first display unit showing information related to the liquid medicine parameters of the first injection phase, and a second display unit showing information related to the liquid medicine parameters of the second injection phase.
• the first and second calculation methods are, for example, a method in which the weight of the subject is input, and the amount of medicinal liquid to be injected into the subject is calculated using the weight information and the amount of iodine per body weight (for example, in mgI/Kg).
• a calculation method based on the amount of iodine per body weight (for example, in mgI/Kg) is basically exemplified, but the present invention is not limited to this.
• the amount may be calculated using a calculation method in which, based on a predetermined reference weight of the subject (for example, 60 kg), if the weight is higher than the reference weight, the amount of medicinal liquid injected (or the amount of iodine) is less than the amount of medicinal liquid injected (or the amount of iodine) calculated by the amount of iodine per body weight method, and if the weight is lower than the reference weight, the amount of medicinal liquid injected (or the amount of iodine) is greater than the amount of medicinal liquid injected (or the amount of iodine) calculated by the amount of iodine per body weight method.
• a predetermined reference weight of the subject for example, 60 kg
• the amount of medicinal liquid injected or the amount of iodine
• the amount of iodine is less than the amount of medicinal liquid injected (or the amount of iodine) calculated by the amount of iodine per body weight method
• the amount of medicinal liquid injected or the amount
• the lean body weight (LBW) method, the body surface area (BSA) method, the blood volume (BV) method, or the adjusted body weight (AdBW) method may be used, and these calculation formulas may be stored in the memory unit for processing by the injection protocol creation unit.
• the drug solution parameters may also be determined according to a regression formula obtained by regression analysis of statistical data and the subject's physical parameters, and such regression formulas may be stored in the memory unit for processing by the injection protocol creation unit.
• the calculation method may be one that determines a liquid medicine parameter (e.g., a liquid medicine amount) per body weight based on, for example, the body weight value or a value obtained by correcting the body weight value with a coefficient of a predetermined physical characteristic.
• the relationship between body weight and the amount of liquid medicine does not necessarily have to be linear.
• the calculation method may also determine a liquid medicine parameter (e.g., a liquid medicine amount) per body surface area other than body weight.
• the calculation method may also determine a liquid medicine parameter (e.g., a liquid medicine amount) based on the area of a predetermined part of the subject in the tomographic image.
• the input reception unit will, for example, accept the operator's changes to the drug solution parameters for the first injection phase or the second injection phase.
• the injection protocol creation unit determines the liquid parameters in the other of the first injection phase or the second injection phase that correspond to the liquid parameters changed in either the first injection phase or the second injection phase. Specifically, as an example, when the liquid parameters are changed in the first injection phase, the liquid parameters in the second injection phase are determined so as to correspond to the changed liquid parameters. Specifically, the injection protocol creation unit determines the other injection parameter based on a formula showing the relationship between the liquid parameters in the first injection phase and the liquid parameters in the second injection phase, and the changed injection parameters.
• the injection protocol creation unit may also refer to a memory unit that stores the liquid parameters of the first injection phase and the liquid parameters of the second injection phase in association with each other, and determine the other injection parameter that corresponds to the changed injection parameter.
• the injection parameter of the first injection phase or the second injection phase may be automatically modified when the injection parameter related to the total amount of medicinal liquid injected in multiple injection phases is changed.
• the injection protocol creation unit modifies the injection parameter of the first injection phase or the second injection phase based on, for example, a calculation formula and the changed injection parameter.
• the above calculation formula is, as an example, a calculation formula showing the relationship between the injection parameter related to the total amount of medicinal liquid and the medicinal liquid parameter of the first injection phase or the second injection phase.
• Imaging system 102 Cable 110 Injection head 111 Movable stand 120 Housing 120a Recess 130 Piston drive mechanism 144 Control unit 145 Reader/writer 150 Console 151 Display device 152 Switch box 154 Memory unit 155 Control unit 156 Input reception unit 157 Injection protocol creation unit 158 Display processing unit 159 Operation control unit 200 Syringe 221 Cylinder member 222 Piston member 225 IC tag 230 Extension tube 300 Imaging device 304 Bed 601 Injection protocol setting screen 610 Human body image 621 Iodine concentration display unit 622 Body weight display unit 631 Total iodine amount display unit 632 First injection phase condition display unit 632a Iodine amount display unit (first display unit) 632a' Iodine amount display section 632b Time display section 633 Second injection phase condition display section 633a Iodine amount display section (second display section) 633b Time display section 640 Injection condition thumbnail display section S100 Liquid injector

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