JP6338965B2 - Medical apparatus and ultrasonic diagnostic apparatus - Google Patents

Description

  Embodiments described herein relate generally to a medical apparatus and an ultrasonic diagnostic apparatus.

  Some ultrasonic diagnostic apparatuses have a 2D array probe (matrix array probe) and a mechanical 4D probe (mechanical three-dimensional probe) in which ultrasonic transducers are two-dimensionally arranged. A series of three-dimensional ultrasonic images including an image of the target part are acquired by photographing the target part of the subject with time with these probes.

  A mid-sagittal cross section of a fetus from a three-dimensional medical image taken when the actual state of the target region becomes a predetermined state, for example, a three-dimensional medical image taken when the posture of the fetus shows left-right symmetry Is generated. Here, the “midline sagittal section” refers to a surface that divides the body into two halves. A target region is measured or inspected based on the mid-sagittal section of the fetus.

  Examples of the type of the target site measured based on the midline sagittal cross section of the fetus include a fetal posterior cervical edema (Nucal Translucency: NT) region. The NT region is the black missing part of the fetal neck. FIG. 11 shows the NT region with a white arrow. The thickness of the NT region is measured from the midline sagittal section of the fetus.

JP 2012-81257 A

  However, the examiner determines whether the medical image is a three-dimensional medical image (that is, a three-dimensional medical image that can generate a mid-sagittal section) taken when the posture of the fetus shows left-right symmetry. Since the image is judged visually, a determination error is likely to occur, and a three-dimensional medical image that can generate a median sagittal section cannot be reliably identified. For this reason, a cross-section different from the mid-sagittal cross-section may be generated from a three-dimensional medical image that is visually determined. In a cross section different from the mid-sagittal cross section, the thickness of the NT region is not accurately measured. Further, when it becomes clear after the measurement that the thickness of the NT region has not been accurately measured, the measurement efficiency is reduced because the measurement is forced to be performed again.

  This embodiment solves the above-described problem. A medical apparatus and an ultrasonic diagnostic apparatus that can accurately measure a target region and improve measurement efficiency by reliably specifying a medical image. The purpose is to provide.

In order to solve the above-described problem, the medical device according to the embodiment uses a three-dimensional medical image of a target part acquired by imaging the target part of a subject, and includes a storage unit, an examination unit, And defining means and a determination unit. A memory | storage part memorize | stores the predetermined state of the target site | part defined based on the some specific site | part located in a target site | part. The inspection means detects the positions of a plurality of specific parts. The defining means defines the actual state of the target part based on the detected positions of the plurality of specific parts. The determination unit obtains information related to the degree of coincidence between the defined real state and the predetermined state stored in the storage unit. Furthermore, the storage unit associates and stores the target part and a predetermined state of the target part, and the inspection unit detects the positions of a plurality of specific parts from the medical image by receiving the designation of the target part.

The functional block diagram of the medical device which concerns on 1st Embodiment. The flowchart which shows a series of flow from the reading of a medical image to the display of the image which shows a mid-sagittal section. The flowchart which shows a series of flow from the reading of a medical image to the display of the image which shows a mid-sagittal section. Fetal MPR image. An image taken when the posture of the fetus shows left-right symmetry. An image taken when the posture of the fetus does not show left-right symmetry. An image when a portion with high luminance is detected continuously in one direction. The image which shows the detected spine and the head arrange | positioned at the end of the axis | shaft. The figure which shows the positional relationship of the position of an orbit and a plane. The figure which shows when all the several positions on a spine exist in a plane. The figure which shows when one of the some positions on a spine does not exist in a plane. The figure which shows when one of the some positions on a spine does not exist in a plane. An image showing a median sagittal section. MPR image of the heart. FIG. 9 is a flowchart showing a series of flows from reading a medical image to displaying a long axis length and the like in the second embodiment. The figure which shows the mitral valve of a left ventricle and the back wall of a left ventricle. The figure which shows long-axis length and a long-axis cross-sectional area.

  For example, a series of three-dimensional ultrasound images (medical images) including an image of the target part are acquired by photographing the target part with time using an ultrasonic probe having a 2D array probe or a mechanical 4D probe. The obtained series of three-dimensional medical images is transmitted to, for example, an image server (not shown) in the hospital. A series of three-dimensional medical images is associated with incidental information including a photographing time when the three-dimensional medical images are photographed. A series of three-dimensional medical images is transmitted to the medical device 1 and stored in the storage unit 3 (see FIG. 1) of the medical device 1.

  As types of target regions, in addition to the NT region, the length of the fetus head (CRL), which is the length from the top of the fetus to the buttocks (CRL), the length of the fetus nasal bone (Nasal) bone: NB), and the long axis length and long axis cross-sectional area of the end diastole left ventricle of the heart are included.

  In order to accurately and efficiently measure these target parts, it is necessary to specify a medical image taken when the actual state S ′ of the target part is a predetermined state S from a series of medical images. . For example, in the measurement of the NT region, CRL, and NB, a medical image captured when the posture of the fetus shows left-right symmetry is specified from a series of medical images, and a median sagittal section is determined from the specified medical image. Need to be generated. Further, for example, in the measurement of the long axis length and the long axis cross-sectional area of the end diastole left ventricle, it is necessary to specify a medical image taken when the long axis length shows the maximum value.

  The medical device 1 receives a designation of a target part and specifies a medical image for measuring the target part from a series of medical images. The medical device 1 for measuring the NT region and the like will be described in the first embodiment. Furthermore, the medical device 1 for measuring the long axis length and the long axis cross-sectional area of the end diastole left ventricle of the heart will be described in a second embodiment. Furthermore, an ultrasonic diagnostic apparatus 100 that performs these measurements will be described in a third embodiment.

<First Embodiment>
Next, a first embodiment of the medical device 1 will be described with reference to the drawings.
FIG. 1 is a functional block diagram of the medical device 1, and FIG. 2 is a flowchart showing a series of flow from reading of a medical image to displaying of an image showing a median sagittal section.
As illustrated in FIG. 1, the medical apparatus 1 includes a control unit 2, a storage unit 3, an interface 4, an examination unit 10, a definition unit 20, and a determination unit 30. The control unit 2 issues a control command for instructing each operation to the storage unit 3, the interface 4, the inspection unit 10, the definition unit 20, and the determination unit 30, thereby comprehensively controlling them. The interface 4 includes an input unit 41, a display control unit 42, and a display unit 43.

[Storage unit 3]
In advance, the storage unit 3 is defined by a predetermined definition method based on the types of target sites and the reference positions of a plurality of specific sites located inside and / or outside the target sites corresponding to the types of target sites. The predetermined state S of the target part is stored in association with each other (“store a specific part corresponding to the type of target part” shown in FIG. 2).

  Here, “located outside the target site” means that when there is a subject whose target site is a part thereof, the target site is located outside the target site and / or located outside the subject. That means. Furthermore, the “predetermined state of the target part” refers to a state when the posture of the fetus shows left-right symmetry. The “reference position” is a conceptual position that corresponds to the position of a specific part detected by the inspection means 10. Here, a plurality of positions on the spine of the fetus, and positions of the orbits Say.

(Definition of the prescribed state)
The predetermined state S of the target site is that when a plane orthogonal to the straight line is provided at the center position Rc of the straight line connecting the positions Rp and Rq of both orbits, the spine is present in the plane (along the plane). Defined.

(Definition method)
(i) A three-dimensional medical image is represented by a coordinate system (x, y, z).
(ii) A spine is specified, and a plurality of points separated from each other are selected as positions of the spine along the length direction. A plurality of positions Ri on the spine in the image are represented by Ri (xi, yi, zi), where i = 1, 2,..., N (n ≧ 3).
(iii) The eye socket is specified, and its positions Rp and Rq are detected. Orbital positions Rp and Rq in the image are represented by Rp (xp, yp, zp) and Rq (xq, yq, zq).
(iv) Find the center position Rc (xc, yc, zc) of the straight line connecting Rp and Rq in the image.
(v) An XYZ coordinate system with the straight line connecting Rp and Rq as the X axis and the center position Rc as the origin (Xc = 0, Yc = 0, Zc = 0) on the X axis is changed in the image coordinate system xyz. The reference position Ri (xi, yi, zi) of the spine is converted to Ri (Xi, Yi, Zi).
(vi) Determination Since the plane perpendicular to the straight line provided at the center position Rc of the straight line connecting the orbital positions Rp and Rq is a plane with Xi = 0, Ri (0, Yi, Zi) where i = 1, 2,..., N (n ≧ 3), the definition is satisfied.

(Interface 4)
FIG. 3 is a flowchart showing a series of flow from reading of a medical image to display of an image showing a mid-sagittal section.
The inspection means 10 reads out images in a predetermined order (for example, in order of photographing times as incidental information) from a series of three-dimensional medical images (“reading out three-dimensional medical images” shown in FIG. Step S101 shown in FIG.

  FIG. 4 is an MPR (Milti Planar Reconstruction) image of the fetus. In FIG. 4, a cylindrical mark M displayed so as to overlap the MPR image is indicated by a broken line. Separately from a series of three-dimensional medical images, a fetal MPR image is acquired and stored in the storage unit 3.

  As shown in FIG. 4, the display control unit 42 displays the fetal MPR image on the display unit 43 and receives the operation of the input unit 41 so that the mark M can be moved and is indicated by the mark M. The detection range of the moving destination is displayed so as to be overlaid on the MPR image so that it can be designated. Here, the “detection range” refers to a range in which the position of the specific part is detected by the inspection means 10 if there is a specific part in the range. Further, the display control unit 42 receives the operation of the input unit 41 and causes the display unit 43 to display the type of the target part so as to be designated. Here, in response to the operation of the input unit 41, the display control unit 42 designates the detection range (here, the abdominal region) indicated by the mark M, and designates the NT region as the target part. ("Specifying target region and detection range" shown in FIG. 2, step S102 shown in FIG. 3).

  When the detection range and the NT region are designated, the medical device 1 detects the position of the specific part by the inspection unit 10 and the actual state S ′ by the definition unit 20 based on the three-dimensional medical image read in the predetermined order. Each step of definition and comparison between the actual state S ′ and the predetermined state S by the determination unit 30 is performed. In comparison between the actual state S ′ and the predetermined state S, it is determined whether or not the actual state S ′ of the fetus is the predetermined state S, that is, the state when the posture of the fetus shows left-right symmetry. The medical device 1 ends reading of the medical image when it is determined that the actual state S ′ is the same as the predetermined state S, and when it is determined that the actual state S ′ is different from the predetermined state S, the medical device 1 The next medical image is read out. Then, each process from the position detection of the specific part to the comparison between the actual state S ′ and the predetermined state S is repeated until it is determined that the actual state S ′ and the predetermined state S are the same.

(Detect position of specific part)
Next, details of each process from the detection of the position of the specific part to the comparison between the actual state S ′ and the predetermined state S will be described.
The inspection means 10 stores in advance a plurality of specific parts corresponding to the type of the target part and the detection method thereof. Here, the specific part corresponding to the NT region includes the fetal spine and the fetal orbit.

  FIG. 5 is an image taken when the posture of the fetus shows left-right symmetry, and FIG. 6 is an image taken when the posture of the fetus does not show left-right symmetry. 5 and 6, the position on the spine is indicated by “Bi”, and the positions of the orbits are indicated by “Bp” and “Bq”. Here, i = 1, 2,..., N (n ≧ 3).

  The inspection means 10 receives the designation of the detection range and the NT region, and detects specific parts (fetal spine, orbit) corresponding to the NT region and their positions from the read three-dimensional medical image. The inspection means 10 detects, as a spine, a continuous portion of a high-luminance portion depicted in a detection range in a three-dimensional medical image (“spine detection” shown in FIG. 2). Further, the inspection means 10 detects a plurality of positions Bi on the spine with the spine as the central axis (“position detection on the spine” shown in FIG. 2). At this time, the position Bi in the medical image is represented by Bi (xi, yi, zi).

  FIG. 7A is an image when a portion with high luminance is continuously detected in one direction. The inspection means 10 obtains the position of the centroid of the region showing high luminance in each image. The position of the centroid in each image is a plurality of positions Bi on the spine.

  Next, the inspection means 10 refers to the spine as the central axis, and detects the head by pattern matching based on the read image (“detection of the head” shown in FIG. 2, step S103 shown in FIG. 3). ). Further, the inspection means 10 detects the orbit of the head and its positions Bp and Bq ("orbital position detection" shown in FIG. 2, step S103 shown in FIG. 3). FIG. 7B is an image showing the detected spine and a predetermined area AR arranged at one end of the spine axis AB. Here, for example, as shown in FIG. 7B, the pattern matching is an image showing a head region (not shown) stored in a database (not shown) and a predetermined area AR arranged at one end of the spine axis AB. Matching with. Further, the inspection unit 10 obtains a center position Bc of a straight line connecting Bp and Bq in the image. The detected positions Bp and Bq are represented by Bp (xp, yp, zp) and Bq (xq, yq, zq). The obtained center position Bc is represented by Bc (xc, yc, zc).

(Definition of real state)
The definition means 20 stores in advance a definition method for defining the actual state S ′ corresponding to the type of the target part (the same method as when the predetermined state S is defined). The definition means 20 defines the real state S ′ by a predetermined definition method based on the positions Bi, Bp, Bq detected by the inspection means 10 (“define real state” shown in FIG. 2, step shown in FIG. S104).

  FIG. 8 is a diagram showing the positional relationship between the orbital positions Bp and Bq and the plane PL. As shown in FIG. 8, the defining means 20 uses the straight line connecting the detected orbital positions Bp and Bq as the X axis, and the center position Bc as the origin on the X axis (Xc = 0, Yc = 0, Zc = 0). ) Is converted into the XYZ coordinate system, and the spine position Bi (xi, yi, zi) in the coordinate system xyz of the medical image is converted into Bi (Xi, Yi, Zi). ("Define XYZ coordinates" shown in FIG. 2: Same as definition method (v)).

FIG. 9 is a diagram illustrating a case where all of a plurality of positions Bi on the spine exist in the plane PL.
Next, when the plane PL orthogonal to the straight line is provided at the center position Bc of the straight line connecting the orbital positions Bp and Bq, the defining means 20 obtains the distance from the plurality of positions Bi on the spine to the plane PL. ("Define actual state" shown in FIG. 2).

(Comparison between the actual state S ′ and the predetermined state S)
The determination unit 30 compares the defined actual state S ′ with the predetermined state S based on the obtained distance (distances from the plurality of positions Bi on the spine to the plane PL).
Since the plane PL is a plane with Xi = 0, the determination unit 30 determines that the actual state S ′ and the predetermined state S are the same when Bi (0, Yi, Zi) (shown in FIG. 2). “Compare the actual state and the predetermined state”, step S105 shown in FIG. This means that there are all of the plurality of positions Bi on the spine in the plane PL, that is, the plane PL has a median sagittal cross section.

  Here, “there are a plurality of positions Bi on the spine in the plane PL” means that the distance from the position Bi to the plane PL is within an allowable range. The allowable range is obtained as follows. For example, a predetermined number of medical images that can generate a plane (that is, a mid-sagittal section) when the thickness of the NT region can be measured with a predetermined accuracy are selected from past samples, and the position Bi is selected for each selected sample. The distance from the plane PL to the plane PL is measured, and an allowable range is obtained from the maximum value of the measured values.

  10A and 10B are diagrams illustrating a case where one or more of a plurality of positions Bi on the spine do not exist in the plane PL. As shown in FIGS. 10A and 10B, when one or more of the plurality of positions Bi on the spine are not located in the plane PL, that is, when the plane PL is not a median sagittal section, the determination unit 30 It is determined that the state S ′ is different from the predetermined state S (“Compare actual state and predetermined state” shown in FIG. 2, step S105 shown in FIG. 3). The determination unit 30 outputs a determination result (“output comparison result” shown in FIG. 2).

(Display of mid-sagittal section, measurement of NT region thickness)
FIG. 11 is an image showing a mid-sagittal section. When the determination result that the actual state S ′ of the target part is the same as the predetermined state S is output (step S105: Yes shown in FIG. 3), the thickness of the NT region indicated by the white arrow in FIG. In FIG. 11, it is configured to be capable of measurement. Here, the “configuration capable of measuring the thickness of the NT region” includes automatic measurement for automatically measuring the thickness and manual measurement for measuring the thickness manually.

  For automatic measurement, a median sagittal section in the plane PL is created based on a three-dimensional medical image, an NT region is extracted from the created median sagittal section, and the centroid of the extracted NT region is the center. A plurality of concentric scales whose radii are different in stages at predetermined intervals (for example, 2 mm) are created, and the created scales are displayed on the display unit 43 so as to overlap the NT region (FIG. 2). (Display a mid-sagittal section), step S106 shown in FIG. 3, and a method of measuring the thickness of the NT region with reference to a scale. On the other hand, as manual measurement, a median sagittal section in the plane PL is created based on a three-dimensional medical image, and the created median sagittal section is displayed on the display unit 43 (shown in FIG. 2). There is a method in which a doctor or the like actually measures the thickness of the NT region in the “midline sagittal section”, step S106 shown in FIG. Similarly, CRL and NB are measured by automatic measurement or automatic measurement.

  When the determination unit 30 determines that the actual state S ′ of the target part is different from the predetermined state S (step S105: No shown in FIG. 3), the process returns to S101 shown in FIG. The next sequential medical image is read out from the series of three-dimensional medical images.

[Modification]
Next, a modification of the medical device 1 according to the first embodiment will be described.
In the modified example, “definition of a predetermined state” and “definition method” are different from the above embodiment, and “definition of a real state”, “comparison between a real state S ′ and a predetermined state S”, and “middle arrow The “display of the cross section” and the “measurement of the thickness of the NT region” are the same as in the above embodiment.

(Definition of the prescribed state)
In the mid-sagittal section that divides the body into two halves, all of the plurality of positions Ri in the longitudinal direction of the spine and the center position Rc of the straight line connecting the positions Rp and Rq of both orbits are within the section. Should exist. On the other hand, as shown in FIGS. 10A and 10B, when the fetus turns its head sideways or tilts its neck, one of the plurality of positions Ri and the center position Rc deviates from the same plane. Located.
Therefore, the predetermined state S of the target region is defined by all of the plurality of positions Ri in the longitudinal direction of the spine being in the same plane and the plane crossing the center position Rc.

(Definition method)
(i) A three-dimensional medical image is represented by a coordinate system (x, y, z).
(ii) A spine is specified, and a plurality of points separated from each other are selected as positions of the spine along the length direction. A plurality of positions Ri on the spine in the image are represented by Ri (xi, yi, zi), where i = 1, 2,..., N (n ≧ 3).
(iii) The eye socket is specified, and its positions Rp and Rq are detected. Orbital positions Rp and Rq in the image are represented by Rp (xp, yp, zp) and Rq (xq, yq, zq).
(iv) Find the center position Rc (xc, yc, zc) of the straight line connecting Rp and Rq in the image.
(v) Determination Satisfy the definition when there is a plane in which all of the plurality of positions Ri are in the same plane and the plane crosses the center position Rc of the straight line connecting the orbital positions Rp and Rq. .
On the contrary, there is no plane in which all of the plurality of positions Ri on the spine detected by the inspection means 10 based on the medical image are in the same plane, and even if such a plane exists, The definition is not satisfied when the center position Rc of the straight line connecting the orbital positions Rp and Rq detected by the inspection means 10 is not crossed. Note that “the plurality of positions Ri are in the same plane” means that the distance from the position Ri to the plane is within an allowable range. This allowable range is obtained by the same method as the above-described method for obtaining it.

<Second Embodiment>
Next, a second embodiment of the medical device 1 when measuring the major axis length of the end diastole left ventricle and / or the major axis cross-sectional area at that time will be described with reference to the drawings.

  Since the configuration of the medical device 1 according to the second embodiment is basically the same as that of the medical device 1 according to the first embodiment, the same components are denoted by the same reference numerals, and the description thereof is omitted. Mainly explained.

  FIG. 12 is an MPR image of the heart. A MPR image of the heart is acquired separately from the series of three-dimensional medical images and stored in the storage unit 3. FIG. 12 shows a left ventricular cavity in a diastole represented in a substantially spade shape. The left ventricular cavity has a pair of mitral valves located on the left and right sides of the left ventricular entrance, and a back wall (rear wall) located at the back of the left ventricle (the apex of the spade). FIG. 12 shows a major axis length LA that is a distance between the center position Rc of the straight line connecting the positions Ru and Rv of the pair of mitral valves and the position Rw of the back wall. The end diastole of the heart is shown as the time when the back wall (rear wall) of the left ventricle moves back and forth and moves to the apex (the last position), and is shown when the long axis length LA is the maximum value. .

  In the first embodiment, the position Ri on the spine of the fetus and the positions Rp and Rq of the orbit are used as the reference positions of the specific parts. In the second embodiment, the position Ru, Let Rv and the position Rw of the back wall of the left ventricle be the reference position of the specific part.

(Definition of the prescribed state)
The predetermined state S of the target region is determined by the distance between the center position Rc of the straight line connecting the positions Ru and Rv of the mitral valve in the left ventricle and the position Rw of the back wall of the left ventricle (hereinafter referred to as the major axis length). , Defined as the maximum value.

(Definition method)
(i) A three-dimensional medical image is represented by a coordinate system (x, y, z).
(ii) The left ventricular mitral valve is specified and its positions Ru and Rv are detected. The positions Ru and Rv in the image are represented by Ru (xu, yu, zu) and Rv (xv, iv, zv).
(iii) Identify the back wall of the left ventricle and detect its position Rw. The position Rw in the image is represented by Rw (xw, yw, zw).
(iv) A center position Rc (xc, yc, zc) of a straight line connecting Ru and Rv is obtained.
(v) A distance (major axis length LA) between the center position Rc and the back wall position Rw is obtained by the following equation (1).
LA = {(xw−xc) ² + (yw−yc) ² + (zw−zc) ² } ^1/2 (1)
(vi) Determination Satisfy the definition when the long axis length LA is the maximum value.

FIG. 13 is a flowchart showing a series of flows from the reading of a medical image to the display of the long axis length and the like in the second embodiment.
As in the first embodiment, the examination unit 10 reads out images in a predetermined order from a series of three-dimensional medical images (“reading out three-dimensional medical images” shown in FIG. 13). The medical device 1 or an image processing device (not shown) generates an MPR image based on a three-dimensional medical image. The storage unit 3 stores fetal MPR images.

  In FIG. 12, a mark M displayed in an overlapping manner on the MPR image is indicated by a broken line. In response to the operation of the input unit 41, the display control unit 42 designates the detection range indicated by the mark M (here, the range of the left ventricle of the heart), and the long axis of the end diastole left ventricle as the target site The long and long-axis cross-sectional areas are designated ("designation of target part and detection range" shown in FIG. 13).

(Detect position of specific part)
FIG. 14 is a diagram showing a mitral valve in the left ventricle and a back wall of the left ventricle. FIG. 14 shows the position U of the right mitral valve, the position V of the left mitral valve, and the position W of the back wall. The inspection means 10 receives the designation of the detection range and the target part, and reads out the specific part (left ventricular mitral valve and back wall) corresponding to the target part by pattern matching and the position thereof, which is read out. It detects from an image ("Detection of the mitral valve" to "Detection of the position of the back wall of the left ventricle" shown in FIG. 13). The detected right mitral valve position U, left mitral valve position V, and back wall position W are U (xu, yu, zu), V (xv, yv, zv), W ( xw, yw, zw).
Further, the inspection means 10 obtains a center position C (xc, yc, zc) of a straight line connecting the positions U, V of the left ventricular mitral valve.

(Definition of real state)
The defining means 20 obtains a long axis length LA ′ that is a distance between the center position C and the back wall position W with reference to the following equation (2) (see “Defining Long Axis Length” in FIG. 13). ”,“ Define real state ”).
LA ′ = {(xw−xc) ² + (yw−yc) ² + (zw−zc) ² } ^1/2 (2)
The definition means 20 obtains the major axis length LA ′ based on the detected positions U, V, W and the obtained center position C every time a three-dimensional medical image is read. For example, when a medical image is read a predetermined number N times, the defining means 20 obtains a predetermined number N of major axis lengths LA ′.

(Comparison between the actual state S ′ and the predetermined state S)
The storage unit 3 stores an initial value “0” of the long axis length LA ′. The determination unit 30 determines whether or not the determined long axis length LA ′ is greater than the long axis length LA ′ stored in the storage unit 3 every time the long axis length LA ′ is determined.

  When the determination unit 30 determines that the determined long axis length LA ′ is larger than the long axis length LA ′ stored in the storage unit 3, the long axis stored in the storage unit 3 with the determined long axis length LA ′. Rewrite the length LA ′ (update the major axis length). On the other hand, when the determination unit 30 determines that the obtained long axis length LA ′ is equal to or less than the long axis length LA ′ stored in the storage unit 3, the long axis length is not updated. For example, when the determination by the determination unit 30 is performed a predetermined number N times, the long axis length LA ′ stored in the storage unit 3 is the maximum value among the obtained N long axis lengths LA ′. Here, “when the determined left ventricular long axis length is the longest” means when the determination unit 30 determines a predetermined number of times. The determination by the determination unit 30 a predetermined number of times is “comparison between the actual state S ′ and the predetermined state S”.

(Measurement of major axis length and major axis cross-sectional area of left ventricle at end diastole)
FIG. 15 is a diagram showing the major axis length and the major axis cross-sectional area. FIG. 15 shows a line PF in which the heart chamber contour of the left ventricle is traced so as to pass through the positions U, C, V, and W.
When the determination unit 30 determines that the actual state S ′ and the predetermined state S are the same, that is, when the major axis length LA ′ is the maximum value, the major axis sectional area at that time can be measured. . For the measurement of the long-axis cross-sectional area, the heart chamber outline of the left ventricle is traced as shown by the line PF in FIG. 15 (at this time, the gland PF passes through the positions U, V, and C), and the area surrounded by the trace For example, the means described in JP 2007-117344 A is used.

The determination unit 30 outputs the maximum value of the major axis length LA ′ (the major axis length LA ′ of the end diastole left ventricle) and / or the major axis length area at that time (see “Comparison result output” shown in FIG. 13). ").
The display control unit 42 displays the maximum value of the long axis length LA ′ and / or the long axis cross-sectional area at that time on the display unit 43 (“display the long axis length etc.” shown in FIG. 13).

  In addition, the end diastole can be identified by the maximum ventricular volume at that time or by the waveform of the electrocardiogram. Therefore, it is possible to read the image acquired when the end diastole is specified with these and measure the long axis length from the image. However, since data other than the major axis length, called ventricular volume, is used to measure the major axis length at the end diastole, and an ECG monitor is required, the major axis length at the end diastole can be measured accurately and easily. Can not. On the other hand, according to the second embodiment, the maximum value of the major axis length LA ′ is obtained from the predetermined number N of major axis lengths LA ′ obtained based on the medical image, thereby expanding It is possible to accurately and easily measure the long axis length at the end stage.

<Third Embodiment>
Next, an ultrasonic diagnostic apparatus 100 according to the third embodiment will be described with reference to the drawings.

  Since the configuration of the ultrasonic diagnostic apparatus 100 according to the third embodiment is basically the same as that of the medical apparatus 1 according to the first embodiment, the same components are denoted by the same reference numerals, the description thereof is omitted, and is different. The configuration will be mainly described.

  In the above embodiment, a series of three-dimensional medical images are acquired by a medical diagnostic apparatus (not shown), transmitted from the medical diagnostic apparatus to a server (not shown) in the hospital, and transmitted from the server to the medical apparatus 1. 1 storage unit 3. The medical device 1 specifies a medical image captured when the actual state is a predetermined state from a series of three-dimensional medical images stored in the storage unit 3.

  In contrast, in the third embodiment, the ultrasonic diagnostic apparatus 100 includes the control unit 2, the storage unit 3, the interface 4, the inspection unit 10, the definition unit 20, the determination unit 30, and an imaging unit (not shown). Then, a series of three-dimensional ultrasonic images are acquired by scanning the target site with ultrasonic waves. Similar to the storage unit 3 of the medical apparatus 1, the storage unit 3 of the ultrasonic diagnostic apparatus 100 stores a specific part and a predetermined state in association with each other.

  The inspection unit 10 reads out one ultrasonic image from a series of three-dimensional ultrasonic images sequentially acquired by the imaging unit in a predetermined order, and detects the position of a specific part from the read ultrasonic image. The defining means 20 defines the actual state of the target part based on the position of the specific part. The determination unit 30 determines whether or not the defined real state is the same as the predetermined state stored in the storage unit 3.

  Upon receiving the determination result that the actual state defined based on the detected position of the specific part is the same as the predetermined state stored in the storage unit 3, the display control unit 42 detects the position of the specific part. Based on the ultrasonic image used at the time, the target part is displayed on the display unit 43 so as to be measurable. Thereby, it becomes possible to measure the target part while photographing the target part.

  On the other hand, upon receiving the determination result that the actual state defined based on the detected position of the specific part and the predetermined state stored in the storage unit 3 are not the same, the inspection unit 10 reads the ultrasonic image The next ultrasonic image is read out from a series of three-dimensional ultrasonic images.

  The configuration described in the above embodiment specifies a medical image captured when the actual state is a predetermined state from a series of three-dimensional medical images, but can also be applied to a two-dimensional medical image. . In addition, although the position of the specific part is shown as the position on the spine or the position of the orbit, it can also be applied to a position on the artificial bone.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example 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.

AB Spine axis AR Predetermined area Bi, Ri Positions Bp, Bq, Rp, Rq on the spine Orbital position Bc, Rc Center position M Mark PL Plane 1 Medical device 2 Control unit 3 Storage unit 4 Interface 41 Input unit 42 Display control unit 43 display unit 10 inspection unit 20 definition unit 30 determination unit 100 ultrasonic diagnostic apparatus

Claims (12)

In a medical device using a medical image of the target part acquired by imaging the target part of a subject,
A storage unit for storing a predetermined state of the target part defined based on a plurality of specific parts located in the target part;
Inspection means for detecting positions of the plurality of specific parts from the medical image;
Defining means for defining the actual state of the target site based on the positions of the detected specific sites;
A determination unit for obtaining information relating to a degree of coincidence between the defined real state and the predetermined state stored in the storage unit;
I have a,
The storage unit associates and stores the target part and a predetermined state of the target part,
The inspection means detects the position of the plurality of specific parts from the medical image by receiving the designation of the target part,
A medical device characterized by that. The storage unit is defined by a predetermined definition method based on reference positions of a plurality of specific parts located inside and / or outside the target part corresponding to the type of the target part and the type of the target part. A predetermined state of the target part that is made to be associated and stored,
The inspection unit stores the plurality of specific parts corresponding to the type of the target part, and when receiving the specification of the target part, the plurality of specific parts for the type of the target part specified from the medical image Detect the position of the part,
The definition means stores a definition method for defining the actual state corresponding to the type of the target part, and when receiving the designation of the target part, the plurality of identifications detected by the inspection part based on the position of the site, to define the actual state defined way about the type of the designated target site, according to claim 1, characterized in that for outputting a real state of sites that previously defined Medical device. The inspection means receives designation of a site of fetal cervical edema as the target site, and positions of a plurality of first specific sites on the spine located outside the target site from the medical image, and the target site Detecting the position of two second specific sites as orbits located outside
The definition means defines the real state based on a positional relationship between a center position of a straight line connecting the positions of the two second specific parts and the plurality of first specific parts,
The determination unit includes the defined real state, the center position, and the predetermined state defined as the positions of the plurality of first specific portions being all in the same plane. Are the same,
The medical device according to claim 2 , wherein when the determination unit determines that the actual state and the predetermined state are the same, the thickness of fetal neck edema can be measured. The defining means obtains a plane orthogonal to the straight line at the center position of the straight line, and defines the real state according to a mutual positional relationship between the obtained flat face and the first specific part,
The determination unit determines whether or not the defined actual state is the same as the predetermined state defined that all of the positions of the plurality of first specific parts are present in the plane. The medical device according to claim 3 , wherein: The definition means defines the actual state based on a mutual positional relationship between the existing plane and the center position when all of the positions of the plurality of first specific parts exist in the same plane. ,
The determination unit is configured with the actual state of the defined, the plane of claim 3 in which the predetermined condition which is defined as passing through the center position, characterized in that determining whether the same Medical device. When the determination unit determines that the real state and the predetermined state are the same, a median sagittal section in the plane is generated based on the medical image, and further, the median sagittal section is displayed. Accordingly, the medical device according to any one of claims 3 to 5 , wherein the thickness of fetal neck edema can be measured. The inspection means reads one medical image from the medical images in a predetermined order, detects the positions of the plurality of specific parts from the read medical image, and based on the detected positions of the plurality of specific parts. The medical image in the next order of the one medical image is read out when it is determined that the actual state defined in 1 is different from the predetermined state stored in the storage unit. The medical device according to claim 6 . The inspection means receives the designation of the left ventricle as the target part, and two third specific parts as mitral valves located on both sides of the left ventricular entrance located in the target part from the medical image And the position of the fourth specific part as the back wall located in the back of the left chamber from the entrance located in the target part,
The defining means obtains a straight line connecting the positions of the two third specific parts, and obtains a left ventricular long axis length which is a distance between the center position of the straight line and the position of the fourth specific part. The real state is defined by
The determination unit determines that the defined real state and the predetermined state are the same when the calculated left ventricular long axis length is the longest,
When the determination unit determines that the actual state and the predetermined state are the same, the longest left ventricular long axis length can be output and / or a length that is a cross-sectional area of the left ventricle at that time The medical device according to claim 2 , wherein the medical device is configured to be capable of measuring an axial sectional area. The inspection means reads a predetermined number of medical images from the medical images in a predetermined order, detects the positions of the third specific part and the fourth specific part based on the read medical images,
The definition means obtains the predetermined number of left ventricular long axis lengths from the positions of the third specific part and the fourth specific part detected based on the predetermined number of medical images by the examination means,
When the left ventricular long axis length obtained by the defining means is the longest among the predetermined number of left ventricular long axis lengths, the determining unit makes the defined real state and the predetermined state the same. The medical device according to claim 8 , wherein the medical device is determined. In an ultrasonic diagnostic apparatus for acquiring an ultrasonic image of the target part by scanning the target part of the subject with ultrasonic waves,
A storage unit for storing a predetermined state of the target part defined based on a plurality of specific parts located in the target part;
Sequentially reading one ultrasonic image from the acquired ultrasonic image, and detecting means for detecting positions of the plurality of specific parts from the read ultrasonic image;
Defining means for defining the actual state of the target site based on the positions of the detected specific sites;
A determination unit for obtaining information relating to a degree of coincidence between the defined real state and the predetermined state stored in the storage unit;
An ultrasonic diagnostic apparatus characterized by comprising: The inspection means reads out one ultrasonic image from the ultrasonic image in a predetermined order, detects the positions of the plurality of specific parts from the read ultrasonic image, and detects the plurality of specific parts detected. When it is determined that the actual state defined based on a position is different from the predetermined state stored in the storage unit, an ultrasonic image in the next order of the one ultrasonic image is read. The ultrasonic diagnostic apparatus according to claim 10 . When it is determined that the actual state defined based on the detected positions of the plurality of specific parts and the predetermined state stored in the storage unit are the same, the positions of the plurality of specific parts are detected. The ultrasonic diagnostic apparatus according to claim 11 , wherein the ultrasonic diagnostic apparatus is configured to be able to measure the target region based on the ultrasonic image used sometimes.

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