WO2009022247A1 - Vue en coupe d'échocardiographie d'effort volumétrique - Google Patents
Vue en coupe d'échocardiographie d'effort volumétrique Download PDFInfo
- Publication number
- WO2009022247A1 WO2009022247A1 PCT/IB2008/053031 IB2008053031W WO2009022247A1 WO 2009022247 A1 WO2009022247 A1 WO 2009022247A1 IB 2008053031 W IB2008053031 W IB 2008053031W WO 2009022247 A1 WO2009022247 A1 WO 2009022247A1
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- WO
- WIPO (PCT)
- Prior art keywords
- planes
- tomographic
- acquired
- volumetric
- reconstructed
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/13—Tomography
- A61B8/14—Echo-tomography
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
- A61B8/461—Displaying means of special interest
- A61B8/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/48—Diagnostic techniques
- A61B8/483—Diagnostic techniques involving the acquisition of a 3D volume of data
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
- A61B8/523—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for generating planar views from image data in a user selectable plane not corresponding to the acquisition plane
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
- G01S7/00—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00
- G01S7/52—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00
- G01S7/52017—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00 particularly adapted to short-range imaging
- G01S7/52053—Display arrangements
- G01S7/52057—Cathode ray tube displays
- G01S7/52068—Stereoscopic displays; Three-dimensional displays; Pseudo 3D displays
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
- G01S7/00—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00
- G01S7/52—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00
- G01S7/52017—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00 particularly adapted to short-range imaging
- G01S7/52053—Display arrangements
- G01S7/52057—Cathode ray tube displays
- G01S7/52074—Composite displays, e.g. split-screen displays; Combination of multiple images or of images and alphanumeric tabular information
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4884—Other medical applications inducing physiological or psychological stress, e.g. applications for stress testing
Definitions
- the present invention relates to stress echocardiography imaging techniques.
- the present invention relates to a method, device and a computer readable medium for displaying ultrasound data on a display.
- the present invention relates to a user interface presenting a novel approach to stress echocardiography by utilizing C-plane slices obtained from volumetric images of the heart before and after stress.
- Stress echocardiography is a test that helps to diagnose heart disease by means of ultrasound images. Following exercise or other stress to the heart, the images reveal parts of the heart that may not be receiving enough blood or oxygen because of blocked arteries.
- the ultrasound portion of this test is performed in the same way as an echocardiogram.
- Exercise or medication is used to increase the heart rate and to show how the heart works under exertion.
- cardiac wall motions of the left ventricle are analyzed before and after stress to detect abnormalities during systole (the contraction phase of the heart) and/or during diastole (the expansion phase of the heart).
- the left ventricle wall is typically divided into a plurality of segments (e.g. 16 or 17, see Fig. 4) according to the standard recommended by the American Society of Echocardiography
- an echocardiographer typically records two B-plane ultrasound sequences from a patient at rest, i.e. before exercise from a parasternal position (see reference number 10 in Fig. 3) in order to obtain a long axis (PLAX; parasternal long axis) and short axis (SAX; short axis) views of the left ventricle as illustrated in Figs. 2A and 2B.
- PPAX long axis
- SAX short axis
- the echocardiographer obtains two B-plane ultrasound sequences from the apical position (see reference number 2 in Fig. 3) in order to obtain the apical four- chamber (AP4) and two-chamber (AP2) views as illustrated in Figs.2C and 2D. Again, the echocardiographer has to align the ultrasound head two times, this time in the apical position.
- the same or similar four views are obtained after exercise (treadmill/bicycle) or medication such that the motion of each of the 16 or 17 segments is comparable between a unstressed and stressed status of the heart. It is also common to acquire the four standardized views under various conditions such that each of the four views can be compared under different conditions.
- the corresponding views are then displayed and compared side-by-side on a screen, e.g. AP2 is displayed before and after exercise side-by- side on a screen, so as to identify possible wall motion abnormalities before and after stress.
- the echocardiographer has to align the transducer at the same four positions before and after stress, i.e. in the two parasternal and in the two apical position before and after stress which is quite difficult.
- an improved stress echocardiography imaging technique It is thus an object of the present invention to provide an improved method for acquiring and displaying echocardiography data. It is a further object of the invention to provide a system which helps an echocardiographer in obtaining and comparing ultrasound data, particularly stress ultrasound date.
- the method of the present invention should provide an improved and simplified imaging technique which enables an echocardiographer in acquiring ultrasound data in a simplified way and further provides the echocardiographer with an image technique which simplifies comparison of echocardiography views before and after stress.
- the present invention provides a method for displaying ultrasound data on a display comprising the steps of acquiring volumetric ultrasound data from a heart, in particular from a left ventricle at different times.
- the volumetric ultrasound data are obtained by an echocardiographer before and after exercise (e.g. treadmill/bicycle) or medication.
- the different times are not restricted to the states before and after exercise, e.g. the ultrasound data may also be obtained during exercise or at different stages of exercise, during a rest period or during different stages of medication.
- the ultrasound data are acquired from one and the same position during the different possible stages.
- the acquiring from the apical position is preferred.
- obtaining the data from the parasternal and the apical position is also an option.
- the acquired ultrasound data are volumetric ultrasound data.
- C-plane cuts i.e. tomographic cuts substantially in an orthogonal direction with respect to the ultrasound propagation direction.
- C-plane is not restricted to orthogonal cuts; typically a C-plane is any plane between the range of 10° and 90° with respect to the ultrasound propagation direction.
- a 90° C-plane is illustrated in Fig. IA and IB with reference numeral 2.
- Figure IA and IB also illustrate with reference numeral 3 a B-plane cut which is a cut substantially in the direction of the sound propagation.
- volumetric ultrasound data allows reconstructing at least one, preferably two three or four tomographic C-p lanes from the volumetric data at different depths from each acquired time.
- the acquired and stored volumetric ultrasound data allow a tomographic reconstruction in every depth in C-plane direction.
- the acquired and stored volumetric ultrasound data also allow tomographic reconstructions in the B- plane direction.
- the tomographic C-planes are reconstructed in two, three, four or even more different depths relative to the position of the ultrasound head. For instance, with three C- planes in appropriate depths, it is possible to view all 16 segments of the ASE standard. Four C-plane cuts, e.g. allow an examination of all 17 segments according to the other ASE standard. For some cases it may also be preferred to reconstruct only a single C- plane, e.g. in case an abnormality has been detected in a specific C-plane.
- the tomographic C-planes are displayed on a screen side-by-side.
- the different C-planes which have been obtained at different times are displayed in an array or matrix side-by-side on the display.
- four different tomographic C-planes before exercise may be displayed in a column.
- the corresponding tomographic C-plane cuts after exercise may be displayed in another column next to the first column on the display, i.e. C-planes taken at the same depth but at different times are displayed in same rows as depicted for example in Fig. 5.
- the rows and columns and/or the individual pictures (or movies) are labelled with the corresponding segment names according to the ASE. This helps an echocardiographer to identify easily which segment or part of the heart is pathological.
- the volumetric data acquired at different times are at least acquired over the time span of a heart cycle such that the diastolic motions and the systolic motions of the heart can be examined.
- the time span is shorter than a complete heart cycle, e.g. in case only the systolic or only the diastolic motions of the heart are of interest.
- the volumetric data are acquired at least over the time span of multiple heart cycles.
- the reconstructed tomographic C-planes may be single images. This may be advantageous in case a specific state of the heart cycle is of interest.
- tomographic C-planes in form of movies.
- the reconstruction of movies provides the advantage that the movies of the tomographic C-planes from different times can be displayed synchronously with regard to the heart cycle side-by-side on the display.
- An echocardiographer may then easily detect a pathological motion of a heart wall when comparing the movies of the C-plane before and after stress. It may be further preferred to display the movies in loops such that the echocardiographer may see the same sequence many times which may help in detection of pathological heart wall motions.
- tomographic C-planes it may be further helpful to examine certain regions of the heart from a different perspective.
- Such a reconstructed B-plane view may be displayed together, e.g. side-by-side, with the C-planes views.
- the storage and display format of the present invention is compatible with common standards, e.g the ultrasound data may be stored in the DICOM format which allows an easy exchange between most of the available ultrasound and displaying systems.
- the present invention also relates to a system for an echocardiography imaging technique.
- the system comprises a memory for storing volumetric ultrasound data, e.g. volumetric ultrasound data from a heart acquired at different times; a processor for reconstructing at least one, preferably two, three, four or more tomographic C-planes from the volumetric data at different depths from each acquired time and a display for displaying the reconstructed tomographic C-planes acquired at different times side-by-side.
- the system is adapted to perform any of the above mentioned method steps.
- the present invention is also directed to a computer readable medium having stored therein data representing instructions executable by a programmed processor for executing the method steps as mentioned above.
- Fig. IA schematically shows the pyramid of a volumetric ultrasound scan region with indicated b- and C-planes.
- Fig. IB schematically shows a scanning pyramid similar to Fig. 1 a but with multiple b- and C-planes at different depths.
- Fig.2A shows the long axis view (PLAX) of the left ventricle taken from the parasternal position.
- Fig.2B shows the short axis view (SAX) of the left ventricle taken from the parasternal position.
- Fig.2C shows the apical four-chamber (AP4) view.
- Fig.2D shows the apical two-chamber (AP4) view.
- Fig.3 shows the torso of a human with indicated parasternal and apical regions.
- Fig.4 shows the bulls-eye plot with 16 segments according to the ASE.
- Fig.5 shows C-planes from the apex, apical, mid and basal region of a heart in columns at different stages of exercise (rest, post exercise 1 and post exercise 2).
- the echocardiographer adjusts the ultrasound head or transducer 1 at the apical position, which is e.g. depicted in Fig. 3 at reference sign 20.
- volumetric ultrasound data from the heart are acquired the first time when the patient is at rest.
- the patient start an exercise, e.g. walking on a treadmill.
- the echocardiographer acquires similar volumetric ultrasound data from the same position, i.e. from the apical position.
- the method or device reconstructs from the acquired and stored volumetric ultrasound data four tomographic C-p lanes at different depths, e.g. from the apex, apical, mid and basal region of the heart.
- the reconstructed C- planes from different depths before and after exercise are displayed side-by-side on a display.
- the C-planes are displayed in rows and columns as depicted for example in Fig. 5.
- the rows correspond to different regions of the heart while the columns enable a direct comparison of corresponding segments of the heart before and after stress.
- Figure 5 shows an example of 12 possible tomographic slices.
- the tomographic C-planes are reconstructed at four different depths, namely at the apex, in the apical region, in the mid region and in the basal region of the heart.
- the different depths are depicted side-by- side column wise.
- similar C-planes i.e. similar depths are reconstructed in a rest position of a patient and at two different times after exercise, e.g. post exercise 1 and post exercise 2.
- the pictures or movies are labelled apex at rest, apex at post 1, apex at post 2, apical at rest, apical at post 1, apical at post 2, mid at rest, mid at post 1, mid at post 2, basal at rest, basal at post 1 and basal at post 2, mid 2, basal 1, basal 2.
- the labelling of the slices will be made available to DICOM export. In this way, the operator is able to analyse efficiently and quickly the left ventricle before and after stress, from apex to base for example.
- Figure 4 shows the bulls-eye plot with 16 segments according to the ASE, i.e. the three rings represent the different planes nearest the top of the heart (outer ring, basal), mid and nearest the bottom of the heart (inner ring, apical or apex).
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Abstract
La présente invention propose un procédé permettant d'afficher des données ultrasonores sur un écran, comprenant les étapes d'acquisition de données ultrasonores volumétriques provenant d'un cœur, en particulier d'un ventricule gauche, à des instants différents. De préférence, les données ultrasonores volumétriques sont acquises avant et après un exercice (par exemple, une séance de tapis roulant/de bicyclette) ou une médication. Sur la base des données ultrasonores volumétriques acquises, des coupes de plans-C tomographiques de profondeurs différentes sont reconstituées. Après la reconstitution, les plans-C tomographiques sont affichés côte à côte sur un écran. De préférence, les différents plans-C qui ont été obtenus à des instants différents sont affichés côte à côte dans un tableau ou une matrice sur écran.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US95590707P | 2007-08-15 | 2007-08-15 | |
US60/955,907 | 2007-08-15 |
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WO2009022247A1 true WO2009022247A1 (fr) | 2009-02-19 |
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PCT/IB2008/053031 WO2009022247A1 (fr) | 2007-08-15 | 2008-07-29 | Vue en coupe d'échocardiographie d'effort volumétrique |
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Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5546807A (en) * | 1994-12-02 | 1996-08-20 | Oxaal; John T. | High speed volumetric ultrasound imaging system |
US6500123B1 (en) * | 1999-11-05 | 2002-12-31 | Volumetrics Medical Imaging | Methods and systems for aligning views of image data |
US20050049479A1 (en) * | 2003-08-29 | 2005-03-03 | Helmut Brandl | Method and apparatus for C-plane volume compound imaging |
EP1609421A1 (fr) * | 2004-06-22 | 2005-12-28 | General Electric Company | Méthode et appareil pour définir un protocole pour une machine ultrasonore |
US20060182320A1 (en) * | 2003-03-27 | 2006-08-17 | Koninklijke Philips Electronics N.V. | Guidance of invasive medical devices by wide view three dimensional ultrasonic imaging |
US20060241412A1 (en) * | 2005-01-21 | 2006-10-26 | Daniel Rinck | Method for visualizing damage in the myocardium |
US20080077013A1 (en) * | 2006-09-27 | 2008-03-27 | Kabushiki Kaisha Toshiba | Ultrasound diagnostic apparatus and a medical image-processing apparatus |
-
2008
- 2008-07-29 WO PCT/IB2008/053031 patent/WO2009022247A1/fr active Application Filing
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5546807A (en) * | 1994-12-02 | 1996-08-20 | Oxaal; John T. | High speed volumetric ultrasound imaging system |
US6500123B1 (en) * | 1999-11-05 | 2002-12-31 | Volumetrics Medical Imaging | Methods and systems for aligning views of image data |
US20060182320A1 (en) * | 2003-03-27 | 2006-08-17 | Koninklijke Philips Electronics N.V. | Guidance of invasive medical devices by wide view three dimensional ultrasonic imaging |
US20050049479A1 (en) * | 2003-08-29 | 2005-03-03 | Helmut Brandl | Method and apparatus for C-plane volume compound imaging |
EP1609421A1 (fr) * | 2004-06-22 | 2005-12-28 | General Electric Company | Méthode et appareil pour définir un protocole pour une machine ultrasonore |
US20060241412A1 (en) * | 2005-01-21 | 2006-10-26 | Daniel Rinck | Method for visualizing damage in the myocardium |
US20080077013A1 (en) * | 2006-09-27 | 2008-03-27 | Kabushiki Kaisha Toshiba | Ultrasound diagnostic apparatus and a medical image-processing apparatus |
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