WO2012017821A1 - Medical image diagnostic device and cardiac measurement value display method - Google Patents
Medical image diagnostic device and cardiac measurement value display method Download PDFInfo
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- WO2012017821A1 WO2012017821A1 PCT/JP2011/066407 JP2011066407W WO2012017821A1 WO 2012017821 A1 WO2012017821 A1 WO 2012017821A1 JP 2011066407 W JP2011066407 W JP 2011066407W WO 2012017821 A1 WO2012017821 A1 WO 2012017821A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/46—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
- A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
Definitions
- the present invention relates to a medical image diagnostic apparatus and a cardiac measurement value display method for measuring living tissue using measurement points set in a tomographic image.
- a conventional medical image diagnostic apparatus an operator sets a measurement point on an acquired tomographic image using an input unit such as a mouse or a trackball. Thereafter, the medical image diagnostic apparatus measures a cardiac measurement value based on the set measurement point, and displays the cardiac measurement value.
- the measurement application of the medical image diagnostic apparatus measures the distance between the measurement points and the area or volume surrounded by the plurality of measurement points.
- the measurement application calculates the area and volume in the set predetermined area.
- Patent Document 1 does not consider updating and measuring a heart measurement value for each heartbeat cycle that is sequentially updated. Therefore, in Patent Document 1, the heart measurement value is displayed without being updated every heartbeat cycle.
- the present invention comprises a tomographic image of a subject, detects a feature waveform from the shape of an electrocardiogram waveform, and the feature waveform having the smallest time difference from the reference time among the detected feature waveforms Is set as a first feature waveform, a heartbeat cycle set by the second feature waveform and the first feature waveform that are continuous with the first feature waveform is set, and a cardiac measurement value is based on the configured tomographic image Is measured, and the tomographic image and the heart measurement value are displayed.
- the medical image diagnostic apparatus of the present invention includes a tomographic image forming unit that forms a tomographic image of a subject, a measuring unit that measures a heart measurement value based on the tomographic image, the tomographic image, and the heart
- a medical image diagnostic apparatus comprising: an image display unit that displays measurement values; a feature waveform detection unit that detects a feature waveform from the shape of an electrocardiogram waveform of the subject; and a detection by the feature waveform detection unit Among the measured feature waveforms, the feature waveform having the smallest time difference from the reference time is taken as the first feature waveform, and the heartbeat cycle set by the second feature waveform and the first feature waveform that are continuous with the first feature waveform
- a heart rate cycle setting unit that sets the heart rate measurement value based on the tomographic image, the characteristic waveform, and the heart rate cycle.
- the cardiac measurement display method of the present invention includes a step of constructing a tomographic image of a subject, a step of detecting a feature waveform from the shape of the electrocardiogram waveform of the subject, and a reference among the detected feature waveforms Setting the heartbeat cycle set by the second feature waveform and the first feature waveform that are continuous with the first feature waveform as the feature waveform having the smallest time difference from the time, and the tomography
- the method includes a step of measuring a heart measurement value based on the image, the characteristic waveform, and the heartbeat cycle, and a step of displaying the tomographic image and the heart measurement value.
- FIG. 1 is a diagram showing an overall configuration of a medical image diagnostic apparatus (ultrasound diagnostic apparatus) according to the present invention.
- 1 is a diagram showing Example 1 of the present invention.
- FIG. 1 is a diagram showing Example 1 of the present invention.
- FIG. 2 is a flowchart showing the operation of the first embodiment of the present invention.
- FIG. 4 is a diagram showing Example 2 of the present invention.
- FIG. 4 is a diagram showing Example 2 of the present invention.
- FIG. 6 is a diagram showing Example 3 of the present invention.
- FIG. 6 is a diagram showing Example 4 of the present invention.
- FIG. 1 is a block diagram showing a configuration of a medical image diagnostic apparatus to which the present invention is applied.
- an ultrasonic diagnostic apparatus will be described as an example of a medical image diagnostic apparatus.
- an ultrasonic diagnostic apparatus uses an ultrasonic probe 12 that is applied to a subject 10, and ultrasonic waves are applied to the subject 10 via the ultrasonic probe 12 at time intervals.
- Transmitting unit 14 that repeatedly transmits, receiving unit 16 that receives the ultrasonic wave reflected from the subject 10 as a reflected echo signal, an ultrasonic transmission / reception control unit 18 that controls the transmitting unit 14 and the receiving unit 16, and a receiving unit 16
- a tomographic image forming unit for forming a tomographic image of the subject 10, for example, a black and white tomographic image, based on the RF signal frame data from the phasing and adding unit 20 22, a black and white scan converter 24 that converts the tomographic image data output from the tomographic image construction unit 22 so as to match the display of the image display unit 26, and an image display unit 26 that displays an image such as a tomographic image. ing.
- the ultrasonic diagnostic apparatus includes an electrocardiogram waveform detection unit 30 that detects an electrocardiogram waveform with an electrocardiograph attached to a desired part of the subject 10, for example, a hand and a leg of the subject 10, and an electrocardiogram waveform detection Analyzing the electrocardiogram waveform detected by the unit 30 and detecting a feature waveform of the electrocardiogram waveform, and a real-time (current) heart among the feature waveforms detected by the feature waveform detection unit 32 Heart rate cycle setting that sets the heart rate cycle using the feature waveform with the shortest time difference and time difference (newest first feature waveform) and the feature waveform continuous to the first feature waveform (second feature waveform) Part 34.
- the first feature waveform has been described so as to select the feature waveform having the shortest time difference from the actual time (current), but the feature waveform at the time of the second feature waveform described above is selected.
- the first feature waveform may be set, and the time phase one heartbeat before may be set as the second feature waveform. In this way, even if the electrocardiographic waveform goes back from the present, the first feature waveform and the second feature waveform can be arbitrarily selected by the operation of the operation unit 40 as long as both are continuous. It is.
- the arbitrary selection of the first feature waveform and the second feature waveform is defined in the present specification as being performed on the electrocardiogram waveform measured at the reference time. That is, the reference time in the heartbeat cycle setting unit may be real time (current), or a heartbeat cycle immediately after desired selection may be set.
- the operator sets a plurality of measurement points on the tomographic image displayed on the image display unit 26.
- heart measurement values such as the heart area, the heart volume, and the length between the measurement points are measured based on the set measurement points. Is provided on the image display unit 26.
- an operation unit 40 that gives an instruction such as setting a measurement point by an operator, and a control unit 42 that controls each component according to the instruction from the operation unit 40 are provided.
- the operation unit 40 includes a trackball for positioning the measurement points, an execution key for executing the operation, a freeze key for freezing the tomographic image, and the like.
- the ultrasonic probe 12 is formed by arranging a plurality of transducers, and has a function of transmitting and receiving ultrasonic waves to and from the subject 10 via the transducers.
- the transmission unit 14 generates a transmission pulse for generating an ultrasonic wave by driving the ultrasonic probe 12, and has a function of setting a convergence point of the transmitted ultrasonic wave to a certain depth. Yes.
- the receiving unit 16 has a function of amplifying the reflected echo signal based on the ultrasonic wave received by the ultrasonic probe 12 with a predetermined gain to generate an RF signal, that is, a received signal.
- the phasing / adding unit 20 has a function of inputting the RF signal amplified by the receiving unit 16 and performing phase control, and forming an ultrasonic beam at one or more convergence points to generate RF signal frame data. ing.
- the tomographic image construction unit 22 receives the RF signal frame data from the phasing addition unit 20 and performs signal processing such as gain correction, log compression, detection, contour enhancement, and filter processing to obtain tomographic image data.
- the monochrome scan converter 24 also includes an A / D converter that converts tomographic image data output from the tomographic image construction unit 22 into a digital signal, and a frame memory that stores a plurality of converted tomographic image data in time series. , Including a controller.
- the black and white scan converter 24 acquires tomographic image data in the subject 10 stored in the frame memory as an image, and reads the acquired tomographic image data in synchronization with the television of the image display unit 26.
- the feature waveform detection unit 32 analyzes the electrocardiogram waveform detected by the electrocardiogram waveform detection unit 30, and detects a feature waveform that appears for each heartbeat period from the shape of the electrocardiogram waveform.
- the vertical axis indicates voltage (potential difference) and the horizontal axis indicates time.
- the characteristic waveform detection unit 32 is a characteristic waveform using the characteristic that the R wave is the largest waveform among the electrocardiographic waveforms detected by the electrocardiogram waveform detection unit 30, that is, the R wave has the largest voltage. R wave is detected.
- the feature waveform detection unit 32 compares the voltage of the electrocardiogram waveform detected by the electrocardiogram waveform detection unit 30 with a predetermined threshold value, and if the voltage exceeds the threshold value, it is an R wave. Is detected. This threshold is set so that the peak (maximum voltage) of the electrocardiographic waveform can be detected. Further, the feature waveform detection unit 32 may detect the R wave based on a differential value obtained by differentiating the electrocardiogram waveform detected by the electrocardiogram waveform detection unit 30. In the present embodiment, an example of detecting the characteristic waveform of the R wave has been described.
- the characteristic waveform detected by the characteristic waveform detection unit 32 is an electrocardiographic waveform such as a P wave, a Q wave, an S wave, or a T wave. It may be a characteristic waveform.
- the type of feature waveform detected by the feature waveform detector 32 can be selected from the R wave, P wave, Q wave, S wave, T wave, and the like by the operation unit 40.
- the R wave cannot be detected clearly, it can be used so that, for example, 500 ms after the P wave time is set as the R wave time in a pseudo manner.
- the heartbeat cycle setting unit 34 Based on the feature waveform that appears for each heartbeat cycle detected by the feature waveform detection unit 32, the heartbeat cycle setting unit 34 includes a newest first feature waveform, a second feature waveform that is continuous with the first feature waveform, Set the heart cycle based on.
- the second feature waveform is the next new feature waveform after the first feature waveform. Therefore, the heartbeat cycle set by the heartbeat cycle setting unit 34 is the newest heartbeat cycle with respect to the real time (current) time.
- the measurement unit 36 uses the newest first feature waveform and the second feature waveform continuous to the first feature waveform. Cardiac measurement values such as heart area, heart volume, length between two measurement points, ejection fraction (EF value), etc. in a set heartbeat cycle are measured. Then, the measurement unit 36 causes the image display unit 26 to display the cardiac measurement value together with the tomographic image updated in real time (current).
- EF value ejection fraction
- FIG. 2 is an example of an image displayed on the image display unit 26.
- the image display unit 26 displays an electrocardiogram waveform 50 detected by the electrocardiogram waveform detection unit 30, a tomographic image 70 output from the black and white scan converter 24, and a heart measurement value 80 measured by the measurement unit 36.
- the electrocardiogram waveform 50 is detected by the electrocardiogram waveform detection unit 30, and on the electrocardiogram waveform 50, a display time phase mark 52 indicating the real time (current) time (time phase) is displayed. .
- the display time phase mark 52 is moved and displayed in the time direction (right direction) as the electrocardiogram waveform 50 is updated.
- the display time phase mark 52 reaches the right end, the display time phase mark 52 is moved to the left end and repeatedly displayed as the electrocardiographic waveform 50 is updated.
- An electrocardiogram waveform 50 shown on the left side of the display time phase mark 52 is an updated electrocardiogram waveform.
- R wave 58 is displayed.
- the R wave detected by the feature waveform detection unit 32 is a kind of feature waveform.
- the R wave 54 is the newest R wave and the newest R wave with respect to the real time (current) time.
- the R wave 56 is the second new R wave with respect to the real time (current) time.
- the R wave 58 is the third newest R wave with respect to the real time (current) time.
- the heartbeat cycle setting unit 34 is configured by a heartbeat cycle A that is set by the newest R wave 54 and the R wave 56 that is next to the R wave 54.
- Set (R-R cycle) The heartbeat period A sandwiched between the R wave 54 and the R wave 56 is one heartbeat period sandwiched between the newest feature waveform and the second newest feature waveform. Therefore, the heartbeat cycle A sandwiched between the R wave 54 and the R wave 56 is the heartbeat cycle having the shortest difference from the real time (current) time.
- the heartbeat cycle with the shortest difference from the real time (current) time may be referred to as the newest heartbeat cycle.
- An electrocardiogram mark 60 is displayed on the image display unit 26 on the electrocardiogram waveform 50 corresponding to the heartbeat cycle A so that it can be recognized that the latest heartbeat cycle A has been set by the heartbeat cycle setting unit 34.
- the electrocardiogram waveform mark 60 is indicated by, for example, a line type (thick line, broken line, etc.) different from the electrocardiogram waveform 50 on the electrocardiogram waveform 50 corresponding to the heartbeat period A sandwiched between the R wave 54 and the R wave 56.
- the electrocardiogram waveform 50 corresponding to the heartbeat cycle A is indicated by a color (red, blue, etc.) different from the electrocardiogram waveform 50.
- the tomographic image 70 is a cross-sectional image of the heart of the subject 10, and is, for example, a two-chamber image (A2C) of the apex.
- the tomographic image 70 has a plurality of measurement points. In this embodiment, nine measurement points are set along the inner wall of the heart displayed as a tomographic image.
- the region 76 is a region surrounded by a plurality of measurement points.
- the measuring unit 36 is a cardiac measurement value such as heart area, heart volume, length between two measurement points, ejection fraction, etc., in the diastole and the systole of the heart cycle A set by the heart cycle setting unit 34 Measure.
- the diastolic period is a section in which the heart expands after the heart contracts and blood is collected from the whole body into the heart.
- the systole is a section where the heart contracts and pumps blood to the whole body.
- the expansion period is a section before and after the R wave, for example, a section from 500 ms before the R wave to 50 ms after the R wave.
- the systole is a section after a predetermined time has elapsed from the R wave, for example, a section from 50 ms after the R wave to 300 ms after the R wave.
- the R wave is included in the diastole section, and the R wave indicates the end diastole immediately before the systole begins.
- the measurement unit 36 measures the area of the heart, the volume of the heart, and the length between two measurement points in the diastole of the heartbeat cycle A set by the heartbeat cycle setting unit 34.
- the measurement unit 36 measures the area of the heart, the volume of the heart, and the length between two measurement points at the time of the R wave that is the end diastole of the heartbeat cycle A.
- the end diastole indicates when the dilation of the heart ends.
- the R wave that is the end diastole of the cardiac cycle A may be the R wave 54 that is newest to the real time (current) time or the R wave 56 that is continuous with the R wave 54.
- the measurement in the diastole is performed at the time of the R wave 56 in the heartbeat cycle A.
- the measurement unit 36 measures the area of the heart, the volume of the heart, and the length between two measurement points at the time of the R wave 56.
- the area of the heart in the diastole, the volume of the heart, and the length between the two measurement points measured by the measurement unit 36 are displayed as the heart measurement value 80 of the image display unit 26.
- the measurement unit 36 is configured so that the heart area, the heart volume, and the two measurement points in the systole of the heartbeat cycle A set by the heartbeat cycle setting unit 34. Measure the length.
- the measurement unit 36 measures, for example, the heart area, the heart volume, and the length between two measurement points at the end systole after a predetermined time from the R wave time.
- the end systole indicates a time when the heart contraction ends, for example, when the heart volume is the smallest.
- the measurement unit 36 performs volume calculation for all tomographic image frames in the cardiac cycle A (the immediately preceding cardiac cycle), and determines the end systolic time by specifying the tomographic image frame that gives the minimum volume of the heart. Then, the measurement unit 36 measures the area of the heart, the volume of the heart, and the length between the two measurement points using the tomographic image frame at the end systole.
- Measure unit 36 can measure the length between two arbitrarily set measurement points. Further, the measurement unit 36 can measure cardiac measurement values such as the long axis length and the short axis length by combining a plurality of measurement results of the length between two arbitrarily set measurement points. Further, the measurement unit 36 can also measure the L index value that is the ratio of the major axis lengths of different cross sections.
- the measurement unit 36 measures the change in the volume of the heart in advance, and based on the measured change in the volume of the heart, the time (T1) from the time of the R wave to the time when the volume of the heart becomes the smallest Measure. Then, the measurement unit 36 measures the heart area, the heart volume, and the length between the two measurement points at the end systole after a predetermined time (T1) from the time of the R wave 56.
- the area of the region 76 surrounded by the plurality of measurement points is measured based on the number of pixels included in the region 76.
- the measurement unit 36 counts the number of pixels in the region 76.
- the measuring unit 36 grasps the number of pixels per 1 mm 2 in advance and measures the area of the region 76 by performing area conversion on the number of pixels counted in the region 76. For example, if the measuring unit 36 grasps the number of pixels per 1 mm 2 as 10 pixels in advance, if the number of pixels counted in the region 76 is 5000 pixels, the area is converted to 500 mm 2 .
- the measuring unit 36 measures the volume of the heart using the Simpson method.
- the Simpson method divides an area 76 surrounded by a plurality of measurement points into rectangular areas in the longitudinal direction, calculates the area of the rectangular area, calculates the volume for each rectangular area, and divides the obtained volume into This is a technique for obtaining a volume by adding.
- the operator sets two measurement points among the nine measurement points using the operation unit 40.
- the measurement point 72 and the measurement point 74 are set.
- the measurement unit 36 measures the distance between the set measurement point 72 and the measurement point 74 as the length between the two measurement points.
- the measurement unit 36 calculates the ejection fraction from the measured end-diastolic heart volume and end-systolic heart volume.
- the ejection fraction can be obtained by the following equation using the volume of the heart in the diastole and the volume of the heart in the systole.
- ⁇ Number 1 ⁇ Ejection rate (%) (Va (end-diastolic heart volume)-Vb (end-systolic heart volume) / Va x 100
- the ejection fraction is calculated by the measuring unit 36 based on the volume of the heart at the time of the R wave 56 that is the end diastole and the minimum volume of the heart that is the end systole.
- the ejection fraction is an evaluation value indicating the contractile function of the heart.
- the measurement unit 36 may calculate an index value indicating the circulatory function of the cardiac cycle A by combining the measurement value at the end diastole and the measurement value at the end systole.
- the measuring unit 36 can measure the cardiac output or single cardiac output in the cardiac cycle A from the difference between the volume of the heart at the end diastole and the volume of the heart at the end systole according to the following formula. it can.
- ⁇ Equation 2 ⁇ Cardiac output Heart rate x (Va-Vb)
- ⁇ Equation 3 ⁇ Stroke output Va-Vb
- FIG. 3 (a) is a form showing the heartbeat state shown in FIG.
- FIG. 3 (b) is a form showing a heartbeat state in which a predetermined time has elapsed from the heartbeat state shown in FIG. 3 (a).
- FIG. 3 (c) is a form showing a heartbeat state in which a predetermined time has elapsed from the heartbeat state shown in FIG. 3 (b).
- the display time phase mark 52 indicating the real time (current) time (time phase) shown in FIG. 3 (a) is moved and displayed in the time direction (right direction) as the electrocardiogram waveform 50 is updated.
- the characteristic waveform detection unit 32 detects the R wave 62 that is a characteristic waveform.
- the R wave 62 is the newest R wave with respect to the real time (current) time, and is the newest R wave.
- the R wave 54 becomes a new R wave with respect to the second at the time of the real time (current).
- the heartbeat cycle setting unit 34 newly sets a heartbeat cycle B (R ⁇ R cycle) sandwiched between the newest R wave 62 and the R wave 54 continuous with the R wave 62. Therefore, in the heartbeat state shown in FIG. 3 (b), the heartbeat cycle B sandwiched between the R wave 62 and the R wave 54 is the newest heartbeat cycle.
- the measurement unit 36 calculates the area of the heart, the volume of the heart, and the length between the two measurement points in the heartbeat cycle B set by the heartbeat cycle setting unit 34. Then, measure cardiac values such as ejection fraction.
- the measurement in the diastole and the systole of the heartbeat cycle B is the same as the measurement in the diastole and the systole of the heartbeat cycle A, and the description is omitted.
- the heart area, heart volume, and length between two measurement points in the diastole and systole of the heartbeat cycle B measured by the measurement unit 36 were measured in the past as the heart measurement value 80 of the image display unit 26. Displayed by overwriting the cardiac measurement.
- the heartbeat cycle setting unit 34 Set the heart rate cycle. Specifically, the heartbeat cycle setting unit 34 sets the heartbeat cycle set by the newly detected first feature waveform and the second feature waveform that is continuous with the first feature waveform. Therefore, each time the feature waveform detection unit 32 detects a new feature waveform, the heartbeat cycle setting unit 34 can keep the heartbeat cycle up to date by updating the heartbeat cycle.
- the measurement unit 36 updates the heart area in the diastole and systole of the heartbeat period, the volume of the heart, the length between two measurement points, and the ejection rate heart that is updated each time a new feature waveform is detected. Measure the measured value.
- the image display unit 26 displays the updated cardiac measurement value 80 in the diastole and systole of the heartbeat cycle.
- the feature waveform detection unit 32 detects the R wave 62 that is the feature waveform until the next R wave is detected. Continue to display heart measurements 80 of the area of the heart during diastole and systole, the volume of the heart, and the length between the two measurement points.
- the control unit 42 freezes the tomographic image 70 updated in the real time (current) in the image display unit 26, and The update of the cardiac measurement value 80 can be stopped.
- the operator can confirm the frozen tomographic image 70 displayed on the image display unit 26 and the latest cardiac measurement value 80. Further, the operator can freeze and display the tomographic image 70 suitable for diagnosis while referring to the updated cardiac measurement value 80.
- Fig. 4 shows a flowchart showing the operation of this embodiment.
- the operator freezes the tomographic image 70 displayed on the image display unit 26 by the control unit 42 by pressing the freeze button of the operation unit 40.
- a frozen tomographic image 70 is displayed on the image display unit 26.
- the operator positions the measurement point on the frozen tomographic image 70 by rotating the trackball of the operation unit 40.
- the operator presses the execution key of the operation unit 40 to set the measurement point at the positioned position.
- a plurality of measurement points can be set on the frozen tomographic image 70.
- the freeze of the tomographic image 70 is canceled and the tomographic image 70 is displayed in real time (current). A plurality of measurement points are followed in accordance with the movement of the tomographic image 70.
- the measurement unit 36 determines to which position the plurality of measurement points have sequentially moved as the heart beats. Specifically, the measurement unit 36 sets a region having an arbitrary shape including a measurement point and the vicinity of the measurement point on the tomographic image, and performs correlation processing between the two tomographic images for this region to track the measurement point.
- the control unit 42 can also analyze the tissue shape of the tomographic image 70 updated in real time (currently) for each heartbeat, and automatically set measurement points based on the tissue shape.
- the control unit 42 has a database that stores diagnostic image information based on the templated tissue of the subject.
- the control unit 42 collates the tomographic image updated in real time (current) with the templated diagnostic image information stored in the database, and based on the collation result, sets the measurement points according to the tissue shape. Install. For example, a plurality of measurement points are set along the tissue shape (heart lumen).
- the measurement unit 36 uses the newest first feature waveform and the second feature waveform that is continuous with the first feature waveform. Measures cardiac measurement values such as heart area, heart volume, length between two measurement points, ejection fraction, etc. in the heartbeat cycle set by the characteristic waveform of.
- the measurement unit 36 updates the heart area in the diastole and systole of the heart cycle, the volume of the heart, the length between the two measurement points, and the ejection fraction, which are updated each time a new feature waveform is detected.
- the heart measurement value is measured, and the heart measurement value 80 is updated.
- a tomographic image forming unit that forms a tomographic image of a subject, a measuring unit that measures a cardiac measurement value based on the tomographic image, and an image that displays the tomographic image and the cardiac measurement value
- a medical image diagnostic apparatus comprising: a display unit; a feature waveform detection unit that detects a feature waveform from a shape of an electrocardiogram waveform of the subject; and a feature waveform detected by the feature waveform detection unit
- a heartbeat cycle setting unit that sets a heartbeat cycle that is set by the second feature waveform that is continuous with the first feature waveform and the first feature waveform as a feature waveform that has the smallest time difference from the reference time
- the measurement unit measures a cardiac measurement value based on the tomographic image, the characteristic waveform, and the heartbeat cycle, and therefore updates and measures the cardiac measurement value for each heartbeat cycle that is sequentially updated.
- the step of constructing a tomographic image of the subject the step of detecting a feature waveform from the shape of the electrocardiographic waveform of the subject, and the time difference from the reference time among the detected feature waveforms
- the measurement unit measures the cardiac measurement value or the index value indicating the cardiovascular function in the diastole and the systole of the heartbeat cycle set by the heartbeat cycle setting unit.
- the measurement unit measures the cardiac measurement value or the index value indicating the cardiovascular function in the diastole and the systole of the heartbeat cycle set by the heartbeat cycle setting unit.
- the cardiac measurement value is updated for each heartbeat cycle that is sequentially updated.
- the cardiac measurement value is updated for each heartbeat cycle that is sequentially updated.
- an operation unit for setting a plurality of measurement points on the tomographic image displayed on the image display unit the measurement unit based on the set plurality of measurement points, the area of the heart, the volume of the heart, Even if at least one cardiac measurement value of the ejection fraction of the heart is measured, it is possible to provide a medical image diagnostic apparatus that updates and measures a cardiac measurement value for each heartbeat cycle that is sequentially updated.
- the heartbeat cycle setting unit detects a first feature waveform that is newly detected and a second feature that is continuous with the first feature waveform. It is possible to provide a medical image diagnostic apparatus that updates and measures a heart measurement value for each heartbeat cycle that is sequentially updated even if the heartbeat cycle is set according to the waveform.
- the tomographic image configuration unit 22 that configures the tomographic image of the subject 10
- the image display unit 26 that displays the tomographic image configured by the tomographic image configuration unit 22, and the image display unit 26
- a medical image diagnostic apparatus including a measurement unit 36 that measures a cardiac measurement value based on a displayed tomographic image
- an electrocardiogram waveform detected from the subject 10 is analyzed, and a feature waveform is detected from the shape of the electrocardiogram waveform
- the newest first feature waveform and the second feature waveform continuous to the first feature waveform are set.
- a heartbeat cycle setting unit 34 for setting a heartbeat cycle the measurement unit 36 measures a heart measurement value in the heartbeat cycle, and the image display unit 26 displays the heart measurement value. Therefore, it is possible to measure the heart measurement value for each heartbeat period for the tomographic image updated at the real time (current) and update the heart measurement value together with the tomographic image updated at the real time (current).
- the heartbeat cycle setting unit 34 is sandwiched between the latest R wave 54 and the R wave 56 that is continuous to the R wave 54 based on the R wave that is the feature waveform detected by the feature waveform detection unit 32. Although one period which is the heartbeat period A is set, a plurality of periods may be set.
- the heartbeat cycle setting unit 34 can set, for example, a heartbeat 2 cycle sandwiched between the latest R wave 54 and the third new R wave R wave 58.
- Example 2 will be described with reference to FIGS.
- the difference from the first embodiment is that the measurement unit 36 measures a cardiac measurement value at every end diastole of the heartbeat cycle or every end systole of the heartbeat cycle.
- FIG. 5 shows the state of the end of diastole (R wave time) of the heartbeat cycle, and the display time phase mark 52 has reached the R wave 54.
- the measurement unit 36 determines the area of the heart, the volume of the heart, and the length between the two measurement points.
- the heart measurement value 80 is measured.
- the image display unit 26 displays a cardiac measurement value 80 that is updated every end diastole of the heartbeat cycle.
- Fig. 6 shows the state of the end systole of the heartbeat cycle (after a predetermined time (T1) from the time of the R wave when the heart is at the minimum volume).
- T1 a predetermined time
- the measurement unit 36 measures a heart measurement value 80 of the heart area, the heart volume, and the length between two measurement points.
- the image display unit 26 displays a heart measurement value 80 that is updated every end systole of the heartbeat cycle.
- the measuring unit 36 calculates and updates the ejection fraction for each end systole of the heart cycle based on the heart volume obtained for each end diastole of the heart cycle and the heart volume obtained for each end systole of the heart cycle. To do.
- the measurement unit measures a cardiac measurement value for each end diastole of the heartbeat cycle or for each end systole of the heartbeat cycle
- the operator performs cardiac measurement for each end diastole of the heartbeat cycle or every end systole of the heartbeat cycle.
- the value can be confirmed in real time (current).
- Example 3 will be described with reference to FIG.
- the difference from the first and second embodiments is that, when the ejection rate measured by the measurement unit 36 is less than or equal to the threshold, the image display unit 26 uses a heart for identifying a cardiac cycle in which an ejection rate less than or equal to the threshold exists. It is a point to display the radio wave type mark.
- the ejection fraction is an evaluation value indicating the contractile function of the heart, and it is generally assumed that the ejection fraction is 40% or less in heart failure.
- the threshold value in this embodiment is set to 40%, for example, in the control unit 42.
- the control unit 42 can recognize a heartbeat cycle in which the ejection fraction less than the threshold exists. Then, an electrocardiographic waveform mark 62 for identifying a cardiac cycle in which an ejection fraction equal to or less than the threshold exists is displayed on the image display unit 26.
- the electrocardiogram waveform mark 62 is indicated on the electrocardiogram waveform 50 by a different line type (thick line, broken line, etc.) from the electrocardiogram waveform 50, or a color different from the electrocardiogram waveform 50 (red, blue) on the electrocardiogram waveform 50. Etc.).
- Ejection rate varies depending on the medical condition.
- the operator can change the threshold set in the control unit 42 by the operation unit 40 according to the medical condition to be observed. Therefore, the operator can identify the heartbeat cycle suitable for the medical condition.
- the operator freezes the tomographic image 70 displayed on the image display unit 26 by the control unit 42 by pressing the freeze button of the operation unit 40.
- the operator can arbitrarily move the display time phase mark 52 by rotating the trackball of the operation unit 40.
- the freeze button is pressed, the tomographic image 70 is not updated in real time (current).
- a tomographic image 70 acquired when the arbitrarily moved display time phase mark 52 passes is displayed on the image display unit 26.
- the operator moves and sets the display time phase mark 52 within the heartbeat cycle where the ejection fraction below the threshold exists as shown in FIG. 7 (b). Then, the tomographic image 70 with the possibility of heart failure can be displayed on the image display unit 26. Therefore, the operator can observe the tomographic image 70 with the possibility of heart failure in detail.
- the image display unit 26 can loop-reproduce the moving image of the tomographic image 70 in the heartbeat cycle in which the ejection rate is equal to or less than the threshold value. Specifically, the image display unit 26 moves the display time phase mark 52 within the heartbeat period sandwiched between the R wave 56 and the R wave 58, and performs the loop reproduction of the moving image on the tomographic image 70.
- the image display unit 26 identifies the cardiac cycle for identifying the cardiac cycle in which the ejection rate equal to or less than the threshold exists. Since the radio wave shape mark is displayed, the operator can observe the tomographic image 70 with the possibility of heart failure in detail with the moving image.
- Example 4 will be described with reference to FIG.
- the difference from the first to third embodiments is that the image display unit 26 displays cardiac measurement values in tomographic images having different cross sections.
- the cardiac measurement value 82 of the apex four-chamber image (A4C) is measured in advance, and is stored together with RF signal frame data or tomographic image data of the apex four-chamber image (A4C) in a storage unit (not shown). By reading the cardiac measurement value 82 from the storage unit, the image display unit 26 can display the cardiac measurement value 82 of the apex four-chamber image (A4C).
- the tomographic image 70 displayed on the image display unit 26 is a two-chamber apex image (A2C).
- the measurement unit 36 includes the newest first feature waveform and the second feature waveform that is continuous with the first feature waveform.
- Measurement of cardiac measurement values such as the area of the heart, the volume of the heart, the length between two measurement points, the ejection fraction, etc. in the heartbeat cycle set by.
- the heart measurement value 80 is updated together with the tomographic image 70 and displayed on the image display unit 26.
- the cardiac measurement value 80 of the apex two-chamber image (A2C) and the cardiac measurement value 82 of the apex four-chamber image (A4C) can be displayed on the image display unit 26.
- the image display unit 26 displays the cardiac measurement values 80 and 82 in the tomographic images of different cross sections for displaying the cardiac measurement values in the tomographic images of different cross sections, thereby enabling the operator to perform a highly accurate diagnosis. Can do.
- the RF signal frame data or tomographic image data stored in the storage unit is read, and the tomographic image of the apex four-chamber image (A4C) is converted into the tomographic image 70 of the apex two-chamber image (A2C). At the same time, it can be displayed on the image display unit 26.
- the tomographic image 70 of the apex two-chamber image (A2C) can be displayed in accordance with the cardiac cycle.
- the measurement unit 36 uses the tomographic image of the apex four-chamber image (A4C) read from the storage unit to determine the area of the heart, the volume of the heart, the length between two measurement points, the ejection rate, etc. It is also possible to measure the measured heart value and display the measured heart value 82 on the image display unit 26.
- A4C apex four-chamber image
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Abstract
Description
駆出率(%)=(Va(拡張末期の心臓の体積)-Vb(収縮末期の心臓の体積)/Va×100
駆出率は、拡張末期であるR波56の時刻における心臓の体積と、収縮末期である心臓の最小体積とによって計測部36にて演算される。駆出率は心臓の収縮機能を示す評価値である。また、計測部36においては、駆出率以外にも、拡張末期における計測値と収縮末期における計測値を組み合わせて、心拍周期Aの循環器機能を示す指標値を算出してもよい。例えば、計測部36は、下記式により、拡張末期における心臓の体積と収縮末期における心臓の体積の差から、心拍周期Aにおける血液の心拍出量又は一回心拍出量を計測することができる。
{数2}
心拍出量=心拍数×(Va-Vb)
{数3}
一回心拍出量=Va-Vb
次に、心臓計測値80を更新することについて、図3を用いて説明する。図3(a)は、図2に示される心拍状態を示す形態である。図3(b)は図3(a)に示される心拍状態から所定時間が経過した心拍状態を示す形態である。図3(c)は図3(b)に示される心拍状態から所定時間が経過した心拍状態を示す形態である。 {Number 1}
Ejection rate (%) = (Va (end-diastolic heart volume)-Vb (end-systolic heart volume) / Va x 100
The ejection fraction is calculated by the measuring
{Equation 2}
Cardiac output = Heart rate x (Va-Vb)
{Equation 3}
Stroke output = Va-Vb
Next, updating the
Claims (15)
- 被検体の断層画像を構成する断層画像構成部と、
前記断層画像に基づいて心臓計測値を計測する計測部と、
前記断層画像と前記心臓計測値とを表示する画像表示部と、を備えた医用画像診断装置であって、
前記被検体の心電波形の形状から特徴波形を検出する特徴波形検出部と、
前記特徴波形検出部で検出された特徴波形のうちの基準時と最も時間差が小さい特徴波形を第1の特徴波形とし、第1の特徴波形に連続する第2の特徴波形と第1の特徴波形とによって設定される心拍周期を設定する心拍周期設定部と、を備え、
前記計測部は、前記断層画像と前記特徴波形と前記心拍周期に基づいて心臓計測値を計測することを特徴とする医用画像診断装置。 A tomographic image constructing unit constituting a tomographic image of the subject;
A measurement unit for measuring a cardiac measurement value based on the tomographic image;
An image display unit that displays the tomographic image and the cardiac measurement value, and a medical image diagnostic apparatus comprising:
A feature waveform detector that detects a feature waveform from the shape of the electrocardiogram waveform of the subject;
Among the feature waveforms detected by the feature waveform detector, the feature waveform having the smallest time difference from the reference time is defined as the first feature waveform, and the second feature waveform and the first feature waveform that are continuous with the first feature waveform And a heartbeat cycle setting section for setting a heartbeat cycle set by
The medical image diagnostic apparatus, wherein the measurement unit measures a cardiac measurement value based on the tomographic image, the characteristic waveform, and the heartbeat cycle. - 前記計測部は、前記心拍周期設定部で設定された前記心拍周期の拡張期及び収縮期における心臓計測値又は循環器機能を示す指標値を計測することを特徴とする請求項1記載の医用画像診断装置。 2. The medical image according to claim 1, wherein the measurement unit measures a cardiac measurement value or an index value indicating a circulatory function in a diastole and a systole of the heartbeat cycle set by the heartbeat cycle setting unit. Diagnostic device.
- 前記心拍周期設定部における基準時は、実時間(現在)であること特徴とする請求項1記載の医用画像診断装置。 2. The medical image diagnostic apparatus according to claim 1, wherein the reference time in the heartbeat cycle setting unit is real time (current).
- 前記特徴波形は、前記心電波形のR波、P波、Q波、S波、T波のいずれか1つであることを特徴とする請求項1記載の医用画像診断装置。 2. The medical image diagnostic apparatus according to claim 1, wherein the characteristic waveform is any one of an R wave, a P wave, a Q wave, an S wave, and a T wave of the electrocardiographic waveform.
- 前記画像表示部に表示されている断層画像に複数の計測点を設定する操作部を備え、前記計測部は、設定された複数の計測点に基づいて、心臓の面積、心臓の体積、心臓の駆出率の少なくとも1つの心臓計測値を計測することを特徴とする請求項1記載の医用画像診断装置。 An operation unit configured to set a plurality of measurement points on the tomographic image displayed on the image display unit, the measurement unit based on the set plurality of measurement points, the area of the heart, the volume of the heart, 2. The medical image diagnostic apparatus according to claim 1, wherein at least one cardiac measurement value of ejection fraction is measured.
- 前記特徴波形検出部が新たな特徴波形を検出する毎に、前記心拍周期設定部は、新たに検出される第1の特徴波形と、前記第1の特徴波形に連続する第2の特徴波形とによって心拍周期を設定することを特徴とする請求項1記載の医用画像診断装置。 Each time the feature waveform detection unit detects a new feature waveform, the heartbeat period setting unit includes a first feature waveform that is newly detected, and a second feature waveform that is continuous with the first feature waveform, 2. The medical image diagnostic apparatus according to claim 1, wherein a heartbeat cycle is set by the method.
- 前記計測部は、前記特徴波形検出部が新たな特徴波形を検出する毎に更新される心拍周期の拡張末期及び収縮末期における心臓計測値を計測することを特徴とする請求項6記載の医用画像診断装置。 7. The medical image according to claim 6, wherein the measurement unit measures a cardiac measurement value at the end diastole and end systole of a heartbeat cycle that is updated each time the feature waveform detection unit detects a new feature waveform. Diagnostic device.
- 前記計測部は、前記心拍周期の拡張末期毎又は前記心拍周期の収縮末期毎に心臓計測値を計測することを特徴とする請求項1記載の医用画像診断装置。 2. The medical image diagnostic apparatus according to claim 1, wherein the measurement unit measures a cardiac measurement value for each end diastole of the heartbeat cycle or for each end systole of the heartbeat cycle.
- 前記計測部で計測された、心臓の駆出率を示す駆出率が閾値以下である場合、前記画像表示部は、閾値以下の駆出率が存在する心拍周期を識別するための心電波形マークを表示することを特徴とする請求項1記載の医用画像診断装置。 When the ejection rate indicating the ejection rate of the heart measured by the measurement unit is less than or equal to a threshold value, the image display unit is an electrocardiographic waveform for identifying a cardiac cycle in which the ejection rate is equal to or less than the threshold value 2. The medical image diagnostic apparatus according to claim 1, wherein a mark is displayed.
- 前記画像表示部は、異なる断面の前記断層画像における前記心臓計測値を表示する請求項1記載の医用画像診断装置。 The medical image diagnostic apparatus according to claim 1, wherein the image display unit displays the cardiac measurement values in the tomographic images of different cross sections.
- 被検体の断層画像を構成するステップと、
前記被検体の心電波形の形状から特徴波形を検出するステップと、
前記検出された特徴波形のうちの基準時と最も時間差が小さい特徴波形を第1の特徴波形とし、第1の特徴波形に連続する第2の特徴波形と第1の特徴波形とによって設定される心拍周期を設定するステップと、
前記断層画像と前記特徴波形と前記心拍周期に基づいて心臓計測値を計測するステップと、
前記断層画像と前記心臓計測値とを表示するステップと、
を含むことを特徴とする心臓計測値表示方法。 Constructing a tomographic image of the subject;
Detecting a characteristic waveform from the shape of the electrocardiographic waveform of the subject;
Among the detected feature waveforms, the feature waveform having the smallest time difference from the reference time is set as the first feature waveform, and is set by the second feature waveform and the first feature waveform that are continuous with the first feature waveform. Setting the heart rate cycle;
Measuring a cardiac measurement value based on the tomographic image, the characteristic waveform, and the heartbeat cycle;
Displaying the tomographic image and the cardiac measurement value;
A method for displaying a cardiac measurement value, comprising: - 前記計測するステップは、前記設定された心拍周期の拡張期及び収縮期における心臓計測値又は循環器機能を示す指標値を計測することを特徴とする請求項11記載の心臓計測値表示方法。 12. The cardiac measurement value display method according to claim 11, wherein the measuring step measures a cardiac measurement value or an index value indicating a circulatory function in a diastole and a systole of the set heartbeat cycle.
- 前記基準時は、実時間(現在)であること特徴とすることを特徴とする請求項11記載の心臓計測値表示方法。 12. The cardiac measurement value display method according to claim 11, wherein the reference time is real time (current).
- 前記断層画像に複数の計測点を設定するステップを含み、前記計測するステップは、設定された複数の計測点に基づいて、心臓の面積、心臓の体積、心臓の駆出率の少なくとも1つの心臓計測値を計測することを特徴とする請求項11記載の心臓計測値表示方法。 Setting a plurality of measurement points in the tomographic image, and the measuring step includes at least one heart of a heart area, a heart volume, and a heart ejection rate based on the set plurality of measurement points. 12. The cardiac measurement value display method according to claim 11, wherein the measurement value is measured.
- 前記特徴波形を検出するステップが新たな特徴波形を検出する毎に、前記心拍周期を設定するステップは、新たに検出される第1の特徴波形と、前記第1の特徴波形に連続する第2の特徴波形とによって心拍周期を設定することを特徴とする請求項11記載の心臓計測値表示方法。 Each time the step of detecting the feature waveform detects a new feature waveform, the step of setting the heartbeat cycle includes a first feature waveform that is newly detected and a second feature waveform that is continuous with the first feature waveform. 12. The cardiac measurement value display method according to claim 11, wherein the heartbeat cycle is set based on the characteristic waveform of the heartbeat.
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