Ultrasonic diagnostic apparatus and control method of ultrasonic diagnostic apparatus

Abstract

An ultrasonic diagnostic apparatus includes an ultrasonic probe, an image generation section which generates an ultrasonic image which photographs a breast of a subject by using transmission and reception of an ultrasonic beam to the subject using the ultrasonic probe, a schematic image generation section which generates a schematic image which draws a region of interest on the basis of a composite two-dimensional image which is generated using a series of radiographic images which are obtained by tomography and which photograph the breast of the subject, information of a tomographic image which is attached to the composite two-dimensional image and which corresponds to the region of interest on the composite two-dimensional image, and information of the region of interest, and a monitor which displays the ultrasonic image, the composite two-dimensional image, and the schematic image.

Description

TECHNICAL FIELD

[0001] The present application relates to an ultrasonic diagnostic apparatus having a function of displaying a schematic image image of a region of interest drawn on a synthetic two-dimensional image acquired by a mammography device together with an ultrasonic image, and a control method of an ultrasonic diagnostic apparatus. BACKGROUND

[0002] Conventionally, in a case where a region of interest of a breast that can be a lesion is detected by mammography examination, next, a corresponding region of interest is sometimes searched for by ultrasonic examination while referring to a radiographic image, and a qualitative diagnosis is performed as to whether the region of interest of the breast included in the ultrasonic image is a lesion.

[0003] Thus, at the time of ultrasonic examination, there is a request to refer to a radiographic image that has already been taken by mammography examination.

[0004] As prior art documents to be referenced by the present application, for example, there are Patent Documents 1, 2, and the like.

[0005] Patent Document 1 discloses a medical information processing system that seeks efficiency of a work flow in an examination that simultaneously uses a tomographic image and an ultrasonic image. In the tomographic image that is a three-dimensional image generated by taking a photograph by changing an X-ray irradiation angle to a breast of a subject, a region of interest is set, reference information that correlates a position information of the region of interest and a schematic image of the breast is generated, and the tomographic image and the reference information are displayed on a display.

[0006] Also, Patent Document 2 discloses a medical information processing system that generates diagnosis assistance information of a subject from an ultrasonic image, a photographing position of the ultrasonic image, and a mammography image. A region of interest is set on the mammography image that is a two-dimensional image, a straight line that contains a position of the region of interest and that is along a photographing direction is drawn on a body mark of the breast, and the mammography image and the body mark of the breast are displayed on a display as the diagnosis assistance information.

[0007] Prior Art Documents

[0008] Patent Documents

[0009] Patent Document 1: Japanese Patent Application Publication No. 2018-43001

[0010] Patent Document 2: Japanese Patent Application Publication No. 2019-193788 SUMMARY

[0011] Technical Problem to be Solved by the Invention

[0012] When performing ultrasonography, if there is a radiograph image of a mammography examination taken before the examination, the radiograph image is often confirmed. Generally, this confirmation work is performed by an image viewer connected to a server, but if the confirmation can be performed on the ultrasonic device, the workflow becomes efficient. Therefore, it is desirable to store the radiograph image of the mammography examination in the ultrasonic device.

[0013] However, in a manner in which a tomographic image that is a three-dimensional image and reference information are displayed on a display as in the medical information processing system of Patent Literature 1, at least a plurality of slice images need to be transmitted from a mammography device or a server to the ultrasonic device to be stored, and there is a problem that a large-capacity storage area needs to be secured in the ultrasonic device.

[0014] Also, in a manner in which a mammography image that is a two-dimensional image and a body marker of a breast are displayed on a display as diagnostic assistance information as in the medical information processing system of Patent Literature 2, even if the diagnostic assistance information is transmitted to the ultrasonic device, distribution information on three dimensions of the breast is lacking, and there is a problem that it is difficult to perform a high-precision diagnosis in the ultrasonic device.

[0015] The present application has been made to solve the above-described conventional problems, and has an object to provide an ultrasonic diagnostic device capable of performing a high-precision diagnosis of a region of interest of a breast without securing a large-capacity storage area, and a control method of the ultrasonic diagnostic device.

[0016] Means for solving the technical problem

[0017] To achieve the above object, an ultrasonic diagnostic device according to the present application is characterized by comprising:

[0018] an ultrasonic probe;

[0019] an image generation section that generates an ultrasonic image that has photographed a breast of a subject by using the ultrasonic probe to perform transmission and reception of an ultrasonic beam to the subject;

[0020] a schematic image generation section that generates a schematic image that depicts a region of interest, based on a composite two-dimensional image that is generated using a series of radiograph images that have been obtained by tomography and that have photographed the breast of the subject, information of a tomographic image that is attached to the composite two-dimensional image and that corresponds to the region of interest on the composite two-dimensional image, and information of the region of interest; and

[0021] a monitor that displays the ultrasonic image, the composite two-dimensional image, and the schematic image.

[0022] The schematic image generation section can generate a schematic image in which a plurality of regions of interest on the composite two-dimensional image are drawn.

[0023] Preferably, there is provided a region of interest list creation section that creates a list of regions of interest included in the composite two-dimensional image, and an input device through which a user performs an input operation, wherein the list created by the region of interest list creation section is displayed on a monitor, and the schematic image generation section generates a schematic image in which a region of interest selected by the user from the list displayed on the monitor via the input device is drawn.

[0024] Alternatively, there can also be provided an input device through which a user performs an input operation, and the composite two-dimensional image is displayed on a monitor, and in a case where a region of interest is included inside the region of interest at an arbitrary position specified by the user via the input device on the composite two-dimensional image displayed on the monitor, the schematic image generation section generates a schematic image in which the region of interest is drawn.

[0025] Preferably, there is provided an emphasis section that emphasizes a region on the composite two-dimensional image corresponding to a region of interest drawn on the schematic image and displays it on a monitor in a case where a region of interest drawn on the schematic image is specified by the user via the input device.

[0026] The emphasis section can be configured to display a sub-window on the composite two-dimensional image, and to display the region of interest in the sub-window in an enlarged manner.

[0027] Alternatively, the emphasis section can also surround the region of interest on the composite two-dimensional image with an emphasis line.

[0028] The schematic image generation section can also generate a schematic image that includes a slice line indicating a tomographic image corresponding to the region of interest.

[0029] There can also be provided a diagnosis opinion display section that displays a diagnosis opinion for the mammography together with the schematic image on a monitor.

[0030] There can be provided a configuration in which, in addition to the ultrasound image, the composite two-dimensional image, and the schematic image being displayed on a monitor, four composite two-dimensional images obtained by cranio-caudal photography and medial-lateral oblique photography for the left and right breasts of a subject are also displayed on the monitor in the form of thumbnails.

[0031] There can also be provided a configuration in which, in a case where the same region of interest as that drawn on the schematic image is imaged in another composite two-dimensional image in which the imaging direction is different from that of the composite two-dimensional image and in which the breast of the subject is imaged, the composite two-dimensional image and the other composite two-dimensional image are displayed on the monitor together with the ultrasound image and the schematic image.

[0032] It is preferable that the identification information of the region of interest, the position of the region of interest, and the slice number of the tomographic image corresponding to the region of interest and the photographing angle be stored in a tag attached to the synthesized two-dimensional image or a file not containing the image.

[0033] It is preferable that the memory storing the synthesized two-dimensional image be provided.

[0034] The control method of the ultrasonic diagnostic apparatus according to the present application is characterized by comprising:

[0035] generating an ultrasonic image photographing a breast of the subject by using an ultrasonic probe to transmit and receive an ultrasonic beam to the subject;

[0036] generating a schematic image drawing a region of interest based on a synthesized two-dimensional image generated using a series of radiographic images obtained by tomographic photography and photographing a breast of the subject, information of a tomographic image attached to the synthesized two-dimensional image and corresponding to the region of interest on the synthesized two-dimensional image, and information of the region of interest; and

[0037] displaying the ultrasonic image, the synthesized two-dimensional image, and the schematic image on a monitor.

[0038] Effects of the Invention

[0039] According to the present application, the schematic image generation section generates a schematic image drawing a region of interest based on a synthesized two-dimensional image generated using a series of radiographic images obtained by tomographic photography and photographing a breast of the subject, information of a tomographic image attached to the synthesized two-dimensional image and corresponding to the region of interest on the synthesized two-dimensional image, and information of the region of interest, and displays the ultrasonic image, the synthesized two-dimensional image, and the schematic image on a monitor, so that a high-precision diagnosis of the region of interest of the breast can be performed without securing a large-capacity storage area. BRIEF DESCRIPTION OF DRAWINGS

[0040] Figure 1 is a block diagram showing the structure of the ultrasonic diagnostic apparatus according to Embodiment 1 of the present application.

[0041] Figure 2 is a block diagram showing the internal structure of the transmission / reception circuit in Embodiment 1.

[0042] Figure 3 is a block diagram showing the internal structure of the image generation section in Embodiment 1.

[0043] Figure 4 is a block diagram showing the structure of a mammography examination connected to the ultrasonic diagnostic apparatus via a network.

[0044] Figure 5is a diagram conceptually showing a generation method of a synthesized two-dimensional image.

[0045] Figure 6 is a diagram showing an example of a schematic image.

[0046] Figure 7 is a diagram showing a schematic image corresponding to a synthesized two-dimensional image in a CC (Cranio-Caudal: head-tail) direction.

[0047] Figure 8 is a diagram showing a method of drawing a slice line on a schematic image corresponding to a synthesized two-dimensional image in a CC direction.

[0048] Figure 9 is a diagram showing a schematic image corresponding to a synthesized two-dimensional image in an MLO (Medio-lateral-Oblique: inner-outer oblique) direction.

[0049] Figure 10 is a diagram showing a method of drawing a slice line on a schematic image corresponding to a synthesized two-dimensional image in an MLO direction.

[0050] Figure 11 is a diagram showing a schematic image corresponding to a synthesized two-dimensional image in a CC direction having a plurality of regions of interest.

[0051] Figure 12 is a diagram showing a schematic image corresponding to a synthesized two-dimensional image in an MLO direction having a plurality of regions of interest.

[0052] Figure 13 is a flowchart showing an action of a mammography apparatus.

[0053] Figure 14 is a flowchart showing an action of an ultrasonic diagnostic apparatus according to Embodiment 1.

[0054] Figure 15 is a diagram showing an example of a display on a monitor in the ultrasonic diagnostic apparatus according to Embodiment 1.

[0055] Figure 16 is a diagram showing an example of a display on a monitor in the ultrasonic diagnostic apparatus according to the modification of Embodiment 1.

[0056] Figure 17 is a block diagram showing a configuration of an ultrasonic diagnostic apparatus according to Embodiment 2.

[0057] Figure 18 is a diagram showing an example of a radiographic image displayed on a monitor in Embodiment 2.

[0058] Figure 19is a drawing showing an example of a radiation image displayed on a monitor in a modification of Embodiment 2.

[0059] Figure 20 is a block diagram showing the structure of an ultrasonic diagnostic apparatus according to Embodiment 3.

[0060] Figure 21 is a drawing showing an example of a display on a monitor in Embodiment 3.

[0061] Figure 22 is a block diagram showing the structure of an ultrasonic diagnostic apparatus according to Embodiment 4.

[0062] Figure 23 is a flowchart showing the operation of an ultrasonic diagnostic apparatus according to Embodiment 4. DETAILED DESCRIPTION

[0063] Hereinafter, an embodiment of the present application will be described with reference to the drawings.

[0064] The following description of the configuration elements is made in accordance with a representative embodiment of the present application, but the present application is not limited to this embodiment.

[0065] In the present specification, a numerical range indicated using "to" means a range including the numerical values recited before and after "to" as lower limit values and upper limit values.

[0066] In the present specification, "the same" and "identical" include a range of errors generally allowed in the technical field.

[0067] Embodiment 1

[0068] In Figure 1 The structure of an ultrasonic diagnostic apparatus according to Embodiment 1 of the present application is shown in Fig. 1. The ultrasonic diagnostic apparatus is provided with an ultrasonic probe 1 and a diagnostic apparatus main body 2. The ultrasonic probe 1 and the diagnostic apparatus main body 2 are connected to each other by wire via a cable not shown.

[0069] The ultrasonic probe 1 has a transducer array 11 and a transceiver circuit 12 connected to the transducer array 11.

[0070] The diagnostic apparatus main body 2 has an image generation section 21 connected to the transceiver circuit 12 of the ultrasonic probe 1, and a display control section 22 and a monitor 23 connected to the image generation section 21 in this order, and an ultrasonic image storage 24 connected to the image generation section 21. Further, the diagnostic apparatus main body 2 has a composite two-dimensional image storage 25, and a region of interest list creation section 26 and a schematic image generation section 27 connected to the composite two-dimensional image storage 25, respectively, and the composite two-dimensional image storage 25, the region of interest list creation section 26 and the schematic image generation section 27 are connected to the display control section 22.

[0071] Further, the diagnostic apparatus main body 2 has a main body side communication section 28 connected to the synthesized two-dimensional image memory 25.

[0072] The image generation section 21, the display control section 22, the ultrasonic wave image memory 24, the synthesized two-dimensional image memory 25, the region of interest list creation section 26, the schematic image generation section 27, and the main body side communication section 28 are connected to a main body control section 29, and the input device 30 is connected to the main body control section 29.

[0073] The main body side processor 31 is constituted by the image generation section 21, the display control section 22, the region of interest list creation section 26, the schematic image generation section 27, the main body side communication section 28, and the main body control section 29.

[0074] The breast X-ray radiography apparatus 5 and the server 6 are connected to the main body side communication section 28 of the diagnostic apparatus main body 2 via the network 4.

[0075] The transducer array 11 of the ultrasonic probe 1 has a plurality of ultrasonic transducers arranged in one or two dimensions. These transducers respectively transmit ultrasonic waves in accordance with a drive signal supplied from the transceiver circuit 12, and receive reflected waves from a subject, outputting analog reception signals. Each transducer is constituted, for example, by forming electrodes at both ends of a piezoelectric body including a piezoelectric ceramic represented by PZT (Lead Zirconate Titanate), a high molecular piezoelectric element represented by PVDF (Poly Vinylidene Di Fluoride), and a piezoelectric single crystal represented by PMN-PT (Lead Magnesium Niobate-Lead Titanate) solid solution.

[0076] The transceiver circuit 12 generates an acoustic ray signal in accordance with a reception signal acquired by the transducer array 11 from the ultrasonic waves transmitted from the transducer array 11 under the control of the probe control section 14. As shown in FIG. 1, the transceiver circuit 12 has a pulse generator 15 connected to the transducer array 11, an amplification section 16 connected in series to the transducer array 11 in order, an AD (Analog to Digital) conversion section 17, and a beam shaper 18. Figure 2

[0077] ​The pulse generator 15 includes, for example, multiple pulse generators. Based on a transmission delay mode selected according to a control signal from the probe control unit 14, it adjusts the delay amount and transmits individual drive signals to multiple transducers to form an ultrasonic beam from the ultrasonic waves transmitted from the multiple transducers of the transducer array 11. Thus, when a pulsed or continuous wave voltage is applied to the electrodes of the transducers of the transducer array 11, the piezoelectric element expands and contracts, generating pulsed or continuous wave ultrasonic waves from each transducer. The composite wave of these ultrasonic waves forms an ultrasonic beam.

[0078] The transmitted ultrasonic beam is reflected by an object such as a part of the subject being examined, and the ultrasonic echo propagates towards the transducer array 11 of the ultrasonic probe 1. The ultrasonic echo propagating towards the transducer array 11 is received by each transducer constituting the transducer array 11. At this time, each transducer constituting the transducer array 11 expands and contracts by receiving the propagating ultrasonic echo, generating a received signal as an electrical signal, and outputting these received signals to the amplification unit 16.

[0079] The amplification unit 16 amplifies the signals input from each oscillator constituting the oscillator array 11 and sends the amplified signals to the AD conversion unit 17. The AD conversion unit 17 converts the signals sent from the amplification unit 16 into digital received data and sends this received data to the beam shaper 18. The beam shaper 18 assigns a delay to each received data converted by the AD conversion unit 17 and adds them together according to a sound velocity or sound velocity distribution set based on a received delay mode selected according to a control signal from the probe control unit 14, thereby performing a so-called received focusing process. Through this received focusing process, an acoustic signal is obtained by phase-integrating and adding the received data converted by the AD conversion unit 17, thereby reducing the focal point of the ultrasonic echo.

[0080] like Figure 3 As shown, the image generation unit 21 of the main body 2 of the diagnostic device has a structure in which the signal processing unit 32, the DSC (Digital Scan Converter) 33 and the image processing unit 34 are connected in series.

[0081] After the signal processing unit 32 performs distance-based attenuation correction on the acoustic signal sent from the main body side communication unit 28 according to the depth of the ultrasonic wave reflection position, it performs envelope detection processing to generate an ultrasonic image signal (B-mode image signal) as tomographic image information related to the tissue in the subject T.

[0082] DSC33 converts (raster conversions) the ultrasonic image signal generated by the signal processing unit 32 into an image signal that follows the scanning method of a normal television signal.

[0083] The image processing section 34 outputs a signal representing an ultrasonic image to the display control section 22 and the ultrasonic image storage 24 after performing various necessary image processing such as gradation processing on the ultrasonic image signal input from the DSC 33. The signal representing the ultrasonic image generated in this way by the image generation section 21 is simply referred to as an ultrasonic image.

[0084] The display control section 22 displays the ultrasonic image on the monitor 23 under the control of the main body control section 29 by performing a prescribed process on the ultrasonic image sent out from the image generation section 21.

[0085] The monitor 23 is a device that displays the ultrasonic image under the control of the display control section 22, and has, for example, a display device such as an LCD (Liquid Crystal Display), an organic EL display, or the like.

[0086] The ultrasonic image storage 24 is a storage that stores the ultrasonic image generated by the image generation section 21 under the control of the main body control section 29. For example, the ultrasonic image storage 24 can store a series of multiple frames of ultrasonic images generated by the image generation section 21 in correspondence with the diagnosis of the breast of the subject.

[0087] The synthetic two-dimensional image storage 25 stores the synthetic two-dimensional image received by the main body side communication section 28 from the breast X-ray imaging apparatus 5 or the server 6 via the network 4. In the breast X-ray imaging apparatus 5, a synthetic two-dimensional image is generated from a series of radiographic images obtained by tomography, and stored in the server 6. For example, four synthetic two-dimensional images including a synthetic two-dimensional image R-CC in the CC (Cranio-Caudal) direction of the right breast of the subject, a synthetic two-dimensional image R-MLO in the MLO (Medio-lateral-Oblique) direction, a synthetic two-dimensional image L-CC in the CC direction of the left breast, and a synthetic two-dimensional image L-MLO in the MLO direction are generated, and these four synthetic two-dimensional images are sent from the breast X-ray imaging apparatus 5 or the server 6 to the main body side communication section 28, and stored in the synthetic two-dimensional image storage 25.

[0088] As the ultrasonic image storage 24 and the synthesized two-dimensional image storage 25, a recording medium such as a flash memory, an HDD (Hard Disc Drive), an SSD (Solid State Drive), an FD (Flexible Disc), an MO disc (Magneto-Optical disc), an MT (Magnetic Tape), a RAM (Random Access Memory), a CD (Compact Disc), a DVD (Digital Versatile Disc), an SD card (Secure Digital card), a USB memory (Universal Serial Bus memory), and the like can be used.

[0089] The region-of-interest list creation section 26 creates a list of regions of interest included in the synthesized two-dimensional image. The list of regions of interest created by the region-of-interest list creation section 26 is displayed on the monitor 23 via the display control section 22.

[0090] The schematic image generation section 27 generates a schematic image described later that schematically represents a breast. The schematic image generated by the schematic image generation section 27 is displayed on the monitor 23 via the display control section 22.

[0091] The body-side communication section 28 sends out, under the control of the body control section 29, the ultrasonic image generated by the image generation section 21 and saved in the ultrasonic image storage 24 to the server 6 via the network 4.

[0092] Also, the body-side communication section 28 receives, under the control of the body control section 29, the synthesized two-dimensional image transmitted from the breast X-ray imaging apparatus 5 or the server 6 via the network 4, and sends out the received synthesized two-dimensional image to the synthesized two-dimensional image storage 25.

[0093] The input device 30 is a device for a user to perform an input operation, and is constituted by, for example, a keyboard, a mouse, a trackball, a touchpad, a touch sensor overlaid on the monitor 23, and the like.

[0094] The body control section 29 performs control of each section of the diagnostic apparatus body 2 in accordance with a control program or the like stored in advance.

[0095] Also, although not illustrated, the main body control section 29 is connected with a main body side storage section. The main body side storage section stores a control program and the like of the diagnostic apparatus main body 2. Also, as the main body side storage section, for example, a flash memory, a RAM (Random Access Memory), an SD card (Secure Digital card), an SSD (Solid State Drive), or the like can be used.

[0096] Further, the main body side processor 31 having the image generation section 21, the display control section 22, the region of interest list creation section 26, the schematic image generation section 27, the main body side communication section 28, and the main body control section 29 is constituted by a CPU (Central Processing Unit) and a control program for causing the CPU to perform various processes, but can also be constituted by an FPGA (Field Programmable Gate Array), a DSP (Digital Signal Processor), an ASIC (Application Specific Integrated Circuit), a GPU (Graphics Processing Unit), and other ICs (Integrated Circuits), or can also be constituted by combining them.

[0097] Also, the image generation section 21, the display control section 22, the region of interest list creation section 26, the schematic image generation section 27, the main body side communication section 28, and the main body control section 29 of the main body side processor 31 can also be integrated in 1 CPU or the like in part or in whole.

[0098] As shown in Figure 4 The breast X-ray imaging apparatus 5 connected with the diagnostic apparatus main body 2 via the network 4 is provided with an X-ray source 51 and an X-ray detector 52.

[0099] For example, with respect to the breast of a subject in a state of being compressed by an unillustrated compression plate, X-rays are irradiated from the X-ray source 51 while changing the X-ray incident angle, and the X-rays that have passed through the breast are detected by the X-ray detector 52, whereby a series of radiographic images are acquired by tomography.

[0100] The breast X-ray imaging apparatus 5 is also mounted with an unillustrated computer, and the generation of a synthetic two-dimensional image can be performed by the computer. That is, as shown in Figure 5As shown, a plurality of tomographic images 53 are generated by three-dimensionally reconstructing a series of radiographic images acquired by tomography, and a composite two-dimensional image 54 is generated based on the plurality of tomographic images 53.

[0101] The plurality of tomographic images 53 are, for example, a plurality of sectional images obtained by slicing the breast in parallel to each other with a slight interval of about 1 mm.

[0102] In addition, in the breast X-ray imaging apparatus 5, it is also possible to generate the composite two-dimensional image 54 based on a series of radiographic images acquired by tomography without passing through the plurality of tomographic images 53 reconstructed three-dimensionally. In addition, when the composite two-dimensional image 54 is generated, it is also possible to generate while reflecting information of the region of interest R extracted by the CAD processing described later. For example, it is also possible to generate the composite two-dimensional image 54 in a manner to further emphasize the region of interest R.

[0103] Further, as the CAD (Computer-Aided Detection) processing of the breast X-ray imaging apparatus 5, detection of the region of interest R is performed for each of the reconstructed plurality of tomographic images 53.

[0104] For example, the region of interest R can be detected from the tomographic images 53 by utilizing deep learning (Deep Learning) of AI (Artificial Intelligence).

[0105] In addition, the CAD processing can be performed by a computer mounted on the breast X-ray imaging apparatus 5, or can be performed by a computer dedicated to the CAD processing connected to the breast X-ray imaging apparatus 5.

[0106] In addition, the composite two-dimensional image 54 is, for example, expressed as image data in a so-called DICOM (Digital Imaging and Communications in Medicine) format to which patient identification information is added, and has a tag to store accompanying information. In any one of the plurality of tomographic images 53, when the region of interest R is detected by the CAD processing, information of the detected region of interest R and information of the tomographic image 53 corresponding to the region of interest R are stored in the tag of the composite two-dimensional image 54. Specifically, identification information of the detected region of interest R, a position of the region of interest R, a slice number of the tomographic image 53 corresponding to the region of interest R and best representing the region of interest R, and the like are stored in the tag.

[0107] Also, in the case of the synthesized two-dimensional image 54 in the MLO direction, the photographing angle at the time of photographing in the mammography apparatus 5, that is, the angle at which the X-ray detector 52 is set, is stored in the PPA (Positioner Primary Angle) which is a public tag of DICOM.

[0108] In addition, as the CAD processing of the mammography apparatus 5, in the case where the synthesized two-dimensional image 54 is generated from a series of radiographic images photographed by tomography, the detection of the region of interest R can be performed not on the reconstructed plurality of tomographic images 53 but on the series of radiographic images photographed by tomography. However, the position of the detected region of interest R needs to be converted into the position in the tomographic image 53 reconstructed in three dimensions, and then converted into the slice number of the tomographic image 53, and stored in the tag of the synthesized two-dimensional image 54.

[0109] As the tag of the synthesized two-dimensional image 54, a DICOM tag can be used. In the DICOM tag, various information such as the slice number corresponding to the region of interest R can be stored. Also, the SOP Instance UID (Service Objective Pair Instance Unique Identifier) of other images can be stored in the DICOM tag. Also, the Study Instance UID (Study Instance Unique Identifier) and the Series Instance UID (Series Instance Unique Identifier) of these other images in the DICOM standard can be stored.

[0110] Also, the information of the detected region of interest R and the information of the tomographic image 53 corresponding to the region of interest R can be stored in a file such as a DICOM-SR (Structured Report) or the like which accommodates only data not including images, instead of being stored in the tag of the synthesized two-dimensional image 54.

[0111] In this way, the reconstructed plurality of tomographic images 53 and the generated synthesized two-dimensional image 54 are sent out from the mammography apparatus 5 to the server 6 via the network 4. Also, the series of radiographic images acquired by tomography can be sent out from the mammography apparatus 5 to the server 6 via the network 4.

[0112] Server 6, connected to the diagnostic device body 2 via network 4, stores various image data generated by the ultrasound diagnostic device and the mammography device 5. Specifically, the ultrasound images generated by the diagnostic device body 2, multiple tomographic images 53 generated by the mammography device 5, and a composite two-dimensional image 54 are stored in server 6. Furthermore, a series of radiographic images obtained through tomography from the mammography device 5 can also be stored in server 6. In this case, as described later, server 6 may also have the function of reconstruction processing and generation of the composite two-dimensional image 54.

[0113] Server 6 can be used as a server in a so-called PACS (Picture Archiving and Communication System).

[0114] exist Figure 6 The diagram shows a schematic image 71 generated by the schematic image generation unit 27 of the diagnostic device body 2. Figure 6 The schematic diagram 71 shown schematically represents the right breast viewed from the front, with a circular breast region 72 and a roughly triangular axillary region 73 representing the armpit and extending obliquely upward from the breast region 72. The breast region 72 is divided into four regions: an upper inner region A, a lower inner region B, an upper outer region C, and a lower outer region D. The axillary region 73 connects to the upper left oblique part of the upper outer region C.

[0115] In addition, by making Figure 6 The schematic image 71 shown is flipped left and right to obtain a schematic image representing the left breast.

[0116] like Figure 7 As shown, in the schematic image 71 generated by the schematic image generation unit 27, the region of interest R is drawn, and the slice line C of the tomographic image 53 that best represents the region of interest R is depicted. The schematic image generation unit 27 can generate the schematic image 71 with the region of interest R drawn and the slice line C depicted by referring to the accompanying information stored in the label or DICOM-SR of the composite two-dimensional image 54, such as the identification information of the region of interest R, the position of the region of interest R, the slice number of the tomographic image 53 that best represents the region of interest R, and the photographic angle.

[0117] First, the schematic image generation unit 27 draws a slice line C on the schematic image 71 based on the slice number of the tomographic image 53, which best represents the photographic angle and the region of interest R, stored in the label of the composite two-dimensional image 54 or in the DICOM-SR. The slice line C has the same angle as the photographic angle and is drawn as a straight line extending parallel to the X-ray detector 52.

[0118] At this time, for example, in the case where the synthesized two-dimensional image 54 is a synthesized two-dimensional image R-CC in the CC direction of the right breast, the imaging angle is "0 degrees", so the slice planes of each tomographic image 53 extend in the horizontal direction. Therefore, as Figure 8 As shown, the slice plane P0 of the first tomographic image 53 in the plurality of tomographic images 53 is located at the bottom of the circular breast region 72 in the schematic image 71, and the slice plane P1 of the last tomographic image 53 in the plurality of tomographic images 53 is located at the top of the circular breast region 72. Slice planes P0 and P1 are equally divided according to the number of tomographic images 53. Furthermore, starting from the slice plane P0 of the first tomographic image 53, slice lines C are drawn at positions corresponding to the slice numbers of the tomographic images 53 stored in the label of the composite 2D image 54 or in the DICOM-SR, representing the slice planes of the tomographic images 53 that best represent the region of interest R.

[0119] For example, when the number of tomographic images 53 is set to 7, and the slice number of the tomographic image 53 that best represents the region of interest R is set to "3", the slice plane P0 and slice plane P1 are equally divided into 6 parts, and the slice line C is drawn from the initial slice plane P0 located at the bottom of the circular breast region 72 at the position of the 3rd slice plane corresponding to the slice number.

[0120] In addition, the number of tomographic images 53 can be stored in the label or DICOM-SR of the synthesized two-dimensional image 54.

[0121] Furthermore, instead of storing the number of tomographic images 53 in the label of the synthesized two-dimensional image 54, the number of tomographic images 53 can be calculated based on the thickness of the breast compressed by the compression plate during the capture of the radiographic image, the slice thickness, and the slice interval.

[0122] Furthermore, it can be set such that the initial slice P0 is located at the top of the circular breast region 72, and the final slice P1 is located at the bottom of the circular breast region 72.

[0123] When the slice line C is depicted in this manner, the schematic image generation unit 27 then projects the outline of the region of interest R in the composite 2D image 54 onto the slice line C while aligning the composite 2D image 54 with the schematic image 71. This determines the position of the region of interest R on the slice line C, as follows: Figure 7 As shown, a schematic image 71 is generated that depicts the slice line C and draws the region of interest R on the slice line C.

[0124] Figure 7The illustrated diagram image 71 corresponds to the synthesized two-dimensional image R-CC of the CC direction of the right breast, but a diagram image 71 corresponding to the synthesized two-dimensional image R-MLO of the MLO direction of the right breast can also be generated in the same manner.

[0125] As shown in Fig. 6, in the synthesized two-dimensional image 54 of the MLO direction, the angle of the X-ray detector 52 at the time of imaging is stored in the public tag PPA of the synthesized two-dimensional image 54 as the photographing angle, and the slice line C also becomes a straight line inclined according to the photographing angle. Figure 9

[0126] Therefore, as shown in Fig. 7, as long as the two slice planes PO and P1 inclined according to the photographing angle are positioned in a manner that the circular breast region 72 of the diagram image 71 is interposed therebetween, the slice planes PO and P1 are equally divided between each other according to the number of the tomographic images 53, and the slice line C is drawn at a position corresponding to the slice number of the tomographic image 53 stored in the tag or the DICOM-SR of the synthesized two-dimensional image 54. Figure 10

[0127] Furthermore, by projecting the outline of the region of interest R in the synthesized two-dimensional image 54 onto the slice line C, as shown in Fig. 8, a diagram image 71 corresponding to the synthesized two-dimensional image R-MLO of the MLO direction of the right breast, which depicts the slice line C and on which the region of interest R is drawn, is generated. Figure 9

[0128] Furthermore, as shown in Figs. 9 and 10, in the case where the synthesized two-dimensional image 54 has a plurality of regions of interest R1, R2, a diagram image 71 depicting the slice lines C1, C2 corresponding to the plurality of regions of interest R1, R2, respectively, and on which the regions of interest R1, R2 are drawn, is also generated in the same manner. Figure 11 Figure 12

[0129] In addition, as shown in Fig. 11, the diagram image 71 corresponds to the synthesized two-dimensional image L-CC of the CC direction of the left breast, Figure 11 Figure 12 as shown in Fig. 12, the diagram image 71 corresponds to the synthesized two-dimensional image L-MLO of the MLO direction of the left breast.

[0130] Furthermore, although not illustrated, a diagram image corresponding to the synthesized two-dimensional image L-CC of the CC direction of the left breast and a diagram image corresponding to the synthesized two-dimensional image L-MLO of the MLO direction of the left breast are also generated in the same manner as the diagram image 71 for the right breast, but are reversed left and right.

[0131] ​​​​​​In addition, multiple regions of interest R1 and R2 are recorded in a list of regions of interest created by the region of interest list creation unit 26. However, it is also possible to draw only the regions of interest selected from the multiple regions of interest R1 and R2 recorded in the list of regions of interest in the schematic image 71, or to draw all regions of interest in the schematic image 71.

[0132] Next, the operation of the ultrasonic diagnostic device according to Embodiment 1 will be explained.

[0133] like Figure 13 As shown in the flowchart, the mammography device 5 pre-photographs the breast of the subject, generating a composite two-dimensional image 54. That is, in step S1, for the breast of the subject being compressed by a compression plate (not shown), X-rays are irradiated from the X-ray source 51 while changing the X-ray incident angle, thereby performing tomography and acquiring a series of radiographic images. Furthermore, by reconstructing the acquired series of radiographic images in three dimensions, multiple tomographic images 53 are generated.

[0134] In the next step S2, as part of the CAD processing of the mammography device 5, the regions of interest R are detected in the three-dimensionally reconstructed tomographic images 53.

[0135] Furthermore, in step S3, a composite two-dimensional image 54 is generated based on multiple tomographic images 53. This composite two-dimensional image 54 is represented as labeled image data, which stores identification information of the detected region of interest R, the location of the region of interest R, the slice number of the tomographic image 53 that best represents the region of interest R, etc. In the case of the composite two-dimensional image 54 in the MLO direction, the photographic angle during tomography is also stored. Alternatively, the identification information of the region of interest R, the location of the region of interest R, the slice number of the tomographic image 53 that best represents the region of interest R, the photographic angle during tomography, etc., are stored in the DICOM-SR.

[0136] A series of radiographic images, multiple tomographic images 53, and a composite two-dimensional image 54 acquired in the mammography device 5 are sent from the mammography device 5 to the server 6 via the network 4, where they are stored.

[0137] Also, in step S4, when the query of the synthetic two-dimensional image 54 and the reception of the request are made by the user of the ultrasonic diagnostic apparatus according to the patient identification information, the synthetic two-dimensional image 54 is transmitted from the mammography apparatus 5 or the server 6 to the diagnostic apparatus main body 2 of the ultrasonic diagnostic apparatus via the network 4. For example, four synthetic two-dimensional images including the synthetic two-dimensional image R-CC and the synthetic two-dimensional image R-MLO of the right breast of the subject in the CC direction and the MLO direction, and the synthetic two-dimensional image L-CC and the synthetic two-dimensional image L-MLO of the left breast of the subject in the CC direction and the MLO direction are transmitted to the diagnostic apparatus main body 2 of the ultrasonic diagnostic apparatus. In addition, it is also possible that the synthetic two-dimensional image 54 is automatically transmitted from the mammography apparatus 5 to the ultrasonic diagnostic apparatus set without receiving the request from the user of the ultrasonic diagnostic apparatus.

[0138] In the ultrasonic diagnostic apparatus, as shown in the flowchart of FIG. 6, in step S5, the synthetic two-dimensional image 54 is received by the main body side communication section 28 of the diagnostic apparatus main body 2 from the mammography apparatus 5 or the server 6 via the network 4, and stored in the synthetic two-dimensional image storage 25. Figure 14

[0139] In the next step S6, the main body control section 29 of the diagnostic apparatus main body 2 displays the four synthetic two-dimensional images 54 including R-CC, R-MLO, L-CC, and L-MLO received by the main body side communication section 28 in the form of thumbnails on the monitor 23, for example. Figure 15 In the monitor 23, the thumbnail images 80 corresponding to the four synthetic two-dimensional images R-CC, R-MLO, L-CC, and L-MLO are shown in the upper right portion.

[0140] Also, in step S7, when one of the thumbnail images 80 corresponding to the four synthetic two-dimensional images R-CC, R-MLO, L-CC, and L-MLO is selected by the user, in step S8, the list 81 of the regions of interest R is created by the region of interest list creating section 26, and displayed on the monitor 23. At this time, the region of interest list creating section 26 creates the list 81 of the regions of interest R included in the synthetic two-dimensional image 54 corresponding to the thumbnail image 80 selected by the user from the thumbnail images 80 corresponding to the four synthetic two-dimensional images R-CC, R-MLO, L-CC, and L-MLO by referring to the label or the DICOM-SR of the synthetic two-dimensional image 54, and displays the list 81 of the regions of interest R on the monitor 23 via the display control section 22.

[0141] ​Further, in step S9, when one of the regions of interest R is selected by the user from the list 81 of the regions of interest R, the schematic image generating section 27 acquires information related to the selected region of interest R by referring to the label or DICOM-SR of the synthesized two-dimensional image 54 in step S10, and performs generation of the schematic image 71 in step Sll. Specifically, the schematic image generating section 27 acquires the identification information of the region of interest R selected by the user, the position of the region of interest R, the slice number of the tomographic image 53 that best represents the region of interest R, the photographing angle, and the like from the label or DICOM-SR of the synthesized two-dimensional image 54, and generates the schematic image 71 that depicts the slice line C and draws the region of interest R on the slice line C.

[0142] The schematic image 71 generated in this way is displayed on the monitor 23 together with the synthesized two-dimensional image 54 corresponding to the thumbnail image 80 selected by the user.

[0143] In addition, it is also possible to register the identification information of the region of interest R, the position of the region of interest R, the slice number of the tomographic image 53 that best represents the region of interest R, the photographing angle, and the like in the database in correspondence with the patient identification information in advance, and in the case where one of the regions of interest R is selected by the user from the list 81 of the regions of interest R, the schematic image generating section 27 acquires these information from the database.

[0144] As the position of the region of interest R, the geometric center position of the region of interest R or the barycentric position of the region of interest R can be used. Further, the major axis and the minor axis of the region of interest R can also be stored as information related to the region of interest R in the label or DICOM-SR of the synthesized two-dimensional image 54.

[0145] When the schematic image 71 is displayed on the monitor 23, an ultrasonic image of the breast of the subject is captured by the user in the next step S12.

[0146] At this time, the ultrasonic probe 1 is brought into contact with the surface of the breast of the subject, and the transmission and reception of ultrasonic waves from the plurality of transducers of the transducer array 11 into the subject is started in accordance with the drive signal from the pulse generator 15 of the transmission / reception circuit 12. The ultrasonic wave echoes from the tissue in the subject received by the plurality of transducers of the transducer array 11 are outputted to the amplification section 16 as reception signals of an analog signal and amplified, and subjected to AD conversion by the AD conversion section 17 to acquire reception data. The reception data is subjected to reception focusing processing by the beamformer 18, and the acoustic ray signals generated thereby are sent to the image generation section 21 of the diagnostic apparatus main unit 2 to generate an ultrasonic image representing tomographic image information relating to the tissue in the subject. At this time, the acoustic ray signals are subjected to correction of the attenuation corresponding to the depth of the reflection position of the ultrasonic waves and envelope detection processing by the signal processing section 32 of the image generation section 21, converted into image signals in accordance with the scanning system of a normal television signal by the DSC 33, and subjected to various necessary image processing such as gradation processing by the image processing section 34.

[0147] Also, in step S13, the synthetic two-dimensional image 54 corresponding to the thumbnail image 80 selected by the user, the schematic image 71 in which the region of interest R selected by the user is drawn, and the ultrasonic image 82 currently captured by the ultrasonic probe 1 are displayed on the monitor 23 together.

[0148] In Figure 15 the state in which the thumbnail image 80 corresponding to the synthetic two-dimensional image R-CC selected by the user is surrounded by a thick line, the region of interest R in the list 81 selected by the user is surrounded by a thick line, and the synthetic two-dimensional image 54 (R-CC) corresponding to the selected thumbnail image 80, the schematic image 71 superimposed on a part of the synthetic two-dimensional image 54, and the currently captured ultrasonic image 82 are displayed on the monitor 23 is shown.

[0149] In the schematic image 71, a slice line C representing the slice plane of the tomographic image 53 that best represents the region of interest R is drawn, and the region of interest R is further drawn on the slice line C, so that the user can determine the scan position of the ultrasonic probe 1, easily search for the region of interest R, and generate an ultrasonic image containing the region of interest R by confirming this schematic image 71.

[0150] Also, in the ultrasonic diagnostic apparatus according to Embodiment 1, the plurality of tomographic images 53 generated by the mammography apparatus 5 are not stored in the diagnostic apparatus main unit 2, but the schematic image 71 in which the region of interest R is drawn is generated on the basis of the synthetic two-dimensional image 54 and the information of the tomographic image 53 accompanying the synthetic two-dimensional image 54 and best representing the region of interest R on the synthetic two-dimensional image 54 and the information of the region of interest R, so that a high-precision diagnosis of the region of interest R of the breast can be performed without the need to secure a large-capacity storage area in the ultrasonic diagnostic apparatus.

[0151] In addition, in the above-described embodiment 1, the user selects a thumbnail image 80 corresponding to the synthetic two-dimensional image R-CC, and a schematic image 71 is generated that draws the region of interest R of the synthetic two-dimensional image 54 (R-CC) corresponding to the selected thumbnail image 80. However, it is also possible to configure the synthetic two-dimensional image 54 (R-MLO) to be displayed on the monitor 23 if the synthetic two-dimensional image 54 (R-MLO) captures the same region of interest R as the region of interest drawn on the schematic image 71, even if the imaging direction is different from that of the synthetic two-dimensional image 54 (R-CC) and the breast of the subject is captured.

[0152] exist Figure 16 The image shows the state of the composite 2D image 54A (R-CC) and composite 2D image 54B (R-MLO) displayed together with the monitor 23.

[0153] For example, specifying via double-click, etc. Figure 15 When the region of interest R in the schematic image 71 is shown, it is determined whether the same region of interest R has been captured in other composite two-dimensional images 54. If there are other composite two-dimensional images 54 that have captured the same region of interest R, they can be displayed on the monitor 23.

[0154] For example, the determination of whether the same region of interest R was captured in the first composite 2D image 54 and the second composite 2D image 54 with different shooting directions is based on the fact that when the region of interest R in the second composite 2D image 54 is drawn on the schematic image 71, it is located in a close position within a threshold relative to the region of interest R in the first composite 2D image 54. If the size of the region of interest R is almost the same and the size difference is within the threshold, it can be determined that they are the same region of interest R.

[0155] Furthermore, in cases of so-called multiple lesions, where regions of interest R of the same size are arranged in close proximity, it is preferable to display all regions of interest R when it is difficult to determine which region of interest R belongs to the same region of interest R. For example, near the region of interest R drawn on the schematic image 71, the number X of regions of interest R that are difficult to determine is recorded, indicating that there are X regions of interest R in close proximity, and further, it is possible to emphasize and display each of the X regions of interest R on the composite two-dimensional image 54.

[0156] Thus, by displaying multiple composite two-dimensional images 54 on the monitor 23, each with different imaging directions and capturing the same area of ​​interest, the user can more easily determine the scanning position of the ultrasound probe 1, enabling a more accurate diagnosis of the breast area of ​​interest R. Furthermore, as... Figure 16As shown, even if the plurality of the synthesized two-dimensional images 54A and 54B are displayed on the monitor 23, no influence is exerted on the currently captured ultrasonic image 82, and thus the user's line of sight for ultrasonic photography using the ultrasonic probe 1 is not unnecessarily moved.

[0157] In addition, in the above-described embodiment 1, the synthesized two-dimensional image 54 is generated by the mammography apparatus 5, but is not limited thereto, and the server 6 can be configured to generate the synthesized two-dimensional image 54. In this case, the server 6 can generate the synthesized two-dimensional image 54 from a series of radiographic images acquired by tomography transmitted from the mammography apparatus 5 via the network 4, or from the plurality of reconstructed tomographic images 53.

[0158] Embodiment 2

[0159] In Figure 17 The structure of the diagnosis apparatus main body 2A in the ultrasonic diagnosis apparatus according to embodiment 2 is shown in FIG. 6. The diagnosis apparatus main body 2A is a diagnosis apparatus main body in which the diagnosis apparatus main body 2 in the ultrasonic diagnosis apparatus according to embodiment 1 is modified. Figure 1 In the diagnosis apparatus main body 2 in the ultrasonic diagnosis apparatus according to embodiment 1 shown in FIG. 5, a highlighting section 35 is newly connected between the synthesized two-dimensional image storage 25 and the display control section 22, and a main body control section 29A is used instead of the components of the main body control section 29, and the other structures are the same as those in the diagnosis apparatus main body 2 in embodiment 1.

[0160] The main body control section 29A is connected to the image generation section 21, the display control section 22, the ultrasonic image storage 24, the synthesized two-dimensional image storage 25, the region of interest list creation section 26, the schematic image generation section 27, the main body side communication section 28, and the highlighting section 35, and the input device 30 is connected to the main body control section 29A.

[0161] The main body side processor 31A is constituted by the image generation section 21, the display control section 22, the region of interest list creation section 26, the schematic image generation section 27, the main body side communication section 28, the highlighting section 35, and the main body control section 29A.

[0162] The highlighting section 35 displays a region on the synthesized two-dimensional image 54 corresponding to the region of interest R on the schematic image 71 in a highlighted manner on the monitor 23 when the region of interest R drawn on the schematic image 71 is specified by the user.

[0163] For example, when the region of interest R of the schematic image 71 is specified by clicking or the like via the input device 30, as shown in FIG. 8, the sub-window 83 is displayed on the synthesized two-dimensional image 54 displayed on the monitor 23 by the highlighting section 35, and the region of interest R is displayed in an enlarged manner in the sub-window 83. Thus, the region of interest R can be highlighted by the enlarged display. Figure 18

[0164] ​Alternatively, in a case where the attention region R of the schematic image 71 is designated, as shown in Figure 19 The emphasis section 35 can also emphasize the attention region R by surrounding the attention region R on the synthesized two-dimensional image 54 displayed on the monitor 23 with an emphasis line 84.

[0165] In addition, the emphasis section 35 can also display on the monitor 23 the region on the synthesized two-dimensional image 54 corresponding to the attention region R by emphasizing the region on the synthesized two-dimensional image 54 for the attention region R selected from the list 81 of attention regions R.

[0166] In this way, by emphasizing the attention region R on the synthesized two-dimensional image 54 by the emphasis section 35, the attention region R becomes easy to observe, and a high-precision diagnosis of the attention region R of the breast can be performed.

[0167] Embodiment 3

[0168] The structure of the diagnosis device main unit 2B in the ultrasonic diagnostic apparatus according to Embodiment 3 is shown in Figure 20 The diagnosis device main unit 2B in the ultrasonic diagnostic apparatus according to Embodiment 2 shown in Figure 17 The diagnosis device main unit 2A in Embodiment 2 is newly connected with a diagnosis opinion display section 36 on the main unit side communication section 28 and the display control section 22, and uses a main unit control section 29B instead of the main unit control section 29A, and the other structures are the same as those of the diagnosis device main unit 2A in Embodiment 2.

[0169] The main unit control section 29B is connected to the image generation section 21, the display control section 22, the ultrasonic image storage 24, the synthesized two-dimensional image storage 25, the attention region list creation section 26, the schematic image generation section 27, the main unit side communication section 28, the emphasis section 35, and the diagnosis opinion display section 36, and the input device 30 is connected to the main unit control section 29B.

[0170] The main unit side processor 31B is constituted by the image generation section 21, the display control section 22, the attention region list creation section 26, the schematic image generation section 27, the main unit side communication section 28, the emphasis section 35, the diagnosis opinion display section 36, and the main unit control section 29B.

[0171] The diagnosis opinion display section 36 displays the diagnosis opinion for the mammography on the monitor 23, for example, in a case where the diagnosis opinion is made in a report system not shown which is connected to the network 4.

[0172] The data of the diagnosis opinion made in the report system is received by the main unit side communication section 28 of the diagnosis device main unit 2 via the network 4, and is sent from the main unit side communication section 28 to the diagnosis opinion display section 36. The data of the diagnosis opinion is sent from the diagnosis opinion display section 36 to the display control section 22, and the diagnosis opinion is displayed on the monitor 23. Figure 21As shown, for example, the diagnosis opinion 85 is displayed on the monitor 23 adjacent to the list 81 of the regions of interest R.

[0173] In addition, in a case where the diagnosis opinion made in the reporting system is not only a diagnosis opinion for the region of interest R but also a diagnosis opinion involving many aspects, the diagnosis opinion display section 36 can also extract the diagnosis opinion for the region of interest R from the data of the diagnosis opinion acquired via the host-side communication section 28 and display it on the monitor 23.

[0174] Further, in a case where the diagnosis opinion made in the reporting system is a diagnosis opinion for a plurality of regions of interest R, the diagnosis opinion display section 36 can also extract only the diagnosis opinion for the region of interest R selected by the user from the list 81 and display it on the monitor 23.

[0175] In this way, by displaying the diagnosis opinion made in the reporting system on the monitor 23, the user of the ultrasonic diagnostic apparatus can perform a high-precision diagnosis while more correctly recognizing the region of interest R.

[0176] Embodiment 4

[0177] In the above-described Embodiment 1, the schematic image 71 corresponding to one region of interest R selected by the user from the list 81 of the regions of interest R displayed on the monitor 23 is generated, but is not limited thereto. For example, it can also be configured to generate the schematic image 71 on the synthetic two-dimensional image 54 displayed on the monitor 23 in a case where an arbitrary position specified by the user is included inside the region of interest R.

[0178] The structure of the diagnosis apparatus main unit 2C in the ultrasonic diagnostic apparatus according to Embodiment 4 is shown in FIG. 17. The diagnosis apparatus main unit 2C is a diagnosis apparatus main unit in which the host-side processor 31C shown in FIG. 18 is used instead of the host-side processor 31 shown in FIG. 10. Figure 22 The diagnosis apparatus main unit 2 in the ultrasonic diagnostic apparatus according to Embodiment 1 shown in FIG. 1 is configured as follows. The diagnosis apparatus main unit 2 is a diagnosis apparatus main unit in which the host-side processor 31 shown in FIG. 10 is used instead of the host-side processor 31C shown in FIG. 18. Figure 1 The diagnosis apparatus main unit 2 in the ultrasonic diagnostic apparatus according to Embodiment 1 shown in FIG. 1 is configured as follows. The diagnosis apparatus main unit 2 is a diagnosis apparatus main unit in which the host-side processor 31 shown in FIG. 10 is used instead of the host-side processor 31C shown in FIG. 18.

[0179] The host control section 29C is connected to the image generation section 21, the display control section 22, the ultrasonic image storage 24, the synthetic two-dimensional image storage 25, the schematic image generation section 27, and the host-side communication section 28, and the input device 30 is connected to the host control section 29C.

[0180] The host-side processor 31C is configured by the image generation section 21, the display control section 22, the schematic image generation section 27, the host-side communication section 28, and the host control section 29C.

[0181] Reference Figure 23The flowchart of FIG. 5 is used to explain the operation of the ultrasonic diagnostic apparatus according to Embodiment 4.

[0182] Steps S5 to S7 are the same as those of the flowchart of Embodiment 1 shown in FIG. 5. That is, in step S5, the four synthesized two-dimensional images 54 including R-CC, R-MLO, L-CC, and L-MLO received by the body-side communication section 28 of the diagnostic apparatus body 2 from the breast X-ray imaging apparatus 5 or the server 6 are saved in the synthesized two-dimensional image storage 25. Figure 14

[0183] In the next step S6, the four synthesized two-dimensional images 54 including R-CC, R-MLO, L-CC, and L-MLO received by the body-side communication section 28 are displayed on the monitor 23 in the form of thumbnails by the body control section 29C of the diagnostic apparatus body 2, for example.

[0184] Also, in step S7, one of the thumbnail images 80 corresponding to the four synthesized two-dimensional images R-CC, R-MLO, L-CC, and L-MLO is selected by the user.

[0185] In step S7, when one of the thumbnail images 80 is selected by the user, the process proceeds to step S14, and the synthesized two-dimensional image 54 corresponding to the selected thumbnail image 80 is displayed on the monitor 23 by the body control section 29C.

[0186] Also, in step S10, the schematic image generation section 27 acquires information related to the region of interest R including the specified position by referring to the labels or DICOM-SR of the synthesized two-dimensional images 54.

[0187] In the next step S15, it is determined whether or not an arbitrary position on the synthesized two-dimensional image 54 displayed on the monitor 23 is specified by the user.

[0188] In step S15, when it is determined that an arbitrary position on the synthesized two-dimensional image 54 is specified by clicking or the like via the input section 30, for example, the process proceeds to step S16, and it is determined whether or not the specified position is included in the region of interest R of the synthesized two-dimensional image 54.

[0189] In step S16, when it is determined that the specified position is included in the region of interest R, the process returns to step S15, and it is determined whether or not an arbitrary position on the synthesized two-dimensional image 54 is newly specified.

[0190] On the other hand, in step S16, when it is determined that the specified position is included in the region of interest R, the process proceeds to step S11, and the schematic image 71 depicting the slice line C and the region of interest R drawn on the slice line C is generated by the schematic image generation section 27 using the information related to the region of interest R acquired in step S10.​

[0191] The schematic image 71 generated in this way is displayed on the monitor 23 together with the synthesized two-dimensional image 54.

[0192] When the schematic image 71 is displayed on the monitor 23, in the next step S12, the user takes an ultrasonic image of the breast of the subject.

[0193] Also, in step S13, the synthesized two-dimensional image 54, the schematic image 71, and the ultrasonic image 82 taken at present by the ultrasonic probe 1 are displayed on the monitor 23.

[0194] Thus, even if the list 81 of regions of interest R is not used, and an arbitrary position is designated by the user on the synthesized two-dimensional image 54 displayed on the monitor 23, as in Embodiment 1, a high-precision diagnosis of the region of interest R of the breast can be performed without having to secure a large-capacity storage area in the ultrasonic diagnostic apparatus.

[0195] Also, it can be configured so that, in the case where a plurality of regions of interest R exist, a schematic image 71 in which all of the regions of interest R are drawn is generated, and one region of interest R is selected from among the plurality of regions of interest R drawn on the schematic image 71.

[0196] In addition, in Embodiments 1 to 4, the ultrasonic probe 1 and the diagnostic apparatus main body 2, 2A, 2B, 2C are connected to each other via a cable not shown by wire, but are not limited thereto, and can be connected to each other wirelessly.

[0197] Explanation of Symbols

[0198] 1 - ultrasonic probe, 2, 2A, 2B, 2C - diagnostic apparatus main body, 4 - network, 5 - mammography apparatus, 6 - server, 11 - transducer array, 12 - transceiver circuit, 15 - pulse generator, 16 - amplification section, 17 - AD conversion section, 18 - beam shaper, 21 - image generation section, 22 - display control section, 23 - monitor, 24 - ultrasonic image memory, 25 - synthesized two-dimensional image memory, 26 - region of interest list creation section, 27 - schematic image generation section, 28 - main body side communication section, 29, 29A, 29B, 29C - main body control section, 30 - input device, 31, 31A, 31B, 31C - main body side processor, 32 - signal processing section, 33 - DSC, 34 - image processing section, 35 - emphasis section, 36 - diagnosis opinion display section, 51 - X-ray source, 52 - X-ray detector, 53 - tomographic image, 54, 54A, 54B, R-CC, R-MLO, L-CC, L-MLO - synthesized two-dimensional image, 71 - schematic image, 72 - breast region, 73 - axillary region, 80 - thumbnail image, 81 - list, 82 - ultrasonic image, 83 - sub-window, 84 - emphasis line, 85 - diagnosis opinion, R, R1, R2 - region of interest, C, C1, C2 - slice line, P0, P1 - slice plane.

Claims

1. An ultrasonic diagnostic apparatus comprising: an ultrasonic probe; an image generation section that generates an ultrasonic image that photographs a breast of a subject by using the ultrasonic probe to transmit and receive an ultrasonic beam to the subject; a schematic image generation section that generates a schematic image that depicts a region of interest on the basis of a composite two-dimensional image in one imaging direction, information of a tomographic image that accompanies the composite two-dimensional image and corresponds to the region of interest on the composite two-dimensional image, and information of the region of interest, the composite two-dimensional image being generated using a series of radiographic images that are obtained by tomographic imaging and that photograph the breast of the subject; and a monitor that displays the ultrasonic image, the composite two-dimensional image, and the schematic image.

2. The ultrasonic diagnostic apparatus according to claim 1, wherein the schematic image generation section generates the schematic image that depicts a plurality of the regions of interest on the composite two-dimensional image, respectively.

3. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the ultrasonic diagnostic apparatus comprises: a region of interest list creation section that creates a list of the regions of interest included in the composite two-dimensional image; and an input device through which a user performs an input operation, in the ultrasonic diagnostic apparatus, the list created by the region of interest list creation section is displayed on the monitor, and the schematic image generation section generates the schematic image that depicts the region of interest selected by the user from the list displayed on the monitor via the input device.

4. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the ultrasonic diagnostic apparatus comprises an input device through which a user performs an input operation, the composite two-dimensional image is displayed on the monitor, and in a case where an arbitrary position on the composite two-dimensional image displayed on the monitor is included inside the region of interest as specified by the user via the input device, the schematic image generation section generates the schematic image that depicts the region of interest.

5. The ultrasonic diagnostic apparatus according to claim 3, wherein the ultrasonic diagnostic apparatus comprises an emphasis section that emphasizes and displays on the monitor a region on the composite two-dimensional image that corresponds to the region of interest depicted on the schematic image in a case where the region of interest depicted on the schematic image is specified by the user via the input device.

6. The ultrasonic diagnostic apparatus according to claim 5, wherein the emphasis section displays a sub-window on the composite two-dimensional image in which the region of interest is displayed enlarged.

7. The ultrasonic diagnostic apparatus according to claim 5, wherein the emphasis section surrounds the region of interest on the composite two-dimensional image with an emphasis line.

8. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the schematic image generation section generates the schematic image that includes a slice line that indicates the tomographic image corresponding to the region of interest. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 9. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the ultrasonic diagnostic apparatus is provided with a diagnosis opinion display section that displays a diagnosis opinion for a mammography examination on the monitor together with the schematic image.

10. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein in addition to the ultrasonic image, the synthetic two-dimensional image, and the schematic image being displayed on the monitor, four synthetic two-dimensional images acquired by cranio-caudal photography and medial-lateral oblique photography for the left and right breasts of the subject are also displayed on the monitor in the form of thumbnails.

11. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein in the case where the same region of interest as that drawn on the schematic image is photographed in a synthetic two-dimensional image that is photographed in a different direction from the synthetic two-dimensional image and that photographs the breast of the subject, the synthetic two-dimensional image and the other synthetic two-dimensional image are displayed on the monitor together with the ultrasonic image and the schematic image.

12. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein identification information of the region of interest, a position of the region of interest, and a slice number, a photographing angle of the tomographic image corresponding to the region of interest are stored in a tag accompanying the synthetic two-dimensional image or a file that does not include an image.

13. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the ultrasonic diagnostic apparatus is provided with a memory that stores the synthetic two-dimensional image.

14. A control method of an ultrasonic diagnostic apparatus, comprising: generating an ultrasonic image that photographs a breast of a subject by using an ultrasonic probe to transmit and receive an ultrasonic beam to the subject; generating a schematic image that draws a region of interest in accordance with a synthetic two-dimensional image in one photographing direction, information of a tomographic image accompanying the synthetic two-dimensional image and corresponding to the region of interest on the synthetic two-dimensional image, and information of the region of interest, the synthetic two-dimensional image being generated using a series of radiographic images obtained by tomographic photography and photographing the breast of the subject; and displaying the ultrasonic image, the synthetic two-dimensional image, and the schematic image on a monitor.

Images