Ultrasonic image processor, ultrasonic diagnostic apparatus, ultrasonic image processing method, and program
Patent Information
- Application Number
- JP2023148139
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2023-09-13
- Publication Date
- 2025-03-26
Smart Images
Figure 2025041074000001_ABST
Abstract
Description
[Technical field]
[0001] The embodiments disclosed in this specification and the drawings relate to an ultrasound image processing device, an ultrasound diagnostic device, an ultrasound image processing method, and a program. [Background technology]
[0002] One example of cardiac function evaluation is left ventricular diastolic function evaluation by echocardiography. Left ventricular diastolic function evaluation is performed, for example, by imaging the left ventricular inflow blood flow using an ultrasonic probe and identifying E waves (Early Waves: early diastolic waves) and A waves (Atrium Waves: atrial contraction waves) from the obtained ultrasonic image of a pulse Doppler waveform. Conventionally, there is a technology that automatically detects the wave heights of E waves and A waves in a pulse Doppler waveform using algorithmic calculations.
[0003] However, when atrial fibrillation occurs, the A waves in the pulse Doppler waveform may disappear, which means that conventional technology that automatically detects E and A waves may detect the missing A waves or fail to detect the A waves that were actually present, resulting in false positives. [Prior art documents] [Patent documents]
[0004] [Patent Document 1] JP 2021-164533 A Summary of the Invention [Problem to be solved by the invention]
[0005] The problem to be solved by the embodiments disclosed in this specification and the drawings is to suppress false detection. However, the problem to be solved by the embodiments disclosed in this specification and the drawings is not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems. [Means for solving the problem]
[0006] An ultrasonic image processing device according to an embodiment has a measurement unit, a detection unit, a determination unit, a presentation unit, and a reception unit. The measurement unit measures a change in a detection target detected by an ultrasonic detection element. The detection unit detects a predetermined item from the change in the detection target. The determination unit determines whether a detection result of the item is missing. When the missing item is determined, the presentation unit presents a candidate for the missing detection result. The reception unit receives an input specifying the missing detection result. [Brief description of the drawings]
[0007] [Figure 1] 1 is a block diagram showing an example of the configuration of an ultrasound diagnostic apparatus 1 according to an embodiment. [Diagram 2] 4 is a flowchart showing an example of processing by the ultrasound image processing device 100. [Diagram 3] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 4] FIG. 1 is a diagram showing an example of an ultrasound image. [Diagram 5] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 6] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 7] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 8] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 9] FIG. 1 is a diagram showing an example of an ultrasound image. [Figure 10] FIG. 1 is a diagram showing an example of an ultrasound image. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0008] Hereinafter, an ultrasonic image processing device, an ultrasonic diagnostic device, an ultrasonic image processing method, and a program according to the embodiments will be described with reference to the drawings. In the embodiments, an ultrasonic diagnostic device includes an ultrasonic image processing device. The ultrasonic diagnostic device is installed in, for example, an examination room where a cardiac surgeon (hereinafter, a user) examines patients suffering from cardiac disease, for example, atrial fibrillation.
[0009] 1 is a block diagram showing an example of the configuration of an ultrasonic diagnostic device 1 according to an embodiment. The ultrasonic diagnostic device 1 according to the embodiment includes, for example, an ultrasonic image processing device 100, an ultrasonic probe 101, an ECG (Electrocardiogram) electrode 102, an input interface 103, and a display 104. The ultrasonic probe 101, the ECG electrode 102, the input interface 103, and the display 104 are connected to the ultrasonic image processing device 100.
[0010] The ultrasonic probe 101 transmits and receives ultrasonic waves. For example, the ultrasonic probe 101 is brought into contact with the body surface of the subject P, and transmits and receives ultrasonic waves to and from a region including at least a part of a detection target such as the heart of the subject P. The ultrasonic probe 101 has a plurality of piezoelectric transducers.
[0011] The piezoelectric transducer is a piezoelectric element having a piezoelectric effect that converts between an electric signal (pulse voltage) and mechanical vibration (vibration caused by sound). The piezoelectric transducer generates ultrasonic waves based on a drive signal (electrical signal) supplied by the ultrasonic image processing device 100. The generated ultrasonic waves are reflected by an acoustic impedance mismatch surface in the subject P, and are received by the piezoelectric transducer as a reflected wave signal (electrical signal) including components scattered by scatterers in the tissue. The ultrasonic probe 101 transmits the received reflected wave signal to the ultrasonic image processing device 100.
[0012] The ultrasonic probe 101 may be an ultrasonic probe of any type. For example, the ultrasonic probe 101 may be a 1D array probe having a plurality of piezoelectric transducers arranged one-dimensionally in a predetermined direction, or a 2D array probe in which a plurality of piezoelectric transducers are arranged two-dimensionally in a lattice pattern.
[0013] The ultrasonic probe 101 may be a mechanical 4D probe that scans a three-dimensional region by mechanically vibrating a plurality of piezoelectric transducers arranged one-dimensionally. The ultrasonic probe 101 detects a detection target of the subject P, for example, changes in E waves and A waves in a pulse Doppler waveform. The ultrasonic probe 101 is an example of an ultrasonic detection element.
[0014] The ECG electrodes 102 include an electrode portion that is attached to the patient's skin by, for example, a suction cup. The ECG electrodes detect ECG signals on the patient's body surface as electrical signals. The electrical signals are used to generate an electrocardiogram of the patient. The ECG electrodes 102 output the detected electrical signals to the image processing circuit 140.
[0015] The input interface 103 accepts various input operations by a user and outputs an electrical signal indicating the content of the accepted input operation to the ultrasonic image processing device 100. For example, the input interface 103 is realized by a mouse, a keyboard, a touch panel, a drag ball, a switch, a button, a joystick, a camera, an infrared sensor, a microphone, or the like. The input interface 103 may be provided in a housing. The input interface 103 may also be realized by a display device (e.g., a tablet terminal) capable of wireless communication with the main body of the ultrasonic image processing device 100. The input interface 103 is an example of an input unit.
[0016] In this specification, the input interface is not limited to an interface having physical operation parts such as a mouse, a keyboard, etc. For example, an example of the input interface also includes an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the device and outputs the electrical signal to a control circuit.
[0017] The input interface 103 includes switches meaning, for example, "SET," "NEXT," and "DELETE." For example, when the user operates the "SET" switch, a predetermined setting process is performed in the image processing circuit 140. When the user operates the "NEXT" switch, the process executed in the image processing circuit 140 moves to the next process. When the user operates the "DELETE" switch, a predetermined display shown on the display 104 is erased.
[0018] The display 104 displays various information. For example, the display 104 displays a medical image (ultrasound image) generated by the ultrasound image processing device 100, a GUI (Graphical User Interface) image that accepts various operations by a user, and the like. The ultrasound image may be a two-dimensional ultrasound image or a three-dimensional ultrasound image.
[0019] The display 104 is, for example, a liquid crystal display, a CRT (Cathode Ray Tube), an organic EL (Electroluminescence) display, etc. The display 104 may be a desktop type, or may be a display device (for example, a tablet terminal) capable of wireless communication with the main body of the ultrasound image processing device 100. The display 104 is an example of a display unit.
[0020] The ultrasonic image processing device 100 includes, for example, a transmission / reception circuit 110, a Doppler signal processing circuit 120, a B-mode processing circuit 130, an image processing circuit 140, a memory 150, a control circuit 160, and an ECG unit 170. The transmission / reception circuit 110, the Doppler signal processing circuit 120, the B-mode processing circuit 130, the image processing circuit 140, the memory 150, the control circuit 160, and the ECG unit 170 are communicatively connected to each other.
[0021] The transmission / reception circuit 110 controls the transmission of ultrasonic waves by the ultrasonic probe 101. For example, the transmission / reception circuit 110 applies the above-mentioned drive signal (drive pulse) to the ultrasonic probe 101 at a timing to which a predetermined transmission delay time is added for each transducer based on an instruction from the control circuit 160. By applying the drive signal, the transmission / reception circuit 110 causes the ultrasonic probe 101 to transmit an ultrasonic beam in which ultrasonic waves are focused into a beam shape.
[0022] The transmission / reception circuit 110 controls reception of the reflected wave signal by the ultrasonic probe 101. As described above, the reflected wave signal is a signal that is generated when the ultrasonic wave transmitted from the ultrasonic probe 101 is reflected by the body tissue of the subject P. For example, based on an instruction from the control circuit 160, the transmission / reception circuit 110 applies a predetermined delay time to the reflected wave signal received by the ultrasonic probe 101 and performs an addition process.
[0023] The transmission / reception circuit 110 performs the addition process to emphasize the reflected component from a direction corresponding to the reception directivity of the reflected wave signal. The transmission / reception circuit 110 converts the reflected wave signal after the addition process into an in-phase signal (I signal, I: In-phase) and a quadrature signal (Q signal, Q: Quadrature-phase) in the baseband.
[0024] The transmission / reception circuit 110 transmits the I signal and Q signal (hereinafter, IQ signal) as a reflected wave signal to the Doppler signal processing circuit 120 and the B-mode processing circuit 130. The transmission / reception circuit 110 may convert the reflected wave signal after the addition process into an RF (Radio Frequency) signal and transmit it to the Doppler signal processing circuit 120 and the B-mode processing circuit 130. The IQ signal and RF signal that are the reflected wave signal contain phase information.
[0025] The B-mode processing circuit 130 performs various signal processing on the reflected wave signal generated by the transmission / reception circuit 110. The B-mode processing circuit 130 performs logarithmic amplification, envelope detection processing, etc. on the reflected wave signal transmitted by the transmission / reception circuit 110 to generate B-mode data. The B-mode data is data in which the signal strength of each sample point (observation point) is expressed by the brightness of luminance. The B-mode processing circuit 130 transmits the generated B-mode data to the image processing circuit 140.
[0026] The B-mode processing circuit 130 also executes signal processing for performing harmonic imaging that visualizes harmonic components. Contrast harmonic imaging (CHI) and tissue harmonic imaging (THI) are known as harmonic imaging. In addition, for contrast harmonic imaging and tissue harmonic imaging, known scan methods include amplitude modulation (AM), phase modulation (PM) called "Pulse Subtraction method" and "Pulse Inversion method," and AMPM, which combines AM and PM to obtain both the effects of AM and PM.
[0027] The Doppler signal processing circuit 120 generates Doppler data by extracting motion information based on the Doppler effect of a moving object at each sample point in the scanning region based on the reflected wave signal generated by the transmission / reception circuit 110. The motion information of the moving object is information such as the average speed, variance value, and power value of the moving object. The moving object is, for example, blood flow, tissue such as the heart wall, and contrast agent. The Doppler signal processing circuit 120 transmits the generated Doppler data to the image processing circuit.
[0028] For example, when the moving object is a blood flow, the motion information of the blood flow is information such as the average velocity, variance, and power of the blood flow (blood flow information). The blood flow information is obtained, for example, by a color Doppler method. In the color Doppler method, first, ultrasonic waves are transmitted and received multiple times on the same scanning line, and then, using an MTI (Moving Target Indicator) filter, signals in a specific frequency band are passed through for signals representing a data string of reflected wave data at the same position (same sample point), and signals in other frequency bands are attenuated.
[0029] That is, signals (clutter components) originating from stationary or slow-moving tissues are suppressed. This allows a blood flow signal related to blood flow to be extracted from a signal representing a data string of reflected wave data. In the color Doppler method, blood flow information such as the average velocity, variance value, and power of the blood flow are estimated from the extracted blood flow signal, and the estimated blood flow information is generated as Doppler data. The Doppler data is an example of reflected wave information based on the reflected wave signal.
[0030] The image processing circuit 140 performs generation processing of an ultrasound image, various image processing for the ultrasound image, etc. The image processing circuit 140 includes, for example, a generation function 141, a reception function 142, a measurement function 143, a detection function 144, a determination function 145, an estimation function 146, an extraction function 147, a specification function 148, and a presentation function 149.
[0031] These components are realized, for example, by a hardware processor (computer) executing a program (software) stored in memory 150. The hardware processor refers to circuitry such as a CPU, a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (e.g., a simple programmable logic device (SPLD) or a complex programmable logic device (CPLD), a field programmable gate array (FPGA)), etc. Instead of storing the program in memory 150, the program may be directly incorporated into the circuitry of the hardware processor.
[0032] In this case, the hardware processor realizes the functions by reading and executing the program embedded in the circuit. The hardware processor is not limited to being configured as a single circuit, but may be configured as one hardware processor by combining multiple independent circuits to realize each function. Also, multiple components may be integrated into one hardware processor to realize each function. Each component of the image processing circuit 140 may be distributed and realized by multiple hardware.
[0033] The image processing circuit 140 generates an ultrasound image including E waves and A waves based on the electrical signal transmitted by the ultrasound probe 101. The image processing circuit 140 measures E waves and A waves as changes in the detection target detected by the ultrasound probe 101 based on the generated ultrasound image. The image processing circuit 140 specifies a predetermined item, for example, a point where the wave heights of E waves and A waves are measured in a plurality of detection areas (hereinafter, wave heights), from the measured detection target, and displays it on the display 104 together with an ultrasound image including the measured E waves and A waves. The detection area is set, for example, one detection area per heartbeat according to the heartbeat of the subject. For this reason, the detection area is set, for example, between one wave height measurement point and the next wave height measurement point of the E wave.
[0034] The image processing circuit 140 divides the ultrasound image into a plurality of detection regions based on, for example, the wave height measurement points of the E wave. The image processing circuit 140 determines whether or not there is a missing wave height measurement point of the A wave in any of the plurality of detection regions. The image processing circuit 140 causes the display 104 to display the ultrasound image and the wave height measurement points of the E wave and the A wave, excluding the missing wave height measurement point of the A wave.
[0035] When it is determined that a wave-height measurement point of the A wave is missing, the image processing circuit 140 presents candidates for wave-height measurement points in the detection region where the wave-height measurement point is missing by displaying them on the display 104. For example, the image processing circuit 140 presents candidates for the wave-height measurement point of the A wave by designating a point on the A wave with a cursor.
[0036] A user operating the ultrasound image processing device 100, for example, operates the input interface 103 while viewing the display on the display 104 to specify an A-wave height measurement point. The image processing circuit 140 receives height information on the missing A-wave height measurement point based on the electrical signal output by the input interface 103. The height information includes, for example, information on the measurement order and measurement items of the height measurement points. Based on the received height information, the image processing circuit 140 sets an A-wave height measurement point in the detection region where an A-wave height measurement point is missing, and displays it on the display 104.
[0037] The generating function 141 acquires reflected wave information based on the reflected wave signal transmitted by the ultrasound probe 101, for example, B-mode data or Doppler data transmitted by the transmitting / receiving circuit 110 or the Doppler signal processing circuit 120. The image processing circuit 140 includes the transmitting / receiving circuit 110, the Doppler signal processing circuit 120, and the B-mode processing circuit 130, and the generating function 141 may be configured to directly acquire the reflected wave signal as the reflected wave information.
[0038] The generating function 141 generates, for example, two-dimensional B-mode image data in which the intensity of the reflected wave is expressed as brightness, based on the two-dimensional B-mode data generated by the B-mode processing circuit 130 and acquired by the generating function 141. The generating function 141 also generates, as an ultrasound image, two-dimensional Doppler image data in which blood flow information is visualized, based on the two-dimensional Doppler data generated by the Doppler signal processing circuit 120 and acquired by the generating function 141.
[0039] The two-dimensional Doppler image data is velocity image data that represents the average velocity of the blood flow, variance image data that represents the variance value of the blood flow, power image data that represents the power of the blood flow, or image data that is a combination of these. The generation function 141 generates, as the Doppler image data, color Doppler image data in which blood flow information such as the average velocity, variance value, and power of the blood flow are displayed in color, or generates Doppler image data in which one blood flow information is displayed in grayscale.
[0040] The generating function 141 generally converts (scan converts) a scan line signal sequence of an ultrasonic scan into a scan line signal sequence of a video format represented by a television, etc., and generates an ultrasonic image for display. Specifically, the generating function 141 generates an ultrasonic image of a Doppler waveform including E waves and A waves.
[0041] The reception function 142 receives information corresponding to the electrical signal output by the input interface 103. For example, when a user operates the input interface 103 to input information related to the wave height measurement point and the input interface 103 outputs the wave height information, the reception function 142 receives wave height information specifying the wave height measurement point of wave A corresponding to the user's input operation. The reception function 142 is an example of a reception unit.
[0042] The measurement function 143 measures a pulse Doppler waveform as a change in the detection target detected by the ultrasound probe 101 in the ultrasound image generated by the generation function 141. The measurement function 143 measures E waves and A waves by performing an algorithmic operation on the measured pulse Doppler waveform. The measurement function 143 is an example of a measurement unit.
[0043] The detection function 144 detects the wave height measurement points of the E wave based on the measurement result by the measurement function 143. The detection function 144 divides the ultrasound image into a plurality of detection areas based on the detected wave height measurement points. The detection function 144 detects the wave height measurement points of the A wave in each of the plurality of detection areas from within the ultrasound image. The detection function 144 is an example of a detection unit.
[0044] The determination function 145 determines whether or not a wave-height measurement point of the A wave is missing in the detection function 144, based on the wave-height measurement point of the A wave detected by the detection function 144. For example, the determination function 145 determines whether or not a wave-height measurement point of the A wave is present in each of a plurality of detection areas, and determines that a wave-height measurement point of the A wave is missing in a detection area where there is no wave-height measurement point. The determination function 145 is an example of a determination unit.
[0045] The estimation function 146 estimates the wave height measurement point of the A wave, which is missing from the measurement by the measurement function 143, among the A waves included in the ultrasound image. For example, when wave height information specifying the wave height measurement point of the A wave is output in the previously captured ultrasound image, the estimation function 146 estimates the wave height measurement point based on the position indicated in the wave height information. The estimation function 146 is an example of an estimation unit. The estimated wave height measurement point is an example of the missing position.
[0046] The extraction function 147 extracts, for example, wave height measurement points on the A wave as candidates for the A wave height measurement points. The extraction function 147 is an example of an extraction unit. The candidates for the A wave height measurement points extracted by the extraction function 147 may be derived in any manner, and for example, a point with the highest numerical value may be derived as a candidate for the A wave height measurement point from the A wave waveform in a specific region, or a point corresponding to a wave height measurement point detected in the past, for example, when the A wave waveform was measured last time, may be derived as a candidate for the A wave height measurement point.
[0047] Alternatively, the candidate wave height measurement point may be a wave height measurement point derived based on wave height information previously transmitted and input by the input interface 103 and accepted by the acceptance function 142. When multiple candidates for wave height measurement points are derived, the extraction function 147 extracts one candidate from these. When multiple candidates for wave height measurement points are derived, the extraction function 147 extracts the derived candidate as is.
[0048] More specifically, for an E wave, it may be the time from the R wave of the electrocardiogram, and for an A wave, it may be the time from the E wave, and the flow velocity may be the same value. Candidates for the A wave height measurement point are displayed, for example, on the display 104. For example, the user operates the input interface 103 while looking at the display of candidates for the A wave height displayed on the display 104 to specify the A wave height measurement point.
[0049] The identifying function 148 judges whether or not wave height information in which a user has specified a candidate wave height measurement point as a wave height measurement point has been output by the input interface 103. When wave height information in which a user has specified a candidate wave height measurement point as a wave height measurement point has been output, the identifying function 148 identifies the candidate wave height measurement point as a wave height measurement point. The identifying function 148 is an example of an identifying unit.
[0050] When it is determined that a wave A wave height measurement point is missing, the presentation function 149 presents candidates for the missing wave A wave height measurement point. The candidates for wave height measurement points are estimated, for example, by the estimation function 146. The candidates for wave height measurement points may be candidates other than the candidates estimated by the estimation function 146. The candidates for wave height measurement points may be, for example, predetermined points in the detection area, such as the center point in the time direction. The presentation function 149 is an example of a presentation unit.
[0051] The memory 150 is, for example, a semiconductor memory element such as a random access memory (RAM) or a flash memory, or a storage device such as a hard disk or an optical disk. The memory 150 stores image data such as B-mode image data or Doppler image data. The memory 150 may store image data such as B-mode data or Doppler data. The data stored in the memory 150 can be called up by a user or the like after a diagnosis, for example.
[0052] The memory 150 can transfer control programs for transmitting and receiving ultrasound, processing images, and displaying images, diagnostic information (e.g., patient ID, user's findings, etc.), and data stored in the memory 150 to an external device via a communication interface (not shown). The external device is, for example, a PC (Personal Computer) used by a doctor or the like who performs image diagnosis, a storage medium such as a CD or DVD, a printer, etc. The memory 150 does not need to be built in the ultrasound image processing device 100 as long as the ultrasound image processing device 100 can access the memory 150 on a network.
[0053] The control circuit 160 controls the overall processing of the ultrasound diagnostic apparatus 1. Specifically, the control circuit 160 controls processing in the transmission / reception circuit 110, the Doppler signal processing circuit 120, the B-mode processing circuit 130, the image processing circuit 140, etc., based on various setting requests input via the input interface 103 and various control programs and various data read from the memory 150.
[0054] The ECG unit 170 acquires the ECG signal output by the ECG electrodes 102. The ECG unit 170 performs various processes including digitalization on the output ECG signal. The ECG unit 170 outputs the ECG signal after digitalization to the image processing circuit 140. The ECG electrodes 102 and the ECG unit 170 form an electrocardiograph, for example, a vector electrocardiograph.
[0055] Next, a description will be given of the processing in the ultrasonic image processing device 100. For example, the ultrasonic image processing device 100 is equipped with a pulse Doppler mode (hereinafter, measurement mode) and a correction mode as processing modes. In the measurement mode, the ultrasonic image processing device 100 performs automatic measurement of the ultrasonic image from generation of the ultrasonic image, and then performs correction of the ultrasonic image in the correction mode.
[0056] Fig. 2 is a flowchart showing an example of processing by the ultrasonic image processing device 100. The processing shown in Fig. 2 is processing when a user (doctor or technician) performs an echocardiogram when there is a possibility of some kind of cardiac disease. The processing shown in Fig. 2 includes processing that is repeated in the ultrasonic image processing device 100. When starting the processing shown in Fig. 2, the ultrasonic image processing device 100 is set to a measurement mode.
[0057] The image processing circuit 140 in the ultrasonic image processing device 100 first acquires the Doppler data and B-mode data generated and transmitted by the Doppler signal processing circuit 120 and the B-mode processing circuit 130 using the generation function 141 (step S101). Next, the generation function 141 collects basic cross sections such as a parasternal long axis cross section of the left ventricle based on the acquired Doppler data and B-mode data, and then collects a left ventricular inflow waveform in pulse Doppler mode to generate an ultrasonic image (step S103).
[0058] When the ultrasonic image is generated by the generation function 141, the measurement function 143 automatically measures E waves and A waves in the pulse Doppler waves included in the ultrasonic image in order to evaluate the diastolic function of the left ventricle (step S105). The measurement function 143 automatically measures multiple heartbeats simultaneously.
[0059] Furthermore, the measurement function 143 specifies the wave heights and wave height measurement points of the E wave and A wave in the pulse Doppler waveform. The presentation function 149 displays on the display 104 an ultrasound image including the pulse Doppler wave formed by the measurement function 143 and the specified wave heights and wave height measurement points of the E wave and A wave.
[0060] 3 to 10 are diagrams showing examples of ultrasonic images. In FIG. 3, a first ultrasonic image IM11 is displayed, which includes a pulse Doppler waveform, an E wave marker indicating an E wave height measurement point on the pulse Doppler waveform, and an A wave marker indicating an A wave height measurement point. The first ultrasonic image is displayed, for example, on a display 104. The E wave marker is displayed with the character symbol "n MV E Vel" (n=1 to 5), and the A wave marker is displayed with the character symbol "n MV A Vel" (n=1 to 5). In an echocardiographic examination, since the left ventricular inflow blood flow is imaged, the A wave height measurement point is usually identified following the E wave height measurement point.
[0061] Here, a procedure for generating an ultrasonic image in which an E wave marker and an A wave marker are displayed will be described. For example, the ultrasonic image processing device 100 measures E waves and A waves by performing an algorithmic operation on the pulse Doppler waveform included in the ultrasonic image generated by the generation function 141 in the measurement function 143. The presentation function 149 displays a second ultrasonic image IM12 showing the continued E waves and A waves on the display 104 as shown in FIG.
[0062] After the measurement function 143 measures the E waves and A waves and the first ultrasound image IM11 is displayed on the display 104, the detection function 144 detects the wave height measurement points of the E waves and the A waves based on the measurement results by the measurement function 143. The presentation function 149 displays on the display 104 a third ultrasound image IM13 including an E wave marker "n MV E Vel" (n=1 to 5) and an A wave marker "n MV A Vel" near the wave height measurement points, as shown in FIG.
[0063] When the automatic measurement is completed, the ultrasonic image processing device 100 shifts the processing mode from the measurement mode to the correction mode (step S107). The shift of the processing mode may be performed automatically when the automatic measurement is completed, or may be performed in response to the user's operation of the input interface 103.
[0064] The ultrasonic image processing device 100 that has been shifted to the correction mode determines and lists erroneous detection areas including erroneous detection of the wave height measurement points of the A wave (step S109). The determination of the erroneous detection areas may be performed automatically by the determination function 145, for example, or may be performed based on a user's designation.
[0065] There are, for example, three patterns of erroneous detection of the A wave height measurement point. These patterns will be described with reference to Figs. 5 and 6. Fig. 5 shows a third ultrasound image IM13 on which an E wave marker and an A wave marker in a pulse Doppler wave are displayed. In the third ultrasound image IM13, the first E wave marker "1 MV E Vel" to the fifth E wave marker "5 MV E Vel", the first A wave marker "1 MV A Vel", the third A wave marker "3 MV A Vel" to the fifth A wave height measurement point "5 MV A Vel" are displayed.
[0066] The first pattern is erroneous detection, which detects a wave height measurement point that does not actually exist. In the third ultrasound image IM13 shown in Fig. 5, the first A wave height measurement point is detected between the first E wave height measurement point and the second E wave height measurement point. However, when atrial fibrillation occurs, the A wave may disappear, and in this case, the A wave at this position has actually disappeared. The first pattern is a false detection that the wave height of the first A wave height measurement point is measured in the automatic measurement at this time. The false detection of the first pattern may be determined by the determination function 145, or may be specified by a user who has viewed the third ultrasonic image IM13 and operated the input interface 103 to input.
[0067] The second pattern is erroneous detection in which a wave height measurement point is omitted. In the third ultrasound image IM13 shown in Fig. 5, the A wave height measurement point is not displayed between the second E wave height measurement point and the third E wave height measurement point. This phenomenon occurs because the measurement of the A wave height between the second E wave height measurement point and the third E wave height measurement point is omitted in the automatic measurement. The determination function 145 determines that the wave height measurement point has been erroneously detected when the A wave height measurement point is not included between the E wave height measurement points.
[0068] On the other hand, when atrial fibrillation occurs, A waves may actually disappear, so the absence of measurement of the A wave height may not be a false positive. Therefore, even if the determination function 145 determines the absence of measurement as a false positive as the second pattern, it may not be a false positive, so the user ultimately determines whether or not it is a false positive and operates the input interface 103 according to the determination result.
[0069] The third pattern is erroneous detection in which the position of the measured wave height measurement point is incorrect. In the third ultrasound image IM13 shown in Fig. 5, the fifth A wave height measurement point is detected between the fourth E wave height measurement point and the fifth E wave height measurement point, but the position of the fifth A wave height measurement point is actually a position shifted to the left from this position. This erroneous detection may be determined by the determination function 145, or may be specified by a user who has viewed the third ultrasound image IM13 and operated the input interface 103 to input.
[0070] In the fourth ultrasound image IM14 shown in Fig. 6, the contents of the erroneous detection are displayed. For the erroneous detection corresponding to the first pattern, a first message image MA11 stating "False detection despite absence of A wave" is displayed. For the erroneous detection corresponding to the second pattern, a second message image MA12 stating "Detection failed despite presence of A wave" is displayed. For the erroneous detection corresponding to the third pattern, a third message image MA13 stating "Position of A wave incorrect" is displayed. The first message image MA11 to the third message image MA13 may not be displayed.
[0071] The determination function 145 determines whether or not the ultrasound image includes a false detection area as a result of listing up the false detection areas including the false detection of the wave height measurement points of the A wave (step S111). If the determination function 145 determines that the ultrasound image does not include a false detection area by listing up no false detection areas including false detection, the ultrasound image processing device 100 ends the process shown in FIG.
[0072] When the erroneous detection area including the erroneous detection is listed and the determination function 145 determines that the ultrasound image includes the erroneous detection area, the presentation function 149 places the cursor displayed on the display 104 in the erroneous detection area (step S113). When the cursor is placed in a position other than the erroneous detection area, the presentation function 149 moves the cursor to the erroneous detection area and places it there, and when the cursor is placed in the position of the erroneous detection area, the presentation function 149 leaves it as it is.
[0073] Next, the determination function 145 determines whether the erroneous detection of the wave A wave height measurement point is a missing wave height measurement point, which is the second pattern (step S115). When it is determined that the erroneous detection of the wave A wave height measurement point is not the second pattern, the determination function 145 advances the process directly to step S119.
[0074] When the determination function 145 determines that the erroneous detection of the A wave height measurement point is a missing wave height measurement point, which is the second pattern, the presentation function 149 displays an erroneous detection area designation frame GA10 where there is a missing point, as in the fifth ultrasound image IM15 shown in Fig. 7, to surround the erroneous detection area. By surrounding the erroneous detection area with the erroneous detection area designation frame GA10, the presentation function 149 notifies the user that there is a possibility of erroneous detection of the A wave height measurement point. The erroneous detection area designation frame GA10 is an example of missing information.
[0075] The left and right ends of the false positive area designation frame GA10 are basically the times of the measurements that were detected, but because it is expected that there will be a certain clinical time difference from that measurement, there can be a certain time difference. Note that in this example, there is only one false positive area and one false positive wave height measurement point, but as a result of automatic measurement, multiple false positive areas and false positive wave height measurement points may be listed depending on the screen measured by automatic measurement and the type of automatic measurement.
[0076] For example, if the erroneous detection is the first or third pattern, the user can recognize the erroneous detection from the waveforms of the E and A waves. On the other hand, if the erroneous detection is the second pattern, there is a possibility that the erroneous detection of the second pattern will be overlooked by mistaking it for the disappearance of A waves due to atrial fibrillation. In response to this, the presentation function 149 displays the erroneous detection area designation frame GA10 and the symbolic characters "MV A Vel" on the display 104 when there is a possibility of erroneous detection of the second pattern. This prevents the user from overlooking the erroneous detection, contributing to suppression of erroneous detection.
[0077] Next, the estimation function 146 estimates wave-height measurement points of A waves that are missing from the measurement by the measurement function 143, among the A waves included in the ultrasound image. Furthermore, the extraction function 147 derives and extracts candidates for the wave-height measurement points estimated by the estimation function 146. The presentation function 149 displays on the display 104, within the erroneous detection region designation frame GA10, the symbol characters "MV A Vel" indicating the wave-height measurement points estimated by the estimation function 146, as candidates for the missing wave-height measurement points on the pulse Doppler waveform (step S117).
[0078] Next, the user visually checks the pulse Doppler waveform and candidate wave height measurement points included in the ultrasound image displayed on the display 104 to check whether there is any erroneous detection. The user checks whether there is any erroneous detection of the first pattern and the third pattern, for example, from the relationship between the E wave and the A wave in the pulse Doppler waveform, for example, the relationship between the wave height measurement points of the E wave and the wave height measurement points of the A wave. Furthermore, the user checks whether there is any erroneous detection of the second pattern by the presence or absence of wave height measurement points of the A wave between the wave height measurement points of the E wave and the display of candidate wave height measurement points.
[0079] When the user confirms that a wave height measurement point has been erroneously detected, the user operates the input interface 103 to input information on the measurement order and measurement items of the erroneously detected wave height measurement point. The input interface 103 generates wave height information based on the input information and outputs it to the image processing circuit 140.
[0080] The image processing circuit 140 receives the outputted wave height information through the reception function 142. The presentation function 149 inputs the measurement order and measurement items of the wave height measurement points according to the wave height information received by the reception function 142, and displays them on the display 104 (step S119). The measurement order is the order in which the wave heights in the pulse Doppler waveform are measured, and the measurement items here are the wave height measurement points, that is, the wave height measurement points of the E wave and the A wave. By displaying the measurement order and measurement items based on the wave height information, information on the wave height measurement points of the pulse Doppler waveform that has been erroneously detected is corrected.
[0081] For example, when the false detection is the second pattern, the A wave marker is not displayed between the second E wave marker and the third E wave marker on the display 104, and the false detection area designation frame GA10 is displayed. Here, the measurement order and measurement items according to the wave height information output by the input interface 103 based on the user's operation are additionally displayed on the display 104. FIG. 8 is an example in which the measurement order and measurement items according to the wave height information are additionally displayed on the display 104. As the measurement order and measurement items according to the A wave height information, the A wave height measurement point in the false detection area is indicated by an arrow image YA10, and the additional A wave marker "Add 2 MV A Vel" is displayed at the indicated position. The presentation function 149 displays the additional A wave marker "Add 2 MV A Vel", which is the result of correcting the candidate wave height measurement point in the false detection area based on the wave height information, on the display 104 together with the detection area marker other than the false detection area.
[0082] Furthermore, when the false detection is the first pattern, the user compares, for example, the waveform of the E wave with the waveform of the A wave while viewing the second ultrasound image IM12 shown in Fig. 4 or the third ultrasound image IM13 shown in Fig. 5. It is assumed that the user determines that a portion of the waveform of the A wave where something feels strange, for example, the first A wave height measurement point, is actually a portion where the A wave has disappeared, and operates the input interface 103. In this case, as shown in Fig. 9, the wave height measurement point is indicated by an arrow image YA11, and the presentation function 149 erases the first A wave marker "1 MV E Vel".
[0083] Also, in the case where the false detection is the third pattern, as in the case where the false detection is the first pattern, the user compares, for example, the waveform of the E wave with the waveform of the A wave while looking at the second ultrasound image IM12 shown in FIG. 4 or the third ultrasound image IM13 shown in FIG. 5. In the waveform of the A wave, there is a part where something feels wrong, for example, there are two peaks in the waveform of the A wave between the fourth E wave height measurement point and the fifth E wave height measurement point. Although the fourth A wave marker "4 MV A Vel" is displayed on one of the two peaks (the later one in time), the doctor may actually determine that the other of the two peaks (the earlier one in time) is the actual wave height measurement point. In this case, the presentation function 149 displays an image indicating the fourth A wave marker "4 MV A Vel" that is the false detection on the display 104 by using an arrow image YA12 as shown in FIG. 10. The presentation function 149 moves the 4th A wave marker “4 MV A Vel” corresponding to the wave height information output by the input interface 103 based on the user's operation to the left, and corrects the measurement order and measurement items on the display 104 and displays them on the display 104.
[0084] Next, the determination function 145 determines whether or not another erroneous detection is included in the erroneous detection area (step S121), for example, in accordance with the user's operation of the input interface 103. The determination in step S121 may be performed without depending on the user's operation of the input interface 103.
[0085] If it is determined that the erroneous detection region contains another erroneous detection, the determination function 145 returns the process to step S115 and repeats the same process. If it is determined that the erroneous detection region does not contain another erroneous detection, the determination function 145 determines whether or not there is an erroneous detection region in another region (step S123).
[0086] If the determination function 145 determines that there is a false detection region in the other detection regions, the presentation function 149 moves the cursor to the false detection region (step S125), returns the process to step S115, and repeats the same process. If the determination function 145 determines that there is no false detection region in the other detection regions, the ultrasound image processing device 100 ends the process shown in FIG.
[0087] When it is determined that a false detection of a missing wave-height measurement point has occurred, the ultrasonic image processing device 100 of the embodiment presents candidates for the missing wave-height measurement point and accepts an input for specifying the missing wave-height measurement point, thereby making it possible to suppress false detection of a wave-height measurement point in a pulse Doppler waveform.
[0088] In the above embodiment, the erroneous detection of A wave is judged, but the erroneous detection of waves other than A wave may be judged, for example, the erroneous detection of A wave and E wave may be detected. In this case, for example, an arbitrary detection area may be set, and when there are multiple wave height measurement points that could not be detected within the detection area, multiple wave height measurement points may be added. For example, in the detection area, it may be impossible to detect the wave height measurement points of E wave as well as the wave height measurement points of A wave. In this case, the target to be added may be switched between the wave height measurement points of A wave and the wave height measurement points of E wave, and the additional A wave marker "Add 2 MV A Vel" and the additional E wave marker "Add 2 MV E Vel" may be displayed, respectively.
[0089] Also, when there are multiple candidates to add, which one is displayed first may be determined based on the position of the cursor. Specifically, since E waves are clinically displayed to the left of A waves, when the cursor is in the left half of the detection area, an additional E wave marker "Add 2 MV E Vel" may be displayed, and when it is in the right half, an additional A wave marker "Add 2 MV A Vel" may be displayed.
[0090] According to at least one of the embodiments described above, erroneous detections can be suppressed by having a measurement unit that measures changes in the detection target detected by the ultrasonic detection element, a detection unit that detects specified items from the changes in the detection target, a determination unit that determines whether the detection results of the items are missing, a presentation unit that presents candidates for the missing detection results when the missing items are determined, and a reception unit that receives input specifying the missing detection results.
[0091] Although some embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope of the invention and its equivalents as described in the claims, as well as in the scope and spirit of the invention. [Explanation of symbols]
[0092] 1. Ultrasound diagnostic equipment 100...Ultrasonic image processing device 101...Ultrasonic probe 102...ECG electrode 103...Input interface 104…Display 110...Transmitting and receiving circuit 120...Doppler signal processing circuit 130...B mode processing circuit 140...Image processing circuit 141…Generation function 142…Reception function 143…Measurement function 144…Detection function 145…Judgment function 146…Estimated function 147…Extraction function 148...Specific functions 149…Presentation function 150…Memory 160...Control circuit 170…ECG unit IM11…First ultrasound image IM12: Second ultrasound image IM13…Third ultrasound image IM14: 4th ultrasound image IM15: 5th ultrasound image MA11…First message image MA12…Second message image MA13…Third message image P...Subject
Claims
1. a measurement unit that measures a change in the detection target detected by the ultrasonic detection element; A detection unit that detects a predetermined item from among changes in the detection target; A determination unit that determines whether the detection result of the item is missing; a presentation unit that presents candidates for the missing detection result when the missing detection result is determined; and a receiving unit that receives an input specifying the missing detection result. Ultrasound imaging device.
2. the candidates for the detection result are derived based on the input previously accepted by the accepting unit; The ultrasound imaging apparatus of claim 1 .
3. the presentation unit presents at least one candidate for the missing detection result when it is determined that a plurality of the detection results are missing; the receiving unit receives the input of a detection result designated from among presented candidates of the detection result; The ultrasound imaging apparatus of claim 1 .
4. The measurement unit measures changes in the detection target in a plurality of detection areas, the candidate for the detection target in the detection area in which the absence is determined is derived based on a detection result in the detection area in which the detection target is detected. The ultrasound imaging apparatus of claim 1 .
5. The measurement unit measures changes in the detection target in a plurality of detection areas, the presentation unit presents a result of correcting the detection target candidates in the detection area determined to be missing based on the input, together with the detection result in the detection area not determined to be missing. The ultrasound imaging apparatus of claim 1 .
6. The presentation unit presents missing information notifying the missing portion when a missing portion is determined in the detection result. The ultrasound imaging apparatus of claim 1 .
7. an estimation unit that estimates a missing position of the detection object that is missing from the measurement among the changes of the detection object; an extraction unit that extracts candidates for the detection target at the estimated missing position; a receiving unit that receives a designation of a candidate for the detection target in a change in the detection target; and a specification unit that specifies the candidate for the detection target as the detection target at the missing position when the specification is received. The ultrasound imaging apparatus of claim 1 .
8. an ultrasonic detection element for detecting a change in a detection target of a subject; an input unit that allows a user to specify a missing position of the detection target based on an input operation; An ultrasonic image processing device according to any one of claims 1 to 7, A display unit that displays the change in the detection target and the candidates for the detection target. Ultrasound diagnostic equipment.
9. The computer Measure the change in the detection target detected by the ultrasonic detection element; Detecting a predetermined item from among the changes in the detection target; Determining whether the detection result of the item is missing; presenting candidates for the missing detection results when the missing detection results are determined; Accepting an input specifying the missing detection results; Ultrasound imaging methods.
10. On the computer, Measure the change in the detection target detected by the ultrasonic detection element; Detecting a predetermined item from among the changes in the detection target; Determining whether the detection result of the item is missing; presenting candidates for the missing detection results when the missing detection results are determined; and accepting an input specifying the missing detection result. program.
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Device and program
JP2021164533A