Dynamic image processing device, mobile visiting car, dynamic image processing method, and dynamic image processing program

Abstract

To recognize a topical ventilation state of a lung without imposing a burden on a patient and set an optimum setting value for an artificial respirator.SOLUTION: A dynamic image processing device includes: an extraction unit that extracts information related to a setting value of a respiration auxiliary device by processing a dynamic image obtained by irradiating a lung of a subject attached with the respiration auxiliary device with a radiation ray and imaging the lung; and an output unit that outputs information.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to a dynamic image processing device, a medical cart, a dynamic image processing method, and a dynamic image processing program. [Background technology]

[0002] For patients who are on a ventilator, especially those who are unconscious, it is necessary to set the ventilator to the optimal value to prevent atelectasis and lung damage. The ventilation volume can be determined from the ventilator, but the ventilator only sees the lung as a balloon and cannot grasp the local ventilation state of the lung. In order to prevent atelectasis and lung damage, it is necessary to grasp the local ventilation state of the lung and set the ventilator to the optimal value.

[0003] A method using EIT (Electrical Impedance Tomography) is known as a method for observing the local ventilation state of the lungs (for example, Patent Document 1). In this method, a belt with electrodes is attached to the patient's chest, the impedance (electrical resistance) of the lungs is measured, and changes in the ventilation (aeration) state are observed from the changes in impedance. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2013-063186 A Summary of the Invention [Problem to be solved by the invention]

[0005] EIT is used exclusively by one patient, and in facilities with only a few machines, it is difficult to share it between patients at the same time, and there are problems with the risk of moving the patient when putting on the EIT belt and the risk of bed sores caused by the belt. In addition, there are risks associated with transporting patients on ventilators (for example, patients in intensive care units) to a CT (Computed Tomography) room for detailed examination.

[0006] Therefore, it is desirable to grasp the local ventilation state of the lungs and set optimal settings for the artificial ventilator without placing a burden on the patient.

[0007] An object of the present invention is to provide a dynamic image processing device, a dynamic image processing method, and a dynamic image processing program that can grasp the local ventilation state of the lungs and set optimal settings for an artificial ventilator without placing a burden on the patient. [Means for solving the problem]

[0008] The dynamic image processing device according to the present invention comprises: an extraction unit that extracts information about a setting value of a respiratory assistance device by processing a dynamic image captured by irradiating radiation on the lungs of a subject wearing the respiratory assistance device; An output unit that outputs the information; Equipped with.

[0009] The medical cart according to the present invention comprises: The dynamic image processing device, a dynamic image capturing device that captures the dynamic image and inputs the dynamic image to the dynamic image processing device; A dolly on which the dynamic image processing device and the dynamic image capturing device are mounted and configured to be movable; Equipped with.

[0010] The dynamic image processing method according to the present invention comprises the steps of: extracting information about settings of a respiratory assistance device by processing dynamic images captured by irradiating the lungs of a subject wearing the respiratory assistance device; The information is output.

[0011] The dynamic image processing program according to the present invention comprises: On the computer, extracting information about settings of a respiratory assistance device by processing dynamic images captured by irradiating the lungs of a subject wearing the respiratory assistance device with radiation; A process of outputting the information; Execute the command. Effect of the Invention

[0012] According to the present invention, it is possible to grasp the local ventilation state of the lungs and set optimal settings for the artificial ventilator without placing a burden on the patient. [Brief description of the drawings]

[0013] [Figure 1] FIG. 1 is a diagram showing a schematic diagram of a medical cart equipped with a dynamic image processing device and a dynamic image capturing device according to an embodiment of the present invention. [Diagram 2] FIG. 2 is a block diagram for explaining the mobile medical cart shown in FIG. [Diagram 3] FIG. 3 is a diagram showing an example of a dynamic image processed in the PL mode (in which the amount of change in the extracted signal is visualized). [Figure 4] FIG. 4 is a graph showing the left / right ratio of the signal change amount in the left and right lungs extracted in PL mode in a plurality of dynamic images with different ventilator settings, corresponding to the setting value. [Diagram 5] Figure 5 is a graph showing the signal change amount during inspiration and expiration in relation to the setting value for each of the left and right lungs and both lungs extracted in PL mode in multiple dynamic images with different ventilator setting values. [Figure 6] FIG. 6 is a graph showing the collapse rate and the overdevelopment rate in relation to set values ​​for the rate of the collapsed area to the entire lung field and the rate of the overdeveloped area to the entire lung field. [Figure 7] FIG. 7 is a diagram showing an example in which a lung field is divided into a plurality of regions in a dynamic image captured by a dynamic image capturing device. [Figure 8A] FIG. 8A is a graph showing the left / right ratio of the upper lung, calculated as the left / right ratio of the signal change amount in the left / right upper lung extracted in PL mode in multiple dynamic images with different ventilator settings, in correspondence with the setting value. [Figure 8B] Figure 8B is a graph showing the left / right ratio of the middle lung, calculated as the left / right ratio of the signal change amount on the left and right sides of the middle lung extracted in PL mode in multiple dynamic images with different ventilator setting values, corresponding to the setting value. [Figure 8C] Figure 8C is a graph showing the left / right ratio of the lower lung, calculated as the left / right ratio of the signal change amount in the left / right lower lung extracted in PL mode in multiple dynamic images with different ventilator setting values, corresponding to the setting value. [Figure 9] Figure 9 is a graph showing the signal change amount between exhalation and inspiration corresponding to the date and time for each of the left and right lungs and both lungs extracted in PL mode in multiple dynamic images taken at different dates and times. [Figure 10] FIG. 10 is a table showing the left / right ratio and respiratory settings corresponding to the date and time, calculated as the signal change amount in the left and right lungs extracted in PL mode from multiple dynamic images taken at different dates and times. [Figure 11] FIG. 11 is a diagram showing an example in which a dynamic image and a plurality of graphs are displayed simultaneously. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[0015] [Medical car] Fig. 1 is a diagram showing a mobile medical cart 10 equipped with a dynamic image processing device 100 and a dynamic image capturing device 200 according to the present embodiment. Fig. 2 is a block diagram showing the mobile medical cart 10 shown in Fig. 1. Fig. 1 shows an example of the mobile medical cart 10 in use.

[0016] The mobile cart 10 includes a dynamic image processing device 100 and a dynamic image capturing device 200. The mobile cart 10 is configured to move so as to be able to approach a patient P (subject) wearing an artificial ventilator 300. The artificial ventilator 300 is an example of a respiratory assistance device according to the present invention.

[0017] Here, a brief description will be given of the ventilator 300. The ventilator 300 is a device that performs mechanical ventilation and artificial respiration by feeding breathing gas into and out of the lungs to assist the breathing of a patient P who cannot breathe or has insufficient breathing. There are several methods for attaching the ventilator 300, but for a patient P in an intensive care unit, for example, tracheal intubation, in which a tube 301 is inserted into the trachea from the mouth or nose, or tracheotomy, in which the trachea is incised and the tube 301 is inserted into the trachea, is used.

[0018] It is desirable to set optimal settings (optimum settings) in the artificial ventilator 300, and in this embodiment, as described later, the dynamic image processing device 100 acquires information about the settings and presents the information to the user, a medical professional. The dynamic image processing device 100 may also be configured to determine the optimal settings, as described later.

[0019] Therefore, the dynamic image processing device 100 is configured to acquire information on the setting value of the artificial ventilator 300 by processing the dynamic image input from the dynamic image capturing device 200. Moreover, the dynamic image capturing device 200 is configured to capture a dynamic image of the lungs of the patient P and input it to the dynamic image processing device 100. The dynamic image is an image capturing the movement of the affected area (here, the lungs) of the patient P.

[0020] Here, the dynamic image processing device 100 and the dynamic image capturing device 200 are mounted on a medical cart 10, as an example, and configured so that dynamic images can be input from the dynamic image capturing device 200 to the dynamic image processing device 100.

[0021] In addition, the dynamic image processing device 100 does not necessarily have to be mounted on the medical cart 10 as long as it is configured to be able to input dynamic images from the dynamic image capturing device 200. For example, the dynamic image processing device 100 may be connected to the dynamic image capturing device 200 via wireless communication or the like and configured to be able to input dynamic images.

[0022] The dynamic image processing device 100 and the dynamic image capturing device 200 provided in the medical cart 10 will be described below, together with other configurations.

[0023] (Dynamic image capture device) First, a dynamic image capturing apparatus 200 will be described. The dynamic image capturing apparatus 200 includes a radiation generating apparatus 210, a radiation detecting apparatus 220, an arm 230, and the like. The dynamic image capturing apparatus 200 has a plurality of imaging modes, such as a dynamic imaging mode and a fluoroscopic imaging mode, as imaging modes. Hereinafter, the dynamic imaging mode will be mainly described.

[0024] (Dynamic image capture device - Radiation generator) The radiation generating device 210 includes a generator 211 and a collimator 212 .

[0025] The generator 211 includes a bulb. When a voltage is applied to the bulb and a current flows therethrough, radiation is emitted from the bulb. When a pulsed voltage is applied to the bulb, pulsed radiation, for example, X-rays, may be emitted from the bulb.

[0026] The generator 211 has a maximum radiation dose, i.e., a permissible radiation dose, limited according to the imaging mode set. In the dynamic imaging mode, the radiation dose is limited due to limitations imposed by a general imaging device.

[0027] Moreover, the generator 211 emits radiation based on imaging conditions set from the input / output unit 241, which will be described later. The imaging conditions are conditions related to radiation emission, such as tube voltage, tube current, irradiation time, current-time product (mAs value), frame rate, allowable number of frames, pulse width, pulse interval, pulse period, pulse duty ratio, etc. In addition, as the imaging conditions, conditions related to the patient P, such as the imaging region, imaging direction, and physique, are also set.

[0028] In the dynamic imaging mode, while an emission instruction is being issued, the radiation generating device 210 repeatedly emits radiation pulses multiple times per unit time (e.g., 15 times per second) for a predetermined time (duration). Note that, although the dynamic imaging mode will be described here as an example in which radiation pulses are emitted, radiation may also be emitted continuously.

[0029] The collimator 212 narrows the irradiation field of the emitted radiation. The collimator 212 may have a shielding member such as a filter. The shielding member may narrow the area irradiated with the emitted radiation. The shielding member may weaken the intensity of the emitted radiation.

[0030] (Dynamic image capture device - Radiation detection device) The radiation detection device 220 includes a sensor substrate, a scanning circuit, a readout circuit, a detection control unit (not shown), a communication unit 221, etc., and detects radiation emitted from the radiation generation device 210 through the patient P. The patient P is a human being, but may also be an animal, etc.

[0031] The sensor substrate has pixels arranged two-dimensionally (in a matrix). Each pixel has a radiation detection element that generates an electric charge according to the amount of radiation received through the subject, and a switch element that stores and releases the electric charge. A scanning circuit switches each switch element on or off. A readout circuit reads out the amount of electric charge released from each pixel as a signal value (intensity).

[0032] The detection control unit controls the entire radiation detection device 220. The detection control unit generates a radiation image from a plurality of signal values ​​read out by the readout circuit.

[0033] The communication unit 221 transmits the data of the radiation image generated by the readout circuit, various signals, and the like to the outside. The communication unit 221 also receives various information and various signals. The communication unit 221 may perform wireless communication or wired communication.

[0034] In each pixel of the radiation detection device 220 configured in this manner, when the radiation detection element receives radiation with the scanning circuit turning off the switch element, the radiation detection element generates and accumulates charge according to the radiation dose. When the scanning circuit switches the switch element on, the accumulated charge is released, and the readout circuit detects the amount of charge released from each pixel and generates a signal value indicating the amount of charge.

[0035] The detection control unit generates a radiation image based on the signal value generated for each pixel. In dynamic imaging, each generated radiation image is a still image. In the case of pulsed radiation, a still image is generated corresponding to each pulse.

[0036] The communication unit 221 communicates with a communication unit 243 mounted on the dolly 250, which will be described later, and transmits the generated radiological image to the communication unit 243. The communication unit 221 may transmit each still image to the communication unit 243 every time it is generated, or may transmit multiple still images collectively to the communication unit 243. The communication unit 221 may communicate with a unit other than the communication unit 243. The communication performed by the communication unit 221 may be wireless communication or wired communication.

[0037] When the radiation generating device 210 performs pulsed radiation, the timing of generating the multiple still images constituting the dynamic image is synchronized with the timing of radiation emission from the radiation generating device 210. On the other hand, when the radiation generating device 210 performs continuous radiation, the generation of the multiple still images constituting the dynamic image is performed at any timing during the continuous radiation.

[0038] When in use, the radiation detection device 220 is driven by an internal battery and is wirelessly connected to a main control unit 240 (described later). Note that the radiation detection device 220 may be supplied with power from the dolly 250 side in a wired or wireless manner.

[0039] When the medical cart 10 is moving or not in use, the radiation detection device 220 may be stored in a storage unit (not shown) provided in the cart 250. At this time, the radiation detection device 220 is connected to the main control unit 240 by wire, and communication with and charging of the radiation detection device 220 is performed. Note that at this time, communication with and charging of the radiation detection device 220 may be performed wirelessly.

[0040] (Dynamic image capture device - arm) The arm 230 includes a vertical arm 231 and a horizontal arm 232. The vertical arm 231 supports the horizontal arm 232 rotatably around its axis. The vertical arm 231 may also support the horizontal arm 232 movably in the horizontal direction. The horizontal arm 232 supports the radiation generation device 210 rotatably around its axis.

[0041] The radiation generation device 210 can be disposed at a position and in a direction facing the patient P by the vertical arm 231 and the horizontal arm 232. The vertical arm 231 and the horizontal arm 232 may be rotatable and movable under the control of the main control unit 240 based on an input from the input / output unit 241, or may be rotatable and movable manually.

[0042] (Dynamic image capture device - main control unit, etc.) The dynamic image capturing device 200 further includes a main control unit 240, an input / output unit 241, a power supply unit 242, a communication unit 243, and the like.

[0043] The main control unit 240 controls the entire medical cart 10. When the cart 250 has a drive unit, the main control unit 240 controls not only the dynamic image capturing device 200 but also the drive unit of the cart 250. Here, the dynamic image processing device 100 is provided separately from the main control unit 240, but the main control unit 240 may also function as the dynamic image processing device 100.

[0044] The main control unit 240 is a so-called computer, and is composed of a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), etc. In the main control unit 240, the CPU reads out various programs such as a system program and a processing program stored in the ROM, expands them in the RAM, and executes various processes according to the expanded programs.

[0045] The input / output unit 241 includes an input unit and an output unit. The input / output unit 241 may have a separate input unit and output unit. The input / output unit 241 may be configured with a touch panel, keyboard, mouse, microphone, and camera that function as an input unit, and a display, speaker, indicator light, and the like that function as an output unit. The input / output unit 241 may be capable of inputting by voice, gesture, and the like.

[0046] The input / output unit 241 inputs settings and operations by the user to the main control unit 240. Furthermore, the input / output unit 241 may input settings and operations by the user to the dynamic image processing device 100 via the main control unit 240. Furthermore, the input / output unit 241 displays dynamic images captured by the dynamic image capturing device 200, information acquired by the dynamic image processing device 100, and the like.

[0047] The power supply unit 242 supplies power to the entire medical cart 10. The power supply unit 242 may supply power not only to the dynamic image processing device 100 and the dynamic image capturing device 200, but also to the radiation detection device 220 to charge the radiation detection device 220.

[0048] The power supply unit 242 may be composed of a rechargeable battery that can be connected to a commercial power source or the like and charged. For example, a nickel-metal hydride battery, a lithium-ion battery, a sodium battery, or the like can be used as the rechargeable battery. In this case, the power supply unit 242 may be connected to a commercial power source or the like and charged when the medical cart 10 is not in use, and may be disconnected from the commercial power source and supplied with power by the battery when in use. Note that the power supply unit 242 is not limited to a rechargeable battery, and other power sources, such as a fuel cell, may be used.

[0049] The communication unit 243 communicates with the communication unit 221 of the radiation detection device 220. The communication unit 243 transmits settings and instructions set by the input / output unit 241 to the communication unit 221. In addition, the communication unit 243 outputs the radiographic image received from the communication unit 221 to the main control unit 240.

[0050] The communication unit 243 may communicate with, for example, the artificial ventilator 300, other than the communication unit 221. The communication unit 243 may also communicate with a medical system, etc. Examples of medical systems include a hospital information system (HIS), a radiology information system (RIS), a picture archiving and communication system (PACS), etc.

[0051] (Trolley) The dolly 250 is configured to mount the dynamic image processing device 100 and the dynamic image capturing device 200, and is movable by wheels 251. The dolly 250 may be moved manually or driven by a driving device.

[0052] When moving the medical cart 10 manually, the handle 252 is held by a person to move the cart. When moving the medical cart 10 by a drive device, for example, a motor drives some of the wheels 251 as drive wheels using power supplied from the power supply unit 242 to move the cart. At this time, the handle 252 may be steered by a person to steer the medical cart 10. When the dynamic image capturing device 200 is in use, the wheels 251 are locked and the position of the medical cart 10 is fixed so that it does not move.

[0053] With the above-described configuration, the mobile cart 10 moves to the vicinity (bedside) of the patient P wearing the artificial respirator 300, and the dynamic image capturing device 200 captures dynamic images by irradiating the lungs of the patient P with radiation. Then, the dynamic image processing device 100 acquires information on the setting values ​​of the artificial respirator 300 from the captured dynamic images, as described below.

[0054] (Dynamic image processing device) The dynamic image processing device 100 is configured to acquire information on the settings of the artificial ventilator 300 by processing the dynamic image input from the dynamic image capturing device 200. The dynamic image processing device 100 is, for example, a computer, and is configured with a CPU, RAM, ROM, etc. In the dynamic image processing device 100, the CPU reads out a dynamic image processing program stored in the ROM, expands it in the RAM, and executes a dynamic image processing method for processing the dynamic image according to the expanded program.

[0055] As described above, the main control unit 240 may also function as the dynamic image processing device 100. However, as an example, the dynamic image processing device 100 will be described here as a device separate from the main control unit 240.

[0056] As described above, the dynamic image capturing device 200 captures dynamic images by irradiating radiation to the lungs of the patient P attached to the artificial respirator 300. The dynamic image processing device 100 includes, as its functions, an extraction unit 101 that processes the dynamic image input from the dynamic image capturing device 200 to extract information related to the setting value of the artificial respirator 300, and an output unit 102 that outputs the extracted information.

[0057] Specifically, the extraction unit 101 has, as a processing mode for processing dynamic images, at least a mode for extracting and visualizing the amount of signal change in the time direction in a specific time frequency band related to breathing for each pixel (hereinafter referred to as PL mode), which allows the behavior of lung tissue during breathing to be visualized.

[0058] The extraction unit 101 performs a predetermined process on the signal change amount extracted in the PL mode, and outputs at least information related to the setting value of the artificial ventilator 300 to the input / output unit 241 via the output unit 102. The process of the extraction unit 101 will be described later with reference to Figs. 3 to 8.

[0059] The output unit 102 outputs the above information and the above optimal setting value to the input / output unit 241, and the input / output unit 241 displays the above information and the above optimal setting value. The output unit 102 may output the above information and the above optimal setting value to the artificial ventilator 300 via the main control unit 240, the communication unit 243, or a cable (not shown).

[0060] In addition, the dynamic image processing device 100 may be provided with a determination unit 103 that determines an optimal setting value for the setting value of the ventilator 300 based on the information extracted by the extraction unit 101, and this optimal setting value is also output from the output unit 102.

[0061] The dynamic image capturing device 200 may be equipped with the PL mode, in which case the dynamic image processing device 100 does not need to perform processing in the PL mode.

[0062] (Processing example 1 in dynamic image processing device) Fig. 3 is a diagram showing an example of a dynamic image processed in the PL mode. Fig. 4 is a graph showing the left / right ratio of the signal change amount in the left and right lungs extracted in the PL mode in a plurality of dynamic images with different settings of the artificial ventilator 300, corresponding to the setting value.

[0063] In this processing example, the extraction unit 101 of the dynamic image processing device 100 obtains the signal change amounts in the left and right lungs extracted in the PL mode as a left / right ratio in a plurality of dynamic images having different setting values ​​of the artificial ventilator 300. The different setting values ​​may include a reference setting value of the artificial ventilator 300. The reference setting value can be set based on the height and weight of the patient P.

[0064] For example, Fig. 3 shows an example of a dynamic image processed in PL mode after imaging of the patient P with a certain value set as the positive end expiratory pressure (PEEP) of the artificial ventilator 300 worn by the patient P. Note that the positive end expiratory pressure is a positive pressure applied to the alveoli so that the airway pressure does not become 0 cmH2O at the end of expiration (so that the alveoli do not completely collapse).

[0065] In Fig. 3, as an example, the density of the dot pattern is changed according to the magnitude of the signal change amount at each pixel, and the larger the signal change amount, the denser the dot pattern is, and it is displayed superimposed on the dynamic image captured by the dynamic image capturing device 200. Note that, although the magnitude of the signal change amount is expressed by the density of the dot pattern in Fig. 3, it is not limited to this, and may be expressed, for example, by differences in hue, etc.

[0066] The extraction unit 101 obtains the signal change amount in the left and right lungs extracted in PL mode as a left / right ratio in the dynamic image after PL mode processing shown in Fig. 3. For example, in Fig. 3, when the signal change amount in both the left and right lungs is 100%, the left lung has a left-right ratio of 30% and the right lung has a ratio of 70%. The extraction unit 101 obtains the left / right ratio of the signal change amount in a plurality of dynamic images having different setting values ​​for the artificial ventilator 300.

[0067] The extraction unit 101 then graphs the left / right ratio of the amount of signal change relative to the setting value, as shown in Fig. 4. The graph shown in Fig. 4 is information related to the setting value of the artificial ventilator 300 extracted by the extraction unit 101.

[0068] The output unit 102 outputs the graph shown in Fig. 4 to the input / output unit 241, and the input / output unit 241 displays the graph shown in Fig. 4. A user (medical worker) refers to the graph displayed on the input / output unit 241 and determines an optimal setting value. For example, a setting value at which the left / right ratio of the amount of signal change is 50%:50% is determined as the optimal setting value. Then, the user sets the optimal setting value as the setting value of the artificial ventilator 300 via the input / output unit 302 of the artificial ventilator 300.

[0069] Furthermore, when the dynamic image processing device 100 includes the determination unit 103, the determination unit 103 determines an optimal setting value with reference to the graph shown in Fig. 4, the output unit 102 outputs the determined optimal setting value to the input / output unit 241, and the input / output unit 241 displays the determined optimal setting value. The user sets the optimal setting value in the ventilator 300 from the input / output unit 302 with reference to the optimal setting value displayed on the input / output unit 241. In this case, the output unit 102 may transmit the optimal setting value to the ventilator 300 via the communication unit 243 or a cable, and the ventilator 300 may set the transmitted optimal setting value as the setting value of the ventilator 300.

[0070] In this processing example, the more dynamic images to be processed, the better, but at least two dynamic images with different settings of the artificial ventilator 300 are sufficient. When the number of dynamic images is small, the left-right ratio value is approximated by a quadratic function or a linear function and graphed.

[0071] As described above, in this processing example, the dynamic image processing device 100 extracts information related to the setting values ​​of the artificial ventilator 300 from the dynamic image, and presents the information.

[0072] The dynamic image capturing by the dynamic image capturing device 200 described above does not burden the patient. Since the dynamic image processing device 100 extracts the magnitude of the signal change amount at each pixel, it is possible to grasp the behavior of the lung tissue corresponding to the pixel, that is, the local ventilation state of the lung. As a result, the dynamic image processing device 100 is able to grasp the local ventilation state of the lung without burdening the patient, and present information so that the optimal setting value can be set for the artificial ventilator 300.

[0073] (Processing example 2 in dynamic image processing device) Figure 5 is a graph showing the signal change between exhalation and inspiration in relation to the setting values ​​for the left and right lungs and both lungs extracted in PL mode in multiple dynamic images with different setting values ​​for the artificial ventilator 300.

[0074] In this processing example, the extraction unit 101 of the dynamic image processing device 100 calculates the signal change amount between exhalation and inhalation for each of the left and right lungs and both lungs extracted in PL mode in multiple dynamic images with different setting values ​​of the artificial ventilator 300.

[0075] Then, the extraction unit 101 graphs the amount of signal change between exhalation and inspiration in the left and right lungs and in both lungs against the set values, as shown in Fig. 5. The graph shown in Fig. 5 is information about the set values ​​of the artificial ventilator 300 extracted by the extraction unit 101.

[0076] Thereafter, the dynamic image processing device 100 performs the same processing as in Processing Example 1. The user refers to the graph (graph shown in FIG. 5) displayed on the input / output unit 241 to determine the optimum setting value. For example, the setting value at which the amount of signal change is maximum is determined as the optimum setting value. Then, the user sets the optimum setting value in the artificial ventilator 300 via the input / output unit 302 as the setting value of the artificial ventilator 300.

[0077] Furthermore, even when the dynamic image processing device 100 includes the determination unit 103, the dynamic image processing device 100 performs the same processing as in processing example 1. The user refers to the optimal setting value displayed on the input / output unit 241 and sets the optimal setting value in the artificial ventilator 300 from the input / output unit 302. In this case, the output unit 102 transmits the optimal setting value to the artificial ventilator 300 via the communication unit 243 or a cable, and the artificial ventilator 300 may set the transmitted optimal setting value as the setting value of the artificial ventilator 300.

[0078] In this processing example, the more dynamic images to be processed, the better, but at least two dynamic images with different settings for the artificial ventilator 300 are sufficient. When the number of dynamic images is small, the left-right ratio is approximated by a quadratic function or a linear function and graphed.

[0079] Moreover, the above-described exemplary process may be performed on a partial region of interest, rather than on the entire lung field, to create the graph shown in FIG.

[0080] As described above, in this processing example as well, the dynamic image processing device 100 extracts information related to the setting values ​​of the artificial ventilator 300 from the dynamic image and presents the information.

[0081] This processing example differs from the above processing example 1 only in the processing (arithmetic processing) in the extraction unit 101. Therefore, in this processing example as well, the dynamic image processing device 100 can grasp the local ventilation state of the lungs without imposing a burden on the patient, and can present information so that an optimal setting value can be set for the artificial ventilator 300.

[0082] (Processing example 3 in dynamic image processing device) FIG. 6 is a graph showing the collapse rate and the overdevelopment rate in relation to set values ​​for the rate of the collapsed area to the entire lung field and the rate of the overdeveloped area to the entire lung field.

[0083] In this processing example, the extraction unit 101 of the dynamic image processing device 100 decreases the setting value of the ventilator 300 from a high value, and regards as collapsed an area where the amount of signal change between inspiration and expiration extracted in PL mode is lower than the previous setting value, and calculates the ratio of the collapsed area to the entire lung field. Also, the extraction unit 101 increases the setting value of the ventilator 300 from a low value, and regards as overdevelopment an area where the amount of signal change between inspiration and expiration extracted in PL mode is lower than the previous setting value, and calculates the ratio of the overdevelopment area to the entire lung field.

[0084] Then, the extraction unit 101 graphs the percentage of the collapsed area and the percentage of the overexpanded area against the setting value, as shown in Fig. 6. The graph shown in Fig. 6 is information related to the setting value of the artificial ventilator 300 extracted by the extraction unit 101.

[0085] Thereafter, the dynamic image processing device 100 performs the same processing as in Processing Example 1. The user refers to the graph (graph shown in FIG. 6) displayed on the input / output unit 241 to determine the optimum setting value. For example, the user determines the setting value corresponding to the position where the graph showing the percentage of the collapsed area and the graph showing the percentage of the overdeveloped area intersect as the optimum setting value. Then, the user sets the optimum setting value in the artificial ventilator 300 via the input / output unit 302 as the setting value of the artificial ventilator 300.

[0086] Furthermore, even when the dynamic image processing device 100 includes the determination unit 103, the dynamic image processing device 100 performs the same processing as in processing example 1. The user refers to the optimal setting value displayed on the input / output unit 241 and sets the optimal setting value in the artificial ventilator 300 from the input / output unit 302. In this case, the output unit 102 transmits the optimal setting value to the artificial ventilator 300 via the communication unit 243 or a cable, and the artificial ventilator 300 may set the transmitted optimal setting value as the setting value of the artificial ventilator 300.

[0087] In this processing example, the more dynamic images to be processed, the better, but at least two dynamic images with different settings for the artificial ventilator 300 are sufficient. When the number of dynamic images is small, the left-right ratio is approximated by a quadratic function or a linear function and graphed.

[0088] As described above, in this processing example as well, the dynamic image processing device 100 extracts information related to the setting values ​​of the artificial ventilator 300 from the dynamic image and presents the information.

[0089] This processing example is also different from the above processing example 1 only in the processing (arithmetic processing) in the extraction unit 101. Therefore, in this processing example as well, the dynamic image processing device 100 can grasp the local ventilation state of the lungs without imposing a burden on the patient, and can present information so that an optimal setting value can be set for the artificial ventilator 300.

[0090] (Processing example 4 in dynamic image processing device) Fig. 7 is a diagram showing an example of a lung field divided into a plurality of regions in a dynamic image captured by the dynamic image capturing device 200. Figs. 8A to 8C are graphs showing the left / right ratios obtained as the signal change amounts of the left and right divided regions extracted in PL mode in a plurality of dynamic images with different settings of the artificial ventilator 300, and corresponding to the settings. Fig. 8A is a graph for the upper lung (upper lobe), Fig. 8B is a graph for the middle lung (middle lobe), and Fig. 8C is a graph for the lower lung (lower lobe).

[0091] Fig. 7 shows an example in which the dynamic image processing device 100 divides a lung field into six regions, left and right and upper, middle and lower, in a dynamic image captured by the dynamic image capturing device 200. The dynamic image processing device 100 is not limited to the example shown in Fig. 7, and may divide the lung field into m regions horizontally and n regions vertically (m x n is an integer of 2 or more).

[0092] In this processing example, only the region of the lung field to be processed is different, and the processing itself is the same as in processing example 1. Therefore, a description that overlaps with processing example 1 will be omitted.

[0093] Here, as shown in Figures 8A to 8C, the left / right ratio of the amount of signal change is obtained for each of the upper, middle, and lower lungs, but for example, the upper / middle / lower ratio of the amount of signal change may be obtained for each of the left and right lungs.

[0094] This processing example is useful when, for example, there is a lesion such as atelectasis in a part of the lung. For example, assume that there is an atelectasis lesion in the right middle lung. In this processing example, the right-left ratio of the signal change amount for different setting values ​​in the right middle lung and the left middle lung is obtained and graphed (see FIG. 8B), and information that takes the lesion into consideration can be presented to set the optimal setting value of the artificial ventilator 300.

[0095] (Processing example 5 in dynamic image processing device) Fig. 9 is a graph showing the signal change amount during inspiration and expiration, which is calculated for each of the left and right lungs and both lungs extracted in PL mode in multiple dynamic images captured at different dates and times, and Fig. 10 is a table showing the left / right ratio and respiratory settings, which are calculated as the left / right ratio, in multiple dynamic images captured at different dates and times, and Fig.

[0096] In order to set optimal settings for the artificial ventilator 300, the dynamic image processing apparatus 100 may present time-series information showing changes over time.

[0097] In this processing example, the extraction unit 101 of the dynamic image processing device 100 calculates the signal change between inspiration and expiration for the left and right lungs and for both lungs extracted in PL mode in dynamic images captured at different dates and times with the same or similar setting values ​​for the ventilator 300.

[0098] Then, the extraction unit 101 graphs the amount of signal change between inspiration and expiration in the left and right lungs and in both lungs against the imaging date and time, as shown in Fig. 9. The graph shown in Fig. 9 is information on the setting value of the artificial ventilator 300 extracted by the extraction unit 101. Note that instead of the graph shown in Fig. 9, a table as shown in Fig. 10 may be used.

[0099] By comparing the amount of signal change between inspiration and expiration under the same or similar conditions of the setting value of the ventilator 300, if the amount of signal change between inspiration and expiration is improving with the passage of time and date, the user can sense a tendency for the lungs of the patient P to recover or for spontaneous breathing to start. In other words, the extraction unit 101 presents time-series information showing changes over time in order to set the optimal setting value of the ventilator 300.

[0100] The extraction unit 101 may also create a table of the left / right ratio of the amount of signal change in the left and right lungs with respect to the imaging date and time, as shown in Fig. 10. The table shown in Fig. 10 is information on the setting value of the artificial ventilator 300 extracted by the extraction unit 101. Note that instead of the table shown in Fig. 10, a graph as shown in Fig. 9 may be used.

[0101] Here too, the user can compare the left / right ratio of the amount of signal change when the setting value of the ventilator 300 is the same or similar, and if the left / right ratio of the amount of signal change improves with the passage of time, he / she can sense a tendency for the lungs of the patient P to recover or for spontaneous breathing to start. In other words, the extraction unit 101 presents time-series information showing changes over time in order to set the optimal setting value of the ventilator 300.

[0102] 9 and 10, it is desirable to compare the amount of signal change between expiration and inspiration and the left-right ratio of the amount of signal change when the setting value of the artificial ventilator 300 is the same. Therefore, the extraction unit 101 may modify the graph in Fig. 9 or the table in Fig. 10 so as to compare the amount of signal change between expiration and inspiration and the left-right ratio of the amount of signal change when the setting value of the artificial ventilator 300 is the same.

[0103] (Processing example 6 in dynamic image processing device) FIG. 11 is a diagram showing an example in which a dynamic image and a plurality of graphs are displayed simultaneously.

[0104] The dynamic image processing device 100 may implement multiple processing examples among the above-mentioned processing examples 1 to 6, and simultaneously display on the input / output unit 241 information extracted in the implemented processing examples together with the dynamic image captured by the dynamic image capturing device 200.

[0105] 11, the dynamic image processing device 100 performs processing examples 1 to 3 among the above-mentioned multiple processing examples 1 to 6, and simultaneously displays information (graphs) extracted in the performed processing examples 1 to 3 on the input / output unit 241 together with the dynamic image captured by the dynamic image capturing device 200. The processing example to be performed is selected by the dynamic image processing device 100 or by a user operation according to, for example, the condition of the patient P, the processing conditions, the environment of the facility, etc. Furthermore, the dynamic image may be changed from the currently displayed dynamic image to a dynamic image captured with other setting values ​​by a user operation.

[0106] The above-mentioned embodiments are merely examples of the embodiment of the present invention, and the technical scope of the present invention should not be interpreted as being limited by these. In other words, the present invention can be embodied in various forms without departing from the gist or main characteristics of the present invention.

[0107] For example, the regions to be processed by the dynamic image processing device 100 may be the entire left lung and the entire right lung as in processing example 1, or divided regions obtained by dividing the lung field into multiple regions as in processing example 3, but they may also be regions of interest manually set by the user, i.e., regions of interest.

[0108] In addition, the dynamic images to be processed may be limited so that past dynamic images are not mistakenly used as the dynamic images to be used in the above processing. For example, the dynamic images to be processed may be limited to those of the same day, or to those within a certain period of time, and dynamic images from other periods may not be selectable. In addition, the dynamic images may be limited to those captured to confirm the optimal setting value of the artificial ventilator 300, and dynamic images captured for other purposes may be excluded.

[0109] In addition, the dynamic image captured to confirm the optimal setting value of the artificial ventilator 300 may have a lower exposure dose than the dynamic image captured for other purposes, since it is sufficient to confirm the amount of signal change. Since multiple images are required to capture dynamic images to confirm the optimal setting value of the artificial ventilator 300, the exposure dose for multiple images can be reduced by lowering the exposure dose for one capture, compared to the case of capturing images for other purposes. In particular, when it is desired to obtain the amount of signal change in a specific region of interest, there are cases where confirmation of the dynamic image is not necessary, and the exposure dose may be set to a low value within a range in which the amount of signal change between regions of interest can be compared, with priority given to obtaining the amount of signal change over the image quality of the dynamic image.

[0110] In the above embodiment, the PL mode has been mainly described, but for example, the DM mode (diaphragm movement amount) and lung field area change rate (change amount) in a dynamic image can be processed in the same manner as the above to obtain the same effect as the above embodiment. Note that the DM mode is a mode that tracks the movement of the diaphragm in a dynamic image and quantifies the amount of movement in the up and down direction. [Explanation of symbols]

[0111] 10 Medical cart 100 Dynamic image processing device 101 Extraction part 102 Output section 103 Decision Section 200 Dynamic image capture device 210 Radiation Generator 211 Generator 212 Collimator 220 Radiation detection equipment 221 Communications Department 230 Arm 231 Vertical Arm 232 Horizontal Arm 240 Main control unit 241 Input / output section 242 Power supply section 243 Communications Department 250 Carts 251 Wheels 252 Handle 300 Respirator 301 Tube 302 Input / output section

Claims

1. an extraction unit that extracts information about a setting value of a respiratory assistance device by processing a dynamic image captured by irradiating radiation on the lungs of a subject wearing the respiratory assistance device; An output unit that outputs the information; Equipped with Dynamic image processing device.

2. The extraction unit extracts the information from at least two of the dynamic images in which the setting values ​​of the respiratory assistance device are different. The dynamic image processing device according to claim 1 .

3. A determination unit that determines an optimal setting value for the setting value based on the information. The dynamic image processing device according to claim 2 .

4. The determination unit compares the information on the left and right lungs to determine the optimal setting value. The dynamic image processing device according to claim 3 .

5. The determination unit determines the optimal setting value by comparing the information between a plurality of regions obtained by dividing the lung field of the lung. The dynamic image processing device according to claim 4 .

6. one of the at least two dynamic images is a dynamic image when a reference setting value of the respiratory assistance device is used as the setting value; Another dynamic image of the at least two dynamic images is a dynamic image obtained when a setting value higher or lower than the reference setting value is used as the setting value. The dynamic image processing device according to claim 2 .

7. The extraction unit extracts the information from the dynamic image when a reference setting value of the respiratory assistance apparatus is used as the setting value. The dynamic image processing device according to claim 1 .

8. The extraction unit extracts a signal change amount in a time direction in a specific time frequency band from the dynamic image, and visualizes the signal change amount. The dynamic image processing device according to claim 1 .

9. The information is a graph showing a left / right ratio obtained by calculating the signal change amount as a ratio between the left and right lungs, in association with different set values. The dynamic image processing device according to claim 8 .

10. The information is a graph showing the amount of change in the signal between inhalation and exhalation in correspondence with different set values. The dynamic image processing device according to claim 8 .

11. The information is a graph showing a ratio of collapse to the entire lung field and a ratio of overdevelopment to the entire lung field in correspondence with different set values. The dynamic image processing device according to claim 8 .

12. The information is a graph or table showing a left-right ratio calculated as a ratio of the signal change amount in the left and right lungs in a time series. The dynamic image processing device according to claim 8 .

13. The information is a graph or a table showing the amount of change in the signal between inspiration and expiration in a time series. The dynamic image processing device according to claim 8 .

14. The information is A graph showing a left / right ratio obtained as a ratio of the signal change amount in the left and right lungs in correspondence with different set values; a graph showing the amount of change in the signal between inhalation and exhalation corresponding to different set points; a graph showing the percentage of collapsed lung field relative to the entire lung field and the percentage of overdeveloped lung field relative to the entire lung field corresponding to different set values; A graph or table showing a left-right ratio calculated as a ratio of the signal change amount in the left and right lungs over time; A graph or table showing the amount of change in the signal between inspiration and expiration in a time series; and The output unit outputs at least two pieces of information. The dynamic image processing device according to claim 8 .

15. The dynamic image processing device according to claim 1 ; a dynamic image capturing device that captures the dynamic image and inputs the dynamic image to the dynamic image processing device; A dolly on which the dynamic image processing device and the dynamic image capturing device are mounted and configured to be movable; Equipped with Medical cart.

16. extracting information about settings of a respiratory assistance device by processing dynamic images captured by irradiating the lungs of a subject wearing the respiratory assistance device; Outputting the information. Dynamic image processing method.

17. On the computer, extracting information about settings of a respiratory assistance device by processing dynamic images captured by irradiating the lungs of a subject wearing the respiratory assistance device with radiation; A process of outputting the information; A dynamic image processing program that executes the above.

Images