Medical image processing device, x-ray diagnostic device, and medical image processing program

Abstract

To provide information related to a depth direction in a vessel branch direction in a medical imaged used in a surgery.SOLUTION: A medical image processing device according to an embodiment includes an image obtaining unit, calculation unit, a first generation unit, and a display control unit. The image obtaining unit obtains: an X-ray image collected from a subject into a vessel of which a medical device has been inserted; and a three-dimensional vessel image including the vessel of the subject. The calculation unit calculates positional information of a tip of the medical device in a three-dimensional space from the X-ray image. The first generation unit: associates, in a positional relationship in the three-dimensional space, the vessel depicted in the three-dimensional vessel image with the tip of the medical device on the basis of the positional information; and generates positional relationship information showing a positional relationship between the tip of the medical device and any one of a plurality of branch vessels connected with a first vessel associated with the tip of the medical device and branched from the first vessel. The display control unit displays the positional relationship information on a display.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention and the embodiments disclosed in the drawings relate to a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program. [Background technology]

[0002] There are various types of intravascular treatments that involve inserting medical devices such as catheters and guidewires into the blood vessels of a subject. During intravascular treatment, X-ray images are collected and displayed to assist the surgeon in operating the medical device. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2021-133036 A Summary of the Invention [Problem to be solved by the invention]

[0004] For example, in PCI (Percutaneous Coronary Intervention), the surgeon performs the procedure while checking two-dimensional fluoroscopic images. Meanwhile, the internal diameter of the main coronary arteries (e.g., the left anterior descending artery and the left circumflex artery) is approximately 3 mm, and the more they branch out from the main arteries and go to the periphery, the thinner they become.

[0005] Moreover, if there is a disease in the coronary artery, the blood inner diameter becomes even thinner. Furthermore, it is difficult for the surgeon to grasp the depth direction in the 2D fluoroscopic image, making it difficult to operate the medical device at the branching part of the coronary artery, and it is not easy to advance the medical device to the treatment site, and it may take time for the medical device to reach the treatment site. This may increase the burden on the subject due to the increase in the amount of contrast agent and the burden of radiation exposure on the subject, surgeon, etc.

[0006] One of the problems to be solved by the embodiments disclosed in this specification and the drawings is to provide information about the depth direction in the branching direction of blood vessels to medical images used in a procedure. However, the problems to be solved by the embodiments disclosed in this specification and the drawings are 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]

[0007] A medical image processing apparatus according to an embodiment includes an image acquisition unit, a calculation unit, a first generation unit, and a display control unit. The image acquisition unit acquires an X-ray image collected from a subject having a medical device inserted into a blood vessel, and a three-dimensional vascular image including the blood vessel of the subject. The calculation unit calculates position information of the tip of the medical device in a three-dimensional space from the X-ray image. The first generation unit associates a positional relationship in the three-dimensional space between the blood vessel depicted in the three-dimensional vascular image and the tip of the medical device, and generates positional relationship information indicating a positional relationship between the tip of the medical device and any one of a plurality of branched blood vessels that are connected to a first blood vessel corresponding to the tip of the medical device and branched from the first blood vessel. The display control unit causes the positional relationship information to be displayed on a display. [Brief description of the drawings]

[0008] [Figure 1] FIG. 1 is a block diagram showing an example of the configuration of a medical information processing system according to an embodiment. [Diagram 2] FIG. 2 is a block diagram showing an example of the configuration of an X-ray diagnostic apparatus according to the embodiment. [Diagram 3] FIG. 3 is a schematic diagram for explaining positional relationship information according to the embodiment. [Figure 4] FIG. 4 is a schematic diagram for explaining the positional relationship information according to the embodiment. [Diagram 5] FIG. 5 is a schematic diagram for explaining the positional relationship information according to the embodiment. [Figure 6]FIG. 6 is a schematic diagram showing an example of a display performed by the medical image processing apparatus according to the embodiment. [Figure 7] FIG. 7 is a schematic diagram showing an example of a display performed by the medical image processing apparatus according to the embodiment. [Figure 8] FIG. 8 is a flowchart for explaining a series of processing steps of the medical image processing apparatus according to the embodiment. [Figure 9] FIG. 9 is a block diagram showing an example of the configuration of a medical information processing system according to the first modified example. [Figure 10] FIG. 10 is a schematic diagram showing an example of a display performed by a medical image-processing apparatus according to the first modified example. [Figure 11] FIG. 11 is a diagram illustrating an example of image processing according to the first embodiment. [Figure 12] FIG. 12 is a diagram illustrating an example of image processing according to the first embodiment. [Figure 13] FIG. 13 is a block diagram showing an example of the configuration of a medical information processing system according to the second modified example. [Figure 14] FIG. 14 is a schematic diagram for explaining the patency degree information according to the second modified example. [Figure 15] FIG. 15 is a schematic diagram for explaining the patency degree information according to the second modified example. [Figure 16] FIG. 16 is a block diagram showing an example of the configuration of a medical information processing system according to the third modified example. [Figure 17] FIG. 17 is a schematic diagram for explaining the processing contents of the medical image processing apparatus according to the third modified example. [Figure 18] FIG. 18 is a schematic diagram for explaining a form indicating a direction of a medical device according to a third modification. [Figure 19] FIG. 19 is a block diagram showing an example of the configuration of a medical information processing system according to the fourth modified example. [Figure 20] FIG. 20 is a schematic diagram for explaining the processing contents of the medical image processing apparatus according to the fourth modified example. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Hereinafter, embodiments of a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program will be described in detail with reference to the drawings.

[0010] (Embodiment) First, an embodiment will be described. In the embodiment, a medical information processing system including a medical image processing apparatus and an X-ray diagnostic apparatus will be described as an example.

[0011] As shown in Fig. 1, a medical information processing system 1 according to the embodiment includes an X-ray diagnostic apparatus 10, an image storage apparatus 20, and a medical image processing apparatus 30. Fig. 1 is a block diagram showing an example of the configuration of the medical information processing system 1 according to the embodiment. As shown in Fig. 1, the X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 are connected to each other via a network.

[0012] The X-ray diagnostic apparatus 10 collects X-ray images from a subject P. Note that an X-ray image processed as data is also referred to as X-ray image data. For example, the X-ray diagnostic apparatus 10 collects a plurality of X-ray image data from the subject P, and transmits the collected plurality of X-ray image data to an image storage apparatus 20 and a medical image processing apparatus 30. Note that the configuration of the X-ray diagnostic apparatus 10 will be described later.

[0013] The image storage device 20 stores a plurality of X-ray image data collected by the X-ray diagnostic apparatus 10. For example, the image storage device 20 is realized by a computer device such as a server device. In this embodiment, the image storage device 20 acquires a plurality of X-ray image data from the X-ray diagnostic apparatus 10 via a network, and stores the acquired plurality of X-ray image data in a memory provided inside or outside the apparatus.

[0014] The medical image processing device 30 acquires a plurality of X-ray image data via a network, and executes various processes using the acquired plurality of X-ray image data. For example, the medical image processing device 30 is realized by a computer device such as a workstation. In this embodiment, the medical image processing device 30 acquires a plurality of X-ray image data collected by the X-ray diagnostic device 10. The medical image processing device 30 also performs image processing on the acquired plurality of X-ray image data. The image processing by the medical image processing device 30 will be described later.

[0015] As shown in FIG. 1, a medical image processing device 30 includes an input interface 31, a display 32, a memory 33, and a processing circuit .

[0016] The input interface 31 is realized by a trackball, switches, buttons, a mouse, a keyboard, a touchpad for performing input operations by touching the operation surface, a touch screen in which the display screen and the touchpad are integrated, a non-contact input circuit using an optical sensor, a voice input circuit, etc. for giving various instructions and making various settings, etc. The input interface 31 converts input operations received from an operator into electrical signals and outputs them to the processing circuit 34.

[0017] The input interface 31 is not limited to one equipped with physical operation parts such as a mouse and a keyboard. For example, an example of the input interface 31 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 medical image processing device 30 and outputs the electrical signal to the processing circuit 34.

[0018] The display 32 displays various types of information. For example, the display 32 displays a GUI (Graphical User Interface) for receiving instructions from an operator and various types of image data. For example, the display 32 is a liquid crystal display.

[0019] The memory 33 is realized by, for example, a semiconductor memory element such as a RAM (Random Access Memory), a flash memory, a hard disk, an optical disk, etc. For example, the memory 33 stores a plurality of X-ray image data acquired from the X-ray diagnostic apparatus 10. In addition, for example, the memory 33 stores a program for each circuit included in the medical image processing apparatus 30 to realize its function.

[0020] The processing circuitry 34 executes an image processing function 341, an image acquisition function 342, a calculation function 343, a first generation function 344, and a display control function 345, thereby controlling the operation of the medical image processing apparatus 30 as a whole.

[0021] 1, each processing function is stored in the form of a program executable by a computer in a memory 33. The processing circuitry 34 is a processor that realizes a function corresponding to each program by reading and executing the program from the memory 33. In other words, the processing circuitry 34 in a state in which each program has been read has a function corresponding to the read program.

[0022] In FIG. 1, the image processing function 341, image acquisition function 342, calculation function 343, first generation function 344 and display control function 345 are realized by a single processing circuit 34. However, the processing circuit 34 may be configured by combining a plurality of independent processors, and each processor may realize a function by executing a program.

[0023] Next, an X-ray diagnostic apparatus 10 that collects a plurality of X-ray image data will be described with reference to Fig. 2. Fig. 2 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 10 according to the first embodiment. As shown in Fig. 2, the X-ray diagnostic apparatus 10 includes an X-ray high voltage device 101, an X-ray tube 102, a collimator 103, a filter 104, a tabletop 105, a C-arm 106, an X-ray detector 107, a control device 108, a memory 109, a display 110, an input interface 111, and a processing circuit 112.

[0024] The X-ray high voltage device 101 supplies a high voltage to the X-ray tube 102 under the control of the processing circuit 112. For example, the X-ray high voltage device 101 has electric circuits such as a transformer and a rectifier, and includes a high voltage generating device that generates a high voltage to be applied to the X-ray tube 102, and an X-ray control device that controls the output voltage according to the X-rays irradiated by the X-ray tube 102. The high voltage generating device may be of a transformer type or an inverter type.

[0025] The X-ray tube 102 is a vacuum tube having a cathode (filament) that generates thermoelectrons and an anode (target) that generates X-rays upon impact of the thermoelectrons. The X-ray tube 102 generates X-rays by irradiating thermoelectrons from the cathode to the anode using a high voltage supplied from the X-ray high voltage device 101.

[0026] The collimator (also called X-ray aperture device) 103 has, for example, four slidable aperture blades. By sliding the aperture blades, the collimator 103 narrows down the X-rays generated by the X-ray tube 102 and irradiates the X-rays to the subject P. Here, the aperture blades are plate-shaped members made of lead or the like, and are provided near the X-ray irradiation port of the X-ray tube 102 to adjust the irradiation range of the X-rays.

[0027] The filter 104 changes the radiation quality of the transmitted X-rays depending on its material and thickness, in order to reduce the radiation dose to the subject P and improve the image quality of the X-ray image data, thereby reducing soft ray components that are easily absorbed by the subject P and reducing high energy components that cause a decrease in contrast in the X-ray image data. In addition, the filter 104 changes the dose and irradiation range of the X-rays depending on its material, thickness, position, etc., and attenuates the X-rays so that the X-rays irradiated from the X-ray tube 102 to the subject P have a predetermined distribution.

[0028] The top board 105 is a bed on which the subject P rests, and is placed on a bed (not shown). The subject P is not included in the X-ray diagnostic apparatus 10.

[0029] The C-arm 106 holds the X-ray tube 102, the collimator 103, and the filter 104, and the X-ray detector 107 so as to face each other across the subject P. Note that, although the X-ray diagnostic apparatus 10 is described in Fig. 2 as being a single-plane apparatus by way of example, the embodiment is not limited thereto, and may be a bi-plane apparatus.

[0030] The X-ray detector 107 is, for example, an X-ray flat panel detector (FPD) having detection elements arranged in a matrix. The X-ray detector 107 detects X-rays irradiated from the X-ray tube 102 and transmitted through the subject P, and outputs a detection signal corresponding to the detected X-ray amount to the processing circuit 112. The X-ray detector 107 may be an indirect conversion type detector having a grid, a scintillator array, and a photosensor array, or may be a direct conversion type detector having a semiconductor element that converts the incident X-rays into an electric signal.

[0031] The control device 108 includes driving mechanisms such as motors and actuators, and circuits for controlling the driving mechanisms. Under the control of the processing circuit 112, the control device 108 controls the operations of the collimator 103, the filter 104, the top plate 105, the C-arm 106, and the like. For example, the control device 108 adjusts the aperture of the aperture blades of the collimator 103 to control the irradiation range of the X-rays irradiated onto the subject P.

[0032] Moreover, the control device 108 adjusts the position of the filter 104 to control the distribution of the dose of X-rays irradiated onto the subject P. In addition, for example, the control device 108 rotates and moves the C-arm 106 and moves the tabletop 105.

[0033] The memory 109 is realized by, for example, a semiconductor memory element such as a RAM or a flash memory, a hard disk, an optical disk, etc. The memory 109 receives and stores, for example, X-ray image data collected by the processing circuitry 112. The memory 109 also stores programs corresponding to various functions that are read out and executed by the processing circuitry 112.

[0034] The display 110 displays various types of information. For example, the display 110 displays a GUI for receiving instructions from an operator and various types of X-ray images. For example, the display 110 is a liquid crystal display or a CRT display.

[0035] The input interface 111 is realized by a trackball, switches, buttons, a mouse, a keyboard, a touchpad for performing input operations by touching the operation surface, a touch screen in which the display screen and the touchpad are integrated, a non-contact input circuit using an optical sensor, a voice input circuit, etc. for giving various instructions and making various settings, etc. The input interface 111 converts input operations received from an operator into electrical signals and outputs them to the processing circuit 112.

[0036] The input interface 111 is not limited to one equipped with physical operation parts such as a mouse and a keyboard. For example, the input interface 111 also includes an example of an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the X-ray diagnostic apparatus 10 and outputs the electrical signal to the processing circuit 112.

[0037] The processing circuitry 112 controls the operation of the entire X-ray diagnostic apparatus 10 by executing a control function 113, an acquisition function 114, and a display control function 115. For example, the processing circuitry 112 reads out a program corresponding to the control function 113 from the memory 109 and executes it to control various functions of the processing circuitry 112 based on an input operation received from an operator via the input interface 111.

[0038] Furthermore, the processing circuitry 112 collects X-ray image data by reading out a program corresponding to the collection function 114 from the memory 109 and executing it. For example, the collection function 114 controls the X-ray high voltage device 101 and adjusts the voltage supplied to the X-ray tube 102 to control the amount of X-rays irradiated to the subject P and on / off. The collection function 114 also controls the control device 108 and adjusts the opening of the aperture blades of the collimator 103 to control the irradiation range of the X-rays irradiated to the subject P.

[0039] Furthermore, the collection function 114 controls the control device 108 to adjust the position of the filter 104, thereby controlling the distribution of the X-ray dose. The collection function 114 controls the control device 108 to control the rotation and movement of the C-arm 106, the movement of the tabletop 105, etc. The collection function 112b also generates X-ray image data based on a detection signal received from the X-ray detector 107, and stores the generated X-ray image data in the memory 109.

[0040] Here, the collection function 114 may perform various image processing on the X-ray image data stored in the memory 109. For example, the collection function 114 performs noise reduction processing using an image processing filter and scattered radiation correction on the X-ray image data.

[0041] Moreover, the processing circuitry 112 reads out a program corresponding to a display control function 115 from the memory 109 and executes it to display the X-ray image data collected by the collection function 114 on the display 110. Moreover, the display control function 115 displays on the display 110 a GUI for receiving instructions from an operator.

[0042] 2, each processing function is stored in the memory 109 in the form of a program executable by a computer. The processing circuitry 112 is a processor that realizes a function corresponding to each program by reading and executing the program from the memory 109. In other words, the processing circuitry 112 in a state where each program has been read has a function corresponding to the read program.

[0043] In FIG. 2, the control function 113, the collection function 114, and the display control function 115 are described as being realized by a single processing circuit 112. However, the processing circuit 112 may be configured by combining a plurality of independent processors, and each processor may realize a function by executing a program.

[0044] The term "processor" used in the above description refers to circuits such as a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an Application Specific Integrated Circuit (ASIC), a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)).

[0045] The processor realizes a function by reading and executing a program stored in the memory 33 or memory 109. Note that each processor in this embodiment is not limited to being configured as a single circuit for each processor, and may be configured as a single processor by combining multiple independent circuits to realize its function. Also, in FIG. 1 and FIG. 2, a single memory 33 or memory 109 is described as storing a program corresponding to each processing function. However, a configuration in which multiple memories 33 are distributed and arranged, and the processing circuit 34 reads out the corresponding program from each memory 33 may be used.

[0046] Similarly, a configuration may be adopted in which a plurality of memories 109 are distributed and the processing circuit 112 reads out the corresponding programs from each of the memories 109. Also, instead of storing the programs in the memories 33 and 109, the programs may be directly embedded in the circuitry of the processor. In this case, the processor realizes the functions by reading and executing the programs embedded in the circuitry.

[0047] The above describes the medical information processing system 1 including the medical image processing device 30 and the X-ray diagnostic device 10. With this configuration, the medical image processing device 30 in the medical information processing system 1 improves the visibility of the X-ray image through processing by the processing circuitry 34, which will be described in detail below. The processing performed by the medical image processing device 30 according to the first embodiment will be described in detail below.

[0048] Next, the acquisition function 114 in the X-ray diagnostic apparatus 10 acquires X-ray image data. For example, the acquisition function 114 first causes the X-ray tube 102 to irradiate the subject P with pulsed X-rays. At this time, the X-ray detector 107 detects the X-rays that have passed through the heart of the subject P, and outputs a detection signal corresponding to the detected X-ray dose to the processing circuitry 112.

[0049] Next, the collection function 114 generates X-ray image data based on the detection signal received from the X-ray detector 107, and outputs the generated X-ray image data to the medical image processing device 30. Furthermore, the collection function 114 generates X-ray image data every time a pulsed X-ray is irradiated, and sequentially outputs the generated X-ray image data to the medical image processing device 30.

[0050] Returning to Fig. 1, next, the image processing function 341 generates an X-ray image including the medical device inserted into the blood vessel of the subject P from the X-ray image data collected by the collection function 114. Specifically, the image processing function 341 generates a three-dimensional blood vessel image including the blood vessel of the subject P from the X-ray image data collected by the collection function 114 and acquired in real time during the execution of a procedure (for example, IVR (Interventional Radiology)).

[0051] Furthermore, the image processing function 341 generates a three-dimensional blood vessel image including the blood vessels of the subject P from the volume data. Specifically, the image processing function 341 performs rendering processing on the volume data to generate a three-dimensional blood vessel image including the blood vessels of the subject P. The specific method of the rendering processing is not particularly limited, and various rendering processing methods such as ray casting can be adopted.

[0052] Here, the volume data refers to three-dimensional image data generated by imaging performed before inserting the medical device into the subject P. This volume data is generated in advance by an X-ray CT apparatus. The X-ray CT apparatus can image volume data with high time resolution equivalent to one beat of the heart, and the volume data has high accuracy and can accurately express a spatial structure. Note that the volume data is not limited to this. For example, the volume data is generated by reconstructing a plurality of captured images collected while rotating the C-arm 106 of the X-ray diagnostic apparatus 10 of this embodiment. Also, the volume data may be three-dimensional image data of the same subject acquired by an MRI apparatus.

[0053] Next, the image acquisition function 342 acquires an X-ray image collected from the subject P with the medical device inserted into the blood vessel. The image acquisition function 342 is an example of an image acquisition unit. Here, the X-ray image is an X-ray image captured during a procedure by inserting the medical device into the subject P. The X-ray image captured during a procedure is also called a fluoroscopic image, which is captured with a relatively low X-ray dose. The fluoroscopic image is an image for observing the state of the blood vessel and the state of the medical device such as a catheter inserted into the blood vessel in real time, and is a video having a predetermined frame rate.

[0054] The image acquisition function 342 also acquires a three-dimensional vascular image including the blood vessels of the subject P. Here, the three-dimensional vascular image is a three-dimensional image generated by imaging performed before the medical device is inserted into the subject P. The three-dimensional image is, for example, a CT (Computed Tomography) image. The three-dimensional image is an image of a region including the heart of the subject P (for example, the chest) captured by an X-ray CT device, and includes the vascular structure of the coronary arteries running inside the subject. For example, the image acquisition function 342 stores the acquired X-ray image and the three-dimensional vascular image in the memory 33.

[0055] The calculation function 343 calculates position information of the tip of the medical device in three-dimensional space from the X-ray image. The calculation function 343 is an example of a calculation unit. Specifically, the calculation function 343 calculates position information of the tip of the medical device in three-dimensional space from the X-ray image acquired by the image acquisition function 342. For example, the calculation function 343 detects in real time the position of the medical device used to perform the procedure from the X-ray image acquired by the image acquisition function 342, and calculates the position information of the medical device in three-dimensional space. The position of the medical device is calculated by detecting an opaque marker provided at the tip of the medical device, for example.

[0056] The first generating function 344 associates the blood vessels depicted in the three-dimensional blood vessel image with the positional relationship of the tip of the medical device in three-dimensional space based on the positional relationship information, and generates positional relationship information indicating the positional relationship between the tip of the medical device and any one of the branch blood vessels of the multiple blood vessels that are connected to the first blood vessel corresponding to the position of the tip of the medical device and branch off from the first blood vessel. The first generating function 344 is an example of a first generating unit. The positional relationship information includes a hue wheel in which hues are arranged in a circular shape. The positional relationship information also indicates a direction in three-dimensional space, and includes color brightness or a shape of a figure. Furthermore, the positional relationship information moves within the blood vessel in response to the movement of the tip position of the medical device.

[0057] Here, the positional relationship information will be described with reference to FIG. 3, FIG. 4, and FIG. 5. FIG. 3, FIG. 4, and FIG. 5 are diagrams for explaining the positional relationship information according to the embodiment. FIG. 3 shows a hue wheel 400 in which hues are arranged in a ring shape, which is included in the positional relationship information. As shown in FIG. 3, the hue wheel 400 has all hues smoothly connected, so that it can show any direction and angle without breaks or sudden changes. For example, by using the hue wheel 400 as a method for showing a spatial direction in three dimensions, blood vessels moving due to pulsation can be smoothly expressed. For example, when blood vessels move a lot, the moving blood vessels can be expressed by changing the hue significantly.

[0058] 4 shows an example in which a hue wheel 400 is superimposed on blood vessels 501 branching in three directions from one blood vessel 500. As shown in Fig. 4, the positional relationship information indicates the branching directions of the blood vessel 500 using the hue wheel 400. For example, as shown in Fig. 4, when the three branching directions are indicated by the hue 401, the hue 401 indicates which direction the blood vessel 501 faces with respect to the entrance of the branch of the blood vessel 501 branching in three directions.

[0059] Furthermore, Fig. 5 shows an example in which a hue wheel 400 is superimposed on blood vessels 502 branching in four directions from one blood vessel 500, and the angle of the branch with respect to the traveling direction is expressed by a hue 402. An area 321 shown in Fig. 5 is an example displayed parallel to the display 32. As shown in Fig. 5, an example is shown in which the position information displays (expresses) the direction of the branching blood vessel 502 using a hue 402 corresponding to the hue wheel 400. For example, as shown in Fig. 5, the angle direction with respect to the traveling direction of the medical device is displayed with light and dark, with the traveling direction side approaching a light color and the opposite direction approaching a dark color.

[0060] That is, the positional relationship information indicates the direction of the tip position of the medical device in three-dimensional space in accordance with the inclination of the blood vessel. It is said that color is intuitively recognized faster than, for example, characters such as numbers. Therefore, by displaying the branching direction of the blood vessel 500 by hue, the surgeon can quickly grasp the branching direction.

[0061] Returning to FIG. 1, the display control function 345 causes the display 32 to display the positional relationship information. The display control function 345 is an example of a display control unit. Specifically, the display control function 345 causes the display 32 to display the positional relationship information generated by the first generation function 344. For example, the display control function 345 superimposes the positional relationship information on the X-ray image or the three-dimensional blood vessel image acquired by the image acquisition function 342. Then, the display control function 345 causes the display 32 to display at least one of the X-ray image 600 or the three-dimensional blood vessel image 800 on which the positional relationship information is superimposed.

[0062] Here, the form of display by the display control function 345 on the display 32 will be described with reference to Fig. 6 and Fig. 7. Fig. 6 and Fig. 7 are schematic diagrams showing an example of display performed by the medical image processing apparatus 30 according to the embodiment. In Fig. 6, a hue circle 400 and a hue 403 are superimposed on an X-ray image 600 including a blood vessel 500 and a medical device 700. In Fig. 7, a hue circle 400 and a hue 404 are superimposed on a three-dimensional blood vessel image 800 including the blood vessel 500 and the medical device 700.

[0063] For example, the surgeon performs a procedure while viewing the hue circle 400 and the X-ray image 600 or the three-dimensional blood vessel image 800 on which the hue is superimposed, as shown in Fig. 6 and Fig. 7. The X-ray image 600 and the three-dimensional blood vessel image 800 shown in Fig. 6 and Fig. 7 show the hue as information regarding the depth direction in the branching direction of the blood vessel. The surgeon can confirm the depth direction of the blood vessel by checking the hue and checking the hue circle 400 corresponding to the hue.

[0064] Next, an example of a procedure for generating and displaying positional relationship information will be described with reference to Fig. 8. Fig. 8 is a flowchart for explaining a series of processing flows of the medical image processing apparatus 30 according to the embodiment. Note that this processing is started after the image processing function 341 of the processing circuitry 43 generates an X-ray image including a medical device inserted into the blood vessel of the subject P and a three-dimensional blood vessel image including the blood vessel of the subject P.

[0065] First, the image acquiring function 342 acquires a three-dimensional blood vessel image including the blood vessels of the subject P (step S81). Next, the image acquiring function 342 acquires an X-ray image collected from the subject P with a medical device inserted into the blood vessel (step S82). Next, the calculation function 343 calculates position information of the tip of the medical device in three-dimensional space from the X-ray image (step S83).

[0066] Next, the first generating function 344 associates the blood vessels depicted in the three-dimensional blood vessel image with the positional relationship of the tip of the medical device in the three-dimensional space, and generates positional relationship information indicating the positional relationship between the tip of the medical device and any one of the branch blood vessels that is connected to the first blood vessel corresponding to the tip of the medical device and branches off from the first blood vessel (step S84). Next, the display control function 345 superimposes the positional relationship information generated by the first generating function 344 on the X-ray image or three-dimensional blood vessel image acquired by the image acquisition function 342 (step S85).

[0067] Next, the display control function 345 causes at least one of the X-ray image 600 and the three-dimensional blood vessel image 800 on which the positional relationship information is superimposed to be displayed on the display 32 (step S86). When this process ends, the process performed by the processing circuitry 34 ends. Note that when the image processing function 341 generates a new X-ray image, this process performed by the processing circuitry 34 starts again.

[0068] As described above, according to the embodiment, the medical image processing device 30 acquires an X-ray image collected from a subject P having a medical device inserted into his / her blood vessels, and a three-dimensional vascular image including the blood vessels of the subject P, calculates position information of the tip of the medical device in three-dimensional space from the X-ray image, matches the positional relationship between the blood vessels depicted in the three-dimensional vascular image and the tip of the medical device in three-dimensional space based on the positional relationship information, generates positional relationship information indicating the positional relationship between the tip position of the medical device and any one of a plurality of branch blood vessels connected to a first blood vessel corresponding to the tip of the medical device and branching off from the first blood vessel, and displays the positional relationship information on a display.

[0069] Thereby, for example, the medical image processing device 30 can provide information on the depth direction in the branching direction of blood vessels for a medical image used in a procedure. The surgeon performs the procedure while looking at the information on the depth direction in the branching direction of blood vessels. For example, a hue is shown as the information on the depth direction in the branching direction of blood vessels. The surgeon can check the hue and the hue wheel 400 corresponding to the hue to check the depth direction of the blood vessels.

[0070] Therefore, the number of times imaging is performed by the X-ray diagnostic apparatus 10 during the procedure can be reduced, and therefore the operator, the subject P, and surrounding staff in the operating room can be exposed to a reduced amount of X-ray radiation from the X-ray tube 102. Furthermore, the number of times imaging is performed by the X-ray diagnostic apparatus 10 during the procedure can be reduced, and therefore the operator can reduce the amount of contrast medium used for the subject P. Furthermore, the number of times imaging is performed by the X-ray diagnostic apparatus 10 during the procedure can be reduced, and therefore the X-ray diagnostic apparatus 10 can use the X-ray tube 102 for a longer period of time. Furthermore, the number of times imaging is performed by the X-ray diagnostic apparatus 10 during the procedure can be reduced, and therefore the operator can improve the throughput of the procedure.

[0071] The above-described embodiment can be modified as appropriate by changing a part of the configuration or function of each device. Therefore, some modifications of the above-described embodiment will be described below as other embodiments. The following mainly describes the differences from the above-described embodiment, and the same reference numerals will be used to denote the common points with the contents already described, and detailed description will be omitted. The other embodiments described below may be implemented individually or in appropriate combination.

[0072] (First Modification) In the above-mentioned embodiment, the blood vessel depicted in the three-dimensional vascular image is associated with the positional relationship of the tip of the medical device in three-dimensional space, and positional relationship information indicating the positional relationship between the tip position of the medical device and any one of a plurality of branched blood vessels connected to a first blood vessel corresponding to the tip of the medical device and branched from the first blood vessel is displayed. In contrast, in the first modification, an electrocardiogram waveform is acquired, and positional relationship information corresponding to the pulsation is displayed based on the acquired electrocardiogram waveform.

[0073] 9 is a block diagram showing an example of the configuration of the medical information processing system according to the first modified example. In the medical image processing device 40 included in the medical information processing system 2 according to the first modified example, the processing circuitry 35 executes an image processing function 341, an image acquisition function 342, a calculation function 343, a first generation function 344, a display control function 345, and a biological information acquisition function 346 to control the operation of the entire medical image processing device 40.

[0074] The biological information acquiring function 346 acquires an electrocardiogram waveform. The biological information acquiring function 346 is an example of a biological information acquiring unit. Specifically, the biological information acquiring function 346 acquires electrocardiogram (ECG) information of the subject P. For example, the biological information acquiring function 346 acquires electrocardiogram waveform information of the subject P from the output of an electrocardiograph. Then, the display control function 345 causes the display 32 to display the positional relationship information generated by the first generating function 344 and the electrocardiogram waveform information acquired by the biological information acquiring function 346. For example, the display control function 345 synchronizes the electrocardiogram waveform with a CT image captured under electrocardiogram synchronization and outputs them together with the positional relationship information.

[0075] Here, the form in which the display control function 345 displays the positional relationship information and the electrocardiogram waveform information on the display will be described with reference to Fig. 10, Fig. 11, and Fig. 12. Fig. 10, Fig. 11, and Fig. 12 are schematic diagrams showing an example of the display performed by the medical image processing device according to the first modified example.

[0076] In FIG. 10, an X-ray image 600, a three-dimensional blood vessel image 800, a perspective image 900, a roadmap image 1000, and electrocardiogram waveform information 1100 are displayed on the display 32. The X-ray image 600, which includes a blood vessel 500 and a medical device 700, has a hue circle 400 and a hue 403 superimposed thereon. The three-dimensional blood vessel image 800, which includes a blood vessel 500 and a medical device 700, has a hue circle 400 and a hue 404 superimposed thereon. The perspective image 900 includes the medical device 700. The roadmap image 1000 is obtained by subtracting the perspective image 900 from the contrast image, leaving only the blood vessel information 1001, and is, for example, three-dimensional blood vessel data. The blood vessel information 1001 has a hue corresponding to the hue circle 400 superimposed thereon. The electrocardiogram waveform information 1100 is vital information such as an electrocardiogram and blood pressure.

[0077] 11, a schematic diagram 1200 of the heart will be described as an example of a display in accordance with the heartbeat. A hue wheel 400 is displayed adjacent to the schematic diagram 1200. The schematic diagram 1200 also displays a medical device 700 and a tip 701 of the medical device 700 inside a blood vessel 500. The tip 701 of the medical device 700 is displayed in a color corresponding to the hue wheel 400. The schematic diagram 1200 also displays a hue 405 corresponding to the direction of the target blood vessel, and the hue 405 is displayed in a color corresponding to the hue wheel 400.

[0078] For example, the hue 405 is displayed while changing color in accordance with the pulsation of the heart with respect to the position of the tip 701 of the medical device 700 and the direction of the target blood vessel. This allows the surgeon to check the hue 405 and insert the medical device 700 into the blood vessel while adjusting the direction of the tip 701 of the medical device 700 in accordance with the timing at which the hue 405 changes. For example, the surgeon can insert the medical device 700 into the blood vessel in accordance with the timing at which the color of the tip 701 of the medical device 700 and the hue 405 become the same color.

[0079] 12 illustrates a display form in which an enlarged view 1201 of the tip 701 of the medical device 700 is displayed together with electrocardiogram waveform information 1205 as a display in accordance with the pulsation. Enlarged views 1202, 1203, and 1204 are enlarged views corresponding to the enlarged view 1201. A first timing T1 in the electrocardiogram waveform information 1205 corresponds to the enlarged view 1202. A second timing T2 in the electrocardiogram waveform information 1205 corresponds to the enlarged view 1203. A third timing T3 in the electrocardiogram waveform information 1205 corresponds to the enlarged view 1204.

[0080] Hues 406, 407, and 408 correspond to the hue 405, which corresponds to the direction of the target blood vessel. This allows the surgeon to check the electrocardiogram waveform information 1205 and the hue 405, and to insert the medical device 700 into the blood vessel while adjusting the direction of the tip 701 of the medical device 700 in accordance with the timing at which the hue 405 changes.

[0081] (Second Modification) For example, when an operator performs a procedure on a subject P, there may be a case where a coronary artery has a lesion and the blood inner diameter is narrowed, making it difficult to operate a medical device. The medical image processing device may be configured to display the blood vessel diameter of the blood vessel into which the medical device is inserted. In the second modified example, a configuration for displaying the blood vessel diameter will be described with reference to FIG.

[0082] 13 is a block diagram showing an example of the configuration of a medical information processing system according to Modification 2. In a medical image processing device 50 included in the medical information processing system 3 according to Modification 2, a processing circuit 36 ​​executes an image processing function 341, an image acquisition function 342, a calculation function 343, a first generation function 344, a display control function 345, a biological information acquisition function 346, and a second generation function 347 to control the operation of the medical image processing device 50 as a whole.

[0083] The second generating function 347 generates patency information indicating a target traveling direction and a degree of blockage in a blood vessel based on an X-ray image. The second generating function 347 is an example of a second generating unit. The patency information is information indicating a patent state in a blood vessel that is blocked by calcification, plaque, thrombus, or the like. Here, the patency information generated by the second generating function 347 will be described with reference to Figs. 14 and 15. Figs. 14 and 15 are schematic diagrams for explaining the patency information.

[0084] 14 shows a medical image 1400 such as an X-ray image. The medical image 1400 shows a main blood vessel 503, a first branch blood vessel 504 branching off from the main blood vessel 503, a medical device 700 located in the main blood vessel 503, a hue wheel 410 corresponding to the medical device 700, a hue 411 located in the first branch blood vessel 504 and corresponding to the target traveling direction, and patency information 412 corresponding to the hue 411 of the first branch blood vessel 504. The hue 411 corresponds to the hue of the hue wheel 410.

[0085] 14, a dotted circle 413 indicates the inner diameter of the first branch blood vessel 504, and indicates a patent hole 414 existing inside the circle 413. In other words, the space other than the patent hole 414 is in a state of being blocked by, for example, calcification, plaque, or a thrombus.

[0086] Fig. 15 is a schematic diagram of an enlarged medical image 1400 shown in Fig. 14. Fig. 15 shows a main blood vessel 503, a first branch blood vessel 504, a second branch blood vessel 505 branching from the first branch blood vessel 504, a first hue circle 420 indicating a direction corresponding to the main blood vessel 503, a hue 421 located in the first branch blood vessel 504 and corresponding to a target traveling direction, a hue 422 located in the second branch blood vessel 505 and corresponding to a target traveling direction, a second hue circle 423 corresponding to a direction of a patent position of the first branch blood vessel 504, and patency information 424 corresponding to the hue 421 of the first branch blood vessel 504. The hue 421 and the hue 422 correspond to the hue of the first hue circle 420.

[0087] 15, a dotted circle 425 indicates the inner diameter of the first branch blood vessel 504, and indicates a patent hole 426 present inside the circle 425. Furthermore, a hue 427 is indicated at one end of the patent hole 426, and a hue 428 is indicated at the other end of the patent hole 426. The hue 427 and the hue 428 correspond to the second hue circle 423. In other words, the surgeon can better grasp the area of ​​the patent hole 426 by assigning the hue 427 and the hue 428 to the patent hole 426 included in the patency degree information 424.

[0088] Returning to Fig. 13, the display control function 345 outputs the patency degree information generated by the second generating function 347. For example, the display control function 345 outputs the patency degree information generated by the second generating function 347 by superimposing it on an X-ray image. This allows the surgeon to grasp the state of the blood vessel even in a procedure on a blood vessel with a narrowed inner diameter, thereby shortening the time required for the procedure and improving the throughput of the procedure, etc.

[0089] (Third Modification) For example, the surgeon may wish to change the settings of a hue circle displayed on the display 32. In the third modified example, a form for changing the settings of a hue circle displayed on the display 32 will be described with reference to FIG. 16. FIG. 16 is a block diagram showing an example of the configuration of a medical information processing system according to the third modified example. In a medical image processing device 60 provided in a medical information processing system 4 according to the third modified example, a processing circuitry 37 controls the operation of the entire medical image processing device 60 by executing an image processing function 341, an image acquisition function 342, a calculation function 343, a first generation function 344, a display control function 345, a biological information acquisition function 346, a second generation function 347, and a parameter change function 348.

[0090] The parameter change function 348 changes parameters related to positional relationship information in response to a user operation. The parameter change function 348 is an example of a parameter change unit. Here, the contents of processing by the parameter change function 348 will be described with reference to Fig. 17. Fig. 17 is a schematic diagram for explaining the contents of processing by a medical image-processing device 60 according to a third modified example.

[0091] 17 shows a parameter change screen 1300 relating to positional relationship information that accepts user operations. The parameters relating to positional relationship information include information relating to the distribution of hues in a hue circle, the brightness of colors indicating a direction in a three-dimensional space, or the type of shape of a figure. For example, the parameter change screen 1300 shows, for a medical image, a color range for accepting a change in the color range of the hue circle, a hue arrangement for accepting a change in the arrangement of the hue circle, a hue brightness for accepting a change in the brightness of the hue, and an angle in the traveling direction for accepting a change in the direction (hereinafter also referred to as an angle) of the medical device corresponding to the direction of a blood vessel.

[0092] The color range is, for example, when the reference colors are 24 colors, the selection is made as to whether to reduce, increase, or halve the reference colors. The arrangement of hues is, for example, a selection as to whether to make the area corresponding to the assigned hues uniform or uneven. The brightness of the hue is, for example, a selection as to whether to make it brighter or darker. The angle in the direction of travel is, for example, a selection as to the color brightness, saturation, angle with the main blood vessel, solid 1, solid 2, solid 3, plane 1, and plane 2.

[0093] Here, the angle in the traveling direction will be described with reference to FIG. 18. FIG. 18 is a schematic diagram for explaining a form indicating the traveling direction of a medical device according to a third modified example. FIG. 18 shows marks 1401, 1402, 1403, and 1404 as forms indicating the direction of the medical device. Also, for example, mark 1401 indicates the angle between the main blood vessel and the medical device with the saturation of the color applied to a circle. For example, mark 1402 indicates the angle indicated by two line segments between the main blood vessel and the medical device.

[0094] Furthermore, for example, mark 1403 indicates the angle between the main blood vessel and the medical device with a three-dimensional figure. Specifically, in the case of solid 1 (cone) and solid 2 (square pyramid) shown in mark 1403, each vertex indicates a direction, and the angle of the vertex indicates the angle between the main blood vessel and the medical device. In the case of solid 3 (sphere) shown in mark 1403, an arbitrary point is set on the surface of the sphere, and the set point indicates a direction, and the size of the sphere indicates the angle between the main blood vessel and the medical device.

[0095] Also, mark 1404 indicates the angle between the main blood vessel and the medical device in a planar figure. Specifically, in the case of plane 1 (circle) shown in mark 1404, an arbitrary point is set on the circle, the set point indicates the direction, and the size of the circle indicates the angle between the main blood vessel and the medical device. In the case of plane 2 (rectangle) shown in mark 1404, the center of the rectangle indicates the direction, and the change in shape from the rectangle to a star indicates the angle between the main blood vessel and the medical device. This makes it possible to indicate the direction of the medical device in three-dimensional space in accordance with the direction of the blood vessel.

[0096] Returning to FIG. 17, the parameter change screen 1300 also shows a screen for displaying the changes ("Preview"), a button for confirming the changes ("Open Preset"), a button for saving the changes ("Save"), and a button for terminating the changes ("Close"). As shown in FIG. 17, the parameter change function 348 can change parameters relating to the positional relationship information displayed on the display 32 in response to a user operation. This allows the surgeon to change the display direction to one that is easy to view, thereby shortening the time required for the procedure and improving the throughput of the procedure, etc.

[0097] (Fourth Modification) For example, the surgeon may wish to change the display direction of a medical image displayed on the display 32. In the fourth modified example, a form for changing the display direction of a medical image displayed on the display 32 will be described with reference to FIG. 19. FIG. 19 is a block diagram showing an example of the configuration of a medical information processing system according to the fourth modified example. In a medical image processing device 70 provided in the medical information processing system 5 according to the fourth modified example, a processing circuit 38 executes an image processing function 341, an image acquisition function 342, a calculation function 343, a first generation function 344, a display control function 345, a biological information acquisition function 346, a second generation function 347, a parameter change function 348, and a display direction change function 349 to control the operation of the entire medical image processing device 70.

[0098] The display direction change function 349 switches the reference for the display direction of the hue circle to the surgeon's line of sight direction or the subject's direction in response to a user's operation. The display direction change function 349 is an example of a display direction change unit. Here, the surgeon's line of sight direction and the subject's direction will be described. The surgeon's line of sight direction is the direction of the subject as seen from a position where the surgeon stands next to the patient. The subject's direction is the direction in which the subject is always in the correct position, in other words, the direction in which the subject's head is facing up.

[0099] Next, the contents of processing by the display direction change function 349 will be described with reference to Fig. 20. Fig. 20 is a schematic diagram for explaining the contents of processing by the medical image processing device 70 according to the fourth modified example. In Fig. 20, the reference of the display direction of the hue circle is shown in the subject direction.

[0100] 20 shows a display direction change screen 1500 for accepting user operations. The display direction change screen 1500 shows, for medical images, a hue wheel display for accepting a change in the hue wheel display, a display direction for accepting a change in the display direction, device tracking for accepting whether to track a medical device, a color navigation type for accepting a display form of branching blood vessels, and a display type for accepting a display timing.

[0101] The color wheel display is, for example, a content for selecting a screen to be displayed on a plurality of displays. The display direction is, for example, a content for selecting whether to fix the color wheel in the projection direction, fix it in the subject direction, or change the display direction according to the movement of the medical device. The color navigation type is, for the direction of the blood vessel to the target position of the branch at the tip of the guide wire, a content for selecting whether to display a circular display and a blood vessel hole shape corresponding to the branched blood vessel, or not to display a circular display and a blood vessel hole shape corresponding to the branched blood vessel, or to color the branched blood vessel, or to make the branched blood vessel a background color. The display type is, for example, a content for selecting whether to display when the medical device approaches a blood vessel branch, or to display it at all times.

[0102] The display direction change screen 1500 also shows a screen for displaying the changes ("Preview"), a button for confirming the changes ("Open Preset"), a button for saving the changes ("Save"), and a button for terminating the changes ("Close"). As shown in Fig. 20, the display direction change function 349 can change the display direction of the medical image displayed on the display 32 in response to a user operation. This allows the surgeon to change the display direction to one that is easy to view, thereby shortening the time required for the procedure and improving the throughput of the procedure.

[0103] Furthermore, if the display direction of the color wheel is based on the operator's line of sight, for example, the actual blood vessel to be treated will be rotated 90 degrees to the left from the X-ray image in Fig. 20 for the operator standing to the right of the patient. In a state where the X-ray image and the actual blood vessel to be treated are rotated 90 degrees, the operator may have difficulty in grasping the direction of operation of the medical device. Therefore, when operating a medical device, the operator can operate the medical device more intuitively based on the operator's line of sight compared to conventional methods.

[0104] In the medical image processing apparatus 30 according to each of the above-mentioned embodiments, a part or all of the functions of the processing circuit 34 may be realized by an external device of the medical image processing apparatus 30. As an example, the image processing function 341, the image acquisition function 342, the calculation function 343, the first generation function 344, and the display control function 345, which are the functions of the processing circuit 34, may be realized by the X-ray diagnostic apparatus 10. In addition, a part or all of the functions of the processing circuit 35, the processing circuit 36, the processing circuit 37, and the processing circuit 38 in the medical image processing apparatus 40, the medical image processing apparatus 50, the medical image processing apparatus 60, and the medical image processing apparatus 70 according to the modified examples may be realized by an external device including the X-ray diagnostic apparatus 10.

[0105] In addition, each component of each device illustrated in the present embodiment is a functional concept, and does not necessarily have to be physically configured as illustrated. In other words, the specific form of distribution and integration of each device is not limited to that illustrated, and all or a part of them can be functionally or physically distributed and integrated in any unit according to various loads and usage conditions. Furthermore, each processing function performed by each device can be realized in whole or in any part by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware using wired logic.

[0106] According to at least one of the embodiments described above, it is possible to provide information regarding the depth direction in the branching direction of blood vessels for medical images used in a procedure.

[0107] Although some embodiments of the present invention 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 described in the claims, as well as in the scope and spirit of the invention. [Explanation of symbols]

[0108] 10. X-ray diagnostic equipment 30, 40, 50, 60, 70 Medical image processing device 34, 35, 36, 37, 38 Processing circuit 341 Image Processing Function 342 Image Acquisition Function 343 Calculation Function 344 1st generation function 345 Display Control Function 346 Biometric information acquisition function 347 Second generation function 348 Parameter change function 349 Display direction change function

Claims

1. an image acquisition unit that acquires an X-ray image collected from a subject having a blood vessel inserted into the blood vessel and a three-dimensional blood vessel image including the blood vessel of the subject; a calculation unit that calculates position information of the tip of the medical device in a three-dimensional space from the X-ray image; a first generating unit that generates positional relationship information indicating a positional relationship between the blood vessel depicted in the three-dimensional vascular image and the tip of the medical device in a three-dimensional space based on the positional information, and between any one of a plurality of branched blood vessels that are connected to a first blood vessel corresponding to the tip of the medical device and branched off from the first blood vessel, and a tip position of the medical device; a display control unit that displays the positional relationship information on a display; A medical image processing device comprising:

2. the positional relationship information includes a hue circle in which hues are arranged in a circle, The medical image processing device according to claim 1 .

3. The positional relationship information indicates a three-dimensional spatial direction and includes a color brightness or a shape of a figure. The medical image processing device according to claim 1 .

4. The display control unit causes the display to display the positional relationship information so as to move within the blood vessel in response to movement of the tip position of the medical device. The medical image processing device according to claim 3 .

5. The positional relationship information indicates a direction of a tip position of the medical device in the three-dimensional space corresponding to an inclination of the blood vessel. The medical image processing device according to claim 4 .

6. The display control unit outputs the electrocardiogram waveform and the CT image captured under electrocardiogram synchronization together with the positional relationship information in synchronization with each other. The medical image processing device according to claim 1 .

7. and a second generating function for generating patency information indicating a target direction of travel and a degree of occlusion in the blood vessel based on the X-ray image, The display control unit outputs the patency degree information. The medical image processing device according to claim 1 .

8. The display control unit outputs the patency degree information by superimposing it on the X-ray image. The medical image processing device according to claim 7 .

9. a parameter change unit that changes a parameter related to the positional relationship information in response to a user operation. The medical image processing device according to claim 1 .

10. The parameters include information on the distribution of hues in a color wheel, a direction in the three-dimensional space, color brightness, or a type of shape of a figure. The medical image processing apparatus according to claim 9 .

11. and a display direction changing unit that changes a reference for the display direction of the hue circle to a direction of the operator's line of sight or a direction of the subject in response to a user's operation. The medical image processing device according to claim 2 .

12. an image acquisition unit that acquires an X-ray image collected from a subject having a blood vessel inserted into the blood vessel and a three-dimensional blood vessel image including the blood vessel of the subject; a calculation unit that calculates position information of the tip of the medical device in a three-dimensional space from the X-ray image; a first generating unit that generates positional relationship information indicating a positional relationship between the blood vessel depicted in the three-dimensional vascular image and the tip of the medical device in a three-dimensional space based on the positional information, and between any one of a plurality of branched blood vessels that are connected to a first blood vessel corresponding to the tip of the medical device and branched off from the first blood vessel, and a tip position of the medical device; a display control unit that displays the positional relationship information on a display; An X-ray diagnostic apparatus comprising:

13. acquiring an X-ray image collected from a subject having a medical device inserted into a blood vessel and a three-dimensional vascular image including the blood vessel of the subject, and calculating position information in a three-dimensional space of a tip of the medical device from the X-ray image; based on the position information, associate the blood vessels depicted in the three-dimensional vascular image with the positional relationship of the tip of the medical device in three-dimensional space, and generate positional relationship information indicating a positional relationship between a branch blood vessel of a plurality of blood vessels connected to a first blood vessel corresponding to the tip of the medical device and branched off from the first blood vessel and a tip position of the medical device; displaying the positional relationship information on a display; A medical image processing program that causes a computer to carry out each process.

Images