Medical image processing apparatus, system, and method

Abstract

To reduce time and effort of a user when making a diagnosis, a treatment plan and the like related to a heart disease.SOLUTION: A medical image processing apparatus includes an acquisition part, a display control part, and an input operation reception part. The processing circuitry acquires a three dimensional image of a blood vessel of a subject and a spatial distribution of a value of wall shear stress at each position of the blood vessel. The display control part displays a display image obtained by assigning the value of the wall shear stress to the three dimensional image from an arbitrary angle. The input operation reception unit receives an input operation for changing the angle. When displaying a display image in which a value of wall shear stress is assigned to a three dimensional image, the display control unit changes a display mode of the display image between a rotation display mode in which the display image is displayed while changing an angle with time and a non-rotation display mode in which the angle is not changed.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] SUMMARY OF THE INVENTION The embodiments disclosed herein and in the drawings relate to medical imaging devices, systems and methods. [Background technology]

[0002] Conventionally, as a technology for supporting the diagnosis and formulation of treatment plans for cardiac diseases, a technology for presenting various information about the blood flow in the blood vessels of a subject's heart based on medical images of the blood vessels has been known. For example, a technology for calculating and displaying wall shear stress (WSS) at each position in the blood vessel as one piece of information about the blood flow has been known. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Special Publication No. 2020-518362 [Patent Document 2] Japanese Patent Application Laid-Open No. 2011-62358 [Patent Document 3] Special Publication No. 2016-533815 Summary of the Invention [Problem to be solved by the invention]

[0004] One of the problems to be solved by the embodiments disclosed in this specification and the drawings is to reduce the effort required by users when diagnosing heart disease and formulating treatment plans. 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 below can also be considered as other problems. [Means for solving the problem]

[0005] A medical image processing apparatus according to an embodiment includes an acquisition unit, a display control unit, and an input operation receiving unit. The acquisition unit acquires a three-dimensional image of a subject's blood vessels and a spatial distribution of wall shear stress values ​​at each position in the blood vessels. The display control unit displays a display image in which the wall shear stress values ​​are assigned to the three-dimensional image from an arbitrary angle. The input operation receiving unit receives an input operation to change the angle. The display control unit changes the display form of the display image in which the wall shear stress values ​​are assigned to the three-dimensional image between a rotational display in which the display image is displayed while changing the angle over time and a non-rotational display in which the angle is not changed. [Brief explanation of the drawings]

[0006] [Figure 1] FIG. 1 is a diagram showing an example of the configuration of a medical image processing system and a medical image processing apparatus according to the first embodiment. [Figure 2] FIG. 2 is a flowchart showing the processing procedure of the processing performed by each processing function of the processing circuitry of the medical image processing apparatus according to the first embodiment. [Figure 3A] FIG. 3A is a diagram illustrating an example of a list according to the first embodiment. [Figure 3B] FIG. 3B is a diagram illustrating an example of a list according to the first embodiment. [Figure 4A] FIG. 4A is a diagram showing an example of a display image of the WSS according to the first embodiment. [Figure 4B] FIG. 4B is a diagram showing an example of a display image of the WSS according to the first embodiment. [Figure 5] FIG. 5 is a diagram for explaining an example of switching the display mode of a display image according to the first embodiment. [Figure 6] FIG. 6 is a diagram for explaining an example of speed adjustment of the rotation speed according to the first embodiment. [Figure 7] FIG. 7 is a diagram for explaining an example of display control by the display control function according to the first embodiment. [Figure 8A]FIG. 8A is a diagram showing an example of display of additional information according to the first embodiment. [Figure 8B] FIG. 8B is a diagram for explaining an example of speed control of the rotation speed based on additional information according to the first embodiment. [Figure 9] FIG. 9 is a diagram for explaining an example of information transfer by the control function according to the first embodiment. [Figure 10] FIG. 10 is a flowchart showing the processing procedure of the processing performed by each processing function of the processing circuitry of the medical image processing apparatus according to the second embodiment. [Figure 11] FIG. 11 is a diagram illustrating an example of display control by the display control function according to the third embodiment. [Figure 12] FIG. 12 is a diagram illustrating an example of display control by the display control function according to the third embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0007] Hereinafter, embodiments of a medical image processing device, system, and method will be described in detail with reference to the drawings. Note that the medical image processing device and medical image processing method according to the present application are not limited to the embodiments shown below. Furthermore, the embodiments can be combined with other embodiments or conventional techniques as long as there is no contradiction in the processing content.

[0008] (First embodiment) FIG. 1 is a diagram showing an example of the configuration of a medical image processing system and a medical image processing apparatus according to the first embodiment.

[0009] 1, a medical image processing system 100 according to this embodiment includes an X-ray CT (Computed Tomography) device 110, a medical image storage device 120, departmental systems 130, a medical information display device 140, and a medical image processing device 150. Here, each device and system is connected to each other via a network 160 so as to be able to communicate with each other.

[0010] In addition to the X-ray CT device 110, the medical image processing system 100 may further include other medical image diagnostic devices such as a magnetic resonance imaging (MRI) device, an ultrasound diagnostic device, a PET (Positron Emission Tomography) device, and a SPECT (Single Photon Emission Computed Tomography) device.

[0011] The X-ray CT device 110 generates a CT image of a subject. Specifically, the X-ray CT device 110 collects projection data representing the distribution of X-rays that have passed through the subject by rotating an X-ray tube and an X-ray detector on a circular orbit that surrounds the subject. The X-ray CT device 110 then generates a CT image based on the collected projection data.

[0012] The medical image storage device 120 stores various medical images related to subjects. Specifically, the medical image storage device 120 acquires CT images from the X-ray CT device 110 via the network 160, and stores the CT images in a memory circuit within the device. For example, the medical image storage device 120 is realized by a computer device such as a server or a workstation. Furthermore, for example, the medical image storage device 120 is realized by a PACS (Picture Archiving and Communication System) or the like, and stores the CT images in a format compliant with DICOM (Digital Imaging and Communications in Medicine).

[0013] Each department system 130 includes various systems such as a Hospital Information System (HIS), a Radiology Information System (RIS), a diagnostic report system, a Laboratory Information System (LIS), a rehabilitation department system, a dialysis department system, and a surgery department system. The medical image processing system 100 is connected to each of these systems and transmits and receives various information to and from each of them. For example, the medical image processing system 100 transmits and receives patient information, examination information, treatment information, information on analysis results, and the like to and from each of the systems included in each department system 130.

[0014] The medical information display device 140 displays various types of medical information related to a subject. Specifically, the medical information display device 140 acquires medical information such as CT images and image processing results from the medical image storage device 120 via the network 160, and displays the medical information on its own display. For example, the medical information display device 140 is realized by computer equipment such as a workstation, a personal computer, or a tablet terminal.

[0015] The medical image processing device 150 performs various types of image processing related to a subject. Specifically, the medical image processing device 150 acquires CT images from the X-ray CT device 110 or the medical image storage device 120 via the network 160, and performs various types of image processing using the CT images. The medical image processing device 150 also acquires various types of information from each department system 130 via the network 160 and executes various types of processing. For example, the medical image processing device 150 is realized by computer equipment such as a server or a workstation.

[0016] For example, the medical image processing device 150 includes a network (NW) interface 151, a storage circuitry 152, an input interface 153, a display 154, and a processing circuitry 155.

[0017] The NW interface 151 controls the transmission and communication of various data sent and received between the medical image processing device 150 and other devices connected via the network 160. Specifically, the NW interface 151 is connected to the processing circuitry 155, and outputs data received from other devices to the processing circuitry 155, or transmits data output from the processing circuitry 155 to other devices. For example, the NW interface 151 is realized by a network card, a network adapter, a NIC (Network Interface Controller), or the like.

[0018] The memory circuitry 152 stores various data and programs. Specifically, the memory circuitry 152 is connected to the processing circuitry 155 and stores data input from the processing circuitry 155, or reads out stored data and outputs it to the processing circuitry 155. For example, the memory circuitry 152 is realized by a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like.

[0019] The input interface 153 accepts input operations of various instructions and information from a user. Specifically, the input interface 153 is connected to the processing circuit 155, converts the input operations received from the user into electrical signals, and outputs the electrical signals to the processing circuit 155. For example, the input interface 153 may be realized by a trackball, a switch button, a mouse, a keyboard, a touchpad that performs input operations by touching the operation surface, a touchscreen that integrates a display screen and a touchpad, a non-contact input interface using an optical sensor, a voice input interface, or the like. Note that in this specification, the input interface 153 is not limited to those that have physical operation components such as a mouse and a keyboard. For example, an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the device and outputs the electrical signal to a control circuit is also included as an example of the input interface 153.

[0020] For example, the input interface 153 receives an input operation for changing the angle of a display image displayed from an arbitrary angle. The input interface 153 is an example of an input operation receiving unit.

[0021] The display 154 displays various types of information and various types of data. Specifically, the display 154 is connected to the processing circuit 155 and displays various types of information and various types of data output from the processing circuit 155. For example, the display 154 is realized by a liquid crystal display, a CRT (Cathode Ray Tube) display, a touch panel, or the like.

[0022] The processing circuitry 155 controls the entire medical image processing device 150. For example, the processing circuitry 155 performs various processes in response to input operations received from a user via the input interface 153. For example, the processing circuitry 155 inputs data transmitted from another device from the NW interface 151 and stores the input data in the storage circuitry 152. Furthermore, for example, the processing circuitry 155 outputs data input from the storage circuitry 152 to the NW interface 151, thereby transmitting the data to another device. Furthermore, for example, the processing circuitry 155 displays the data input from the storage circuitry 152 on the display 154.

[0023] The above describes exemplary configurations of the medical image processing system 100 and medical image processing device 150 according to this embodiment. For example, the medical image processing system 100 and medical image processing device 150 according to this embodiment are installed in medical facilities such as hospitals and clinics, and support users such as doctors in making diagnoses and formulating treatment plans for heart diseases.

[0024] Specifically, the medical image processing device 150 calculates and displays the wall shear stress (WSS) at each position in the blood vessels based on medical images of the blood vessels in the subject's heart. Here, the medical image processing device 150 automatically changes the display format in consideration of the cost of calculating the WSS and the visibility of the doctor, thereby reducing the effort required of the user when diagnosing heart disease or formulating a treatment plan.

[0025] Because the calculation cost and accuracy of WSS vary depending on the calculation method, if it is not properly controlled taking into account the user's purpose of use, there is a possibility that unnecessary calculation costs will be incurred or that the WSS will not be calculated with the accuracy required by the user. However, manually setting the calculation method taking into account various circumstances is time-consuming for the user.

[0026] Therefore, the medical image processing apparatus 150 according to this embodiment is configured to reduce the user's workload by appropriately controlling the calculation and display of the WSS in consideration of the user's purpose of use.

[0027] Specifically, the medical image processing device 150 changes the display format of the WSS depending on the display method of the WSS. For example, when displaying a 3D image of a blood vessel showing the WSS, the medical image processing device 150 changes the display format between rotated display and non-rotated display. The medical image processing device 150 having such a configuration will be described in detail below. Note that the following describes an example in which a coronary artery CT image is used as a medical image related to blood vessels.

[0028] For example, as shown in FIG. 1, in this embodiment, the processing circuitry 155 of the medical image processing apparatus 150 executes an acquisition function 155a, a determination function 155b, a calculation function 155c, a display information generation function 155d, a display control function 155e, and a control function 155f. Here, the acquisition function 155a is an example of an acquisition unit. The determination function 155b is an example of a determination unit. The calculation function 155c is an example of a calculation unit. The display information generation function 155d is an example of a generation unit. The display control function 155e is an example of a display control unit. The control function 155f is an example of a control unit.

[0029] The acquisition function 155a acquires coronary artery CT images of the subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the NW interface 151. Specifically, the acquisition function 155a acquires three-dimensional coronary artery CT images that can be used to calculate the WSS. The acquisition function 155a can also acquire blood flow index values ​​from devices connected to the medical image processing system 100 via the NW interface 151. That is, the acquisition function 155a can acquire blood flow index values ​​calculated by devices connected to the medical image processing system 100. For example, the acquisition function 155a acquires WSS values ​​and fractional flow reserve (FFR) values ​​at each position of the coronary artery that are calculated by devices connected to the medical image processing system 100. Note that in this embodiment, a case will be described in which the calculation function 155c calculates the above-mentioned blood flow index values ​​using the three-dimensional coronary artery CT images acquired by the acquisition function 155a.

[0030] The determination function 155b performs a determination process on the WSS calculation target and the calculation result. Specifically, the determination function 155b performs a determination process on the validity of the WSS calculation target and the validity of the WSS calculation result. The processing by the determination function 155b will be described in detail later.

[0031] The calculation function 155c extracts the central lines of the coronary arteries included in the coronary artery CT image of the subject acquired by the acquisition function 155a. The calculation function 155c also calculates index values ​​related to the blood flow of the coronary arteries based on the coronary artery CT image of the subject acquired by the acquisition function 155a. For example, the calculation function 145b calculates the WSS value, the fractional flow reserve (FFR), and the like at each position of the coronary arteries from the coronary artery CT image of the subject using a known method such as CFD (Computational Fluid Dynamics) or machine learning.

[0032] For example, when calculating index values ​​using CFD, the calculation function 155c performs fluid analysis using analysis conditions such as blood physical property values ​​(e.g., hematocrit, blood viscosity, density, etc.), vascular wall elasticity value, iterative calculation conditions (maximum number of iterations in iterative calculation, relaxation coefficient, tolerance of residual, etc.), and analysis initial values ​​(blood flow rate, pressure, fluid resistance, initial value of pressure boundary, etc.) and vascular shape data to calculate index values ​​related to blood flow in a target region of the blood vessel. As an example, the calculation function 155c calculates index values ​​such as pressure, blood flow rate, blood flow velocity, vector, and wall shear stress for each position of the coronary artery.

[0033] The display information generating function 155d generates display information including various images and information for display. For example, the display information generating function 155d generates a three-dimensional image of the coronary artery by three-dimensionally reconstructing the vascular region of the coronary artery in a coronary artery CT image. For example, the display information generating function 155d generates a volume rendering (VR) image, a surface rendering (SR) image, a curved planar reconstruction (CPR) image, a multi-planar reconstruction (MPR) image, a stretched multi-planar reconstruction (SPR) image, etc.

[0034] Furthermore, for example, the display information generating function 155d generates various display information indicating object information, calculation results by the calculating function 155c, etc. The display information generated by the display information generating function 155d will be described in detail later.

[0035] The display control function 155e displays the display information generated by the display information generation function 155d on the display 154 and controls the display state. Specifically, the display control function 155e controls the display of a display image in which a WSS value is assigned to a 3D image, from any angle. For example, the display control function 155e controls the rotational display of a display image showing the WSS calculated by the calculation function 155c. The processing performed by the display control function 155e will be described in detail later.

[0036] The control function 155f transfers the calculation result of WSS to a predetermined transfer destination and executes various processes, etc. The processes performed by the control function 155f will be described in detail later.

[0037] The processing circuitry 155 described above is realized by, for example, a processor. In this case, each of the processing functions described above is stored in the storage circuitry 152 in the form of a program executable by a computer. The processing circuitry 155 then reads and executes each program stored in the storage circuitry 152 to realize the function corresponding to each program. In other words, the processing circuitry 155 has each of the processing functions shown in FIG. 1 when each program has been read.

[0038] The processing circuitry 155 may be configured by combining multiple independent processors, and each processor may execute a program to realize each processing function. Furthermore, each processing function of the processing circuitry 155 may be realized by being appropriately distributed or integrated into a single or multiple processing circuits. Furthermore, each processing function of the processing circuitry 155 may be realized by a combination of hardware and software, such as circuits. While an example in which programs corresponding to each processing function are stored in a single storage circuitry 152 has been described here, the embodiment is not limited to this. For example, a configuration in which programs corresponding to each processing function are distributed and stored in multiple storage circuits, and the processing circuitry 155 reads and executes each program from each storage circuit, may also be used.

[0039] As described above, when displaying a 3D image of a blood vessel showing the WSS, the medical image processing apparatus 150 changes the display format between rotated and non-rotated display. First, the processing procedure by the medical image processing apparatus 150 will be described with reference to FIG. 2. FIG. 2 is a flowchart showing the processing procedure performed by each processing function of the processing circuitry 155 of the medical image processing apparatus according to the first embodiment. Note that FIG. 2 illustrates an example in which the WSS is calculated in advance before receiving a WSS calculation instruction from a user.

[0040] 2, in this embodiment, the acquisition function 155a acquires a coronary artery CT image of a subject from the X-ray CT device 110 or the medical image storage device 120 (step S101). For example, the acquisition function 155a acquires a coronary artery CT image every time the X-ray CT device 110 collects the coronary artery CT image or every time the coronary artery CT image is stored in the medical image storage device 120. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the acquisition function 155a from the storage circuitry 152 and executing it.

[0041] Next, the determination function 155b determines whether the acquired coronary artery CT image satisfies the conditions when it is used as a target (step S102). Specifically, the determination function 155b determines whether the acquired coronary artery CT image is appropriate for use in calculating the WSS. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the determination function 155b from the storage circuitry 152 and executing it.

[0042] Here, if the determination function 155b determines that the condition is met (step S102, affirmative), the medical image processing apparatus 150 proceeds to step S103. On the other hand, if the determination function 155b determines that the condition is not met (step S102, negative), the medical image processing apparatus 150 returns to step S101 and acquires image data.

[0043] Next, the calculation function 155c calculates an index value related to blood flow based on the coronary artery CT image of the subject acquired by the acquisition function 155a (step S103). For example, the calculation function 155c calculates WSS. This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the calculation function 155c from the storage circuitry 152.

[0044] Next, the determination function 155b determines the calculation result and stores the determination result in the storage circuitry 152 (step S104). Specifically, the determination function 155b determines whether the calculation result of WSS calculated by the calculation function 155c is valid. Then, the determination function 155b stores the determination result in the storage circuitry 152 in association with identification information for identifying the subject. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the determination function 155b from the storage circuitry 152 and executing it.

[0045] Next, the display control function 155e determines whether or not a display operation for displaying the index value has been received via the input interface 153 (step S105). If the display control function 155e has received the display operation (step S105, YES), the medical image processing apparatus 150 proceeds to step S106. On the other hand, if the display control function 155e has not received the display operation (step S105, NO), the medical image processing apparatus 150 returns to step S101 and continues acquiring image data. This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the display control function 155e from the storage circuitry 152.

[0046] Next, the display information generating function 155d generates a list showing the index value for each subject, and the display control function 155e displays the generated list on the display 154 (step S106). This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the display information generating function 155d and a program corresponding to the display control function 155e from the storage circuitry 152.

[0047] Next, the display control function 155e determines whether or not a selection operation on the list has been received via the input interface 153 (step S107). If the display control function 155e has received the selection operation (step S107, YES), the medical image processing apparatus 150 proceeds to step S108. On the other hand, if the display control function 155e has not received the selection operation (step S107, NO), the medical image processing apparatus 150 continues to display the list. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the display control function 155e from the storage circuitry 152 and executing it.

[0048] Next, the display information generating function 155d generates display information related to the selected information, and the display control function 155e displays the generated display information on the display 154 (step S108). This processing is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the display information generating function 155d and a program corresponding to the display control function 155e from the storage circuitry 152.

[0049] Next, the display control function 155e switches between a display image (1D-WSS) showing the spatial distribution of WSS values ​​at each cross-sectional position of the blood vessel relative to the blood vessel centerline on an image of the coronary artery and a display image (3D-WSS) showing the spatial distribution of WSS values ​​at each position inside or on the blood vessel wall on an image of the coronary artery, depending on the display method (step S109). For example, the display control function 155e changes the display mode so that the 1D-WSS is displayed during rotational display, in which the display image is displayed while changing the angle over time, and the 3D-WSS is displayed during non-rotational display, in which the angle is not changed. For example, when an operation to change the display angle of the display image is accepted by the input interface 153, the display control function 155e displays the 1D-WSS. On the other hand, when an operation to change the display angle is not accepted, the display control function 155e displays the 3D-WSS. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the display control function 155e from the storage circuitry 152 and executing it.

[0050] Next, the display control function 155e determines whether the display conditions have been changed (step S110). For example, the display control function 155e determines whether the rotation conditions or the display conditions have been changed. For example, the display control function 155e determines whether the rotation conditions, including at least one of the number of rotations and the rotation speed, or the display conditions, including enlargement or reduction, have been changed. Here, if the display conditions have been changed (step S110, Yes), the display control function 155e further changes the display form (step S111).

[0051] For example, when a 1D-WSS image is displayed in a rotational display mode, if the rotation speed of the displayed image is reduced, the display control function 155e changes the displayed image from a 1D-WSS image to a 3D-WSS image. Furthermore, when a 1D-WSS image is displayed in a rotational display mode, if the displayed image is enlarged, the display control function 155e changes the type of image to be displayed as a WSS image. On the other hand, if the display conditions have not been changed (step S110: No), the display control function 155e proceeds to step S112. This process is realized, for example, by the processing circuitry 155 retrieving and executing a program corresponding to the display control function 155e from the storage circuitry 152.

[0052] Next, the display control function 155e determines whether or not an end operation has been received via the input interface 153 (step S112). If an end operation has been received (step S112, YES), the medical image processing apparatus 150 ends the processing. On the other hand, if an end operation has not been received (step S112, NO), the medical image processing apparatus 150 returns to step S106 and displays the list again.

[0053] Hereinafter, each process executed by the medical image processing apparatus 150 will be described in detail.

[0054] (Determination process regarding calculation target) 2, the determination function 155b determines the validity of the calculation target in calculating the WSS. Specifically, the determination function 155b determines the validity of the calculation target using preset conditions.

[0055] For example, the determination function 155b determines whether or not the WSS can be calculated for the coronary artery CT image acquired in step S101. As an example, the determination function 155b determines whether or not the coronary artery CT image satisfies four conditions: "1: the heart is included in the imaging range," "2: contrast is used," "3: ECG-synchronized imaging is performed," and "4: the image is acquired at a heart rate of 70 or less."

[0056] In this case, the judgment function 155b may, for example, acquire information corresponding to the above-mentioned four conditions from the DICOM header of the coronary artery CT image and perform the judgment process, or may acquire information corresponding to the above-mentioned four conditions by communicating with each department system 130 and perform the judgment process.

[0057] The determination function 155b can also make a determination using image processing technology. For example, the determination function 155b searches for the anatomical structure of the heart from an image using image processing technology, and if the corresponding anatomical structure cannot be detected, it can determine that the condition "1: the heart is included in the imaging range" is not met. Similarly, the determination function 155b can determine that the condition "2: contrast is present" is not met if the anatomical structure of the coronary artery cannot be detected from the image using image processing technology or if the pixel value at the position of the coronary artery is small.

[0058] The conditions for determining whether or not the WSS can be calculated are not limited to the above four conditions, and various other conditions may be used.

[0059] For example, the determination function 155b determines whether the WSS can be calculated by determining whether the protocol of the acquired CT image is included in the range of the recommended protocol for acquiring coronary artery CT images used to calculate the index value related to blood flow. As an example, the determination function 155b determines whether the slice thickness and matrix size of the acquired CT image are within the range of the recommended protocol.

[0060] Furthermore, for example, the determination function 155b detects noise in the image due to the subject's movement during imaging or metal (a stent or a pacemaker), and determines whether the amount of detected noise exceeds a threshold, thereby determining whether the WSS can be calculated. As an example, the determination function 155b calculates the S / N (signal-to-noise ratio) in the acquired coronary artery CT image, and compares the calculated S / N with a threshold, thereby determining whether the WSS can be calculated from the acquired coronary artery CT image.

[0061] Furthermore, for example, the determination function 155b can perform a determination process based on a combination of multiple conditions. For example, conditions are set for inconsistencies between the examination date and the imaging date, or for the validity of the subject information. For example, if the examination date of an acquired coronary artery CT image is "2020" but the imaging date is "2019," the determination function 155b determines that calculation of the WSS using the coronary artery CT image is not possible. Also, for example, if the age is "30 years old" but the weight is "10 kg," the determination function 155b determines that the validity of the information about the subject is low and determines that calculation of the WSS is not possible.

[0062] Furthermore, for example, the determination function 155b can also perform the determination process based on information related to the medication history of the subject. For example, the determination function 155b acquires information related to the medication history of the subject from each department system 130, and determines that calculation of the WSS is not possible if aspirin or a vasodilator has been administered to the subject immediately before imaging, since there is a high possibility that a calculation result that differs from normal will be calculated.

[0063] (Calculation process of index value) 2, the calculation function 155c calculates the index value related to the blood flow. Specifically, the calculation function 155c calculates the value of WSS at each position of the coronary artery.

[0064] For example, as described above, the calculation function 155c calculates the WSS value in the acquired coronary artery CT image by a known method using CFD, machine learning, or the like. Here, the calculation function 155c can calculate a one-dimensional WSS (hereinafter, 1D-WSS) and a three-dimensional WSS (hereinafter, 3D-WSS). Specifically, the calculation function 155c calculates a 1D-WSS indicating the WSS at each cross-sectional position of the blood vessel based on the center line of the blood vessel, and a 3D-WSS indicating the WSS at each position inside the blood vessel or on the blood vessel wall.

[0065] The calculation function 155c can also calculate one-dimensional and three-dimensional values ​​of blood flow index values ​​other than WSS. For example, the calculation function 155c can calculate 1D-FFR, which indicates the FFR at each cross-sectional position of the blood vessel based on the center line of the blood vessel, and 3D-FFR, which indicates the FFR at each position within the blood vessel.

[0066] Here, 3D-FFR and 3D-WSS have the advantage of being able to provide more accurate information because they calculate WSS and FFR at local positions, but on the other hand, they have the disadvantage of high calculation costs, such as calculation time, computer processing, and storage area usage.In contrast, 1D-FFR and 1D-WSS have the disadvantage of lower accuracy of information compared to 3D-FFR and 3D-WSS, but on the other hand, they have the advantage of lower calculation costs, such as calculation time, computer processing, and storage area usage.

[0067] The medical image processing apparatus 150 can accept manual setting of CFD parameters via the input interface 153 when the calculation function 155c calculates the index value.

[0068] (Determination process regarding calculation results) 2, the determination function 155b determines the validity of the calculation result of WSS. Specifically, the determination function 155b determines the validity of the calculation result using preset conditions.

[0069] For example, when the calculation function 155c fails to calculate the WSS due to a calculation error or when the calculation result or the calculation process deviates from a preset standard, the determination function 155b determines that the calculation result is invalid. For example, the determination function 155b performs a determination process on the calculation result of the WSS for each coronary artery position or each blood vessel branch, and stores the determination result in association with the position or blood vessel branch.

[0070] In the process of determining the calculation results, for example, a standard coronary artery shape model generated in advance using a large amount of image data, a preset WSS reference value, or the like is used. For example, the determination function 155b calculates the degree of deviation between the coronary artery shape calculated in the WSS calculation process and the standard coronary artery shape model, and determines that the calculation results are invalid if the calculated degree of deviation exceeds a threshold. Furthermore, for example, the determination function 155b calculates the degree of deviation between the calculated WSS value and a reference value, and determines that the calculation results are invalid if the calculated degree of deviation exceeds a threshold.

[0071] The determination function 155b can also make a determination using the calculated fluid. In such a case, the determination function 155b determines that the calculation result is invalid when there is a fluid distribution that is not possible in a normal subject, such as when backflow occurs over a wide range of blood vessels.

[0072] In addition, in the case of WSS, stress is usually generated in a direction corresponding to the running direction of the blood vessel. Therefore, the determination function 155b can determine that the calculation result of WSS is invalid if the area where stress is generated in the inward / outward direction of the blood vessel is more than a predetermined area.

[0073] In addition, the judgment function 155b can also judge that the calculation result is invalid if there is a contradiction in the parameters manually set via the input interface 153 (for example, a mesh size of 50*50 and a mesh count of 100 for an image size of 100*100) or if the manually set parameters are invalid (for example, they are outside the range of the recommended protocol).

[0074] (List display process) As described in step S106 of FIG. 2, when the display control function 155e receives a display operation from a user, it first displays a list summarizing the WSS calculation results for each subject. Specifically, the display information generation function 155d generates a list summarizing the WSS calculation results for each subject using the various calculation results calculated by the calculation function 155c and subject information. The display control function 155e displays the list generated by the display information generation function 155d on the display 154. FIGS. 3A and 3B are diagrams showing examples of a list according to the first embodiment.

[0075] For example, when the display control function 155e receives a display operation from a user, it causes the display 154 to display a list associating "ID," "Patient name," "Average WSS," "Max WSS," "Min WSS," and "Calcium Score," as shown in FIG. 3A. Here, "ID" indicates an identifier for uniquely identifying the subject. "Patient name" indicates the name of the subject. "Average WSS" indicates the average value of the calculated WSS. "Max WSS" indicates the maximum value of the calculated WSS. "Min WSS" indicates the minimum value of the calculated WSS. "Calcium Score" indicates the calcium score of the blood vessel for which the WSS was calculated.

[0076] Here, the display control function 155e highlights results that deviate from the reference value in the list. Specifically, the display control function 155e compares a preset reference value with the value calculated by the calculation function 155c, and highlights results that deviate by a threshold or more. For example, as shown in FIG. 3A, the display control function 155e highlights "Max WSS: 9" for "ID: 100001."

[0077] The display control function 155e can also display analysis results other than the WSS in the list. For example, the display control function 155e displays calcium scores in addition to WSS values, as shown in Fig. 3A. Note that the list shown in Fig. 3A shows only calcium scores as analysis results other than WSS, but the embodiment is not limited to this. For example, the presence or absence of plaque, FFR values, and the like may also be displayed in association with each other.

[0078] The display control function 155e can display various lists in addition to the list shown in Fig. 3 A. For example, when "Max WSS: 9" of "ID: 100001" that is highlighted in the list shown in Fig. 3A is selected, the display control function 155e switches the display information to display a list showing the details of the WSS for each vascular branch as shown in Fig. 3B.

[0079] Here, the list shown in FIG. 3B indicates the "Average WSS," "Max WSS," and "Min WSS" for each vascular branch in the coronary arteries "RCA," "LAD," and "LCX." For example, as shown in FIG. 3B, the display control function 155e displays "RCA," "LAD," and "LCX" as tabs, and displays a list including "Average WSS," "Max WSS," and "Min WSS" for the vascular branch included in the selected tab. Note that in FIG. 3B, since "Max WSS: 9" highlighted in FIG. 3A was selected, the "RCA" tab including the result of "Max WSS: 9" was automatically selected, and a list showing the "Average WSS," "Max WSS," and "Min WSS" for each vascular branch in the "RCA": "SN," "CB," "RVB," "AM," "AVN," and "PD" is displayed.

[0080] Here, when the user selects the "LAD" or "LCX" tab, the display control function 155e displays a list showing the "Average WSS," "Max WSS," and "Min WSS" for the vascular branches included in the selected tab ("LAD" or "LCX").

[0081] (WSS display processing) 2, when a selection operation on the list is accepted, the display control function 155e controls to display the WSS of the selected subject (or vascular branch). Specifically, the display information generation function 155d first generates a 3D image of the blood vessel in which the wall shear stress value is calculated for each position of the blood vessel. Then, the display control function 155e displays a display image in which the wall shear stress value is reflected in the 3D image.

[0082] For example, the display information generation function 155d generates a VR image of the coronary arteries of a selected subject. Then, the display control function 155e displays a color image in which colors corresponding to WSS values ​​are mapped to the VR image of the coronary arteries. In this case, the display control function 155e acquires the WSS values ​​of all positions of the coronary arteries calculated by the calculation function 155c and identifies the range of possible WSS values ​​from the maximum and minimum values ​​of the acquired WSS values. Then, the display control function 155e sets a color arrangement (color lookup table) for the identified range and maps a color corresponding to the WSS value of each position to each position of the coronary arteries.

[0083] 4A is a diagram showing an example of a display image of WSS according to the first embodiment. For example, as shown in FIG. 4A, the display control function 155e displays a color image in which colors corresponding to the WSS value are mapped to a VR image of the entire coronary artery of a selected subject. Here, the display control function 155e can display a color image colorized based on the result of 1D-WSS and a color image colorized based on the result of 3D-WSS for the VR image of the coronary artery.

[0084] For example, the display control function 155e extracts the centerlines of blood vessels, and generates and displays a first display image (1D-WSS) in which one-dimensional information assigned to each centerline position is assigned to a three-dimensional image of the spatial distribution of wall shear stress values ​​at each position of the blood vessel, and a second display image (3D-WSS) in which three-dimensional information assigned to each spatial position of the blood vessel is assigned to a three-dimensional image. That is, in the 1D-WSS display, the display control function 155e displays the spatial distribution of WSS, which is calculated by the 1D-WSS and has no direction dependency in the vascular axis direction, by color mapping it onto a three-dimensional blood vessel image. In addition, in the 3D-WSS display, the display control function 155e displays the spatial distribution of local WSS, which is calculated by the 3D-WSS and expressed in the form of a three-dimensional vector, by color mapping it onto a three-dimensional blood vessel image.

[0085] Here, the display state at the start of display can be set arbitrarily. Specifically, the display control function 155e starts displaying the display image at a preset angle, magnification, or the like at the start of display. For example, the display control function 155e starts displaying the display image at a display angle set based on the WSS calculation result or the characteristics of the blood vessels. As an example, the display control function 155e starts displaying at a display angle at which the position where the WSS value is maximum or minimum is displayed.

[0086] Furthermore, the display control function 155e can change the display format of the display image depending on the size of the display area in which the display image is displayed. Specifically, the display control function 155e can switch between 1D-WSS display and 3D-WSS display depending on the size of the display area in which the display image is displayed.

[0087] For example, when the size of the display area is larger than a predetermined size, the display control function 155e displays a color image colorized based on the results of 3D-WSS. On the other hand, when the size of the display area is smaller than a predetermined size, the display control function 155e displays a color image colorized based on the results of 1D-WSS.

[0088] The display control function 155e can also change the vascular image to be displayed depending on the size of the display area. For example, when the size of the display area is smaller than a predetermined size, the display control function 155e displays a color image in which the WSS result is reflected in the CPR image for each vascular branch.

[0089] In this case, the display information generating function 155d first generates a CPR image for each blood vessel branch using the coronary artery CT image. Then, the display control function 155e displays a display image in which the WSS value is reflected in the CPR image. For example, as shown in FIG. 4B, the display control function 155e arranges the CPR images generated for each blood vessel branch in the coronary arteries "RCA," "LAD," and "LCX," and displays a display image in which the WSS value is reflected in the CPR image of each blood vessel branch.

[0090] The size of the display area may be the size of an area allocated to display the display image on the display, or the size of the display on which the display image is displayed. For example, when displaying on a medical information display device such as a tablet terminal or a smartphone, the size of the display of each device may be used as the size of the display area.

[0091] (WSS rotation display processing) As described in step S109 of FIG. 2, when the display image is displayed, the display control function 155e can switch between 1D-WSS display and 3D-WSS display depending on the display method of the display image.

[0092] For example, the display control function 155e switches between 1D-WSS display and 3D-WSS display in response to a user operation (e.g., browsing, rotation, etc.) for changing the display position of the display image. As an example, the display control function 155e performs 1D-WSS display when the display position of the display image is changed, and performs 3D-WSS display when the display image is stationary.

[0093] For example, when the display image is rotated, the display control function 155e displays the spatial distribution of the WSS values ​​at each position of the blood vessel as 1D-WSS, which is one-dimensional information on the image of the blood vessel, and when the display image is not rotated, the display control function 155e displays the spatial distribution of the WSS values ​​at each position of the blood vessel as 3D-WSS, which is three-dimensional information on the image of the blood vessel.

[0094] FIG. 5 is a diagram illustrating an example of switching the display mode of a display image according to the first embodiment. Here, FIG. 5 illustrates a display mode when the display image is rotated and a display mode when the display image is not rotated. For example, as shown in the left diagram of FIG. 5, the display control function 155e performs a 1D-WSS display while the display position is being changed by a rotation operation performed by a user. That is, the display control function 155e performs control in response to the rotation operation by the user so that color images in which the results of the 1D-WSS are reflected in the VR image of the coronary arteries rendered from a direction facing the user are sequentially displayed.

[0095] On the other hand, the display control function 155e performs 3D-WSS display while the color image remains stationary without any operation by the user, as shown in the right diagram of Fig. 5. That is, the display control function 155e controls the display so that a color image reflecting the results of 3D-WSS is continuously displayed on the VR image of the coronary arteries rendered from a direction facing the user.

[0096] For example, while the display image is being manipulated, it is important to grasp the overall trend, and when it is stationary, detailed analysis is required. Therefore, by performing the above-mentioned switching display, the display control function 155e can display an appropriate display image according to the situation, thereby reducing the user's effort.

[0097] In addition, since the amount of data is generally larger in 3D-WSS display, the drawing speed may be slower. However, when operating the displayed image, it is necessary to switch the drawing quickly to improve usability. Therefore, as described above, the display control function 155e can suppress a decrease in drawing speed by displaying the image in 1D-WSS when operating the displayed image.

[0098] In the above example, the case where the display mode is switched in response to a user's operation on the displayed image has been described, but the display control function 155e can also automatically rotate the display using a cine display, etc. For example, the display control function 155e controls the display to start rotating a color image using 1D-WSS at the same time as starting the display in step S108 of Fig. 2. Then, upon receiving an operation from the user to stop the rotating display, the display control function 155e stops the rotating display and switches to displaying a color image using 3D-WSS.

[0099] Here, the display control function 155e can change the display mode of the display image based on various conditions. Specifically, the display control function 155e can change the display mode of the display image in various ways based on the rotation conditions of the display image, the display conditions of the display image, or the calculation result of the WSS.

[0100] For example, when a rotation condition of a display image is used, the display control function 155e switches between 1D-WSS display and 3D-WSS display depending on the number of rotations and the rotation speed of the display image. For example, when the number of rotations and the rotation speed of the display image are equal to or less than a threshold, the display control function 155e performs 3D-WSS display. On the other hand, when the number of rotations and the rotation speed of the display image exceed a threshold, the display control function 155e performs 1D-WSS display.

[0101] Here, the display control function 155e can perform display control that combines control based on rotation / non-rotation and control based on the rotation conditions described above. For example, when displaying using 1D-WSS in rotated display mode, the display control function 155e switches to 3D-WSS display if the rotation speed is changed to a threshold or lower. Furthermore, when displaying using 3D-WSS in non-rotated display mode, the display control function 155e continues displaying using 3D-WSS if the conditions are changed to start rotation at a rotation speed lower than the threshold. Furthermore, for example, when displaying using 3D-WSS in rotated display mode, the display control function 155e can also change the type of medical image (e.g., CT image) used as the display image depending on the number of rotations and the rotation speed. For example, when at least one of the number of rotations and the rotation speed is lower than a threshold, the display control function 155e displays a display image using a predetermined type of medical image.

[0102] Furthermore, for example, during rotational display, the display control function 155e can switch between 1D-WSS display and 3D-WSS display depending on the rotation angle. For example, while rotating and displaying the coronary arteries, the display control function 155e displays the coronary arteries closest to the center of the display image using 3D-WSS, and the coronary arteries farther from the center of the display image using 1D-WSS. For example, the coronary arteries consist of three blood vessels, the LAD, LCX, and RCA, that run around the heart. Therefore, while rotating and displaying the coronary arteries, the display control function 155e displays one of the three arteries closest to the center of the display image using 3D-WSS, and the other blood vessels farther from the center of the display image using 1D-WSS. That is, the display control function 155e switches to 3D-WSS display for each coronary artery when it comes near the center of the display image as the display image rotates, and switches to 1D-WSS display when it moves away from the center.

[0103] In this way, the coronary arteries close to the central position of interest are displayed in detailed 3D, and conversely, the coronary arteries displayed to the side are displayed in 1D rather than in detailed, which allows the general trends to be displayed in an easy-to-understand and simplified manner, thereby preventing oversight even when the distribution of values ​​for the coronary arteries displayed to the side is not satisfactory.

[0104] Furthermore, for example, when the display conditions of the display image are used, the display control function 155e switches between 1D-WSS display and 3D-WSS display depending on whether the color image is enlarged or reduced. For example, when the color image is enlarged at a magnification rate exceeding a threshold, the display control function 155e displays the color image using 3D-WSS. On the other hand, when the color image is reduced at a reduction rate exceeding a threshold, the display control function 155e displays the color image using 1D-WSS.

[0105] Here, the display control function 155e can perform display control that combines control based on rotation / non-rotation and control based on the display conditions described above. For example, when a display image is enlarged by a magnification ratio exceeding a threshold value while being displayed using 1D-WSS during rotated display, the display control function 155e switches to 3D-WSS display. Furthermore, when a display image is reduced by a reduction ratio exceeding a threshold value while being displayed using 3D-WSS during non-rotated display, the display control function 155e switches to 1D-WSS display. Furthermore, for example, when a display image is enlarged or reduced during rotated display and non-rotated display, the display control function 155e can change the type of medical image (e.g., CT image) used for the display image. For example, when a display image is enlarged by a magnification ratio exceeding a threshold value or reduced by a reduction ratio exceeding a threshold value, the display control function 155e displays a display image using a predetermined type of medical image.

[0106] Furthermore, for example, when using the WSS calculation results, the display control function 155e performs 3D-WSS display of positions likely to be gazed upon by the user (positions with characteristic WSS or positions where plaque exists). For example, when performing rotational display using 1D-WSS, the display control function 155e switches to 3D-WSS display when a position where the WSS value is equal to or greater than a threshold or a position where the WSS value is less than the threshold approaches the front of the screen. Furthermore, for example, the display control function 155e identifies the position of plaque or calcification in a coronary artery, and switches to 3D-WSS display when the identified position approaches the front of the screen. The display control function 155e can appropriately use existing methods to identify the position of plaque or calcification in a coronary artery. For example, there are methods using image processing based on the distribution of pixel values ​​and methods using machine learning.

[0107] (Rotational speed) The rotation speed in the above-described rotation display can be changed as appropriate according to various conditions. Specifically, the display control function 155e can arbitrarily change the rotation speed during the rotation display based on the calculation result of the WSS, the properties of the blood vessels, etc.

[0108] For example, when the calculation result of WSS is used, the display control function 155e controls the rotation display so that the rotation speed is reduced at the timing when the position of the blood vessel where the maximum and minimum values ​​of WSS are calculated is displayed. That is, the display control function 155e slows down the rotation speed when the position showing the characteristic WSS value approaches the front of the screen.

[0109] Fig. 6 is a diagram illustrating an example of speed adjustment of the rotation speed according to the first embodiment. Fig. 6 shows a graph with the rotation speed on the vertical axis and the rotation angle on the horizontal axis. Also, in Fig. 6, curve L1 shows the rotation speed when the calculated spatial distribution of WSS includes a characteristic WSS value, and curve L2 shows the rotation speed when the calculated spatial distribution of WSS does not include a characteristic WSS value.

[0110] For example, the display control function 155e reduces the rotation speed as the position showing the maximum WSS value approaches the front of the screen, and increases the rotation speed as the position showing the maximum WSS value moves away from the front of the screen, as shown by the curve L1 in Fig. 6. Furthermore, the display control function 155e controls the rotation speed so that it reduces the rotation speed as the position showing the minimum WSS value approaches the front of the screen, and increases the rotation speed as the position showing the minimum WSS value moves away from the front of the screen, and then restores the original speed, as shown by the curve L1 in Fig. 6.

[0111] The rotation speed may be adjusted based on the maximum and minimum values ​​for the entire coronary artery, or may be adjusted based on the maximum and minimum values ​​for each branch of the coronary artery. Furthermore, the rotation speed may be adjusted based on the maximum and minimum values, or may be adjusted based on the WSS values ​​above and below the threshold.

[0112] 6. If the calculated spatial distribution of WSS does not include a characteristic WSS value, the display control function 155e rotates and displays the display image at a constant rotation speed, as shown by the curve L2 in FIG.

[0113] Furthermore, when the characteristics of blood vessels are used, the display control function 155e controls the rotation display so as to reduce the rotation speed at the timing when the position of the lesion site in the blood vessel is displayed. For example, the display control function 155e controls the rotation speed so as to reduce the rotation speed as the position where plaque or calcification is detected approaches the front of the screen, and to increase the rotation speed and restore it to the original speed as the position where plaque or calcification is detected moves away from the front of the screen.

[0114] Furthermore, the display control function 155e can perform a control that combines the above-described rotation speed adjustment and display mode switching (switching between 1D-WSS display and 3D-WSS display). Fig. 7 is a diagram for explaining an example of display control by the display control function according to the first embodiment. Here, Fig. 7 shows a case in which the speed adjustment on the curve L1 shown in Fig. 6 is combined with the switching of the display mode.

[0115] For example, as shown in Fig. 7, a reference speed is set for the rotation speed. Here, the reference speed is set arbitrarily, for example, in advance for each user or each examination content. Then, the display control function 155e performs display using 1D-WSS when the rotation speed is faster than the reference speed, and performs display using 3D-WSS when the rotation speed is slower than the reference speed.

[0116] (Display direction control process) In the above-described rotational display, the display direction can be changed as appropriate according to various conditions. Specifically, the display control function 155e can arbitrarily change the display direction of the display image during the rotational display based on the calculation result of the WSS, the properties of the blood vessels, etc.

[0117] For example, in a rotational display, the display control function 155e adjusts the vertical direction of rendering so that the direction of blood vessel flow at the positions where the maximum and minimum values ​​of WSS are calculated and the position of the diseased part of the blood vessel approach the front of the screen, so that the direction of blood vessel flow at those positions becomes approximately parallel to the screen.

[0118] (Display of additional information) When displaying the display image described above, various additional information can be added to the image. Specifically, the display control function 155e can display a display image to which additional information related to the calculation result of WSS has been added. More specifically, the display control function 155e displays a display image in which the WSS value at each position of the blood vessel is reflected in a three-dimensional image of the blood vessel, and adds information indicating the validity of the calculation result to positions where the validity of the calculation result is low.

[0119] For example, when calculating the WSS, there are cases where the WSS cannot be calculated in a part of the image due to the influence of noise contained in the image, etc. Therefore, the display control function 155e displays additional information indicating that the WSS calculation failed at the position in the displayed image where the WSS could not be calculated.

[0120] 8A is a diagram showing an example of display of additional information according to the first embodiment. For example, as shown in FIG. 8A, the display control function 155e displays an "E" indicating an error at a position where the WSS could not be calculated.

[0121] Here, the display control function 155e can control the display of the above-mentioned additional information in combination with the rotational display. For example, when the display image is rotated, the display control function 155e displays an "E" indicating an error at positions where the WSS could not be calculated as the positions approach the front of the screen. Then, when the display image is rotated, the display control function 155e controls the display to erase the "E" displayed at positions where the WSS could not be calculated as the positions move away from the front of the screen.

[0122] Furthermore, the display control function 155e can control the display of the additional information in combination with the rotation speed. For example, when rotating the display image, the display control function 155e changes the rotation speed as the position where the WSS could not be calculated approaches the front of the screen.

[0123] 8B is a diagram illustrating an example of speed control of the rotation speed based on additional information according to the first embodiment. Here, FIG. 8B shows a graph in which the vertical axis represents the rotation speed and the horizontal axis represents the rotation angle. For example, the display control function 155e controls the rotation speed so that it increases as the position where the error exists approaches the front of the screen, and decreases as the position where the error exists moves away from the front of the screen, and then restores the original speed.

[0124] (Output of calculation results and judgment results) The medical image processing apparatus 150 can output the calculation results and determination results of the index values ​​described above to various output destinations. Specifically, the control function 155f transfers the calculation results and determination results of the index values ​​to a predetermined transfer destination.

[0125] For example, the control function 155f can transfer information about the WSS of a blood vessel position specified by a user to various destinations. Fig. 9 is a diagram for explaining an example of information transfer by the control function 155f according to the first embodiment. Here, Fig. 9 shows a case where the control function 155f transfers information about a blood vessel position specified by a user to an interpretation report.

[0126] 9, first, the display control function 155e displays a VR image on the display 154. Here, the display control function 155e displays, for example, a color image in which a color according to the WSS value is reflected on the VR image of the coronary arteries, and performs the above-mentioned rotation display, etc. Then, when the user executes a designation operation to designate a position on the color image via the input interface 153, the display control function 155e displays an enlarged image in which the designated position (area) is enlarged.

[0127] Here, the display control function 155e displays a cross-sectional image of the original image (for example, an MPR image in a CT image) corresponding to the specified position (area) alongside the enlarged image, as shown in Fig. 9. In this way, the display control function 155e displays various information on the display 154 in response to various operations from the user.

[0128] When the user performs a transfer operation via the input interface 153, the information to be transferred is transferred to the transfer destination. For example, as shown in Fig. 9, the control function 155f outputs, for the radiology report, an enlarged image, a cross-sectional image, and information indicating the WSS value at the specified blood vessel position, such as "the maximum WSS at the RCE plaque position is 8 Pa."

[0129] 9 is merely an example, and the control function 155f can transfer various other information. For example, the control function 155f can transfer other characteristic WSS values ​​(high WSS value, low WSS value, etc.) and information related to WSS obtained from coronary artery morphology information (e.g., the distance from the bifurcation of the coronary artery in the specified region, the distance from large calcification, etc.) to the radiology report.

[0130] The control function 155f can also transfer the calculated WSS and the assessment results to the medical image storage device 120, each department system 130, and the medical information display device 140. For example, the control function 155f transfers the calculated WSS value to a viewer used by a user, a workstation, an electronic medical record system, etc. Each device stores the transferred WSS value in its own memory circuit. The control function 155f may transfer only characteristic values ​​of the calculated WSS to each of the above-mentioned devices. Furthermore, if the location of plaque is known in advance or if plaque coordinate information is recorded by using existing technology, the control function 155f may transfer only the WSS at the location where plaque is present based on that information. Furthermore, for example, the control function 155f may transfer the above-mentioned color image to a PACS.

[0131] Here, the control function 155f can also transfer the above-mentioned information separately for each blood vessel branch. For example, the control function 155f transmits the maximum and minimum WSS values ​​for each blood vessel branch of the coronary artery to various devices on the network 160.

[0132] The control function 155f can also switch the transfer destination of the WSS calculation result depending on the index value related to blood flow in the blood vessel. In such a case, the calculation function 155c simultaneously calculates index values ​​other than the WSS (e.g., FFR, etc.). The control function 155f switches the device to which the WSS is transferred depending on the index value calculated at the same time.

[0133] For example, if the FFR value is greater than a threshold, the control function 155f transfers the WSS calculation result to a workstation for interpretation. On the other hand, if the FFR value is less than the threshold, the control function 155f transfers the WSS calculation result to an electronic medical record, the doctor's mobile phone, email address, etc. This allows the control function 155f to quickly notify the doctor of the calculation result when the FFR value is small and the urgency is considered high.

[0134] The control function 155f can also transfer information related to the calculation of wall shear stress to the 3D printer. In such a case, for example, the 3D printer is connected to the network 160, and the control function 155f transmits the coronary artery morphology information calculated during the WSS calculation process and the WSS calculation results to the 3D printer. At this time, the control function 155f may determine and control whether to transfer the information to the 3D printer based on the WSS value. For example, if the maximum WSS value is higher than a predetermined reference value, the information may be transferred to the 3D printer, but if it is lower, the control function 155f may not transfer the information to the 3D printer.

[0135] The 3D printer uses the received morphological information and the WSS calculation results to generate a coronary artery model specific to the subject. For example, the 3D printer generates a coronary artery model using a predetermined material (such as resin) based on the received morphological information. At that time, the 3D printer generates the model using a material and color corresponding to the WSS value. Note that the material and color corresponding to the WSS value are preset in the 3D printer.

[0136] The control function 155f also transfers the calculation result of the WSS to a medical image diagnostic device. For example, the control function 155f transfers the calculation result of the WSS to an intravascular imaging device using intravascular ultrasound (IVUS) or optical coherence tomography (OCT).

[0137] For example, the control function 155f monitors the registration information in each department system 130 to determine whether an IVUS or OCT has been scheduled. When an IVUS or OCT is scheduled, the control function 155f further determines whether information about the WSS has been saved for the subject for whom the appointment is scheduled. If WSS information about the subject has been saved, the control function 155f acquires the saved information about the WSS and transfers it to the intravascular imaging device.

[0138] In addition, the control function 155f can acquire an image captured by an intravascular imaging device in response to a user's operation and display the acquired image with WSS information superimposed on it. In this case, the control function 155f first acquires an image from the intravascular imaging device and aligns it with the coronary artery CT image used to calculate the WSS. For example, the control function 155f aligns the image based on anatomical features included in each image.

[0139] Then, based on the alignment results, the display control function 155e displays a display image in which the corresponding WSS value is superimposed on each position of the coronary artery in the image received from the intravascular imaging device. Furthermore, the control function 155f transfers the display image with the WSS value superimposed to the intravascular imaging device. This allows the intravascular imaging device to display an IVUS or OCT image showing the WSS value.

[0140] (Interaction with other devices) For example, the medical image processing device 150 can perform processing in cooperation with other devices on the network 160. For example, the control function 155f cooperates with the RIS to perform control so as to secure computational resources for calculating the WSS at the scheduled time when a reservation for a coronary artery CT image is made at the RIS. The control function 155f may also accept input regarding the image size and various parameters at the time the reservation is made. The control function 155f can also estimate the calculation end time from the reservation information and return the estimated calculation end time to the user.

[0141] Furthermore, the control function 155f outputs a reservation for an examination device or a notification urging the user to make a reservation for an examination device based on the calculated WSS result. For example, if the WSS value at the location where plaque is present is very high, the control function 155f assumes that the patient's risk in the image is high, and therefore automatically makes a reservation for an intravascular OCT examination or a reservation for an operating room. For example, if the WSS value at the location where plaque is present is very high, the control function 155f issues a notification to the user urging the user to make a reservation for an intravascular OCT examination.

[0142] In the above-described embodiment, the control function 155f transfers the WSS calculation result to an external device. However, the embodiment is not limited to this. For example, the control function 155f can transfer the determination result of the determination function 155b together with the WSS calculation result. That is, the control function 155f can transfer the determination result of the validity of the calculation target and the determination result of the validity of the WSS calculation result together with the WSS calculation result.

[0143] In the above-described embodiment, the determination process is performed after the image data is acquired. However, the embodiment is not limited to this. For example, the determination process may be performed by first acquiring image data that satisfies a condition.

[0144] In such a case, when the target imaging test (e.g., CT) is performed, the X-ray CT device 110 transfers the imaging conditions of the captured image to the medical image processing device 150. Alternatively, the imaging conditions set on the RIS may be transferred to the medical image processing device 150. The determination function 155b compares the transferred imaging conditions with predetermined conditions to determine whether the conditions are met. Depending on the set conditions, information may be obtained from the electronic medical record for determination. If it is determined that the imaging conditions satisfy the conditions, the acquisition function 155a requests the X-ray CT device 110 or the medical image storage device 120 to provide the corresponding image data.

[0145] As described above, according to the first embodiment, the display information generation function 155d generates a 3D image of the blood vessels, reflecting the WSS value for each position of the blood vessel. The display control function 155e changes the display format of the display image, reflecting the WSS value in the 3D image, between rotated and non-rotated display. Therefore, the medical image processing apparatus 150 according to the first embodiment can appropriately display the display image depending on the situation, thereby reducing the user's effort when diagnosing heart disease and formulating a treatment plan.

[0146] Furthermore, according to the first embodiment, when the display image is rotated, the display control function 155e displays a 1D-WSS on the image of the blood vessel, which shows the spatial distribution of WSS values ​​at each cross-sectional position of the blood vessel based on the center line of the blood vessel, and when the display image is not rotated, the display control function 155e displays a 3D-WSS on the image of the blood vessel, which shows the spatial distribution of WSS values ​​at each position inside the blood vessel or on the blood vessel wall. Therefore, the medical image processing device 150 according to the first embodiment makes it possible to automatically perform appropriate display when rotating and when not rotating.

[0147] Furthermore, according to the first embodiment, the display control function 155e further changes the display form of the display image according to the rotation condition of the display image. Therefore, the medical image processing apparatus 150 according to the first embodiment can perform more appropriate display.

[0148] Furthermore, according to the first embodiment, the display control function 155e further changes the display form of the display image according to the display conditions of the display image. Therefore, the medical image processing apparatus 150 according to the first embodiment can perform more appropriate display.

[0149] Furthermore, according to the first embodiment, the display control function 155e further changes the display form of the display image depending on the size of the display area in which the display image is displayed. Therefore, the medical image processing apparatus 150 according to the first embodiment can perform more appropriate display.

[0150] Furthermore, according to the first embodiment, the display control function 155e changes the rotation speed of the display image based on the calculation result of WSS. Therefore, the medical image processing apparatus 150 according to the first embodiment enables a rotation display that is easier to observe.

[0151] Furthermore, according to the first embodiment, the display control function 155e controls the rotation display so as to reduce the rotation speed at the timing when the position of the blood vessel for which the maximum and minimum values ​​of WSS are calculated is displayed. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to display the position to be focused on at a rotation speed that makes it easy to observe.

[0152] Furthermore, according to the first embodiment, the display control function 155e controls the rotation display so as to increase the rotation speed at the timing when the position of a blood vessel for which the WSS calculation result is incorrect is displayed. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to pass a position where observation should be omitted at a high rotation speed.

[0153] According to the first embodiment, the display control function 155e changes the rotation speed of the display image based on the characteristics of the blood vessels. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to switch the rotation speed at the position to be watched.

[0154] Furthermore, according to the first embodiment, the display control function 155e controls the rotation display so as to reduce the rotation speed at the timing when the position of the lesion site in the blood vessel is displayed. Therefore, the medical image processing device 150 according to the first embodiment makes it possible to appropriately observe the lesion site that should be closely observed.

[0155] Furthermore, according to the first embodiment, the determination function 155b determines the validity of the calculation target in calculating the WSS. The display control function 155e displays the validity determination result. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to select only highly reliable targets as calculation targets.

[0156] According to the first embodiment, the determination function 155b determines the validity of the calculation result in calculating the WSS. The display control function 155e displays the determination result of the validity of the calculation result. Therefore, the medical image processing apparatus 150 according to the first embodiment can target only highly reliable results.

[0157] Furthermore, according to the first embodiment, the display control function 155e displays a list of WSS calculation results for each subject, and highlights results that deviate from the reference value in the list. Therefore, the medical image processing apparatus 150 according to the first embodiment enables diagnosis to be made based on the results with the highest priority.

[0158] Furthermore, according to the first embodiment, the display control function 155e further displays analysis results other than WSS in the list. Therefore, the medical image processing apparatus 150 according to the first embodiment enables composite diagnosis.

[0159] Furthermore, according to the first embodiment, the display control function 155e adds information indicating the validity of calculation results at positions where the validity of the calculation results is low in a display image in which the WSS values ​​at each position of the blood vessel are reflected in a three-dimensional image of the blood vessel, and displays the information. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to grasp at a glance the positions of results with low reliability.

[0160] According to the first embodiment, the calculation function 155c calculates the WSS value at each position of the blood vessel. The control function 155f transfers the WSS calculation result to a predetermined transfer destination. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to transfer the WSS result to various transfer destinations.

[0161] According to the first embodiment, the control function 155f transfers the calculation result of the WSS to the medical report. Therefore, the medical image processing apparatus 150 according to the first embodiment can reduce the time and effort required to create the medical report.

[0162] According to the first embodiment, the control function 155f transfers information related to the calculation of the WSS to the three-dimensional printer. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to easily generate a model based on the result of the WSS.

[0163] According to the first embodiment, the control function 155f transfers the calculation result of the WSS to the medical image diagnostic apparatus. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to reflect the result of the WSS in the medical image.

[0164] According to the first embodiment, the control function 155f switches the destination of the WSS calculation result depending on the index value related to the blood flow in the blood vessel. Therefore, the medical image processing apparatus 150 according to the first embodiment makes it possible to transfer the WSS result to an appropriate destination depending on the index value.

[0165] Furthermore, according to the first embodiment, the control function 155f reserves an examination device or outputs a notification prompting the reservation of an examination device based on the calculation result of the WSS. Therefore, the medical image-processing device 150 according to the first embodiment makes it possible to reliably make the necessary arrangements thereafter according to the result of the WSS.

[0166] According to the first embodiment, the control function 155f controls the allocation of computational resources for calculating the WSS in accordance with the reservation for the collection of medical image data used for calculating the WSS. Therefore, the medical image processing apparatus 150 according to the first embodiment enables smooth scheduling of the calculation of the WSS.

[0167] (Second embodiment) In the first embodiment described above, the WSS is calculated in advance each time image data is collected. In the second embodiment, the WSS is calculated in response to a user instruction. The medical image processing apparatus 150 according to the second embodiment differs from the first embodiment in the processing content of the display control function 155e. This point will be mainly described below.

[0168] First, the processing procedure by the medical image processing apparatus 150 according to the second embodiment will be described with reference to Fig. 10. Fig. 10 is a flowchart showing the processing procedure of processing performed by each processing function of the processing circuitry 155 of the medical image processing apparatus according to the second embodiment. Note that Fig. 10 shows an example of calculating the WSS in response to a WSS calculation instruction from a user.

[0169] 10, in this embodiment, when a start operation is received via the input interface 153 (step S201, YES), the acquisition function 155a acquires coronary artery CT images of the specified subject from the X-ray CT device 110 or the medical image storage device 120 (step S202). This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the acquisition function 155a from the storage circuitry 152. Note that the process is in a standby state until a start operation is received via the input interface 153 (step S201, NO).

[0170] Next, the determination function 155b determines whether the acquired coronary artery CT image satisfies the conditions when it is used as a target (step S203). Specifically, the determination function 155b determines whether the acquired coronary artery CT image is appropriate for use in calculating the WSS. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the determination function 155b from the storage circuitry 152 and executing it.

[0171] If the determination function 155b determines that the condition is met (step S203, YES), the medical image processing apparatus 150 proceeds to step S204. On the other hand, if the determination function 155b determines that the condition is not met (step S203, NO), the medical image processing apparatus 150 proceeds to step S205.

[0172] When the process proceeds to step S205, the display control function 155e outputs a warning (step S205). For example, the display control function 155e displays a warning on the display 154 indicating that the acquired coronary artery CT image is not appropriate as a target for calculating the WSS. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the display control function 155e from the storage circuitry 152 and executing it.

[0173] Next, the calculation function 155c determines whether to continue the processing (step S206). For example, the calculation function 155c determines whether it has been instructed to continue or to stop the processing via the input interface 153. This processing is realized, for example, by the processing circuitry 155 calling up a program corresponding to the calculation function 155c from the storage circuitry 152 and executing it.

[0174] Here, if the calculation function 155c determines to continue (step S206, YES), the medical image processing apparatus 150 proceeds to step S204. On the other hand, if the calculation function 155c determines not to continue (step S206, NO), the medical image processing apparatus 150 returns to step S201 and performs the determination process.

[0175] In step S204, the calculation function 155c calculates an index value related to blood flow based on the coronary artery CT image of the subject acquired by the acquisition function 155a (step S204). For example, the calculation function 155c calculates WSS. This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the calculation function 155c from the storage circuitry 152.

[0176] Next, the determination function 155b determines whether the calculation result is appropriate (step S207). Specifically, the determination function 155b determines whether the calculation result of WSS calculated by the calculation function 155c is appropriate. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the determination function 155b from the storage circuitry 152 and executing it.

[0177] Here, if the determination function 155b determines that it is appropriate (step S207, YES), the medical image processing apparatus 150 proceeds to step S208. On the other hand, if the determination function 155b determines that it is not appropriate (step S207, NO), the medical image processing apparatus 150 proceeds to step S209.

[0178] When the process proceeds to step S2059, the display control function 155e outputs a warning (step S209). For example, the display control function 155e displays a warning indicating that the calculated WSS value is invalid on the display 154. This process is realized, for example, by the processing circuitry 155 calling up a program corresponding to the display control function 155e from the storage circuitry 152 and executing it.

[0179] Next, the display control function 155e determines whether to continue the processing (step S210). For example, the display control function 155e determines whether an instruction to continue or to stop has been given via the input interface 153. This processing is realized, for example, by the processing circuitry 155 calling up a program corresponding to the display control function 155e from the storage circuitry 152 and executing it.

[0180] Here, if the display control function 155e determines to continue (step S210, YES), the medical image processing apparatus 150 proceeds to step S208. On the other hand, if the display control function 155e determines not to continue (step S210, NO), the medical image processing apparatus 150 returns to step S201 and performs the determination process.

[0181] In step S208, the display information generating function 155d generates display information relating to the result, and the display control function 155e displays the generated display information on the display 154 (step S208). This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the display information generating function 155d and a program corresponding to the display control function 155e from the storage circuitry 152.

[0182] Next, the display control function 155e switches between 1D-WSS and 3D-WSS display depending on the display method (step S211). For example, the display control function 155e changes the display format so that 1D-WSS is displayed when rotating and 3D-WSS is displayed when not rotating. This process is realized, for example, by the processing circuitry 155 calling up and executing a program corresponding to the display control function 155e from the storage circuitry 152.

[0183] Next, the display control function 155e determines whether the display conditions have been changed (step S212). For example, the display control function 155e determines whether the rotation conditions or the display conditions have been changed. For example, the display control function 155e determines whether the rotation conditions including at least one of the number of rotations and the rotation speed, or the display conditions including enlargement or reduction, have been changed. Here, if the display conditions have been changed (step S212, yes), the display control function 155e further changes the display form (step S213). On the other hand, if the display conditions have not been changed (step S212, no), the display control function 155e proceeds to step S214.

[0184] Next, the display control function 155e determines whether or not a termination operation has been received via the input interface 153 (step S212). If a termination operation has been received (step S212, YES), the medical image processing apparatus 150 terminates the processing. On the other hand, if a termination operation has not been received (step S212, NO), the medical image processing apparatus 150 returns to step S211 and continues the switching display.

[0185] (warning display) As described above, the display control function 155e according to the second embodiment outputs a warning according to the result of the determination process by the determination function 155b. For example, the display control function 155e can display a warning according to each determination result and can also display information on the display 154 notifying whether or not different image data is to be acquired.

[0186] Furthermore, for example, the display control function 155e can also display a warning when an event that is difficult to predict in advance, such as a power outage or an abnormality in the computer, occurs and the calculation does not end normally.

[0187] Furthermore, the display control function 155e can not only display a warning but also automatically search for images that satisfy the conditions from the medical image storage device 120 or the X-ray CT device 110 on the network 160 and present them as candidates. In such a case, the determination function 155b executes a determination process on image data of the same subject stored in the medical image storage device 120 or the X-ray CT device 110 to extract image data that satisfy the conditions. Then, the display control function 155e displays information about the extracted image data (candidates for calculation) on the display 154. Here, the determination conditions used by the determination function 155b may be newly set conditions for presenting candidates. For example, the conditions for presenting candidates may be set based on the strength of the influence on the calculation accuracy in the WSS calculation.

[0188] Furthermore, the display control function 155e can display warnings not only about the WSS but also about other index values. For example, the display control function 155e displays a warning about calculation results of values ​​(such as FFR) that perform calculations similar to the WSS, because these calculations are likely to cause problems.

[0189] The determination function 155b according to the second embodiment performs the same determination process as in the first embodiment.

[0190] As described above, according to the second embodiment, the display control function 155e displays a warning depending on the determination of the validity of the calculation target and the validity of the WSS calculation result. Therefore, the medical image processing apparatus 150 according to the second embodiment enables efficient calculation of the WSS.

[0191] (Third embodiment) In the third embodiment, various modes for displaying a cross-sectional image showing a cross-section of a blood vessel will be described. For example, the display control function 155e according to the third embodiment displays, as a display image, an image to which a WSS value is assigned at a pixel position corresponding to the pixel value of each pixel in the cross-sectional image showing a cross-section of a blood vessel. The input interface 153 accepts an input operation for moving the position of the cross-section to be displayed as a display image. The display control function 155e changes the speed of movement of the position of the cross-section based on the input operation, based on the calculation result of the WSS.

[0192] FIG. 11 is a diagram illustrating an example of display control by the display control function according to the third embodiment. Here, FIG. 11 illustrates a case where a short-axis cross-sectional image (cross-cut image), which is a cross-section perpendicular to the center line of a blood vessel, is displayed as a cross-sectional image showing a cross-section of a blood vessel. For example, as shown in FIG. 11, the display control function 155e displays a VR image of a coronary artery in the display area A1, and displays short-axis cross-sectional images of the coronary artery at various positions in the display areas A21 to A26. The display control function 155e can display an image in which each pixel of the short-axis cross-sectional image is expressed according to the WSS value corresponding to each pixel position. For example, a color image expressed in a color according to the WSS value can be displayed. Alternatively, an image expressed using transparency, brightness, grayscale value, texture, symbol, mark, or the like according to the WSS value may be displayed. Of course, these are merely examples, and any image expressed according to the WSS value may be displayed.

[0193] The input interface 153 accepts a scroll operation on the scroll bar B1. Here, the scroll bar B1 shown in FIG. 11 is a GUI for switching between short-axis tomographic images to be displayed in the display regions A21 to A26 among multiple short-axis tomographic images generated at positions along the centerlines of the coronary arteries. That is, the user can switch between the short-axis tomographic images to be displayed in the display regions A21 to A26 along the centerlines of the coronary arteries by operating the scroll bar B1 via the input interface 153. In the following description, it is assumed that the switching speed of the short-axis tomographic images is specified by an input operation performed by the user using the input interface 153.

[0194] First, switching of short-axis cross-sectional images by operating the scroll bar B1 will be described. The user operates the mouse pointer displayed on the screen using the input interface 153. The scroll bar B1 displays icons (rectangular areas within the scroll bar B1) that conceptually indicate which positions of the short-axis cross-sectional images of the blood vessels to be displayed are displayed in the display areas A21 to A26. That is, when the icon is located at the top of the scroll bar B1, multiple short-axis cross-sectional images near the origin of the blood vessels are displayed, and when the icon is located at the bottom of the scroll bar B1, multiple short-axis cross-sectional images near the peripheral portion of the blood vessels are displayed. The user operates the mouse pointer and drags the icon to specify the destination of the icon. The display control function 155e sequentially switches the short-axis images already displayed in the display areas A21 to A26 to short-axis images that are not currently displayed, according to the destination of the specified icon. Specifically, the image displayed at position A22 is displayed at position A21, and the image displayed at position A23 is displayed at position A22, and this switching is repeated, and the short-axis cross-sectional image that was not displayed when the input operation started is displayed at position A26. By sequentially repeating this switching of display positions, the display is switched to the short-axis images that were not displayed, and the switching ends when the short-axis cross-sectional image corresponding to the position of the specified icon is displayed in display areas A21 to A26.

[0195] Instead of dragging the icon, this operation can be performed by specifying any position on the scroll bar B1 with the mouse pointer and clicking the mouse to confirm the position, which will scroll the icon to the specified position and switch the display of short-axis images in conjunction with the scrolling of the icon.

[0196] Next, the switching speed of the short-axis cross-sectional images will be described. As described above, the user operates the scroll bar B1 to switch to and display a short-axis cross-sectional image that was not displayed when the input operation started. The speed of this switching display becomes faster as the distance between the position of the icon when the input operation started and the destination position of the icon specified by the user by a drag operation or the like increases, and conversely, the speed becomes slower as the distance decreases.

[0197] Here, the display control function 155e according to the third embodiment changes the speed of switching the position of the cross section based on the input operation based on the calculation result of the WSS when switching the display of short-axis cross-sectional images in response to the operation of the scroll bar B1. For example, when a short-axis cross-sectional image of a blood vessel position for which the maximum and minimum WSS values ​​are calculated is displayed, the display control function 155e reduces the switching speed in the display areas A21 to A26 of the short-axis cross-sectional image. Note that, similar to the conditions for controlling the rotation speed in the rotational display described in the above embodiment, the display control function 155e according to the third embodiment can change the switching speed in the display areas A21 to A26 of the short-axis cross-sectional image based on the position where an error exists in the calculation result of the WSS, the properties of the blood vessel, the position of the lesion, etc.

[0198] Furthermore, the display control function 155e according to the third embodiment can change the display mode of short-axis tomographic images in accordance with the switching speed of the tomographic images based on an input operation. For example, when a user operates the scroll bar B1 via the input interface 153 to switch the short-axis tomographic images displayed in the display areas A21 to A26 along the centerlines of the coronary arteries, if the user scrolls the scroll bar B1 at a speed equal to or greater than a predetermined threshold, the display control function 155e displays the short-axis tomographic images as images expressed in colors corresponding to the 1D-WSS values. On the other hand, if the user scrolls the scroll bar B1 at a speed less than the predetermined threshold, the display control function 155e displays the short-axis tomographic images as images expressed in colors corresponding to the 3D-WSS values.

[0199] In the above example, a case has been described in which a short-axis tomographic image is displayed as a cross-sectional image showing a cross section of a blood vessel. However, the display control function 155e can also display a CPR image as a cross-sectional image showing a cross section of a blood vessel. FIG. 12 is a diagram for explaining an example of display control by the display control function according to the third embodiment. For example, as shown in FIG. 12, the display control function 155e displays a VR image of a coronary artery in the display region A1 and a CPR image of the coronary artery in the display region A3. Note that, similar to the case of a short-axis tomographic image, the display control function 155e can display an image in which each pixel of the CPR image is represented according to the value of WSS corresponding to each pixel position.

[0200] Here, the display control function 155e changes the speed of switching the position of the cross section based on the input operation, based on the calculation result of the WSS, in the same way as in the display of the short-axis cross-sectional image, also in the CPR image. In this case, for example, the scroll bar B1 is a GUI that switches the position of the CPR image displayed in the display area A3 along the running direction of the blood vessel.

[0201] The display control function 155e changes the speed of switching the display position of the CPR image based on the input operation, based on the calculation result of the WSS, when switching the display position of the CPR image in response to the operation of the scroll bar B1 shown in Fig. 12. For example, the display control function 155e reduces the switching speed of the CPR image in the display area A3 when the position where the maximum and minimum WSS values ​​are calculated is displayed on the CPR image. Note that the display control function 155e according to the third embodiment can also change the switching speed when displaying the CPR image based on the position where an error exists in the calculation result of the WSS, the characteristics of the blood vessel, the position of the lesion, etc., similar to the conditions for controlling the rotation speed in the rotational display described in the above embodiment.

[0202] Furthermore, the display control function 155e according to the third embodiment can change the display mode of a CPR image in accordance with the speed of switching the position based on an input operation. For example, when a user operates the scroll bar B1 via the input interface 153 to switch the position of a CPR image displayed in the display area A3, if the user scrolls the scroll bar B1 at a speed equal to or greater than a predetermined threshold, the display control function 155e displays the CPR image as an image expressed in a color corresponding to the 1D-WSS value. On the other hand, if the user scrolls the scroll bar B1 at a speed less than the predetermined threshold, the display control function 155e displays the CPR image as an image expressed in a color corresponding to the 3D-WSS value.

[0203] As described above, according to the third embodiment, the display control function 155e displays a display image in which a wall shear stress value is assigned to a cross-sectional image showing a cross-section of a blood vessel. The input interface 153 accepts an input operation to change the position of the cross-section to be displayed as a display image. The display control function 155e changes the speed of the change in the position of the cross-section based on the input operation, based on the calculation result of the wall shear stress. Therefore, the medical image processing apparatus 150 according to the third embodiment allows the user to easily grasp the position of the cross-section of interest.

[0204] Furthermore, according to the third embodiment, the display control function 155e displays a display image in which a wall shear stress value is assigned to a cross-sectional image showing a cross-section of a blood vessel. The input interface 153 accepts an input operation for changing the position of the cross-section to be displayed as the display image. The display control function 155e changes the display form of the display image depending on the speed at which the position of the cross-section is changed based on the input operation. Therefore, the medical image processing apparatus 150 according to the third embodiment makes it possible to appropriately display the WSS depending on the speed at which the display position of the cross-sectional image is changed.

[0205] (Other embodiments) In the above-described embodiment, the display format during rotation is described as using 1D-WSS, which indicates the WSS at each cross-sectional position of the blood vessel relative to the center line of the blood vessel. However, the embodiment is not limited to this. For example, a display equivalent to 1D-WSS may be obtained by using the directional average value of the local WSS obtained from 3D-WSS.

[0206] In the above-described embodiment, an example has been described in which information about the WSS is displayed on the display 144 of the medical image processing device 150, but the embodiment is not limited to this. For example, information about the WSS may be displayed on the display of the medical information display device 140.

[0207] In the above-described embodiment, the medical image processing apparatus 150 calculates the WSS and displays the calculation results. However, the embodiment is not limited to this. For example, when calculating the 1D-WSS and 3D-WSS, a server-client computer configuration may be used, with some of the calculations performed on the server side. For example, the 3D-WSS, which requires a large amount of calculation, may be calculated on the server side, and the 1D-WSS may be calculated on the client side.

[0208] Alternatively, for example, the process up to recognizing (extracting) the shape of blood vessels may be performed on the client side, and only the process of calculating the WSS using CFD or the like may be performed on the server side. In such a case, instead of transferring the entire image to the server side, only the shape structure extracted on the client side may be transferred to the server side. For example, the server side may store analysis conditions in advance and calculate the WSS using the shape structure received from the client side and the stored analysis conditions.

[0209] Alternatively, for example, the client may transfer to the server, in addition to the shape information, blood parameters specific to the subject (such as hematocrit value), boundary conditions, and the elasticity of the vascular wall. The server uses this information transferred from the client to calculate the WSS.

[0210] Here, the same value is set for each structure of blood vessels, and data size can be made extremely small by data compression by transmitting only data associated with coordinates. For example, if there are two types of structures, vascular wall and non-vascular wall, the structures can be expressed using two values, 0 and 1. Similarly, if there are 10 types of structures, the structures can be expressed using 10 values ​​from 0 to 9.

[0211] In this way, by communicating only the data necessary for calculation between the server and the client, the transfer speed and the calculation cost on the server side can be reduced. Also, the server may be configured to specify the vascular branch to be calculated based on the user's instructions and calculate the WSS of only that vascular branch.

[0212] In the above-described embodiment, an example has been described in which the determination unit, calculation unit, generation unit, display control unit, and control unit in this specification are realized by the determination function, calculation function, display information generation function, display control function, and control function of a processing circuit, respectively, but the embodiment is not limited to this. For example, in addition to being realized by the determination function, calculation function, display information generation function, display control function, and control function described in the embodiment, the determination unit, calculation unit, generation unit, display control unit, and control unit in this specification may also be realized by hardware only, software only, or a combination of hardware and software.

[0213] Furthermore, the term "processor" used in the description of the above-mentioned embodiments refers to circuits such as a central processing unit (CPU), a graphics processing unit (GPU), 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)). Here, instead of storing a program in a memory circuit, the processor may be configured so that the program is directly embedded in the circuit. In this case, the processor realizes its function by reading and executing the program embedded in the circuit. Furthermore, each processor in the present embodiment is not limited to being configured as a single circuit for each processor, but may also be configured as a single processor by combining multiple independent circuits to realize its function.

[0214] Here, the program executed by the processor is provided in advance in a read-only memory (ROM) or a storage circuit. The program may be provided by being recorded on a computer-readable, non-transitory storage medium such as a compact disk (CD)-ROM, a flexible disk (FD), a recordable CD-R (CD-R), or a digital versatile disk (DVD) in a format that can be installed or executed on these devices. The program may also be provided or distributed by being stored on a computer connected to a network such as the Internet and downloaded via the network. For example, the program may be composed of modules including the above-described processing functions. In actual hardware, a CPU reads and executes the program from a storage medium such as a ROM, whereby each module is loaded into a main memory device and generated on the main memory device.

[0215] In addition, in the above-described embodiments and modifications, the components of each device shown in the drawings are functional concepts and do not necessarily have to be physically configured as shown. In other words, the specific form of distribution or integration of each device is not limited to that shown in the drawings, and all or part of the devices can be functionally or physically distributed or integrated in any unit depending on various loads, usage conditions, etc. Furthermore, all or any part of the processing functions performed by each device can be realized by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware using wired logic.

[0216] Furthermore, among the processes described in the above-mentioned embodiments and modifications, all or part of the processes described as being performed automatically can be performed manually, or all or part of the processes described as being performed manually can be performed automatically using a known method.In addition, the information including the processing procedures, control procedures, specific names, various data and parameters shown in the above documents and drawings can be changed as desired unless otherwise specified.

[0217] According to at least one of the embodiments described above, it is possible to reduce the effort required of a user when making a diagnosis or formulating a treatment plan for a heart disease.

[0218] Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their modifications are included within the scope and spirit of the invention, as well as within the scope of the invention and its equivalents as defined in the claims.

[0219] With respect to the above embodiment, the following supplementary notes are disclosed as one aspect and optional features of the invention.

[0220] (Appendix 1) an acquisition unit that acquires a three-dimensional image of a blood vessel of a subject and a spatial distribution of a value of wall shear stress at each position of the blood vessel; a display control unit that displays a display image in which the value of the wall shear stress is assigned to the three-dimensional image from an arbitrary angle; an input operation receiving unit that receives an input operation to change the angle; and the display control unit changes the display form of the display image in which the value of the wall shear stress is assigned to the three-dimensional image between a rotational display in which the display image is displayed while changing the angle over time and a non-rotational display in which the angle is not changed. Medical imaging equipment. (Appendix 2) The display control unit may extract the core line of the blood vessel, and generate a first display image in which one-dimensional information assigned to each core line position is assigned to the three-dimensional image of the spatial distribution of wall shear stress values ​​at each position of the blood vessel, and a second display image in which three-dimensional information assigned to each spatial position of the blood vessel is assigned to the three-dimensional image, and when the display image is to be displayed in a rotated manner, the first display image is displayed, and when the display image is to be displayed non-rotated, the second display image is displayed. (Appendix 3) The display control unit may further change a display form of the display image in accordance with at least one of a rotation count and a rotation speed of the display image. (Appendix 4) The display control unit may further change a display form of the display image in accordance with the enlargement or reduction of the display image. (Appendix 5) The display control unit may further change a display form of the display image in accordance with a size of a display area in which the display image is displayed. (Appendix 6) In the rotational display, the display control unit may change a rotation speed of the display image based on the calculation result of the wall shear stress. (Appendix 7) The display control unit may perform control such that the rotation speed is reduced at a timing when the positions of the blood vessels at which the maximum and minimum values ​​of the wall shear stress are calculated are displayed in the rotation display. (Appendix 8) The display control unit may control the rotation display so as to increase the rotation speed at a timing when a position of a blood vessel for which the calculation result of the wall shear stress is erroneous is displayed. (Appendix 9) In the rotation display, the display control unit may change a rotation speed of the display image based on a property of the blood vessel. (Appendix 10) The display control unit may perform control such that the rotation speed is reduced at a timing when the position of a lesion site in the blood vessel is displayed in the rotation display. (Appendix 11) The method further includes a determination unit that determines the validity of a calculation target in calculating the wall shear stress, The display control unit may display the result of the validity determination. (Appendix 12) a determination unit that determines the validity of a calculation result in calculating the wall shear stress, The display control unit may display a determination result of the validity of the calculation result. (Appendix 13) The display control unit may display a list of the calculation results of the wall shear stress for each subject, and may highlight results that deviate from a reference value in the list. (Appendix 14) The display control unit may further display analysis results other than the wall shear stress in the list. (Appendix 15) The display control unit may also display a display image in which the values ​​of wall shear stress at each position of the blood vessel are reflected in a three-dimensional image of the blood vessel, and add information indicating the validity of the calculation results to positions where the validity of the calculation results is low. (Appendix 16) a calculation unit that calculates a value of wall shear stress at each position of the blood vessel; a control unit that transfers the calculation result of the wall shear stress to a predetermined transfer destination; may further comprise: (Appendix 17) The control unit may transfer the calculation result of the wall shear stress to a medical report. (Appendix 18) The control unit may transfer information relating to the calculation of the wall shear stress to a three-dimensional printer. (Appendix 19) The control unit may transfer the calculation result of the wall shear stress to a medical image diagnostic apparatus. (Appendix 20) The control unit may switch a transfer destination of the calculation result of the wall shear stress depending on an index value related to blood flow in the blood vessel. (Appendix 21) The system may further include a control unit that reserves an examination device or outputs a notification urging the user to reserve the examination device based on the calculation result of the wall shear stress. (Appendix 22) The system may further include a control unit that controls to secure computational resources to be used for calculating the wall shear stress in accordance with a reservation for collection of medical image data to be used for calculating the wall shear stress. (Appendix 23) the display control unit displays a display image in which the value of the wall shear stress is assigned to a cross-sectional image showing a cross section of the blood vessel; the input operation receiving unit receives an input operation for changing a position of the cross section to be displayed as the display image; The display control unit may change a speed of changing the position of the cross section based on the input operation, based on a calculation result of the wall shear stress. (Appendix 24) the display control unit displays a display image in which the value of the wall shear stress is assigned to a cross-sectional image showing a cross section of the blood vessel; the input operation receiving unit receives an input operation for changing a position of the cross section to be displayed as the display image; The display control unit may change a display form of the display image in accordance with a speed at which the position of the cross section is changed based on the input operation. (Appendix 25) A medical image processing system including a medical image processing device and a medical information display device, the medical image processing device acquires a three-dimensional image of a blood vessel of a subject and a spatial distribution of a value of wall shear stress at each position of the blood vessel; The medical information display device, a display image in which the wall shear stress value is assigned to the three-dimensional image is displayed from an arbitrary angle; Accepting an input operation to change the angle; In displaying the display image in which the value of the wall shear stress is assigned to the three-dimensional image, a display form of the display image is changed between a rotational display in which the display image is displayed while changing the angle over time and a non-rotational display in which the angle is not changed. Medical image processing system. (Appendix 26) Obtaining a three-dimensional image of a blood vessel of a subject and a spatial distribution of wall shear stress values ​​at each position of the blood vessel; a display image in which the wall shear stress value is assigned to the three-dimensional image is displayed from an arbitrary angle; Accepting an input operation to change the angle; In displaying the display image in which the value of the wall shear stress is assigned to the three-dimensional image, a display form of the display image is changed between a rotational display in which the display image is displayed while changing the angle over time and a non-rotational display in which the angle is not changed. A medical image processing method comprising: [Explanation of symbols]

[0221] 100 Medical Image Processing System 140 Medical information display device 150 Medical image processing device 155 Processing Circuit 155b Judgment function 155c calculation function 155d Display information generation function 155e Display Control Function 155f Control Function

Claims

1. an acquisition unit that acquires a shape of a blood vessel in a three-dimensional image of the blood vessel of a subject; a display control unit that rotates and displays the three-dimensional blood vessel image representing the shape of the blood vessel on a display screen at a predetermined rotation speed; an identification unit that acquires biological information about the blood vessel and identifies a position of the biological information in the three-dimensional blood vessel image; and the display control unit reduces the rotation speed in the rotational display from the predetermined rotation speed based on a positional relationship between a display angle of the blood vessel three-dimensional image in the rotational display and the biological information. Medical imaging equipment.

2. The biological information is information regarding the properties of the blood vessels, The medical image processing apparatus according to claim 1 , wherein the position of the biological information identified by the identifying unit is the position of a lesion site.

3. The biological information is plaque or calcification, The medical image processing apparatus according to claim 1 , wherein the position of the biological information identified by the identifying unit is a position where the plaque or the calcification is detected.

4. A medical image processing device as described in claim 1, wherein the biological information is wall shear stress in the blood vessel.

5. A medical image processing device as described in Claim 4, wherein the position of the biometric information identified by the identification unit is a position where the value of the wall shear stress satisfies a predetermined condition.

6. A medical image processing device as described in Claim 4, wherein the position of the biological information identified by the identification unit is the position of a value that satisfies a condition when compared with a threshold value, the position of a maximum value, or the position of a minimum value in the distribution of wall shear stress in a specified region of the blood vessel.

7. A medical image processing device described in any one of claims 1 to 6, wherein the display control unit reduces the rotation speed in the rotation display from the predetermined rotation speed when the position of the biometric information identified by the identification unit is displayed on the display screen in the 3D vascular image displayed by the rotation display.

8. 7. The medical image processing device according to claim 6, wherein the display control unit reduces the rotation speed of the rotation display from the predetermined rotation speed when the position of the biological information identified by the identification unit approaches the front of the display screen in the three-dimensional vascular image displayed by the rotation display.

9. A medical image processing device according to any one of claims 1 to 8, wherein the display control unit rotates and displays the three-dimensional vascular image at the predetermined rotation speed when the biological information is not acquired in the three-dimensional image.

10. A medical image processing device described in any one of claims 1 to 9, wherein the display control unit changes the display direction of the vascular three-dimensional image when the position of the biometric information identified by the identification unit is displayed on the display screen in the rotational display.

11. A medical image processing device as described in Claim 10, wherein the display control unit changes the display direction of the three-dimensional image of the blood vessel so that the direction of the blood vessel at the position of the biometric information identified by the identification unit is approximately parallel to the display screen.

12. A medical image processing device described in any one of claims 1 to 11, wherein the three-dimensional vascular image is an image that represents the spatial distribution of wall shear stress values ​​in the blood vessel in three-dimensional space.

13. a determining unit for determining the validity of a medical image from which the spatial distribution of the wall shear stress value is obtained as a medical image from which the wall shear stress value is obtained; The medical image processing apparatus according to claim 4 , wherein the display control unit displays the result of the determination of the validity.

14. a determination unit that determines the validity of the spatial distribution of the wall shear stress value, The medical image processing apparatus according to claim 4 , wherein the display control unit displays a result of the determination of the validity of the value.

15. The medical image processing apparatus according to claim 4 , wherein the display control unit displays a list of the wall shear stress values ​​for each subject, and highlights values ​​in the list that deviate from a reference value.

16. The medical image processing apparatus according to claim 15 , wherein the display control unit further displays analysis results other than the wall shear stress in the list.

17. The medical image processing device according to claim 14, wherein the display control unit displays a display image in which the values ​​of wall shear stress at each position of the blood vessel are reflected in the three-dimensional image of the blood vessel, by adding information indicating that the validity of the values ​​is low at positions where the validity of the values ​​is low.

18. A calculation unit that calculates a spatial distribution of wall shear stress values ​​at each position of the blood vessel acquired by the acquisition unit using a three-dimensional image of the blood vessel of the subject. a control unit that transfers the calculation result of the wall shear stress to at least one of a processing unit within the device itself and an external device; The medical image processing device according to any one of claims 1 to 17, further comprising:

19. The medical image processing apparatus according to claim 18 , wherein the control unit transfers the calculation result of the wall shear stress to a processing unit that processes a medical report.

20. The medical image processing apparatus according to claim 18 , wherein the control unit transfers the vascular morphology information and the calculation result of the wall shear stress to a three-dimensional printer that generates a model of the blood vessel using the received information.

21. The medical image processing apparatus according to claim 18 , wherein the control unit transfers information including the calculation result of the wall shear stress to a medical image diagnostic apparatus.

22. The medical image processing apparatus according to claim 18 , wherein the control unit switches a transfer destination of the calculation result of the wall shear stress depending on an index value related to the blood flow in the blood vessel.

23. The medical image processing apparatus according to claim 4 , further comprising a control unit that reserves an examination device or outputs a notification urging the user to reserve the examination device based on the value of the wall shear stress.

24. 23. The medical image processing device according to claim 18, further comprising a control unit that acquires reservation information for the collection of medical image data used in the calculation of the wall shear stress, and controls to secure computational resources to be used in the calculation of the wall shear stress when a reservation for the collection of the medical image data is made.

25. A medical image processing system including a medical image processing device and a medical information display device, the medical image processing device acquires a shape of the blood vessels in a three-dimensional image of the blood vessels of a subject; The medical information display device, The three-dimensional blood vessel image representing the shape of the blood vessel is rotated and displayed on a display screen at a predetermined rotation speed; acquiring biological information about the blood vessel and identifying a position of the biological information in the three-dimensional image of the blood vessel; reducing the rotation speed in the rotated display from the predetermined rotation speed based on a positional relationship between a display angle of the three-dimensional blood vessel image in the rotated display and the biological information; Medical image processing system.

26. acquiring a shape of a blood vessel in a three-dimensional image of the blood vessel of a subject; The three-dimensional blood vessel image representing the shape of the blood vessel is rotated and displayed on a display screen at a predetermined rotation speed; acquiring biological information about the blood vessel and identifying a position of the biological information in the three-dimensional image of the blood vessel; reducing the rotation speed in the rotated display from the predetermined rotation speed based on a positional relationship between a display angle of the three-dimensional blood vessel image in the rotated display and the biological information; A medical image processing method comprising:

Images