Ultrasonic diagnostic apparatus, control method of ultrasonic diagnostic apparatus, and control program of ultrasonic diagnostic apparatus

Abstract

To provide an ultrasonic diagnostic apparatus which enables objective evaluation by quantifying joint instability in the examination of the joint instability.SOLUTION: The ultrasound diagnostic apparatus includes a point-of-interest setting unit 17a configured to set a first point of interest and a second point of interest on a first bony structure and a second bony structure, respectively, which are adjacent to each other and connected to a joint shown in an ultrasound image, a point-of-interest tracing unit 17b configured to trace positions of the first point of interest and the second point of interest in the ultrasound image in a moving image format generated during the examination, a positional relationship analyzing unit 17c configured to calculate temporal changes of distances between the first point of interest and the second point of interest in each frame of the ultrasound image in the moving image format generated during the examination, and an examination result outputting unit 17d configured to output the temporal changes of the distances or widths of the changes during the examination as an examination result.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present disclosure relates to an ultrasound diagnostic apparatus, a control method for an ultrasound diagnostic apparatus, and a control program for an ultrasound diagnostic apparatus. [Background technology]

[0002] Conventionally, there is known an ultrasound diagnostic device that generates ultrasound images (i.e., tomographic images) of the inside of a subject by transmitting ultrasound waves into the inside of the subject and receiving and analyzing the ultrasound echoes (see, for example, Patent Document 1). The ultrasound diagnostic device can acquire two-dimensional or three-dimensional ultrasound images in real time by scanning in azimuth directions with ultrasound waves focused in a specific direction. Furthermore, by generating ultrasound images continuously over time with the ultrasound diagnostic device, it is possible to observe the living parts of the subject as moving images. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2015-037472 Summary of the Invention [Problem to be solved by the invention]

[0004] In recent years, advances in ultrasound diagnostic equipment have made it possible to observe morphological characteristics of the human body (e.g., muscle development and atrophy), and the application of such ultrasound diagnostic equipment to the examination of joint instability is being considered.

[0005] Joint instability is a condition in which ligaments become lax and the joint becomes chronically unstable (wobbly) as a result of inadequate treatment after a joint sprain. Such joint instability typically occurs in the ankle and arm. For example, if such joint instability occurs in the ankle, it can cause repeated sprains, and if left untreated, it can lead to damage to the articular cartilage and osteoarthritis of the ankle. Therefore, in medical settings, joint instability tests are routinely performed to evaluate the progress of the joint after a joint sprain.

[0006] Fig. 1 is a diagram showing the state of an examination for joint instability (here, examination of an ankle joint), and Fig. 2 is a diagram showing an example of an ultrasound image of an ankle joint.

[0007] Joint instability can typically be evaluated based on the movement of two adjacent bones connected to the joint when the joint is compressed. For example, in an examination of ankle joint instability, the movement of the fibula and talus connected to the ankle joint (here, the anterior tibiofibular ligament) is observed when the ankle joint is repeatedly compressed. Note that, in an ultrasound image of the anterior talofibular ligament (Rs), cross-sectional images of the fibula (Rt1) and the talus (Rt2) on either side of the anterior talofibular ligament (Rs) can be observed (see Figure 2).

[0008] Specifically, an examination for joint instability (here, examination of the ankle joint) using an ultrasound diagnostic device is performed according to the following flow. Step S1: The examiner applies an ultrasound probe to the subject's ankle. Step S2: The examiner operates the ultrasound diagnostic device body to start capturing moving images of ultrasound images. Step S3: The examiner repeatedly presses the ankle of the subject at predetermined time intervals (for example, at intervals of several seconds). Step S4: The examiner operates the ultrasound diagnostic device body to finish capturing the moving ultrasound image.

[0009] The examiner (hereinafter referred to as the "user") typically evaluates joint instability by observing how the ankle joint changes when repeatedly pressing on it in the video ultrasound images acquired using this flow.

[0010] It is desirable that this type of joint instability test can be performed by users who are not experienced. However, currently, evaluation of joint instability is subjective, relying on the user's intuition and requiring high skill and extensive experience. This results in variability among users, leaving room for improvement in terms of the reliability of the test results. In other words, it is desirable to quantify joint instability and enable objective evaluation in joint instability tests.

[0011] The present disclosure has been made in consideration of the above-mentioned problems, and aims to provide an ultrasound diagnostic device, a control method for an ultrasound diagnostic device, and a control program for an ultrasound diagnostic device that can quantify joint instability and enable objective evaluation in testing for joint instability. [Means for solving the problem]

[0012] The present disclosure mainly solves the above-mentioned problems by: An ultrasound diagnostic apparatus used to examine joint instability of a subject, an acquisition unit that acquires first and second ultrasound images of the joint of the subject in different time series; a point of interest setting unit that sets a first point of interest and a second point of interest on a first bone tissue and a second bone tissue that are adjacent to each other and connected to the joint portion and that appear in each of the first and second ultrasound images; a calculation unit that calculates an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasonic image and a change in a distance between the first point of interest and the second point of interest in the second ultrasonic image; an inspection result output unit that outputs the evaluation index; The ultrasound diagnostic device is equipped with:

[0013] In other respects, 1. A control method for an ultrasound diagnostic apparatus applied to an examination for joint instability of a subject, comprising: A process of acquiring first and second ultrasound images of the joint of the subject in different time series; a process of setting a first point of interest and a second point of interest on a first bone tissue and a second bone tissue connected to the joint that are adjacent to each other and that are shown in each of the first and second ultrasound images; A process of calculating an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasound image and a change in a distance between the first point of interest and the second point of interest in the second ultrasound image; A process of outputting the evaluation index; The present invention relates to a method for controlling an ultrasonic diagnostic apparatus including the above-mentioned components.

[0014] In other respects, A control program for an ultrasound diagnostic apparatus used to examine joint instability of a subject, comprising: A process of acquiring first and second ultrasound images of the joint of the subject in different time series; a process of setting a first point of interest and a second point of interest on a first bone tissue and a second bone tissue connected to the joint that are adjacent to each other and that are shown in each of the first and second ultrasound images; A process of calculating an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasound image and a change in a distance between the first point of interest and the second point of interest in the second ultrasound image; A process of outputting the evaluation index; The present invention relates to a control program for an ultrasonic diagnostic apparatus having the above-mentioned features. [Effects of the Invention]

[0015] The ultrasound diagnostic device according to the present disclosure makes it possible to quantify joint instability and perform objective evaluation in an examination for joint instability. [Brief explanation of the drawings]

[0016] [Figure 1] A diagram showing the examination of joint instability (in this case, the ankle joint) [Figure 2] FIG. 10 is a diagram showing an example of an ultrasound image of an ankle joint. [Figure 3] FIG. 1 is a diagram showing an example of the appearance of an ultrasound diagnostic apparatus according to a first embodiment; [Figure 4] FIG. 1 is a block diagram showing an example of the configuration of the main parts of a control system of an ultrasound diagnostic apparatus according to a first embodiment; [Figure 5] FIG. 1 is a diagram showing an example of a detailed configuration of a control unit according to a first embodiment; [Figure 6] FIG. 2 is a diagram showing an example of two points of interest (a first point of interest and a second point of interest) set by a point of interest setting unit. [Figure 7] FIG. 1 is a diagram showing an example of the behavior of two points of interest (first and second points of interest) during joint instability testing. [Figure 8] FIG. 1 is a diagram showing an example of a change over time in the distance between two points of interest (a first point of interest and a second point of interest) during a joint instability test. [Figure 9] FIG. 10 is a diagram showing an example of a display of test results of a joint instability test outputted to the test result output unit according to the first embodiment; [Figure 10] FIG. 10 is a diagram showing an example of an operation flow of a control unit according to the first embodiment; [Figure 11] FIG. 10 is a diagram showing an example of a display of test results of a joint instability test outputted to a test result output unit according to the second embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0017] Hereinafter, preferred embodiments of the present disclosure will be described in detail with reference to the accompanying drawings. In this specification and drawings, components having substantially the same functions are designated by the same reference numerals, and redundant description will be omitted.

[0018] (First embodiment) [Overall configuration of ultrasound diagnostic device 1] The configuration of an ultrasonic diagnostic device according to one embodiment of the present invention (hereinafter referred to as "ultrasonic diagnostic device 1") will be described below with reference to FIGS.

[0019] Fig. 3 is a diagram showing an example of the appearance of the ultrasonic diagnostic device 1. Fig. 4 is a block diagram showing an example of the configuration of the main parts of the control system of the ultrasonic diagnostic device 1.

[0020] The ultrasound diagnostic device 1 visualizes the shape, properties, or dynamics inside a subject as an ultrasound image. The ultrasound diagnostic device 1 according to this embodiment is used, for example, to capture ultrasound images of an ankle joint and perform an examination for ankle instability.

[0021] 3, the ultrasonic diagnostic device 1 includes an ultrasonic diagnostic device main body 10 and an ultrasonic probe 20. The ultrasonic diagnostic device main body 10 and the ultrasonic probe 20 are connected via a cable 30.

[0022] The ultrasonic probe 20 transmits an ultrasonic beam (for example, about 1 to 30 MHz) into a subject (for example, a human body), and also functions as an acoustic sensor that receives ultrasonic echoes of the transmitted ultrasonic beam reflected within the subject and converts them into electrical signals.

[0023] The user performs an examination for ankle joint instability by bringing the transmitting and receiving surface of the ultrasound probe 20 into contact with the body surface of the subject's joint and operating the ultrasound diagnostic device 1. The ultrasound probe 20 can be any type, such as a convex probe, linear probe, sector probe, or three-dimensional probe.

[0024] The ultrasonic probe 20 includes, for example, a plurality of transducers (e.g., piezoelectric elements) arranged in a matrix, and a channel switching unit (e.g., a multiplexer) for switching and controlling the driving state of the plurality of transducers on and off individually or in block units (hereinafter referred to as "channels").

[0025] Each transducer of the ultrasonic probe 20 converts a voltage pulse generated by the ultrasonic diagnostic device main body 10 (transmitter 12) into an ultrasonic beam and transmits it into the subject, receives ultrasonic echoes reflected within the subject, converts them into electrical signals (hereinafter referred to as "received signals"), and outputs them to the ultrasonic diagnostic device main body 10 (receiver 13).

[0026] As shown in FIG. 4, the ultrasound diagnostic device main body 10 includes an operation input unit 11, a transmitting unit 12, a receiving unit 13, an ultrasound image generating unit 14, a display image generating unit 15, a display unit 16, and a control unit 17.

[0027] The transmitting unit 12, the receiving unit 13, the ultrasound image generating unit 14, and the display image generating unit 15 are composed of dedicated or general-purpose hardware (electronic circuits) corresponding to each process, such as a DSP (Digital Signal Processor), an ASIC (Application Specific Integrated Circuit), or a PLD (Programmable Logic Device), and work in cooperation with the control unit 17 to realize each function.

[0028] The operation input unit 11 receives, for example, a command to start a diagnosis or input of information about the subject. The operation input unit 11 includes, for example, an operation panel having a plurality of input switches, a keyboard, a mouse, etc. The operation input unit 11 may be configured as a touch panel that is provided integrally with the display unit 16.

[0029] The transmission unit 12 is a transmitter that transmits a voltage pulse as a drive signal to the ultrasonic probe 20 in accordance with instructions from the control unit 17. The transmission unit 12 includes, for example, a high-frequency pulse oscillator and a pulse setting unit. The transmission unit 12 adjusts the voltage pulse generated by the high-frequency pulse oscillator to the voltage amplitude, pulse width, and transmission timing set by the pulse setting unit, and transmits the adjusted voltage pulse for each channel of the ultrasonic probe 20.

[0030] The transmitter 12 has a pulse setting unit for each of the multiple channels of the ultrasonic probe 20, and is capable of setting the voltage amplitude, pulse width, and transmission timing of the voltage pulse for each of the multiple channels. For example, the transmitter 12 can change the target depth or generate different pulse waveforms by setting appropriate delay times for the multiple channels.

[0031] The receiving unit 13 is a receiver that receives and processes the received signals related to the ultrasonic echoes generated by the ultrasonic probe 20 in accordance with instructions from the control unit 17. The receiving unit 13 includes a preamplifier, an AD conversion unit, and a receiving beam former.

[0032] The receiver 13 amplifies the received signals related to weak ultrasonic echoes for each channel using a preamplifier, and converts the received signals into digital signals using an AD converter.The receiver 13 then combines the received signals of multiple channels into one signal using a receive beamformer by phasing and adding the received signals of each channel to generate acoustic line data.

[0033] The ultrasound image generating unit 14 acquires the received signal (acoustic line data) from the receiving unit 13 and generates an ultrasound image (that is, a tomographic image) of the inside of the subject.

[0034] For example, when the ultrasonic probe 20 transmits a pulsed ultrasonic beam in the depth direction, the ultrasonic image generation unit 14 successively stores in a line memory the signal intensities of the ultrasonic echoes detected thereafter. Then, as the ultrasonic beam from the ultrasonic probe 20 scans the inside of the subject, the ultrasonic image generation unit 14 sequentially stores in the line memory the signal intensities of the ultrasonic echoes at each scanning position to generate two-dimensional data in units of frames. Then, the ultrasonic image generation unit 14 converts the signal intensities of the two-dimensional data into brightness values ​​to generate an ultrasonic image representing the two-dimensional structure in a cross section including the ultrasonic transmission direction and the ultrasonic scanning direction.

[0035] The ultrasound image generating unit 14 may include, for example, an envelope detection circuit that performs envelope detection on the received signal obtained from the receiving unit 13, a logarithmic compression circuit that performs logarithmic compression on the signal strength of the received signal detected by the envelope detection circuit, and a dynamic filter that is a bandpass filter whose frequency characteristics change according to the depth and removes noise components contained in the received signal.

[0036] The ultrasound image generating unit 14 has a cine memory unit (not shown), and temporarily stores a plurality of ultrasound images (a plurality of frame images) generated within the last few minutes in the cine memory unit so that they can be played back as moving images.

[0037] The display image generation unit 15 acquires the ultrasound image data from the ultrasound image generation unit 14 and generates a display image including a display area for the ultrasound image. Then, the display image generation unit 15 sends the generated display image data to the display unit 16. The display image generation unit 15 sequentially updates the display image every time a new ultrasound image is acquired from the ultrasound image generation unit 14, and displays the display image on the display unit 16 in a moving image format.

[0038] In addition, during an instability test, the display image generation unit 15 generates a display image in which an image displaying the test results of the instability test is embedded in the display area together with an ultrasound image in accordance with instructions from the control unit 17 (described later with reference to Figure 10).

[0039] The display image generating unit 15 may generate a display image after performing predetermined image processing such as coordinate conversion processing and data interpolation processing on the ultrasound image output from the ultrasound image generating unit 14.

[0040] Display unit 16 is configured with, for example, a liquid crystal display, an organic EL display, a CRT display, etc. Display unit 16 acquires display image data from display image generation unit 15 in accordance with instructions from control unit 17, and displays the display image.

[0041] The control unit 17 controls the operation input unit 11, the transmitting unit 12, the receiving unit 13, the ultrasound image generating unit 14, the display image generating unit 15, and the display unit 16 according to their respective functions, thereby performing overall control of the ultrasound diagnostic device 1.

[0042] The control unit 17 has a CPU (Central Processing Unit) 171 as the arithmetic / control unit 17, a ROM (Read Only Memory) 172 as a main storage device, and a RAM (Random Access Memory) 173. Basic programs and basic setting data are stored in the ROM 172. The CPU 171 reads a program corresponding to the processing content from the ROM 172, loads it into the RAM 173, and executes the loaded program, thereby centrally controlling the operations of the functional blocks (transmitter 12, receiver 13, ultrasound image generator 14, display image generator 15, and display 16) of the ultrasound diagnostic apparatus main body 10.

[0043] [Detailed configuration of control unit 17] Next, the detailed configuration of the control unit 17 will be described with reference to Figures 5 to 10. Note that only the configuration of the control unit 17 that functions during a joint instability test will be described here.

[0044] FIG. 5 is a diagram showing an example of a detailed configuration of the control unit 17. As shown in FIG.

[0045] The control unit 17 includes an interest point setting unit 17a, an interest point tracking unit 17b, a positional relationship analysis unit 17c, and an examination result output unit 17d, and thereby the control unit 17 outputs the examination results almost automatically during the joint instability examination.

[0046] FIG. 6 is a diagram showing an example of two points of interest (a first point of interest P1 and a second point of interest P2) set by the point of interest setting unit 17a.

[0047] Figure 7 is a diagram showing an example of the behavior of two points of interest (first point of interest P1 and second point of interest P2) during a joint instability examination. The left image in Figure 7 is an ultrasound image of the joint in a non-pressured state (released state). The right image in Figure 7 is an ultrasound image of the joint in a pressed state (pressured state).

[0048] FIG. 8 is a diagram showing an example of the change over time in the distance L0 between two points of interest (a first point of interest P1 and a second point of interest P2) during a joint instability examination.

[0049] As a result of extensive research, the inventors of the present application have found that, during a joint instability examination, the degree to which bone tissues on both sides (in this embodiment, the fibula Rt1 and the talus Rt2) connected to the joint change distance when pressed by an examiner, depending on the degree of instability of the joint (in this embodiment, the anterior tibiotalar ligament Rs). In other words, the inventors of the present application have come up with the technical idea that by focusing on the degree to which the distance between two adjacent bone tissues connected to the joint (see L0 in FIG. 7) changes during a joint instability examination, this can be used as an objective index for measuring the degree of joint instability. Based on this technical idea, the inventors have designed the configurations of the point of interest setting unit 17a, the point of interest tracking unit 17b, the positional relationship analysis unit 17c, and the examination result output unit 17d.

[0050] The point of interest setting unit 17a sets a first point of interest P1 and a second point of interest P2 on adjacent first bone tissue Rt1 and second bone tissue Rt2 connected to the joint Rs depicted in the ultrasound image. The point of interest setting unit 17a according to the present embodiment detects the presence area of ​​the first bone tissue Rt1, the presence area of ​​the second bone tissue Rt2, and the presence area of ​​the joint Rs from the ultrasound image by image analysis of the ultrasound image, and sets, for example, the first point of interest P1 at a position adjacent to one end of the joint Rs on the first bone tissue Rt1, and sets the second point of interest P2 at a position adjacent to the other end of the joint Rs on the second bone tissue Rt2.

[0051] A method for detecting the area where the first bone tissue Rt1 exists, the area where the second bone tissue Rt2 exists, and the area where the joint Rs exists from an ultrasound image is typically a well-known pattern matching method, such as processing using a trained neural network (e.g., a convolutional neural network) or template matching.

[0052] Furthermore, the positions at which the interest point setting unit 17a sets the interest points P1 and P2 may be any positions that allow the movement patterns of the first and second bone tissues Rt1 and Rt2 to be recognized, and may be near the boundary between the first and second bone tissues Rt1 and Rt2 and the joint portion Rs.

[0053] The positions of the first and second points of interest P1 and P2 in the ultrasound image may be set by user input, but are preferably set automatically by image analysis. This eliminates the need for the user to check the areas of the first and second bone tissues Rt1 and Rt2 adjacent to each other, where the joint Rs is connected, on the ultrasound image and set the first and second points of interest P1 and P2 at appropriate positions on the first and second bone tissues Rt1 and Rt2 (for example, at both ends of the joint). This improves user convenience and enables more accurate instability assessment.

[0054] The interest point tracking unit 17b tracks the positions of a first interest point P1 on the first bone tissue Rt1 and a second interest point P2 on the second bone tissue Rt2 in a moving ultrasound image generated during a joint instability examination.

[0055] For example, the point of interest tracking unit 17b sets a first region of interest (template) of a predetermined size centered on the first point of interest P1, and sets a second region of interest (template) of a predetermined size centered on the second point of interest P2. Then, the point of interest tracking unit 17b identifies the positions of the first region of interest and the second region of interest in each frame, for example, by known pattern matching. As a result, the point of interest tracking unit 17b identifies the position of the first point of interest P1 and the position of the second point of interest P2 in each frame. Note that the positions of the first point of interest P1 and the second point of interest P2 are identified, for example, as coordinate positions in the ultrasound image.

[0056] For example, the positional relationship analysis unit 17c analyzes the temporal change in the positional relationship between the first point of interest P1 and the second point of interest P2 in each frame of a moving ultrasound image generated during a joint instability examination, identified by the point of interest tracking unit 17b, and calculates the temporal change in the distance L0 between the first point of interest P1 and the second point of interest P2. That is, the positional relationship analysis unit 17c calculates the distance L0 between the first point of interest P1 and the second point of interest P2 in each frame (hereinafter also referred to as the "distance L0 between the points of interest") from the coordinates of the first point of interest P1 and the coordinates of the second point of interest P2 in each frame, and outputs this result in association with the time axis (see, for example, FIG. 8).

[0057] The test result output unit 17d outputs the change over time in the distance L0 between the first point of interest P1 and the second point of interest P2 or the width of that change as the test result. The test result output by the test result output unit 17d is then input to the display image generation unit 15, for example, and reflected in the display image generated by the display image generation unit 15, which is then displayed on the display screen of the display unit 16.

[0058] Fig. 9 is a diagram showing an example of the display of the examination results of the joint instability examination output to the examination result output unit 17d. Fig. 9 shows an example in which an area Rb in which time-series data of the distance between points of interest L0 during the joint instability examination is displayed in a graph format is displayed together with a tomographic image display area Ra in the display image Rall.

[0059] It is preferable that the test result output unit 17d notify the user of the test results of the joint instability test as a graph display of time-series data of the inter-point-of-interest distance L0, for example, as shown in Fig. 9 (see the Rb area in Fig. 9). This allows the user to understand the behavior of the joint when the joint of the subject is pressed during the joint instability test. This also allows the user to understand the interlocking of the movement of the joint in response to the pressure on the joint of the subject, and it is also possible to obtain suggestions about the more detailed condition of the joint from the interlocking pattern.

[0060] When displaying a graph of the time-series data of the distance L0 between points of interest, the examination result output unit 17d may display the graph so that the data is updated sequentially each time an ultrasound image is acquired, starting from the point at which acquisition of the ultrasound image begins. This allows the user to grasp the behavior of changes in the distance L0 between points of interest in real time. In this case, the examination result output unit 17d displays the ultrasound images generated at each time in the tomographic image display area Ra of FIG. 9, for example.

[0061] Furthermore, when the joint instability test is completed, the test result output unit 17d preferably notifies the user of the range of change in the inter-point-of-interest distance L0 during the joint instability test (i.e., the range between the maximum and minimum values ​​of the inter-point-of-interest distance L0) (ΔL0 in FIG. 8) calculated from the time-series data of the inter-point-of-interest distance L0 (see display area Rb2 in FIG. 9). This allows the user to obtain the test results of the joint instability test as objective numerical values.

[0062] In this case, the examination result output unit 17d calculates the variation range of the inter-point-of-interest distance L0 during the joint instability examination, for example, by setting the time when the ultrasound image is acquired as the examination start timing and the time when the acquisition of the ultrasound image is completed as the examination end timing, in response to a user's operation input. However, the examination result output unit 17d may wait for detection of periodic behavior of the inter-point-of-interest distance L0 from time-series data of the inter-point-of-interest distance L0 while the user repeatedly presses the joint of the subject during the joint instability examination, and when such periodic behavior of the inter-point-of-interest distance L0 is detected, calculate the variation range of the inter-point-of-interest distance L0 during the joint instability examination from the periodic behavior. The examination result output unit 17d may detect the periodic behavior of the inter-point-of-interest distance L0 by any method, such as autocorrelation calculation or frequency analysis (e.g., FFT analysis).

[0063] Furthermore, when the joint instability examination is completed, the examination result output unit 17d preferably causes the display unit 16 to display, in the tomographic image display area Ra in Fig. 9, the ultrasound image at the timing when the distance between the points of interest L0 is at its maximum. This allows the user to immediately view the ultrasound image in which the joint is most fully extended, and also enables the user to check the state of the joint from the ultrasound image.

[0064] Furthermore, the examination result output unit 17d preferably superimposes a guide image indicating the region where the joint is present on the ultrasound image displayed on the display unit 16 during or after the joint instability examination, and changes the display mode of the guide image based on the magnitude of the change in the distance L0 between the points of interest (see the guide image Ra1 superimposed on the tomographic image display area Ra in FIG. 9). For example, the examination result output unit 17d displays the guide image in red when the change in the distance L0 between the points of interest is equal to or greater than a predetermined reference value (e.g., a reference value for distinguishing between a normal state and an abnormal state of joint instability), and displays the guide image in blue when the change in the distance L0 between the points of interest is less than the predetermined reference value.

[0065] Preferably, the examination result output unit 17d divides the variation ΔL0 of the distance L0 between the points of interest during the joint instability examination by the variation in the vertical movement of the first point of interest P1 and / or the second point of interest P2 (i.e., the movement in the depth direction on the ultrasound image) during the joint instability examination, normalizes the variation, and then outputs the normalized variation as the examination result. This is because the force with which the examiner presses the joint of the subject during the joint instability examination tends to change with each examination. In this regard, the force with which the examiner presses the joint of the subject can be estimated from the variation in the vertical movement of the first point of interest P1 and / or the second point of interest P2 during the joint instability examination. In other words, by dividing the change ΔL0 in the distance L0 between points of interest during a joint instability test by the change in the vertical movement of the first point of interest P1 and / or the second point of interest P2 during a joint instability test as the test result, a more objective indicator of joint instability that does not depend on the force with which the examiner presses on the subject's joint can be obtained as the test result.

[0066] [Operation flow of the control unit 17] 10 is a diagram showing an example of the operation flow of the control unit 17 according to this embodiment. The operation flow in FIG. 10 is processing executed by the control unit 17 when, for example, the joint instability examination mode is selected by the user on the operation mode selection screen of the ultrasound diagnostic device 1.

[0067] In step S11, the control unit 17 acquires the ultrasound image generated by the ultrasound image generation unit .

[0068] In step S12, the control unit 17 detects the joint Rs and the first bone tissue Rt1 and second bone tissue Rt2 connected to the joint Rs in the ultrasound image.

[0069] In step S13, the control unit 17 sets a first point of interest P1 on the first bone tissue Rt1, and also sets a second point of interest P2 on the second bone tissue Rt2.

[0070] In step S14, the control unit 17 tracks the positions of the first and second points of interest P1 and P2 in the moving ultrasound images generated during the joint instability examination.

[0071] In step S15, the control unit 17 calculates the change over time in the distance L0 between the first interest point P1 and the second interest point P2 in the moving ultrasound image generated during the joint instability examination.

[0072] In step S16, the control unit 17 outputs the change over time in the distance L0 between the first point of interest P1 and the second point of interest P2 to the display image generation unit 15, and displays, for example, a graph of the change over time in the distance L0 between the first point of interest P1 and the second point of interest P2 on the display screen of the display unit 16 together with the ultrasound image generated by the ultrasound image generation unit 14 and updated sequentially (see Figure 9).

[0073] The control unit 17 repeatedly executes steps S11 to S16 during the joint instability test mode. Then, when the joint instability test is completed, the change range of the distance L0 between the first point of interest P1 and the second point of interest P2 during the test is displayed on the display screen of the display unit 16 (see FIG. 9).

[0074] [effect] As described above, the ultrasound diagnostic device 1 according to this embodiment: an ultrasonic image generating unit 14 that generates an ultrasonic image of the joint based on a received signal acquired from the ultrasonic probe; a point of interest setting unit (17a) that sets a first point of interest and a second point of interest on a first bone tissue and a second bone tissue that are adjacent to each other and connected to the joint portion and that are shown in the ultrasound image; an interest point tracking unit (17b) for tracking the positions of the first interest point and the second interest point in the moving ultrasound image generated during the examination; a positional relationship analysis unit (17c) that analyzes a change over time in the positional relationship between the first point of interest and the second point of interest in each frame of the ultrasound image in the moving image format generated during the examination, and calculates a change over time in the distance between the first point of interest and the second point of interest; an inspection result output unit 17d that outputs the change in the distance over time or the width of the change as an inspection result; It is equipped with:

[0075] Therefore, the ultrasound diagnostic device 1 according to this embodiment makes it possible to quantitatively confirm the instability of the subject's joints. In other words, this eliminates subjective evaluation in joint instability testing, allowing for more objective evaluation.

[0076] (Second embodiment) The ultrasound diagnostic apparatus 1 according to this embodiment differs from the first embodiment in that the test result output unit 17d is capable of comparing the temporal change or the amplitude of change in the distance L0 between the points of interest at the joint Rs on the left side of the subject's body with the temporal change or the amplitude of change in the distance L0 between the points of interest at the joint Rs on the right side of the subject's body, or outputs the comparison results.

[0077] FIG. 11 is a diagram showing an example of the display of the examination results of the joint instability examination output to the examination result output unit 17d according to this embodiment.

[0078] When testing for joint instability, similar tests are performed on both the joints on the left side of the subject's body and the joints on the right side of the subject's body, and the difference in joint instability between the left and right sides obtained during this test can be used to evaluate the joint on the side that is the main subject of the test, making it possible to increase the reliability of the test results.

[0079] In other words, although the movement of a subject's joints generally varies from person to person, by comparing the movement of the left ankle joint and the movement of the right ankle joint of the same subject, it is possible to accurately compare the movement of the joint in a normal state with the movement of the joint on the side where a sprain or the like has occurred.

[0080] From this perspective, the test result output unit 17d according to this embodiment displays, for example, a temporal change in the distance between points of interest L0-left at the left ankle joint of the subject and a temporal change in the distance between points of interest L0-right at the right ankle joint of the subject in a graph display area Rb of the time-series data of the distance between points of interest L0, as shown in Fig. 10. Note that, for example, the test result output unit 17d, in response to a user's operation input, tags the test results when a joint instability test for the left ankle joint of the subject and the test results when a joint instability test for the right ankle joint of the subject so that they can be identified, and outputs both of them in a comparable manner based on this data.

[0081] As described above, the ultrasound diagnostic device 1 according to this embodiment is useful in that it can output more reliable examination results for joint instability examinations.

[0082] Although specific examples of the present invention have been described above in detail, these are merely examples and do not limit the scope of the claims. The technology described in the claims includes various modifications and alterations of the specific examples exemplified above. [Industrial Applicability]

[0083] The ultrasound diagnostic device according to the present disclosure makes it possible to quantify joint instability and perform objective evaluation in an examination for joint instability. [Explanation of symbols]

[0084] 1. Ultrasound diagnostic equipment 10. Ultrasound diagnostic device body 11 Operation input section 12 Transmitter 13 Receiving unit 14 Ultrasound image generation unit 15 Display image generation unit 16 Display section 17 Control Unit 17a Interest point setting section 17b Interest point tracking unit 17c Positional relationship analysis section 17d Test result output section 20 Ultrasound Probe 30 Cable

Claims

1. An ultrasound diagnostic apparatus used to examine joint instability of a subject, an acquisition unit that acquires first and second ultrasound images of the joint of the subject in different time series; a point of interest setting unit that sets a first point of interest and a second point of interest on a first bone tissue and a second bone tissue that are adjacent to each other and connected to the joint portion and that are shown in each of the first and second ultrasound images; a calculation unit that calculates an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasound image and a change in a distance between the first point of interest and the second point of interest in the second ultrasound image; an inspection result output unit that outputs the evaluation index; An ultrasound diagnostic device comprising:

2. The interest point setting unit selects the point of interest from the ultrasound image by image analysis of the ultrasound image. detecting an area where the first bone tissue, the second bone tissue, and the joint are present; The first point of interest is set at a position adjacent to one end of the joint, and the second bone tissue is positioned adjacent to the joint. and setting the second point of interest at a position adjacent to the other end of the portion. The ultrasonic diagnostic apparatus according to claim 1 .

3. The test result output unit displays a guide image indicating the area where the joint exists on the ultrasound image. and displaying the guide image in a superimposed manner based on the magnitude of the change width of the distance. Change the display mode. The ultrasonic diagnostic apparatus according to claim 1 .

4. the test result output unit outputs the evaluation index at the joint on the left side of the body of the subject and the evaluation index of the distance at the joint on the right side of the body of the subject in a manner that makes them comparable or outputs a comparison result thereof. The ultrasonic diagnostic apparatus according to claim 1 .

5. the examination result output unit displays, on a monitor screen, one of the first ultrasound image and the second ultrasound image in which the distance between the first point of interest and the second point of interest is large, together with the evaluation index. The ultrasonic diagnostic apparatus according to claim 1 .

6. the examination result output unit normalizes the amount of change by dividing it by an amount of change in the vertical movement of the first point of interest and / or the second point of interest between the first ultrasound image and the second ultrasound image, and outputs the normalized amount as the evaluation index. The ultrasonic diagnostic apparatus according to claim 1 .

7. the joint is an ankle joint or a shoulder joint of the subject; The ultrasonic diagnostic apparatus according to claim 1 .

8. 1. A control method for an ultrasound diagnostic apparatus applied to an examination for joint instability of a subject, comprising: acquiring first and second ultrasound images of the joint of the subject in different time series; a process of setting a first point of interest and a second point of interest on a first bone tissue and a second bone tissue connected to the joint that are adjacent to each other and that are shown in the first ultrasound image and the second ultrasound image, respectively; A process of calculating an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasound image and a change in a distance between the first point of interest and the second point of interest in the second ultrasound image; A process of outputting the evaluation index; A method for controlling an ultrasonic diagnostic apparatus comprising:

9. A control program for an ultrasound diagnostic apparatus used to examine joint instability of a subject, comprising: acquiring first and second ultrasound images of the joint of the subject in different time series; a process of setting a first point of interest and a second point of interest on a first bone tissue and a second bone tissue connected to the joint that are adjacent to each other and that are shown in the first ultrasound image and the second ultrasound image, respectively; A process of calculating an evaluation index of the unstable examination based on a change in a distance between the first point of interest and the second point of interest in the first ultrasound image and a change in a distance between the first point of interest and the second point of interest in the second ultrasound image; A process of outputting the evaluation index; A control program for an ultrasound diagnostic apparatus having the above-mentioned steps.

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