Image diagnostic support device, image diagnostic support system, measurement method and program

Abstract

To enable simpler diagnosis of MMVD using imaging tests. [Solution] The control unit of the image diagnostic support device acquires a medical image (radiography image) of the subject. Next, the control unit receives a request to specify the position of auxiliary lines used to measure the left atrial size (VLAS) of the subject in the acquired medical image, and overlays the auxiliary lines on the medical image based on the specified position and displays them on the display unit. Then, the control unit acquires the measurement result of the left atrial size and stores the acquired measurement result of the left atrial size in the storage unit.

Description

Technical Field

[0001] The present invention relates to an image diagnosis support device, an image diagnosis support system, a measurement method, and a program.

Background Art

[0002] In veterinary hospitals, more than 50% of the pets that come to the hospital are dogs. Approximately 10% of the primary medical treatments for dogs are heart diseases, and 75% of them are said to be MMVD (mitral valve mucoid degeneration). MMVD corresponds to what is called cardiomegaly in humans, and there are a variety of diagnostic methods, such as radiological examination, heart murmur examination, and cardiac echocardiogram examination, which are complex. Physicians are making a comprehensive diagnosis from the result values of the examinations they have performed. The complexity of diagnosing the most frequent diseases is likely to lead to a longer examination time.

[0003] Conventionally, in image examination by radiation, MMVD has been diagnosed by the VHS (Vertebral heart size) method. Also, in order to simplify the examination more, new discrimination methods such as the VLAS (Vertebral Left Atrial Size) method have been established as alternative methods to VHS, and it is desired that the stage of MMVD can be quickly diagnosed using these methods.

[0004] As a diagnostic technique for canine heart diseases, for example, Patent Document 1 discloses a stage diagnosis method for DMVD (degenerative mitral valve disease).

Prior Art Documents

Patent Documents

[0005]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0006] However, Patent Document 1 does not disclose any imaging examinations for MMVD. Furthermore, while imaging diagnostic devices equipped with VHS measurement assistance functions are known for diagnosing MMVD, no devices equipped with VLAS measurement assistance functions are known. Therefore, a simpler diagnosis is not possible.

[0007] The objective of this invention is to enable a simpler diagnosis of MMVD using imaging tests. [Means for solving the problem]

[0008] To solve the above problems, the image diagnostic support device according to the present invention An acquisition unit that acquires medical images of the subject, An input unit for specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the aforementioned medical image, A display unit that superimposes the auxiliary lines onto the medical image based on the specified position, A measurement result acquisition unit that acquires the measurement result of the spinal left atrial size, It is equipped with.

[0009] Furthermore, the image diagnostic support system according to the present invention is An acquisition unit that acquires medical images of the subject, An input unit for specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the aforementioned medical image, A display unit that superimposes the auxiliary lines onto the medical image based on the specified position, A measurement result acquisition unit that acquires the measurement result of the spinal left atrial size, It is equipped with.

[0010] Furthermore, the measurement method according to the present invention is The process of acquiring medical images of the subject, The process involves specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the medical image using an input unit, A step of displaying the auxiliary lines superimposed on the medical image based on the specified position on the display unit, A step of obtaining a measurement result of the left atrial size of the spine; including.

[0011] In addition, the program according to the present invention, a computer, an acquisition unit that acquires a medical image of a subject, an input unit for designating the position of an auxiliary line for measuring the left atrial size of the spine in the medical image, a display unit that superimposes and displays the auxiliary line on the medical image based on the designated position, a measurement result acquisition unit that acquires a measurement result of the left atrial size of the spine, function as.

Effect of the Invention

[0012] According to the present invention, it becomes possible to more simply diagnose MMVD using an image examination.

Brief Description of the Drawings

[0013] [Figure 1] It is an overall configuration diagram of the diagnostic support system in this embodiment. [Figure 2] It is a main part block diagram showing the functional configuration of the image diagnostic support device in FIG. 1. [Figure 3] It is a diagram showing an example of a medical image display screen. [Figure 4] It is a flowchart showing the flow of VLAS measurement processing executed by the control unit in FIG. 2. [Figure 5] It is a diagram showing a change in display on a medical image in VLAS measurement processing. [Figure 6] It is a flowchart showing the flow of MMVD diagnostic support processing executed by the control unit in FIG. 2. [Figure 7] It is a diagram showing an example of a diagnostic support screen. [Figure 8] It is a diagram showing an example of a weighting setting screen. [Figure 9] It is a diagram showing an example of a past diagnosis result screen. [Modes for carrying out the invention]

[0014] Preferred embodiments of the present invention will be described below with reference to the drawings. However, the present invention is not limited to the illustrated examples.

[0015] [Configuration of the diagnostic support system] Figure 1 shows an example of the overall configuration of the diagnostic support system 100 (image diagnostic support system) in this embodiment. The diagnostic support system 100 is a system for assisting a physician in diagnosing canine MMVD. As shown in Figure 1, the diagnostic support system 100 includes a radiography device 1, an echocardiography device 2, a heart murmur testing device 3, an image diagnostic support device 4, etc. The image diagnostic support device 4 can communicate with the radiography device 1, the echocardiography device 2, and the heart murmur testing device 3 via a communication network N such as a LAN (Local Area Network) or the Internet. Each device constituting the diagnostic support system 100 conforms to standards such as HL7 (Health Level Seven), FHIR (Fast Healthcare Interoperability Resources), and DICOM (Digital Image and Communications in Medicine). Communication between each device is performed in accordance with HL7, FHIR, DICOM, etc. The number of each device is not particularly limited.

[0016] The radiography apparatus 1 (DR, CR) performs radiography on a dog as a subject and acquires medical images (radiography images). The radiography apparatus 1 writes supplementary information (patient information (patient ID, patient name, dog breed, sex, date of birth, weight, etc.), examination date and time, body part, body position, image ID, etc.) to the header of the medical image file obtained by the imaging and transmits it to the image diagnostic support device 4. In this embodiment, the radiography apparatus 1 acquires plain X-ray images as medical images.

[0017] The echocardiography device 2 is equipped with an ultrasound transducer and transmits ultrasound waves to the chest of the dog being examined. It generates a received signal in response to the reflected ultrasound waves from within the dog and, based on the received signal, visualizes the internal state of the dog as an ultrasound image. The echocardiography device 2 also measures echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter (LVIDDN), etc., based on the ultrasound image and transmits the measurement results (echocardiography results) to the image diagnostic support device 4, along with patient information and the date and time of the examination. Alternatively, the ultrasound image may be transmitted to the image diagnostic support device 4 along with the examination results.

[0018] The heart murmur testing device 3 acquires the heart sounds of the subject, acquires the heart murmur intensity based on the acquired heart sounds, and transmits it to the image diagnostic support device 4 in association with patient information and the date and time of the examination. For example, the heart murmur testing device 3 analyzes the acquired heart sounds of the subject to acquire the heart murmur intensity. Alternatively, the heart murmur testing device 3 may be equipped with an input means for inputting the heart murmur intensity determined by a physician based on the acquired heart sounds of the subject, and the heart murmur intensity may be acquired by input from the input means. The heart murmur testing device 3 may also record the heart sound data (or heart murmur data) and transmit the heart sound data (or heart murmur data) to the image diagnostic support device 4. The control unit 41 of the image diagnostic support device 4 may then analyze the heart sound data (or heart murmur data) to acquire the heart murmur intensity. Alternatively, a physician may determine the heart murmur intensity based on the heart sound data (or heart murmur data) and input it using the operation unit 42.

[0019] The image diagnostic support device 4 is a device equipped with functions to support the diagnosis of canine MMVD, including a function to assist in VLAS measurement in medical images of the right lateral recumbent chest received (acquired) from the radiography device 1.

[0020] Traditionally, VHS has been used to diagnose MMVD. VHS is a numerical value obtained by measuring how many times the length of the fourth thoracic vertebral body the sum of the distance from the ventral edge of the tracheal bifurcation to the apex (L) and the maximum transverse diameter of the heart perpendicular to it (S) is in a medical image of the right lateral-lying chest. VHS is complicated and unreliable because it requires measuring the length of L and the length of S perpendicular to it while the heart is beating. Therefore, the image diagnostic support device 4 of this embodiment assists in the measurement of VLAS, which is easier to measure and more reliable, thereby making the diagnosis of MMVD easier. VLAS is a numerical value obtained by measuring the distance from the ventral edge of the tracheal bifurcation to the intersection of the posterior vena cava and the left atrium in a medical image of the right lateral-lying chest, and determining how many vertebrae this distance corresponds to from the fourth thoracic vertebra. It is called the spinal left atrial size.

[0021] Figure 2 is a block diagram showing the functional configuration of the image diagnostic support device 4. As shown in Figure 2, the image diagnostic support device 4 comprises a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, and a storage unit 45. The various parts of the image diagnostic support device 4 are connected by a bus 46.

[0022] The control unit 41 is composed of a CPU (Central Processing Unit), RAM (Random Access Memory), etc. The control unit 41 comprehensively controls the operation of each part of the image diagnostic support device 4. The CPU of the control unit 41 reads various processing programs stored in the memory unit 45, loads them into RAM, and executes various processes according to the programs. The control unit 41 functions as an acquisition unit, a measurement result acquisition unit, an information acquisition unit, an output unit, and a dog breed acquisition unit.

[0023] The operation unit 42 consists of a keyboard with various keys, a pointing device such as a mouse, or a touchscreen attached to the display unit 43. The operation unit 42 outputs operation signals input by the user through key operations, mouse operations, or touch operations on the touchscreen to the control unit 41. The operation unit 42 functions as an input unit.

[0024] The display unit 43 is configured with a monitor such as an LCD (Liquid Crystal Display). The display unit 43 displays various screens according to the instructions of the display signals input from the control unit 41. Note that the monitor is not limited to one, and may be provided with multiple monitors.

[0025] The communication unit 44 is configured, for example, as a network interface, and transmits and receives data with external devices connected via a communication network N by wire or wireless connection. In this embodiment, the communication unit 44 is configured as a network interface, but it can also be configured as a port into which a USB memory stick or SD card can be inserted.

[0026] The storage unit 45 is composed of an HDD (Hard Disk Drive), semiconductor memory, etc. The storage unit 45 stores programs for executing various processes, including the VLAS measurement process and MMVD diagnostic support process described later. The storage unit 45 also stores parameters, files, etc., necessary for program execution.

[0027] For example, the memory unit 45 is equipped with an image database 451, an echocardiogram database 452, a heart murmur database 453, a diagnostic results database 454, and the like. Image DB451 stores medical images acquired from radiography device 1 and their associated information in an associated manner. The echocardiography database (DB452) stores echocardiography results obtained from the echocardiography device (2), associated with patient information and the date and time of the examination. These echocardiography results include, for example, echocardiography LA / AO and weight-normalized left ventricular diastolic diameter (LVIDDN). The heart murmur DB453 stores the heart murmur intensity acquired from the heart murmur testing device 3, associated with patient information and the date and time of the examination. The diagnostic results DB454 stores MMVD diagnostic results associated with patient information and the date of diagnosis. For example, the diagnostic results DB454 includes items such as patient ID, patient name, sex, date of birth, breed, weight, body type, measurement results, weighting information, overall findings (stage), remarks, and date of diagnosis. Examples of measurement results include murmur intensity, echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter, VHS, and VLAS. The diagnostic results DB454 stores information for these items as one record. Here, murmur intensity, echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter, VHS, and VLAS are pieces of information that are examination items in the diagnosis of MMVD. The weighting information is information used to identify the weighting of each of the murmur intensity, echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter, VHS, and VLAS when the diagnosis (overall findings) was made, and in this embodiment, it is a custom number described later.

[0028] Furthermore, if the image diagnostic support device 4 can acquire other test results that constitute examination items in the diagnosis of MMVD from within the device or from external equipment, the storage unit 45 may be equipped with a database for storing such test results. For example, if the image diagnostic support device 4 can acquire VHS test results from within the device or from external equipment, the storage unit 45 may be equipped with a database that stores the VHS test results in association with patient information and the date and time of the examination.

[0029] Furthermore, the memory unit 45 stores the weighting (reference values) for each examination item in diagnosis, such as heart murmur intensity, echocardiogram LA / AO, weight-standardized left ventricular diastolic diameter, VHS, and VLAS, associated with custom numbers described later. The memory unit 45 also stores the criteria (thresholds) for diagnosing the stage of MMVD, as defined by the American College of Veterinary Internal Medicine (ACVIM), for each examination item.

[0030] [Operation of the medical imaging support device] Next, we will explain the operation of the image diagnostic support device 4. When medical images and associated information data from the radiography device 1 are received by the communication unit 44, the control unit 41 stores the received medical images and associated information in the image database 451. When the communication unit 44 receives the echocardiography results, patient information, and examination date and time data from the echocardiography device 2, the control unit 41 stores the received echocardiography results, patient information, and examination date and time in the echocardiography DB 452, associating them with each other. When the communication unit 44 receives data on heart murmur intensity, patient information, and examination date and time from the heart murmur testing device 3, the control unit 41 stores the received heart murmur intensity, patient information, and examination date and time in the heart murmur DB 453, associating them with each other.

[0031] Furthermore, the control unit 41 displays a list of medical images stored in the image database 451 on the display unit 43 in response to the operation of the operation unit 42. When a medical image to be diagnosed is selected from the list screen by the operation unit 42, the control unit 41 retrieves the selected medical image and its associated information from the image database 451 and displays the medical image display screen 431 on the display unit 43.

[0032] Figure 3 shows an example of a medical image display screen 431 displayed on the display unit 43. As shown in Figure 3, the medical image display screen 431 is provided with a medical image display area 431a, a VLAS measurement button 431b, a diagnostic support button 431c, and the like.

[0033] When the VLAS measurement button 431b is pressed by the operation unit 42, the control unit 41 executes the VLAS measurement process. Figure 4 is a flowchart showing the flow of the VLAS measurement process. The VLAS measurement process is performed through the cooperation of the control unit 41 and the program stored in the storage unit 45.

[0034] In the VLAS measurement process, first, the control unit 41 receives the position of the ventral edge P1 of the tracheal bifurcation from the operation of the operation unit 42 on the medical image displayed on the display unit 43 (step S1). Preferably, the control unit 41 displays a message on the display unit 43 or outputs it by voice prompting the user to specify the position of the ventral edge of the tracheal bifurcation.

[0035] Next, the control unit 41 receives the position of point P2 where the left atrium tail and the posterior vena cava intersect, as specified by the operation unit 42, on the medical image displayed on the display unit 43 (step S2). Preferably, the control unit 41 displays a message on the display unit 43 or outputs it by voice prompting the user to specify the position of the point where the left atrium tail and the posterior vena cava intersect.

[0036] Once the positions of P1 and P2 are specified, the control unit 41 displays an auxiliary line L1 superimposed between P1 and P2 on the medical image, as shown in G1 of Figure 5 (step S3).

[0037] Next, the control unit 41 receives the input of the position of the fourth thoracic vertebra P3 from the operation of the operation unit 42 on the medical image displayed on the display unit 43 (step S4). Preferably, the control unit 41 displays a message on the display unit 43 or outputs it by voice prompting the user to specify the position of the fourth thoracic vertebra.

[0038] Next, the control unit 41 receives the specification of a position P4 parallel to the vertebra with P3 as the starting point, based on the operation of the operation unit 42 on the medical image displayed on the display unit 43 (step S5). Preferably, the control unit 41 displays a message on the display unit 43 or outputs it by voice prompting the user to specify a position parallel to the vertebra with the position of the fourth thoracic vertebra P3 as the starting point.

[0039] When the positions of P3 and P4 are specified, the control unit 41 displays an auxiliary line L2 superimposed between P3 and P4 on the medical image, as shown in G2 of Figure 5 (step S6).

[0040] Next, the control unit 41 adjusts the length of auxiliary line L2 to match the length of auxiliary line L1, as shown in G3 of Figure 5 (step S7). At this time, the control unit 41 uses P3 on auxiliary line L2 as the base point, keeping the angle the same, and adjusts the length to match that of auxiliary line L1.

[0041] Next, the control unit 41 displays the measurement result input field 431d, the save button 431e, and the cancel button 431f on the display unit 43 (step S8). The measurement result input field 431d is a field for the user (physician) to input the VLAS measurement results by operating the control unit 42. The save button 431e is a button to instruct the user to save the entered VLAS measurement results. The cancel button 431f is a button to instruct the user to cancel the VLAS measurement.

[0042] Here, auxiliary line L2 is a line that starts from the fourth thoracic vertebra in the medical image, runs parallel to the long axis of the fourth thoracic vertebral body, and has a length between the ventral edge P1 of the tracheal bifurcation and point P2 where the caudal side of the left atrium and the posterior vena cava intersect. Therefore, the user can easily measure the VLAS (vertebral left atrial size) by counting the number of vertebral bodies (thoracic vertebrae) contained within auxiliary line L2 on the medical image. The measurement result should be entered in units of 0.1.

[0043] Next, the control unit 41 determines whether or not the VLAS measurement result has been entered from the measurement result input field 431d by the operation of the operation unit 42 (step S9). If the control unit determines that a measurement result has been entered from the measurement result input field 431d (step S9; YES), the control unit 41 determines whether or not the save button 431e has been pressed (step S10). If it is determined that the save button 431e has been pressed (step S10; YES), the control unit 41 acquires the input VLAS measurement result, stores it in the image DB 451 in association with the displayed medical image (step S11), and terminates the VLAS measurement process. The control unit 41 stores (stores) the acquired VLAS measurement results in the image DB 451, associating them with the displayed medical image. For example, the control unit 41 adds the VLAS measurement results to the supplementary information of the displayed medical image and stores them in the image DB 451.

[0044] If the control unit 41 determines that no VLAS measurement results have been entered in the measurement result input field 431d (step S9; NO), or if it determines that the save button 431e has not been pressed (step S10; NO), the control unit 41 proceeds to step S12.

[0045] In step S12, the control unit 41 determines whether or not the cancel button 431f is pressed (step S12). If it determines that the cancel button 431f is not pressed (step S12; NO), the control unit 41 returns to step S9. If it is determined that the cancel button 431f has been pressed (step S12; YES), the control unit 41 erases the auxiliary lines L1 and L2 from the medical image (step S13) and terminates the VLAS measurement process.

[0046] In the VLAS measurement process described above, the position of auxiliary line L1 is specified by specifying points P1 and P2, but the position of auxiliary line L1 may also be specified by tracing between points P1 and P2 with the operation unit 42. Similarly, although the position of auxiliary line L2 is specified by specifying points P3 and P4, the position of auxiliary line L2 may also be specified by tracing between points P3 and P4 with the operation unit 42. Furthermore, auxiliary lines L1 and L2 are not limited to thin lines like those shown in Figure 5, but also include lines with a certain thickness (width), such as those marked with a highlighter pen. Furthermore, although the VLAS measurement process shown in Figure 4 was explained using the example of a user visually measuring the VLAS, the image diagnostic support device 4 may also automatically measure (calculate) the VLAS. For example, the control unit 41 may recognize the region of the fourth thoracic vertebra from the medical image through image analysis, calculate how many times the length of the auxiliary line L2 is compared to the length of the long axis of the fourth thoracic vertebral body, and obtain this as the VLAS measurement result. The region of the fourth thoracic vertebra may also be recognized using machine learning or the like.

[0047] Furthermore, in the VLAS measurement process described above, the position of the ventral edge P1 of the tracheal bifurcation and the position of the point P2 where the left atrium tail and the posterior vena cava intersect were accepted first, followed by the position of the fourth thoracic vertebra P3 and the position P4 parallel to the vertebra with P3 as the base point. However, it is also possible to accept the position of the ventral edge P1 of the tracheal bifurcation and the position of the point P2 where the left atrium tail and the posterior vena cava intersect.

[0048] When the diagnostic support button 431c is pressed by the operation unit 42 on the medical image display screen 431, the control unit 41 executes MMVD diagnostic support processing. Figure 6 is a flowchart showing the flow of the MMVD diagnostic support process. The MMVD diagnostic support process is executed through the cooperation of the control unit 41 and the program stored in the storage unit 45.

[0049] First, the control unit 41 acquires the VLAS measurement results for the displayed medical image from the storage unit 45 (step S21). The control unit 41 acquires the VLAS measurement results for the medical images displayed from the image DB 451.

[0050] Next, the control unit 41 obtains the latest measurement results of other examination items in the MMVD diagnosis from the storage unit 45 (step S22). The control unit 41 acquires measurement results for other examination items from sources such as the echocardiogram DB452 and heart murmur DB453. The acquired measurement results include at least one piece of information such as echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter, and heart murmur intensity. If a predetermined period of time has elapsed since the examination date and time of the most recent measurement result, the control unit 41 will not acquire the measurement results for that examination item. If the measurement results for echocardiogram LA / AO, weight-normalized left ventricular diastolic diameter, and heart murmur intensity cannot be acquired, the control unit 41 will output a warning.

[0051] Next, the control unit 41 compares each acquired measurement result with a predetermined reference value and determines the MMVD stage (step S23). Here, the memory unit 45 stores the criteria (thresholds) for diagnosing the stage of MMVD as defined by the American College of Veterinary Internal Medicine (ACVIM) for each examination item. The control unit 41 compares the measurement results of each examination item with the criteria (thresholds) for diagnosing the stage of MMVD as defined by ACVIM, which are stored in the memory unit 45, to diagnose the stage of MMVD.

[0052] Next, the control unit 41 derives an overall diagnostic result (overall findings) of MMVD based on the stage diagnosed in step S23 (step S24). For example, the control unit 41 uses the stage with the highest severity among the stages diagnosed based on each examination item as the overall diagnostic result. This is to ensure that potential serious conditions are not overlooked. However, the method for deriving the overall diagnostic result is not limited to this.

[0053] Next, the control unit 41 displays the diagnostic support screen 432 on the display unit 43 (step S25). Figure 7 shows an example of the diagnostic support screen 432. As shown in Figure 7, the diagnostic support screen 432 includes a patient information display field 432a, a body type input field 432b, a medical history input field 432c, a consultation information display field 432d, a remarks input field 432e, and so on. Patient information display section 432a is a field where patient information such as the patient ID, name, and breed of the dog of the subject is displayed. Body type input field 432b is a checkbox for selecting whether the user is obese or underweight. The medical history input field 432c is for entering information if you have a medical history.

[0054] The examination information display section 432d displays information on VLAS, echocardiogram LA / AO, weight-standardized left ventricular diastolic diameter, heart murmur intensity, VHS, and overall findings. The examination information display section 432d has fields for displaying the criteria for each examination item in the diagnosis of MMVD, measurement results (test results), diagnostic results (stage), and overall findings. The criteria displayed in the examination information display section 432d are the range of measurement results that, as defined by ACVIM, indicate the need for medication. The measurement results display the information obtained in steps S21 and S22. The diagnostic results display the diagnostic results based on each examination item derived in step S23. The overall findings display the overall diagnostic result (current diagnostic result) derived in step S24. Furthermore, the measurement results for each examination item can also be manually entered by operating the control unit 42. When measurement results are entered in the examination information display field 432d by operating the control unit 42, the control unit 41 derives and re-displays the stage and overall findings based on the entered measurement results. In addition, the overall findings may be changeable by operating the control unit 42. That is, the overall findings may be changed based on the physician's overall diagnosis.

[0055] In this way, the diagnostic support screen 432 can simultaneously display multiple examination items necessary for MMVD diagnosis on a single screen. This minimizes the need to switch between screens and shortens the time to diagnosis.

[0056] The remarks input field 432e is for doctors to enter treatment plans, such as medication.

[0057] A setting button 432f is displayed near the examination information display area 432d. The setting button 432f is a button used to instruct the display of the weighting setting screen 433. The weighting setting screen 433 is a screen for setting the weighting of the importance of each examination item in the diagnosis of MMVD, and functions as a setting unit. When the setting button 432f is pressed by the operation unit 42, the control unit 41 causes the weighting setting screen 433 shown in Figure 8 to pop up on the display unit 43.

[0058] Additionally, the diagnostic support screen 432 displays buttons such as the "Reference Past Diagnoses" button 432g, the "Confirm Findings" button 432h, and the "Close" button 432i. The Past Diagnosis Reference button 432g is used to display past diagnosis results, including those of other patients. The Finding Confirmation button 432h is used to confirm the diagnosis (overall findings) based on the information displayed on the diagnosis support screen 432. The Close button 432i is used to close the diagnosis support screen 432.

[0059] Returning to Figure 6, the control unit 41 determines whether or not the setting button 432f has been pressed (step S26). If the control unit 41 determines that the setting button 432f has not been pressed (step S26; NO), it proceeds to step S29. If the control unit 41 determines that the setting button 432f has been pressed (step S26; YES), it causes the weighting setting screen 433 to pop up on the display unit 43 (step S27). The weighting setting screen 433, as shown in Figure 8, is provided with a slider bar 433a corresponding to each examination item in the MMVD diagnosis. The weight of each examination item can be adjusted by moving the knob on the slider bar 433a. By default, the position of the knob on the slider bar 433a is in the center. When the knob on the slider bar 433a is in the center, the weight of the corresponding examination item is set to "normal". When the weight is "normal", the ACVIM reference value is used as the reference value for the corresponding examination item. Moving the knob on the slider bar 433a to the left allows you to set a higher weight for the corresponding examination item. The further to the left the slider bar 433a is moved, the higher the weight of the corresponding examination item becomes, and the lower the reference value for the corresponding examination item becomes compared to the ACVIM reference value. This makes it easier for the measurement results of the corresponding examination item to be reflected in the diagnosis. Moving the knob on the slider bar 433a to the right allows you to set a lower weight for the corresponding examination item. Moving the slider bar 433a to the right reduces the weight of the corresponding examination item, and the reference value for that item is set higher than the ACVIM reference value. This makes it less likely that the measurement results of the corresponding examination item will be reflected in the diagnosis. Each slide bar 433a related to the diagnosis of MMVD is associated with a reference value display area 433b. The reference value display area 433b displays reference values ​​corresponding to the weight set by the slide bar 433a.

[0060] As described above, the weighting setting screen 433 allows you to weight the importance of each examination item used in diagnosing MMVD. Therefore, in addition to comparing the measurement data of each examination item with the ACVIM reference values, it is also possible to perform a diagnosis by giving more weight to the examination items that the user (physician) considers important based on their experience.

[0061] The weighting (reference value) of each examination item in the above MMVD diagnosis is associated with one of the custom numbers from Custom 1 to Custom 5, and up to five such values ​​can be stored and recalled. The weighting setting screen 433 has a pull-down menu 433c for selecting a custom number from Custom 1 to Custom 5 to associate with the weighting set on the weighting setting screen 433. If a custom number for which a weighting has already been registered is selected in the pull-down menu 433c, the weighting content corresponding to the selected custom number will be displayed on the weighting setting screen 433.

[0062] The weighting setting screen 433 is also equipped with a reset button 433d, a save button 433e, and a close button 433f. The reset button 433d is used to reset the weighting of each examination item and to return the reference values ​​to the ACVIM reference values. The save button 433e is used to reflect the weighting set on the weighting setting screen 433 in the diagnosis on the diagnosis support screen 432 and to save it to the memory unit 45. The close button 433f is used to close the weighting setting screen 433.

[0063] When the weighting setting screen 433 is displayed, the control unit 41 performs the weighting setting process in response to the operation of the operation unit 42 (step 28), and then proceeds to step S29. In the weighting setting process, the control unit 41 sets the weighting (reference value) for each examination item in the MMVD diagnosis based on operations such as the slider bar 433a and the reset button 433d on the weighting setting screen 433. When the save button 433e is pressed, the control unit 41 stores the reference value for each examination item corresponding to the set weight in the storage unit 45, associating it with the selected custom number. If the reference value corresponding to the selected custom number is already registered, for example, a warning is issued. The control unit 41 also changes the reference value used for the MMVD diagnosis on the diagnostic support screen 432 based on the weighting set on the weighting setting screen 433, derives the diagnostic results for each examination item and the overall diagnostic results, and reflects them on the diagnostic support screen 432. When the close button 433f is pressed, the control unit 41 terminates the weighting setting process and closes the weighting setting screen 433.

[0064] In step S29, the control unit 41 determines whether or not the past diagnosis reference button 432g has been pressed (step S29). If the control unit 41 determines that the past diagnosis reference button 432g has not been pressed (step S29;N), it proceeds to step S32. If the control unit 41 determines that the past diagnosis reference button 432g has been pressed (step S29; YES), it displays the past diagnosis results screen 434 on the display unit 43 (step S30).

[0065] As shown in Figure 9, the past diagnosis results screen 434 includes a filtering condition input field 434a, a consultation date input field 434b, a search button 434c, a past diagnosis results display field 434d, a close button 434e, etc. The filtering condition input field 434a is for inputting filtering conditions for past diagnosis results to be displayed in the past diagnosis results display field 434d. Filtering conditions can include whether to include / exclude the current patient, breed, sex, age, weight, body type, stage, remarks (treatment plan), and values ​​for each examination item. The consultation date input field 434b is for inputting the range of dates the diagnosis results were received to be displayed in the past diagnosis results display field 434d. The search button 434c is a button to instruct the system to search for diagnosis results that match the entered filtering conditions. The past diagnosis results display field 434d is a field to display past diagnosis results that match the filtering conditions. The close button 434e is a button to instruct the system to close the past diagnosis results screen 434.

[0066] When the past diagnostic results screen 434 is displayed, the control unit 41 performs the past diagnostic results display process according to the operation of the operation unit 42 (step S31), and then proceeds to step S32. In step S31, input is made in the filtering condition input field 434a and the examination date input field 434b by operating the operation unit 42, and when the search button 434c is pressed, the control unit 41 searches the diagnosis result DB 454 for past diagnosis results that match the filtering condition and examination date. The control unit 41 then displays the current diagnosis result and the retrieved past diagnosis results in the past diagnosis result display field 434d. The current diagnosis result is the current diagnosis result on the diagnosis support screen 432, and is displayed, for example, on the first row of the past diagnosis result display field 434d. When the close button 434e is pressed, the control unit 41 terminates the past diagnosis result display process and closes the past diagnosis result screen 434.

[0067] Here, on the past diagnosis results screen 434, past diagnosis results (including treatment plans) for other patients can be filtered by breed, age, body type, values ​​for each examination item, etc., and displayed along with the current diagnosis results. Therefore, for example, past diagnosis results for dogs of the same breed, body type, and condition as the patient currently being diagnosed can be displayed along with the current diagnosis results, making it possible to compare and refer to past diagnosis results for dogs in similar conditions to the patient currently being diagnosed. This allows for the use of accumulated data to improve diagnoses, such as understanding breed-specific trends and treatment plans (medication, etc.).

[0068] In this embodiment, the past diagnostic results to be displayed are narrowed down based on the input to the filtering condition input field 434a. However, past diagnostic results for the same dog breed as the current patient may also be displayed in the past diagnostic results display field 434d. That is, the control unit 41 may acquire information on the current patient's (subject's) dog breed, search the diagnostic results DB 454 for past diagnostic results for the same dog breed as the subject, and display them together with the current diagnostic results in the past diagnostic results display field 434d. This improves diagnostic performance by allowing the display of results such as differences in medication results trends depending on the dog breed.

[0069] Returning to Figure 6, in step S32, the control unit 41 determines whether or not the finding confirmation button 432h has been pressed (step S32). If it is determined that the findings confirmation button 432h has not been pressed (step S32; NO), the control unit 41 proceeds to step S34. If the control unit determines that the Finding Confirmation button 432h has been pressed (step S32; YES), the control unit 41 stores the examination information and remarks (treatment plan) displayed on the diagnostic support screen 432 in the diagnostic result DB 454, associating them with the patient information of the patient being diagnosed, including the breed of the dog (step S33). In other words, the control unit 41 stores the body shape, measurement results for each examination item, overall findings, remarks, weighting information, diagnosis date, etc., displayed on the diagnostic support screen 432 in the diagnostic result DB 454, associating them with the patient information of the patient being diagnosed, including the breed of the dog. Then, the control unit 41 proceeds to step S34.

[0070] In step S34, the control unit 41 determines whether or not the close button 432i has been pressed (step S34). If the control unit 41 determines that the close button 432i has not been pressed (step S34; NO), it returns to step S26. If the control unit determines that the close button 432i has been pressed (step S34; YES), the control unit 41 closes the diagnostic support screen 432 and terminates the MMVD diagnostic support process.

[0071] As described above, the control unit 41 of the image diagnostic support device 4 acquires a medical image (radiography image) of the subject. Next, the control unit 41 accepts the operation of the operation unit 42 to specify the position of the auxiliary lines used to measure the left atrial size (VLAS) of the subject in the acquired medical image, and overlays the auxiliary lines on the medical image based on the specified position and displays them on the display unit 43. Then, the control unit 41 acquires the measurement result of the left atrial size and stores the acquired measurement result of the left atrial size in the storage unit 45. Therefore, since it can assist in VLAS measurement during imaging examinations and obtain measurement results, it becomes possible to diagnose MMVD more simply using imaging examinations.

[0072] Furthermore, the control unit 41 acquires at least one piece of information from the subject, including the heart murmur intensity, echocardiogram LA / AO, and weight-normalized left ventricular diastolic diameter, and displays the measured spinal left atrial size and at least one of the above pieces of information on the display unit 43. Therefore, since multiple examination items necessary for MMVD diagnosis can be displayed simultaneously on a single screen, the need to switch between screens can be minimized, shortening the time to diagnosis.

[0073] Furthermore, the control unit 41 displays a weighting setting screen 433 on the display unit 43 for setting the importance of at least one piece of information in the diagnosis of MMVD, such as spinal left atrial size, heart murmur intensity, echocardiogram LA / AO, and weight-standardized left ventricular diastolic diameter. Therefore, it becomes possible to make diagnoses that place more emphasis on the examination items that the user (physician) considers important based on their experience and other factors.

[0074] Furthermore, the control unit 41 derives a diagnosis of MMVD based on at least one piece of information, including spinal left atrial size, heart murmur intensity, echocardiogram LA / AO, and weight-normalized left ventricular diastolic diameter. The control unit 41 then displays the current and past MMVD diagnosis results on the display unit 43. Therefore, it becomes possible to compare current diagnostic results with past diagnostic results. Current diagnostic results can be compared and referenced with past diagnostic results, including those of other patients.

[0075] For example, the control unit 41 acquires information about the dog breed of the subject and displays past and current diagnostic results for the same breed on the display unit 43. Therefore, the diagnostic performance is improved because the user can be provided with trends in past diagnostic results for the same breed.

[0076] Furthermore, the control unit 41 calculates the left atrium size of the spine based on the specified auxiliary lines. Therefore, VLAS can be measured more easily.

[0077] It should be noted that the present invention is not limited to the embodiments described above, and various modifications are possible without departing from the spirit of the invention. For example, the subject is not limited to dogs, but may be a variety of mammals such as cats.

[0078] Furthermore, although the above embodiment described an example where VLAS measurement is performed using a simple X-ray image of the chest in the right lateral recumbent position, the medical image to be used for VLAS measurement may also be a dynamic image of the chest in the right lateral recumbent position. A dynamic image is an image consisting of multiple frame images acquired by continuously photographing the subject multiple times. When a dynamic image is used for VLAS measurement, the control unit 41 extracts frame images from the frame images constituting the dynamic image at predetermined measurement timings, such as the diastolic or systolic phases of the heart's width, and performs VLAS measurement using the extracted frame images.

[0079] Furthermore, in the above embodiment, the image DB451, echocardiogram DB452, heart murmur DB453, diagnostic result DB454, etc., are provided in the storage unit 45 within the image diagnostic support device 4. Alternatively, these databases may be provided in a storage device separate from the image diagnostic support device 4.

[0080] Furthermore, while the above description discloses examples using hard disks, semiconductor non-volatile memory, etc., as computer-readable media for the program according to the present invention, the invention is not limited to these examples. Portable recording media such as CD-ROMs can also be used as other computer-readable media. In addition, carrier waves can be used as a medium for providing the data of the program according to the present invention via a communication line.

[0081] Furthermore, the detailed configuration and operation of each device constituting the diagnostic support system can also be modified as appropriate, without departing from the spirit of the invention.

[0082] Although embodiments of the present invention have been described and illustrated in detail above, the disclosed embodiments are for illustrative purposes only and are not limiting. The scope of the present invention should be interpreted by the terms of the appended claims. [Explanation of symbols]

[0083] 1. Radiography equipment 2. Echocardiography equipment 3. Heart murmur testing equipment 4. Image diagnostic support device 41 Control Unit 42 Operation section 43 Display section 44 Communications Department 45 Storage section 451 Image Database 452 Echocardiography DB 453 Heart murmur DB 454 Diagnostic Results Database 46 bus

Claims

1. An acquisition unit that acquires medical images of the subject, An input unit for specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the aforementioned medical image, A display unit that superimposes the auxiliary lines onto the medical image based on the specified position, A measurement result acquisition unit that acquires the measurement result of the spinal left atrial size, A diagnostic imaging support device equipped with the following features.

2. The measurement result acquisition unit acquires the measurement result of the left atrium size of the spine by calculating the left atrium size of the spine based on the auxiliary line. The image diagnostic support device according to claim 1.

3. The measurement result acquisition unit acquires the measurement result of the left atrium of the spine by receiving the input of the measurement result of the left atrium of the spine from the input unit. The image diagnostic support device according to claim 1.

4. The system includes an information acquisition unit that acquires at least one piece of information from the subject, such as the heart murmur intensity, echocardiogram LA / AO, and weight-standardized left ventricular diastolic diameter. The image diagnostic support device according to claim 1, wherein the display unit displays the measurement result of the spinal left atrial size and the at least one piece of information.

5. The image diagnostic support device according to claim 4, further comprising a setting unit for setting the weighting of the importance of at least one of the following pieces of information in the diagnosis of mitral valve myxomatous degeneration: spinal left atrial size, heart murmur intensity, echocardiographic LA / AO, and weight-standardized left ventricular diastolic diameter.

6. The system includes a lead-out unit that derives a diagnostic result for mitral valve myxomatous degeneration based on at least one piece of information: spinal left atrial size, heart murmur intensity, echocardiogram LA / AO, and weight-normalized left ventricular diastolic diameter. The image diagnostic support device according to claim 4, wherein the display unit displays the derived current diagnostic result and past diagnostic results.

7. The subject is a dog, A memory unit that stores past diagnostic results and information about the dog breed in association with each other, A dog breed acquisition unit that acquires information about the breed of the dog being tested, Equipped with, The image diagnostic support device according to claim 6, wherein the display unit displays the current diagnostic result and past diagnostic results of the same dog breed as the subject.

8. An acquisition unit that acquires medical images of the subject, An input unit for specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the aforementioned medical image, A display unit that superimposes the auxiliary lines onto the medical image based on the specified position, A measurement result acquisition unit that acquires the measurement result of the spinal left atrial size, A diagnostic imaging support system equipped with the following features.

9. The process of acquiring medical images of the subject, The process involves specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the medical image using an input unit, A step of displaying the auxiliary lines superimposed on the medical image based on the specified position on the display unit, The process of obtaining the measurement results of the left atrium size of the spine, Measurement methods, including those mentioned above.

10. Computers Acquisition unit for acquiring medical images of the subject, An input unit for specifying the position of auxiliary lines for measuring the left atrium size of the subject's spine in the aforementioned medical image. A display unit that superimposes the auxiliary lines onto the medical image based on the specified position. A measurement result acquisition unit that acquires the measurement result of the spinal left atrial size, A program designed to function as such.

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