Medical image diagnostic device and medical information processing program

Abstract

To set a desired imaging cross section to a target portion with a reduced load and higher accuracy than conventional techniques.SOLUTION: A medical image diagnostic apparatus according to embodiment comprises an acquisition part, a generation part, a calculation part, and a display control part. The acquisition part acquires three-dimensional data concerning a target portion. The generation part generates a three-dimensional model of the target portion by using the acquired three-dimensional data. The calculation part calculates the position of at least one recommended cross section to set to the target portion based on information concerning the size of the target portion obtained by using the three-dimensional model. The display control part causes a display part to display the position of the at least one recommended cross section.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The embodiments disclosed in the present specification and drawings are directed to medical imaging diagnostic equipment. reference and medical information Regarding the processing program. [Background technology]

[0002] For example, one of the representative treatments for reducing the risk of stroke due to atrial fibrillation is transcatheter left atrial appendage closure using a left atrial appendage closure device. This transcatheter left atrial appendage closure is a treatment in which a left atrial appendage closure device is placed at the inlet of the left atrial appendage using a catheter. In transcatheter left atrial appendage closure, it is necessary to accurately know the shape of the inlet of the left atrial appendage and its surrounding areas in order to determine the size standard of the left atrial appendage closure device. Conventionally, the shape of the inlet of the left atrial appendage and its surrounding areas is measured using, for example, four-section ultrasound images obtained using a transesophageal probe.

[0003] However, in the conventional method, the four planes used for shape measurement must be set quickly and correctly by manual operation, which places a heavy burden on the operator. In addition, since two-dimensional ultrasound images are used, the measurement accuracy may not be sufficient. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2007-229302 A Summary of the Invention [Problem to be solved by the invention]

[0005] One of the problems to be solved by the embodiments disclosed in this specification and the drawings is to set a desired imaging section for a target region with less burden and higher accuracy than in the past. However, the problems to be solved by the embodiments disclosed in this specification and the drawings are not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems. [Means for solving the problem]

[0006] A medical image diagnostic apparatus according to an embodiment includes an acquisition unit, a generation unit, a calculation unit, and a display control unit. The acquisition unit acquires three-dimensional data related to a target region. The generation unit generates a three-dimensional model of the target region using the acquired three-dimensional data. The calculation unit calculates the position of at least one recommended cross section to be set in the target region based on information related to the size of the target region obtained using the three-dimensional model. The display control unit causes the position of the at least one recommended cross section to be displayed on a display unit. [Brief description of the drawings]

[0007] [Figure 1] FIG. 1 is a block diagram showing an example of an ultrasonic diagnostic apparatus according to an embodiment. [Diagram 2] FIG. 2 is a diagram illustrating an example of functions of the image generating circuit according to the embodiment. [Diagram 3] FIG. 3 is a diagram for explaining an example of a shape estimation model generation process executed by the image generation circuit according to the embodiment. [Figure 4] FIG. 4 is a diagram for explaining an example of a target portion size measurement process executed by the image generating circuit according to the embodiment. [Diagram 5] FIG. 5 is a diagram for explaining an example of the recommended cross-sectional position calculation process executed by the image generating circuit according to the embodiment. [Figure 6] FIG. 6 is a flowchart showing an example of the flow of a process for measuring the size of a target portion according to the embodiment. [Figure 7]FIG. 7 is a flowchart showing an example of the flow of a device size determination process according to the embodiment. [Figure 8] FIG. 8 is a flowchart showing an example of the flow of left atrial appendage closure surgery supporting processing including recommended cross-section position calculation processing according to the embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0008] Hereinafter, an ultrasound diagnostic apparatus according to an embodiment will be described in detail with reference to the drawings. In the following, for the sake of specificity, a case in which a diagnosis target is the left atrial appendage will be taken as an example.

[0009] 1 is a block diagram showing an example of an ultrasonic diagnostic apparatus 100 according to an embodiment. As shown in FIG. 1, the ultrasonic diagnostic apparatus 100 includes a main body 10, an ultrasonic probe 1, an input device 3, and a display 2.

[0010] The device main body 10 includes a transmission / reception circuit 101, a buffer memory 102, a B-mode processing circuit 103, a Doppler processing circuit 104, an output interface 105, an input interface 106, an image generating circuit 107, a display control circuit 108, an image memory 109, a storage circuit 110, a control circuit 111, and a NW (network) interface 112. The device main body 10 is also connected to an external device 400 via a network NW.

[0011] The ultrasonic probe 1 has a plurality of elements such as piezoelectric transducers. These elements generate ultrasonic waves based on a drive signal supplied from a transmission / reception circuit 101 of the device body 10. The ultrasonic probe 1 also receives a reflected wave from the subject P and converts it into an electrical signal. The ultrasonic probe 1 also has, for example, a matching layer provided on the piezoelectric transducer and a backing material that prevents the ultrasonic wave from propagating backward from the piezoelectric transducer. The ultrasonic probe 1 is detachably connected to the device body 10.

[0012] When ultrasonic waves are transmitted from the ultrasonic probe 1 to the subject P, the transmitted ultrasonic waves are successively reflected by discontinuous surfaces of acoustic impedance in the internal tissues of the subject P, and are received as reflected wave signals by multiple elements of the ultrasonic probe 1. The amplitude of the received reflected wave signal depends on the difference in acoustic impedance at the discontinuous surfaces where the ultrasonic waves are reflected. When the transmitted ultrasonic pulse is reflected by the surface of a moving blood flow or a heart wall, the reflected wave signal undergoes a frequency shift due to the Doppler effect depending on the velocity component of the moving body in the ultrasonic transmission direction. Then, the ultrasonic probe 1 outputs the reflected wave signal to the transmission / reception circuit 101 of the device main body 10.

[0013] The ultrasonic probe 1 according to this embodiment is a transesophageal probe. Here, the transesophageal probe is a probe that is inserted from the nose or mouth and placed in the esophagus to ultrasonically scan the heart, etc. from inside the body (esophagus). In this embodiment, the transesophageal probe is a two-dimensional array probe (a probe having a plurality of ultrasonic transducers arranged in a two-dimensional matrix at the tip) capable of acquiring volume data. In addition to the two-dimensional array probe, the transesophageal probe may be a mechanical probe that can ultrasonically scan an arbitrary cross section by mechanically rotating a one-dimensional array probe in which a plurality of ultrasonic transducers are arranged in a predetermined direction. The case of using a mechanical probe as the ultrasonic probe 1 will be described in Modification 2.

[0014] The input device 3 is realized by input means such as a mouse, a keyboard, a button, a panel switch, a touch command screen, a foot switch, a trackball, a joystick, etc. The input device 3 receives various setting requests from an operator of the ultrasound diagnostic device 100, and transfers the received various setting requests to the device body 10. For example, instructions regarding the start and end of a recommended cross-section support function, which will be described later, are input via the input device 3.

[0015] The display 2 displays, for example, a GUI (Graphical User Interface) for an operator of the ultrasound diagnostic apparatus 100 to input various setting requests using the input device 3, and displays ultrasound images and the like shown by ultrasound image data generated in the apparatus body 10. The display 2 is realized by a liquid crystal monitor, a CRT (Cathode Ray Tube) monitor, or the like. The display 2 is an example of a display unit.

[0016] The transmission / reception circuit 101, under the control of the control circuit 111, causes the ultrasonic probe 1 to transmit ultrasonic waves and causes the ultrasonic probe 1 to receive ultrasonic waves (reflected waves of ultrasonic waves). In other words, the transmission / reception circuit 101 executes ultrasonic scanning via the ultrasonic probe 1.

[0017] More specifically, the transmission / reception circuit 101, under the control of the control circuit 111, causes the ultrasonic probe 1 to transmit ultrasonic waves. The transmission / reception circuit 101 includes, for example, a trigger generation circuit, a delay circuit, and a pulser circuit, which are not shown. The trigger generation circuit repeatedly generates a trigger pulse for forming a transmission ultrasonic wave at a predetermined rate frequency fr Hz. In addition, the delay circuit provides each trigger pulse with a delay time required for focusing ultrasonic waves into a beam shape for each channel and determining the transmission directivity. The pulser circuit applies a drive pulse to the ultrasonic probe 1 at a timing based on this trigger pulse.

[0018] Furthermore, the transmission and reception circuit 101 generates reflected ultrasonic data, which is ultrasonic data based on the reflected ultrasonic signal received by the ultrasonic probe 1. Then, the transmission and reception circuit 101 stores the generated reflected ultrasonic data in the buffer memory .

[0019] More specifically, the reflected wave of the ultrasonic wave transmitted by the ultrasonic probe 1 reaches a piezoelectric transducer inside the ultrasonic probe 1, and is then converted from mechanical vibration to an electrical signal (reflected wave signal) in the piezoelectric transducer and input to the transmission / reception circuit 101. The transmission / reception circuit 101 has, for example, a preamplifier, an A / D (Analog to Digital) converter, a quadrature detection circuit, and the like, and performs various processes on the reflected wave signal received by the ultrasonic probe 1 to generate reflected wave ultrasonic data. In this embodiment, the phrase "acquiring ultrasonic data" includes obtaining ultrasonic data by transmitting and receiving ultrasonic waves. The transmission / reception circuit 101 is an example of an acquisition unit in this embodiment.

[0020] The reflected wave data is two-dimensional data in which multiple data from multiple sample points aligned in the depth direction on a scanning line (hereinafter also referred to as a raster) are aligned in the raster direction, the number of which is the same as the number of rasters.

[0021] The preamplifier amplifies the reflected wave signal for each channel and performs gain adjustment (gain correction). The A / D converter converts the gain-corrected reflected wave signal into a digital signal by A / D converting it. The quadrature detection circuit converts the A / D converted reflected wave signal into an in-phase signal (I signal, I: In-phase) and a quadrature signal (Q signal, Q: Quadrature-phase) in the baseband.

[0022] Then, the quadrature detection circuit stores the I signal and the Q signal as reflected ultrasonic data in the buffer memory 102. Hereinafter, the I signal and the Q signal are collectively referred to as an IQ signal. In addition, since the IQ signal is A / D converted digital data, it is also referred to as IQ data.

[0023] The buffer memory 102 at least temporarily stores the reflected ultrasonic data (IQ data) generated by the transmission / reception circuit 101. For example, the buffer memory 102 stores the reflected ultrasonic data acquired by transmitting and receiving ultrasonic waves multiple times per raster. Here, multiple pieces of reflected ultrasonic data for the same raster are acquired by transmitting and receiving ultrasonic waves multiple times per raster, and hereinafter, the number of pieces of reflected ultrasonic data for the same raster will be referred to as the ensemble number, and the data itself will be referred to as ensemble data. The buffer memory 102 stores the ensemble data arranged in the time direction in the order of the raster by the number of ensembles. The buffer memory 102 is realized by, for example, a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory.

[0024] The B-mode processing circuit 103 performs processes such as logarithmic amplification, envelope detection, and logarithmic compression on the reflected ultrasound data read from the buffer memory 102, and generates data (B-mode data) in which the signal intensity is expressed as luminance brightness.

[0025] The Doppler processing circuit 104 performs frequency analysis on the reflected ultrasonic data stored in the buffer memory 102 to generate data (Doppler data) that extracts motion information based on the Doppler effect of a moving object within a region of interest (ROI) set in the scan area. The moving object is, for example, blood. For example, the Doppler processing circuit 104 can execute a color Doppler method, also known as a color flow mapping (CFM) method.

[0026] The ultrasonic probe 1, the transmission / reception circuit 101, and the B-mode processing circuit 103 are an example of an acquisition unit.

[0027] The output interface 105 outputs the electrical signal from the control circuit 111 to the outside. The output interface 105 is connected to the control circuit 111 via a bus, for example, and outputs the electrical signal from the control circuit 111 to the display 2.

[0028] The input interface 106 receives various instructions from an operator via the input device 3. The input interface 106 is connected to the control circuit 111 via, for example, a bus, converts the operation instructions input by the operator into electrical signals, and outputs the electrical signals to the control circuit 111. Note that the input interface 106 is not limited to being connected to physical operation components such as a mouse and a keyboard. For example, a circuit that receives an electrical signal corresponding to an operation instruction input from an external input device provided separately from the ultrasound diagnostic apparatus 100 and outputs the electrical signal to the control circuit 111 is also included as an example of the input interface.

[0029] The image generating circuit 107 generates two-dimensional ultrasound image data (hereinafter also referred to as "two-dimensional image data" or "slice data") and three-dimensional ultrasound image data (hereinafter also referred to as "three-dimensional data" or "volume data") based on the data generated by the B-mode processing circuit 103 and the Doppler processing circuit 104. The image generating circuit 107 stores the generated ultrasound image data in the image memory 109.

[0030] More specifically, the image generating circuitry 107 generates two-dimensional or three-dimensional B-mode image data based on the B-mode data generated by the B-mode processing circuitry 103.

[0031] The image generating circuit 107 generates two-dimensional or three-dimensional Doppler image data based on the Doppler data generated by the Doppler processing circuit 104. The Doppler image data is an example of blood flow image data in this embodiment. The image generating circuit 107 generates the Doppler image data based on the intensity information and phase change information included in the Doppler data generated by the Doppler processing circuit 104.

[0032] The image generating circuitry 107 generates a two-dimensional image corresponding to an arbitrary cross section by MPR (Multi Planar Reconstruction) processing using the volume data. In this embodiment, an image obtained by MPR processing is called an MPR image.

[0033] Furthermore, the image generation circuit 107 performs a process of generating a shape estimation model using the volume data (hereinafter referred to as a "shape estimation model generation process"). The image generation circuit 107 performs a measurement process relating to the size of the target part using the generated shape estimation model (hereinafter referred to as a "target part size measurement process"). The image generation circuit 107 performs a process of calculating the position of at least one recommended cross section based on the result of the target part size measurement process (hereinafter referred to as a "recommended cross section position calculation process").

[0034] Here, the recommended plane means a plane that is desirable for imaging and observing a target region for the purpose of diagnosis, surgery, etc. The position of the recommended plane can be anatomically determined based on, for example, the size, shape, etc. of the target region.

[0035] Furthermore, the image generating circuitry 107 executes a process for determining the size of a device to be used in treating or operating on the target site based on the result of the process for measuring the size of the target site (hereinafter referred to as a "device size determination process").

[0036] The shape estimation model generation process, the target portion size measurement process, the recommended cross-section position calculation process, and the device size determination process will be described in detail later.

[0037] The display control circuit 108 causes the display 2 to display ultrasound images based on various ultrasound image data generated by the image generation circuit 107. The display control circuit 108 causes the display 2 to display the position of at least one recommended cross section. The display control circuit 108 causes the display 2 to display the shape estimation model obtained by the shape estimation model generation process, the measurement results of the target part size measurement process, the calculation results of the recommended cross section position calculation process, and the determination results of the device size determination process. The display control circuit 108 may also cause the display 2 to display a GUI for the operator to input various setting requests using the input device 3. The display control circuit 108 is an example of a display control unit.

[0038] The image memory 109 stores various image data generated by the control circuit 111. For example, the image memory 109 is realized by a semiconductor memory element such as a RAM, a flash memory, a hard disk, or an optical disk.

[0039] The storage circuit 110 is realized by, for example, a magnetic or optical storage medium, a semiconductor memory element such as a flash memory, a hard disk, or a storage medium readable by a processor such as an optical disk. The storage circuit 110 stores a program for realizing ultrasonic transmission and reception, various data, etc.

[0040] In addition, the storage circuit 110 stores a table associating information on the size of the left atrial appendage with the size of the left atrial appendage closure device. Here, the information on the size of the left atrial appendage is information including at least any one of, for example, the maximum diameter, the minimum diameter, the circumferential length, the area, the distance from the ultrasonic transmission / reception surface of the ultrasonic probe 1 to the left atrial appendage inlet (left atrial appendage distance), and the distance from the left atrial appendage inlet to an arbitrary inner wall of the left atrial appendage (left atrial appendage depth).

[0041] Note that the program and various data may be stored in the storage circuit 110 in advance, for example. Also, the program and various data may be stored in a non-transitory storage medium, distributed, read from the non-transitory storage medium, and installed in the storage circuit 110. Note that the storage circuit 110 may be regarded as an example of the storage unit in the present embodiment.

[0042] The control circuit 111 comprehensively controls the operation of the entire ultrasonic diagnostic apparatus 100. For example, the control circuit 111 controls ultrasonic scanning by controlling the ultrasonic probe 1 via the transmission / reception circuit 101.

[0043] Also, the control circuit 111 controls the position of the ultrasonic scanning cross-section in order to acquire a two-dimensional image of the recommended cross-section calculated by the recommended cross-section position calculation process described later.

[0044] The NW interface 112 is connected to an external device 400 via a network NW, for example, and performs data communication with the external device 400 .

[0045] The external device 400 is, for example, a workstation that executes processes such as post-processing of various data generated by the ultrasound diagnostic apparatus 100 and display of ultrasound image data. The external device 400 includes, for example, a processing circuit such as a processor, a storage device, a display, an input device, and a NW interface that can be connected to the ultrasound diagnostic apparatus 100 via a network NW. The external device 400 may also be a tablet terminal or the like.

[0046] The B-mode processing circuit 103, the Doppler processing circuit 104, the image generating circuit 107, the display control circuit 108, and the control circuit 111 shown in FIG. 1 are realized by a processor. For example, a computer-executable program that defines the processes to be executed by these circuits is stored in the storage circuit 110. These circuits realize the functions corresponding to each program by reading the programs from the storage circuit 110 and executing them. Also, although FIG. 1 has been described as a single storage circuit 110 storing programs corresponding to each processing function, a configuration in which multiple storage circuits are distributed and arranged, and each circuit reads out a corresponding program from an individual storage circuit, may be used.

[0047] In the above description, an example has been described in which the "processor" reads out and executes a program corresponding to each function from the storage circuit 110, but the embodiment is not limited to this. The term "processor" refers to a circuit such as a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (e.g., a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)). When the processor is, for example, a CPU, the processor realizes each function shown in FIG. 1 and FIG. 2 by reading out and executing a program stored in the storage circuit 110. On the other hand, when the processor is an ASIC, instead of storing a program in the storage circuit 110, the function is directly incorporated as a logic circuit in the circuit of the processor. Note that each processor in the present embodiment is not limited to being configured as a single circuit for each processor, and may be configured as one processor by combining multiple independent circuits to realize the function. Furthermore, a plurality of components in FIG. 1 and FIG. 2 described later may be integrated into one processor to realize the functions thereof.

[0048] Next, the image generating circuit 107 will be described in detail.

[0049] Fig. 2 is a diagram showing an example of functions of the image generating circuit 107 according to the embodiment. As shown in Fig. 2, the image generating circuit 107 includes an image generating function 107a and a calculation function 107b.

[0050] The image generating function 107a generates a three-dimensional model of the target site using the acquired three-dimensional data. That is, the image generating function 107a executes a shape estimation model generation process. More specifically, the image generating function 107a acquires, for example, a plurality of short-axis cross-sectional images of the left atrial appendage using volume data related to the left atrial appendage. The image generating function 107a searches for the inner wall of the left atrial appendage in each of the acquired short-axis cross-sectional images of the left atrial appendage, for example, by threshold processing, segmentation using AI, or the like. The image generating function 107a traces and connects the inner wall of the left atrial appendage acquired by the search, and generates a shape estimation model of the left atrial appendage as a three-dimensional model of the target site. The shape estimation model of the left atrial appendage generated by the image generating function 107a is displayed in a predetermined form on the display 2. The image generating function 107a is an example of an image generating unit.

[0051] 3 is a diagram for explaining an example of a shape estimation model generation process executed by an image generation circuit according to the embodiment, and is a diagram showing an example of a display image 20 displayed on the display 2 as a result of the shape estimation model generation process. As shown in Fig. 3, the display image 20 includes an A cross-sectional area 21 displaying an A cross-sectional image 210, a B cross-sectional area 22 displaying a B cross-sectional image 220, a C cross-sectional area 23 displaying a C cross-sectional image 230, a shape estimation model display area 24 displaying a shape estimation model 240, an electrocardiogram waveform display area 26, a cross-section navigation information display area 27, a measurement value display area 28, and an ultrasound probe navigation information display area 29.

[0052] Here, the A cross-section is a predetermined cross-section that extends in the ultrasonic transmission / reception direction (raster direction) and the raster arrangement direction. The B cross-section is a predetermined cross-section that is orthogonal to the A cross-section and extends in the raster direction and the raster arrangement direction. The C cross-section is a predetermined cross-section that is orthogonal to the raster direction and the raster arrangement direction (i.e., orthogonal to the A cross-section and the B cross-section). The straight line 21b and the straight line 21c in the A cross-section region 21 indicate the positions of the B cross-section image 220 and the C cross-section image 230, the straight line 22a and the straight line 22c in the B cross-section region 22 indicate the positions of the A cross-section image 210 and the C cross-section image 230, and the straight line 23a and the straight line 23b in the C cross-section region 23 indicate the positions of the A cross-section image 210 and the B cross-section image 220, respectively. The cross-sections 27a, 27b, 27c in the cross-section navigation information display region 27 indicate the respective positions and positional relationships of the A cross-section image 210, the B cross-section image 220, and the C cross-section image 230 in the volume data. The ultrasonic probe navigation information display region 29 indicates the position (angle) of the current A cross-section.

[0053] The image generation function 107a acquires the C cross-section image 230, which is a short-axis cross-section image of the left atrial appendage, at a plurality of positions on the long axis of the left atrial appendage, and searches for the inner wall of the left atrial appendage in each short-axis cross-section image. In FIG. 3, the searched inner wall of the left atrial appendage is indicated by a plurality of points in the C cross-section image 230. The image generation function 107a traces and connects the inner wall of the left atrial appendage obtained by the search to generate a shape estimation model 240 of the left atrial appendage.

[0054] Note that the shape estimation model generation process by the image generation function 107a is repeatedly executed according to the volume rate of the ultrasonic scan. Therefore, when the positions of the A cross-section, the B cross-section, and the C cross-section are updated, the shape estimation model 240 is also updated in real time in conjunction with these updates.

[0055] Returning to Fig. 2, calculation function 107b calculates the position of at least one recommended cross section to be set on the target region based on information about the size of the target region obtained using the three-dimensional model. That is, calculation function 107b executes a target region size measurement process to obtain information about the size of the left atrial appendage using a shape estimation model (or an ultrasound image used to generate the shape estimation model). The information about the size of the left atrial appendage obtained by calculation function 107b is displayed in a predetermined form on display 2. Note that calculation function 107b is an example of a calculation unit.

[0056] FIG. 4 is a diagram for explaining an example of a target part size measurement process executed by an image generation circuit according to an embodiment, and shows an example of a display image 30 displayed on the display 2 during the target part size measurement process.

[0057] 4, the display image 30, like the display image 20, includes an A cross-sectional area 31 displaying an A cross-sectional image 310, a B cross-sectional area 32 displaying a B cross-sectional image 320, a C cross-sectional area 33 displaying a C cross-sectional image 330, a shape estimation model display area 34 displaying a shape estimation model 340, an electrocardiogram waveform display area 36, ​​a cross-section navigation information display area 37, a measurement value display area 38, and an ultrasound probe navigation information display area 39. Also, the straight lines 32a, 33a and the cross section 27a indicate the position of the A cross section, the straight lines 31b, 33b and the cross section 27b indicate the position of the B cross section, and the straight lines 31c, 32c and the cross section 27c indicate the position of the C cross section.

[0058] 4, calculation function 107b uses shape estimation model 340 to measure left atrial appendage distance 311 and left atrial appendage depth 312 shown in A slice image 310. Furthermore, calculation function 107b approximates the left atrial appendage as an ellipsoid, and uses shape estimation model 340 to measure the maximum diameter, minimum diameter, circumferential length, and area of ​​the left atrial appendage ostium shown in C slice image 330. The measurement results measured by calculation function 107b are displayed, for example, in measurement value display area 28 in FIG. 4 as maximum diameter 38a, minimum diameter 38b, circumferential length 38c, and area 38d of the left atrial appendage ostium.

[0059] Returning to Fig. 2, the calculation function 107b executes a recommended cross section position calculation process using the shape estimation model. More specifically, the calculation function 107b approximates the left atrial appendage as an ellipsoid, and calculates the positions of the cross sections including the maximum diameter and the minimum diameter as the positions of the recommended cross sections using the shape estimation model. The positions of the recommended cross sections calculated by the calculation function 107b are displayed on the display 2 in a predetermined form.

[0060] FIG. 5 is a diagram for explaining an example of a recommended cross-sectional position calculation process executed by an image generation circuit according to an embodiment, and is a diagram showing an example of a display image 40 displayed on the display 2 during a target part size measurement process.

[0061] 5, the display image 40, like the display image 20, includes an A cross-sectional area 41 displaying an A cross-sectional image 410, a B cross-sectional area 42 displaying a B cross-sectional image 420, a C cross-sectional area 43 displaying a C cross-sectional image 430, a shape estimation model display area 44 displaying a shape estimation model 440, an electrocardiogram waveform display area 46, a cross-section navigation information display area 47, a measurement value display area 48, and an ultrasound probe navigation information display area 49. Also, straight lines 42a, 43a and the cross section 47a indicate the position of the A cross section, straight lines 41b, 43b and the cross section 47b indicate the position of the B cross section, and straight lines 41c, 42c and the cross section 47c indicate the position of the C cross section.

[0062] The calculation function 107b measures the cross-sectional position including the maximum diameter and the cross-sectional position including the minimum diameter of the left atrial appendage ostium shown in the C cross-sectional image 330. The cross-sectional position including the maximum diameter and the cross-sectional position including the minimum diameter of the left atrial appendage ostium measured by the calculation function 107b are displayed, for example, in the C cross-sectional image 330 of Fig. 5 as a straight line corresponding to the major axis and the minor axis of an ellipse approximating the left atrial appendage ostium.

[0063] In addition, the calculation function 107b calculates the angle of the recommended cross section from the reference position (reference angle). The angle of the recommended cross section from the reference position measured by the calculation function 107b is displayed as a recommended scan angle 48e in the measurement value display area 48 in Fig. 5, for example (similarly, it is shown as a recommended scan angle 28e in Fig. 3 and as a recommended scan angle 38e in Fig. 4).

[0064] 5, an angle 49a from the reference position of the current A-section is displayed in the ultrasound probe navigation information display area 49. Therefore, the operator can easily and quickly visually confirm how many degrees the A-section should be rotated from the current position (angle) in order to set the position of the A-section to the position of the recommended A-section.

[0065] 5 shows an example in which an angle 48e from the reference position of the recommended cross section and an angle 49a from the reference position of the current A cross section are displayed side by side. In addition to these angle information, or instead of these angle information, angle information indicating how many degrees the cross section should be rotated from the current position (angle) of the A cross section can be displayed. Note that the angle information indicating how many degrees the cross section should be rotated from the current position (angle) of the A cross section is an example of information regarding the difference between the position of the current ultrasound scanning cross section and the position of at least one recommended cross section.

[0066] Returning to Fig. 2, calculation function 107b executes a device size determination process based on the result of the target portion size measurement process. More specifically, calculation function 107b compares information on the size of the left atrial appendage obtained by the target portion size measurement process with a device size table stored in memory circuitry 110 to determine the size of the left atrial appendage closing device to be used in treating the patient. The size of the left atrial appendage closing device determined by calculation function 107b is displayed on display 2 in a predetermined form.

[0067] Next, the flow of various support processes executed by the ultrasound diagnostic apparatus 100 in this embodiment configured as above will be described.

[0068] (Measurement process of target site size) FIG. 6 is a flowchart showing an example of the flow of the measurement process of the target site size according to the embodiment. Note that this measurement process of the target site size is executed, for example, in preoperative or postoperative imaging diagnosis when performing a surgical plan. Further, this measurement process of the target site size is executed so that the size at the cardiac phase when the left atrial volume is maximum is measured in synchronization with the electrocardiogram waveform. Further, when calculation processing is performed in a plurality of phases, it is executed so that the size at the phase with the largest maximum diameter of the left atrial appendage inlet is measured.

[0069] As shown in FIG. 6, volume data regarding the left atrial appendage is acquired using the ultrasonic probe 1 as a transesophageal probe (step S1).

[0070] The image generation function 107a of the image generation circuit 107 generates a shape estimation model of the left atrial appendage (step S2).

[0071] The calculation function 107b of the image generation circuit 107 executes a measurement process of the target site size using the generated shape estimation model (step S3).

[0072] The display control circuit 108 causes the display 2 to display the generated shape estimation model and information regarding the size of the left atrial appendage obtained as the measurement result (step S4).

[0073] (Device size determination process) FIG. 7 is a flowchart showing an example of the flow of the device size determination process according to the embodiment. Note that this device size determination process is executed, for example, when determining the size of the left atrial appendage closure device at the time of surgical planning. Further, since each process from step S11 to step S14 shown in FIG. 7 is the same as each process from step S1 to step S4 shown in FIG. 6, the description thereof is omitted.

[0074] The calculation function 107b of the image generating circuit 107 executes a device size determination process based on the result of the measurement process of the target part size (step S15).

[0075] The display control circuit 108 causes the display 2 to display the size of the left atrial appendage closure device obtained as a result of the device size determination process in a predetermined format (step S16).

[0076] (Left atrial appendage closure surgery support processing) Fig. 8 is a flowchart showing an example of the flow of left atrial appendage closure surgery support processing including a recommended cross-section position calculation processing according to the embodiment. Note that this left atrial appendage closure surgery support processing is executed, for example, when the left atrial appendage is monitored in real time during a transcatheter left atrial appendage closure surgery. Also, each process from step S21 to step S24 shown in Fig. 8 is similar to each process from step S1 to step S4 shown in Fig. 6, and therefore description thereof will be omitted.

[0077] The calculation function 107b of the image generating circuit 107 performs a recommended cross-sectional position calculation process based on the result of the measurement process of the target region size, and calculates a scanning cross-sectional position as the recommended cross-sectional position (step S25).

[0078] The control circuit 111 executes ultrasonic transmission / reception control based on the scanning cross-sectional position calculated as the recommended cross-sectional position (step S26). That is, the control circuit 111 controls the position of the ultrasonic scanning cross-section and executes ultrasonic transmission / reception in order to acquire a two-dimensional image of the scanning cross-sectional position calculated as the recommended cross-sectional position. More specifically, the control circuit 111 selects a plurality of ultrasonic transducers for two-dimensionally scanning the ultrasonic scanning cross-sectional position calculated as the recommended cross-sectional position from among a plurality of ultrasonic transducers arranged two-dimensionally. The control circuit 111 performs ultrasonic scanning of the recommended cross-section using the selected plurality of ultrasonic transducers, and acquires a two-dimensional image corresponding to the recommended cross-section.

[0079] The image generating circuitry 107 generates a two-dimensional image corresponding to the scanning sectional position. The display control circuitry 108 causes the display 2 to display the two-dimensional image corresponding to the scanning sectional position in a predetermined format (step S27).

[0080] The acquisition, generation and display of two-dimensional images corresponding to steps S26 and S27 are repeatedly performed for the scanning cross-sectional position calculated in step S25.

[0081] The control circuit 111 determines whether or not to end the ultrasound scan based on, for example, the presence or absence of a freeze operation from the ultrasound probe 1 or the input device 3 (step S28). If the control circuit 111 determines not to end the ultrasound scan (No in step S28), the processes in steps S21 to S27 are repeatedly executed. On the other hand, if the control circuit 111 determines to end the ultrasound scan (Yes in step S28), the left atrial appendage closure surgery support process is terminated.

[0082] The processes of steps S21 to S27 can be executed in synchronization with the electrocardiogram waveform, for example, at a predetermined frequency (for example, at least once) per heartbeat.

[0083] In addition, if the left atrial appendage closure surgery is performed in a single sequence from determining the size of the left atrial appendage closure device, the device size determination process shown in Figure 7 will be executed, and then the left atrial appendage closure surgery support process shown in Figure 8 will be executed.

[0084] As described above, the image generating function 107a of the ultrasound diagnostic apparatus 100 according to this embodiment generates a shape estimation model as a three-dimensional model of the left atrial appendage using the acquired three-dimensional data related to the left atrial appendage. The calculation function 107b calculates the position of at least one recommended cross section to be set in the left atrial appendage based on information about the size of the left atrial appendage ostium obtained using the shape estimation model. The display control circuit 108 causes the display 2 to display the position of the at least one recommended cross section.

[0085] Therefore, the operator can automatically grasp the position of at least one recommended plane to be set for the left atrial appendage, and as a result, the operator can set a desired imaging plane for the target region with less burden and higher accuracy than in the past.

[0086] In addition, the calculation function 107b of the ultrasound diagnostic apparatus 100 according to this embodiment calculates information regarding size, including at least one of the maximum diameter, minimum diameter, circumference, and area, of the left atrial appendage ostium in the shape estimation model, and calculates the position of at least one recommended cross section to be set in the left atrial appendage based on the calculated size information.

[0087] Therefore, the position of at least one recommended plane to be set in the left atrial appendage can be accurately calculated based on anatomical information.

[0088] The display control circuit 108 of the ultrasound diagnostic device 100 according to this embodiment causes the position of the current ultrasound scanning section and the position of at least one recommended section to be displayed on the display 2. The display control circuit 108 of the ultrasound diagnostic device 100 according to this embodiment can also cause the display 2 to display information relating to a difference between the position of the current ultrasound scanning section and the position of at least one recommended section.

[0089] Therefore, the operator can easily and quickly visually confirm how many degrees the current ultrasonic scanning section should be rotated from the current position (angle) in order to set the position of the current ultrasonic scanning section to the position of the recommended section, which supports the surgeon during the left atrial appendage closure surgery and reduces the workload.

[0090] The control circuit 111 of the ultrasound diagnostic device 100 according to this embodiment controls the position of an ultrasound scanning section based on the position of at least one recommended cross section. That is, the control circuit 111 executes control related to ultrasound transmission and reception so that the position of the ultrasound scanning section coincides with the position of at least one recommended cross section.

[0091] Therefore, for example, during left atrial appendage closure surgery, ultrasonic images corresponding to the recommended cross sections can be displayed in real time. Furthermore, the ultrasonic images corresponding to the recommended cross sections are updated successively. By observing the displayed ultrasound image, the surgeon can perform the procedure while visually checking the exact situation, which can assist the surgeon and contribute to improving the quality of left atrial appendage closure surgery.

[0092] The calculation function 107b of the ultrasound diagnostic apparatus 100 according to this embodiment determines the size of the left atrial appendage closing device based on the information on the size of the left atrial appendage. The display control circuit 108 causes the display 2 to display the determined size of the left atrial appendage closing device.

[0093] Therefore, the size of the left atrial appendage closure device can be accurately and automatically determined based on the actual values ​​accurately measured using the recommended cross section, which reduces the burden on doctors in determining the size of the left atrial appendage closure device and contributes to improving the quality of left atrial appendage closure surgery.

[0094] (Variation 1) In the ultrasound diagnostic apparatus 100 according to the above embodiment, after the position of the recommended cross section is calculated, the ultrasound scanning region is switched from a three-dimensional region to a two-dimensional region, and the recommended cross section is two-dimensionally scanned.

[0095] Alternatively, after calculating the position of the recommended cross section, the ultrasound scanning area may remain three-dimensional, and an MPR image corresponding to the position of the recommended cross section may be obtained from the volume data obtained by ultrasound scanning, and displayed as a two-dimensional image corresponding to the recommended cross section.

[0096] (Variation 2) In the above embodiment, a two-dimensional array probe is used as the transesophageal probe, that is, the ultrasonic probe 1. In contrast, the transesophageal probe, that is, the ultrasonic probe 1, may be a mechanical ultrasonic probe that can scan a desired cross section by rotating an array of ultrasonic transducers arranged one-dimensionally.

[0097] In such a case, the control circuit 111 rotates the ultrasonic transducer array according to the position of the calculated recommended cross-section, and performs ultrasonic transmission and reception for the scanning cross-sections corresponding to cross-section A and cross-section B.

[0098] According to such a configuration, even a mechanical transesophageal probe can achieve the same effects as those of the above-described embodiment.

[0099] (Modification 3) In the above-described embodiment, information regarding the size such as the maximum diameter was measured at a predetermined cardiac phase (for example, the cardiac phase when the left atrial volume is maximum) in synchronization with the electrocardiogram waveform. In contrast, information regarding the size may be measured using a shape estimation model at a plurality of cardiac phases in synchronization with the electrocardiogram waveform. In such a case, for example, an index value including phase information such as the standard deviation of the maximum diameter can also be displayed.

[0100] (Modification 4) In the above-described embodiment, the case where the medical image diagnostic apparatus is the ultrasonic diagnostic apparatus 100 was taken as an example. In contrast, the shape estimation model generation process, the measurement process of the target site size, the recommended cross-section position calculation process, and the device size determination process described in the above embodiment can also be applied to other medical image diagnostic apparatuses such as an X-ray computed tomography (CT) imaging apparatus (X-ray CT apparatus), an X-ray diagnostic apparatus, and a magnetic resonance imaging apparatus. For example, by performing the same process using the CT volume data acquired by the X-ray CT apparatus, the position of the recommended cross-section in the diagnostic target can be calculated.

[0101] Furthermore, the shape estimation model generation process, target part size measurement process, recommended cross-section position calculation process, and device size determination process according to the embodiment can be realized not only in a medical image diagnostic device, but also in a medical information processing device such as a medical workstation. In such a case, the medical information processing device can acquire, for example, volume data captured by the medical image diagnostic device, and use the volume data to execute the shape estimation model generation process according to the embodiment. Furthermore, information such as the device size, measurement results, and recommended cross-section position obtained according to the shape estimation model generation process according to the embodiment can be transmitted in real time from the medical information processing device to, for example, the medical image diagnostic device or another terminal.

[0102] (Variation 5) In the above embodiment, in order to provide a more specific explanation, the diagnosis target is the left atrial appendage. However, the shape estimation model generation process, the target part size measurement process, the recommended cross-sectional position calculation process, and the device size determination process according to the embodiment are not limited to the target part being other than the left atrial appendage, and can also be applied to the target part being, for example, the atrial septum, the mitral valve, etc.

[0103] According to at least one of the embodiments described above, it is possible to set a desired imaging section for a target region with less burden and higher accuracy than in the past.

[0104] Although some embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, modifications, and combinations of embodiments can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope of the invention and its equivalents as described in the claims, as well as in the scope and spirit of the invention. [Explanation of symbols]

[0105] 1 Ultrasound probe 2. Display 3 Input Devices 10. Device body 21, 31, 41 A cross-sectional area 22, 32, 42 B cross-sectional area 23, 33, 43 C cross section area 22a, 23a, 27a A cross section position 22b, 23b, 27b B cross section position 22c, 23c, 27c C section position 24, 34, 44 Shape estimation model display area 26, 36, 46 Electrocardiogram waveform display area 27, 37, 47 Section navigation information display area 28, 38, 48 Measurement value display area 28a, 38a, 48a Maximum diameter of the left atrial appendage ostium 28b, 38b, 48b Minimum diameter of left atrial appendage ostium 28c, 38c, 48c Circumference of the left atrial appendage ostium 28d, 38d, 48d Area of ​​left atrial appendage ostium 28e, 38e, 48e Recommended cross section 29, 39, 49 Ultrasound probe navigation information display area 32a, 33a, 37a A cross section position 32b, 33b, 37b B cross section position 32c, 33c, 37c C section position 42a, 43a, 47a A cross section position 42b, 43b, 47b B cross section position 42c, 43c, 47c B cross section position 100 Ultrasound diagnostic equipment 101 Transmitting and receiving circuit 102 Buffer memory 103 B-mode processing circuit 104 Doppler processing circuit 105 Output Interface 106 Input Interface 107 Image Generation Circuit 107a Image generation function 107b Calculation function 108 Display control circuit 109 Image Memory 110 Memory circuit 111 Control circuit 112 Network Interface 210, 310, 410 A cross-sectional images 220, 320, 420 B-section images 230, 330, 430 C section images 240, 340, 440 Shape estimation model P Subject

Claims

1. an acquisition unit for acquiring three-dimensional data including a target site where the device is to be placed; a calculation unit that automatically calculates a position of at least one recommended cross section of the target site when the device is placed in the target site based on information about a size and a shape of the target site included in the acquired three-dimensional data; a display control unit that causes information indicating a position of the at least one recommended cross-section to be displayed on a display unit; Equipped with the target site is the left atrial appendage; the calculation unit calculates a position of the recommended cross section based on information about a size and a shape of the short-axis cross section of the left atrial appendage included in the three-dimensional data; the display control unit causes the display unit to display navigation information including information regarding a difference between a position of the recommended cross section and a position of a current ultrasonic scanning cross section. Medical imaging diagnostic equipment.

2. A generator that generates a three-dimensional model of the target site using the acquired three-dimensional data, The calculation unit calculates a position of at least one of the recommended cross sections based on information regarding a size and a shape of the target region obtained by using the three-dimensional model. The medical image diagnostic apparatus according to claim 1 .

3. The calculation unit calculates information regarding the size of the target area in a short-axis cross section set in the three-dimensional model, the information including at least one of a maximum diameter, a minimum diameter, a circumference, and an area, and calculates a position of the at least one recommended cross section to be set in the left atrial appendage based on the calculated information regarding the size. The medical image diagnostic apparatus according to claim 2 .

4. the medical image diagnostic apparatus is an ultrasound diagnostic apparatus, the calculation unit calculates a position of the at least one recommended cross section as an ultrasound scanning cross section using a transesophageal probe; The medical image diagnostic apparatus according to claim 1 .

5. the display control unit causes the display unit to display a position of a current ultrasonic scanning section and a position of the at least one recommended section. The medical image diagnostic apparatus according to claim 4.

6. a control unit for controlling a position of an ultrasonic scanning section based on the position of the at least one recommended section, The medical image diagnostic apparatus according to claim 1 .

7. The calculation unit determines a size of a medical device to be placed at the target site based on the information regarding the size; The display control unit causes the display unit to display the determined size of the medical device.

7. A medical image diagnostic apparatus according to claim 1.

8. On the computer, an acquisition function for acquiring three-dimensional data including a target site where the device is to be placed; a calculation function that automatically calculates the position of at least one recommended cross section of the target site when the device is placed in the target site based on information about the size and shape of the target site included in the acquired three-dimensional data; a display control function for displaying information indicating the position of the at least one recommended cross section on a display unit; Realize this, the target site is the left atrial appendage; the calculation function calculates a position of the recommended cross section based on information about the size and shape of the short-axis cross section of the left atrial appendage included in the three-dimensional data; and displaying, on the display unit, navigation information including information regarding a difference between a position of the recommended cross section and a position of a current ultrasonic scanning cross section, in the display control function. Medical information processing program.

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