Medical Image Processing Apparatus and Method

Abstract

To reduce a user's labor and time in formation or the like of a diagnosis or treatment plan concerning a cardiac disease.SOLUTION: A medical image processing apparatus according to an embodiment includes an extraction unit and a display control unit. The extraction unit extracts a degree of a disease related to the heart from a medical image. The display control unit displays, when the degree of the disease related to the heart is high, a first index value related to a blood vessel and calculated from a blood pressure or a blood flow, and displays, when the degree of the disease related to the heart is low, wall shear stress serving as a second index value related to the blood vessel, as information related to the blood flow of the blood vessel and calculated on the basis of the medical image.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The embodiments disclosed in this specification and the drawings relate to a medical image processing apparatus, system, and method.

Background Art

[0002] Conventionally, as a technology for assisting in the diagnosis of heart diseases and the formulation of treatment plans, etc., a technology for calculating and presenting various information related to the blood flow of blood vessels based on medical images of the blood vessels of a subject's heart is known. For example, as one of the information related to blood flow, a technology for calculating and displaying the wall shear stress (WSS) at each position of a blood vessel is known.

[0003] Generally, when diagnosis and treatment plans are formulated using such technologies, users such as doctors comprehensively judge by integrating various information in addition to WSS. However, when presenting a plurality of information without limitation, the work of acquiring and understanding the information becomes complicated, and the labor of the user increases.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Patent Document 2

Patent Document 3

Summary of the Invention

Problems 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 reduce the labor of users when diagnosing heart diseases and formulating treatment plans. However, the problems to be solved by the embodiments disclosed in this specification and the drawings are not limited to the above problems. The problems corresponding to the respective effects of each configuration shown in the embodiments described later can also be regarded as other problems.

Means for Solving the Problems

[0006] The medical image processing apparatus according to the embodiment includes an extraction unit and a display control unit. The extraction unit extracts the degree of a disease related to the heart from a medical image. The display control unit displays, as information related to the blood flow of blood vessels calculated based on the medical image, a first index value related to the blood vessels calculated from blood pressure or blood flow when the degree of the disease related to the heart is high, and displays wall shear stress as a second index value related to the blood vessels when the degree of the disease related to the heart is low.

Brief Description of the Drawings

[0007]

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[0008] Hereinafter, embodiments of the medical image processing apparatus, system, and method will be described in detail with reference to the drawings.

[0009] (First Embodiment) FIG. 1 is a diagram showing a configuration example of the medical image processing system and the medical image processing apparatus according to the first embodiment.

[0010] For example, as shown in FIG. 1, the medical image processing system 100 according to the present embodiment includes an X-ray CT (Computed Tomography) apparatus 110, a medical image storage apparatus 120, an electronic medical record system 130, a medical information display apparatus 140, and a medical image processing apparatus 150. Here, each apparatus and system is communicably connected via a network 160.

[0011] Note that, in addition to the X-ray CT apparatus 110, the medical image processing system 100 may further include other medical image diagnostic apparatuses such as a magnetic resonance imaging (MRI) apparatus, an ultrasonic diagnostic apparatus, a positron emission tomography (PET) apparatus, and a single photon emission computed tomography (SPECT) apparatus. Further, in addition to the electronic medical record system 130, the medical image processing system 100 may further include other systems such as a hospital information system (HIS) and a radiology information system (RIS).

[0012] The X-ray CT apparatus 110 generates a CT image of a subject. Specifically, the X-ray CT apparatus 110 collects projection data representing the distribution of X-rays that have passed through the subject by rotating and moving an X-ray tube and an X-ray detector on a circular orbit surrounding the subject. Then, the X-ray CT apparatus 110 generates a CT image based on the collected projection data.

[0013] The medical image storage device 120 stores various medical images related to a subject. Specifically, the medical image storage device 120 acquires CT images from the X-ray CT device 110 via the network 160, and stores the CT images in a storage circuit within the device itself. For example, the medical image storage device 120 is realized by computer devices such as a server or a workstation. Also, for example, the medical image storage device 120 is realized by a PACS (Picture Archiving and Communication System) or the like, and stores CT images in a format compliant with DICOM (Digital Imaging and Communications in Medicine).

[0014] The electronic medical record system 130 stores various medical data related to the medical records and patient information of a subject. Specifically, the electronic medical record system 130 generates medical data related to a subject, or acquires it from other devices via the network 160, and stores the medical data in a storage circuit within the system itself. For example, the electronic medical record system 130 is realized by computer devices such as a server or a workstation.

[0015] The medical information display device 140 displays various medical information related to a subject. Specifically, the medical information display device 140 acquires medical information such as CT images and the processing results of image processing from the medical image processing device 150 via the network 160, and displays the medical information on a display within the device itself. For example, the medical information display device 140 is realized by computer devices such as a workstation, a personal computer, or a tablet terminal.

[0016] The medical image processing apparatus 150 performs various image processes on a subject. Specifically, the medical image processing apparatus 150 acquires CT images from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the network 160, acquires medical data from the electronic medical record system 130, and performs various image processes using the CT images and the medical data. For example, the medical image processing apparatus 150 is realized by a computer device such as a server or a workstation.

[0017] For example, the medical image processing apparatus 150 includes a network (NetWork: NW) interface 151, a storage circuit 152, an input interface 153, a display 154, and a processing circuit 155.

[0018] The NW interface 151 controls the transmission and communication of various data transmitted and received between the medical image processing apparatus 150 and other apparatuses connected via the network 160. Specifically, the NW interface 151 is connected to the processing circuit 155, and transmits data received from other apparatuses to the processing circuit 155, or transmits data received from the processing circuit 155 to other apparatuses. For example, the NW interface 151 is realized by a network card, a network adapter, a NIC (Network Interface Controller), or the like.

[0019] The storage circuit 152 stores various data and various programs. Specifically, the storage circuit 152 is connected to the processing circuit 155, stores data received from the processing circuit 155, or reads out stored data and transmits it to the processing circuit 155. For example, the storage circuit 152 is realized by a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like.

[0020] The input interface 153 receives input operations of various instructions and various information from the user. Specifically, the input interface 153 is connected to the processing circuit 155, converts the input operations received from the user into electrical signals, and transmits them to the processing circuit 155. For example, the input interface 153 is realized by a trackball, a switch button, a mouse, a keyboard, a touch pad that performs an input operation by touching an operation surface, a touch screen in which a display screen and a touch pad are integrated, a non-contact input interface using an optical sensor, and a voice input interface, etc. Note that in this specification, the input interface 153 is not limited to only those having physical operation components such as a mouse and a keyboard. For example, a processing circuit for electrical signals that receives an electrical signal corresponding to an input operation from an external input device provided separately from the apparatus and transmits this electrical signal to the control circuit is also included in the example of the input interface 153.

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

[0022] The processing circuit 155 controls the entire medical image processing apparatus 150. For example, the processing circuit 155 performs various processes according to the input operations received from the user via the input interface 153. Also, for example, the processing circuit 155 receives data transmitted by another apparatus from the NW interface 151 and stores the received data in the storage circuit 152. Also, for example, the processing circuit 155 transmits the data received from the storage circuit 152 to the NW interface 151 to transmit the data to another apparatus. Also, for example, the processing circuit 155 displays the data received from the storage circuit 152 on the display 154.

[0023] The configuration examples of the medical image processing system 100 and the medical image processing apparatus 150 according to the present embodiment have been described above. For example, the medical image processing system 100 and the medical image processing apparatus 150 according to the present embodiment are installed in medical facilities such as hospitals and clinics, and assist in diagnoses related to heart diseases and formulation of treatment plans by users such as doctors.

[0024] Specifically, the medical image processing apparatus 150 calculates and presents various types of information regarding the blood flow of the blood vessel based on the medical image. For example, as one of the information regarding the blood flow, the medical image processing apparatus 150 calculates and displays the WSS at each position of the blood vessel.

[0025] Generally, when diagnoses and determination of treatment policies are made using such technology, users such as doctors comprehensively judge by integrating various information in addition to the WSS. However, when presenting a plurality of information without limitation, the work of acquiring and understanding the information becomes complicated, and the labor of the user increases.

[0026] For this reason, the medical image processing apparatus 150 according to the present embodiment is configured to be able to reduce the labor of the user when making diagnoses related to heart diseases and determination of treatment policies.

[0027] Specifically, the medical image processing apparatus 150 displays, as information regarding the blood flow of the blood vessel calculated based on the medical image, a first index value regarding the blood vessel calculated from blood pressure or blood flow, and the WSS as a second index value regarding the blood vessel. Then, the medical image processing apparatus 150 switches and displays the first index value and the WSS based on the information regarding the subject. Here, the first index value is a different type of index value from the wall shear stress which is the second index value.

[0028] Here, the medical image processing apparatus 150 extracts the degree of a disease related to the heart from a medical image. Then, as information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the disease related to the heart is high, the medical image processing apparatus 150 displays a first index value related to the blood vessel calculated from blood pressure or blood flow, and when the degree of the disease related to the heart is low, the medical image processing apparatus 150 displays WSS as a second index value related to the blood vessel.

[0029] According to such a configuration, it is possible to appropriately switch and display WSS calculated from a medical image and other index values according to the state of the subject. As a result, it becomes possible to reduce the labor of the user when performing diagnosis related to heart disease, formulation of a treatment plan, and the like.

[0030] Hereinafter, the medical image processing apparatus 150 having such a configuration will be described in detail. Note that hereinafter, as a medical image, a coronary CT image is used, and an example in which fractional flow reserve (FFR) is displayed as a first index value related to a blood vessel calculated from blood pressure or blood flow will be described.

[0031] For example, as shown in FIG. 1, in the present embodiment, the processing circuit 155 of the medical image processing apparatus 150 includes an acquisition function 155a, a calculation function 155b, an extraction function 155c, and a display control function 155d. Here, the extraction function 155c is an example of an extraction unit. Also, the display control function 155d is an example of a display control unit.

[0032] The acquisition function 155a acquires a coronary CT image of a subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the NW interface 151.

[0033] The calculation function 155b calculates FFR and WSS based on the coronary CT image of the subject acquired by the acquisition function 155a.

[0034] For example, the calculation function 155b calculates the FFR and WSS at each position of the coronary artery from the coronary artery CT image of the subject by using known methods such as CFD (Computational Fluid Dynamics) and machine learning.

[0035] The extraction function 155c extracts the degree of a disease related to the heart from the coronary artery CT image of the subject acquired by the acquisition function 155a. Here, the "degree of disease" includes not only the state with a disease but also the state without a disease. That is, the "degree of disease" can indicate not only the degree of the disease when there is a disease but also the absence of a disease.

[0036] For example, the extraction function 155c extracts the degree of coronary artery disease from the coronary artery CT image of the subject acquired by the acquisition function 155a as the degree of a disease related to the heart.

[0037] Specifically, the extraction function 155c extracts the disease degree indicating the degree of coronary artery disease by analyzing the coronary artery CT image of the subject. Also, for example, the extraction function 155c extracts the presence probability of myocardial ischemia as the disease degree indicating the degree of coronary artery disease. At this time, for example, the extraction function 155c may extract the presence probability based on the distribution of CT values in each myocardial region, or may extract the presence probability using a discriminator that has previously learned the characteristics of images with and without myocardial ischemia by machine learning techniques.

[0038] Note that in this embodiment, the disease degree indicating the degree of coronary artery disease extracted by the extraction function 155c is not limited to the presence probability of myocardial ischemia, and may be any value as long as it is what the user requests for controlling the display of the FFR and WSS described later. For example, the extraction function 155c may directly assign a value to be used as the disease degree from the result of a diagnosis separately performed on the subject by a user such as a doctor, or may extract a value indicating the severity of myocardial ischemia from the Perfusion Index obtained from the coronary artery CT image as the disease degree.

[0039] The display control function 155d displays the FFR and WSS calculated by the calculation function 155b on the display 154 as information regarding the blood flow of the coronary arteries calculated based on the coronary artery CT image of the subject acquired by the acquisition function 155a. Then, the display control function 155d switches and displays the FFR and the WSS based on the information regarding the subject.

[0040] Here, when the degree of coronary artery disease extracted by the extraction function 155c is high as information regarding the blood flow of the coronary arteries calculated based on the coronary artery CT image of the subject acquired by the acquisition function 155a, the display control function 155d displays the FFR, and when the degree of the coronary artery disease is low, the display control function 155d displays the WSS.

[0041] Specifically, when the disease degree indicating the degree of coronary artery disease is higher than the first threshold, the display control function 155d displays the FFR, and when the disease degree indicating the degree of coronary artery disease is lower than the second threshold smaller than the first threshold, the display control function 155d displays the WSS. Also, when the disease degree indicating the degree of coronary artery disease is between the first threshold and the second threshold, the display control function 155d displays both the FFR and the WSS.

[0042] FIG. 2 is a diagram showing an example of information display performed by the display control function 155d according to the first embodiment.

[0043] For example, as shown in FIG. 2, the display control function 155d determines the type of information to be displayed on the display 154 based on the probability of the presence of myocardial ischemia extracted by the extraction function 155c. At this time, for example, when the probability of the presence of myocardial ischemia is higher than a preset first threshold (presence probability: high), the display control function 155d determines the type of information to be displayed as the FFR. Also, when the probability of the presence of myocardial ischemia is lower than a preset second threshold (<first threshold) (presence probability: low), the display control function 155d determines the type of information to be displayed as the WSS. Further, when the probability of the presence of myocardial ischemia is included in the range from the first threshold to the second threshold (presence probability: medium), the display control function 155d determines the type of information to be displayed as both the FFR and the WSS.

[0044] That is, when the probability of myocardial ischemia is high, the display control function 155d determines to display only the FFR information, which is the information necessary for quick judgment, because a situation where a quick judgment on the treatment indication and the formulation of a treatment plan are assumed. Also, when the probability of myocardial ischemia is low, the display control function 155d determines to display only the WSS information, which is the information necessary for long-term judgment, because a situation where a long-term treatment plan is formulated is assumed.

[0045] Then, the display control function 155d displays the determined type of information on the display 154. For example, the display control function 155d first generates a three-dimensional image of the coronary artery (e.g., a VR (Volume Rendering) image, an SR (Surface Rendering) image, etc.) by three-dimensionally reconstructing the vascular region of the coronary artery in the coronary artery CT image. Also, the display control function 155d specifies the range in which FFR and WSS can be obtained from the maximum and minimum values of FFR and WSS at each position of the coronary artery, and sets a color array (color lookup table) based on the range. Then, the display control function 155d generates a color map image by assigning a color corresponding to each position in the three-dimensional image of the coronary artery to FFR and WSS respectively. And when the display control function 155d determines that the type of information to be displayed is FFR, it displays the FFR color map image on the display 154, and when it determines that the type of information to be displayed is WSS, it displays the WSS color map image on the display 154. Also, when the display control function 155d determines that the type of information to be displayed is both FFR and WSS, it displays the color maps of FFR and WSS side by side on the display 154.

[0046] In this embodiment, the display form of each piece of information displayed by the display control function 155d is not limited to a color map image, and may be any display form as long as the user can correctly recognize each piece of information. For example, the display control function 155d may set an arrangement of patterns or textures based on the ranges that can be captured for each of the identified FFR and WSS, and may generate images by assigning patterns or textures corresponding to each position in the three-dimensional image of the coronary artery for each of the FFR and WSS. Also, for example, the display control function 155d may allow the user to arbitrarily set the display form of each piece of information using a user interface realized by the input interface 153 and the display 154. Also, for example, when displaying both the FFR and the WSS, the display control function 155d may calculate corresponding points in those images to display the images in a linked manner, or may automatically rotate and display the images using a cine display or the like. Also, the display control function 155d may display a moving image by reconstructing each image as a moving image based on a preset rotation speed and angle.

[0047] The above describes each processing function possessed by the processing circuitry 155. Here, for example, the processing circuitry 155 is realized by a processor. In this case, each of the above-mentioned processing functions is stored in the storage circuitry 152 in the form of a program executable by a computer. Then, the processing circuitry 155 realizes a function corresponding to each program by reading and executing each program stored in the storage circuitry 152. In other words, the processing circuitry 155 has each processing function shown in FIG. 1 in a state where each program is read.

[0048] Note that the processing circuit 155 may be configured by combining a plurality of independent processors, and each processing function may be realized by each processor executing a program. Also, each processing function of the processing circuit 155 may be appropriately distributed or integrated into a single or a plurality of processing circuits for realization. Further, each processing function of the processing circuit 155 may be realized by a combination of hardware such as a circuit and software. Here, an example in which a program corresponding to each processing function is stored in a single storage circuit 152 has been described, but the embodiment is not limited to this. For example, the programs corresponding to each processing function may be distributed and stored in a plurality of storage circuits, and the processing circuit 155 may be configured to read and execute each program from each storage circuit.

[0049] FIG. 3 is a flowchart showing a processing procedure of processing performed by each processing function of the processing circuit 155 of the medical image processing apparatus 150 according to the first embodiment.

[0050] For example, as shown in FIG. 3, in the present embodiment, when the acquisition function 155a receives an instruction to start processing from a user via the input interface 153 (step S101, Yes), the coronary artery CT image of the subject is acquired from the X-ray CT apparatus 110 or the medical image storage apparatus 120 (step S102). This processing is realized, for example, by the processing circuit 155 calling and executing a program corresponding to the acquisition function 155a from the storage circuit 152.

[0051] Subsequently, the calculation function 155b calculates FFR and WSS based on the coronary artery CT image of the subject acquired by the acquisition function 155a (step S103). This processing is realized, for example, by the processing circuit 155 calling and executing a program corresponding to the calculation function 155b from the storage circuit 152.

[0052] Subsequently, the extraction function 155c extracts the disease degree indicating the degree of coronary artery disease from the coronary artery CT image of the subject acquired by the acquisition function 155a (step S104). This process is realized, for example, by the processing circuit 155 calling and executing a program corresponding to the extraction function 155c from the storage circuit 152.

[0053] Subsequently, when the disease degree indicating the degree of coronary artery disease is higher than the first threshold (step S105, Yes), the display control function 155d displays the FFR calculated by the calculation function 155b (step S106). Further, when the disease degree indicating the degree of coronary artery disease is lower than the second threshold lower than the first threshold (step S105, No, step S107, Yes), the display control function 155d displays the WSS calculated by the calculation function 155b (step S108). Further, when the disease degree indicating the degree of coronary artery disease is between the first threshold and the second threshold (step S107, No), the display control function 155d displays the FFR and WSS calculated by the calculation function 155b (step S109). This process is realized, for example, by the processing circuit 155 calling and executing a program corresponding to the display control function 155d from the storage circuit 152.

[0054] As described above, in the first embodiment, the medical image processing apparatus 150 switches and displays the WSS and FFR calculated from the coronary artery CT image according to the state of the subject. Thereby, when diagnosing a heart disease or formulating a treatment plan, the WSS and FFR can be automatically displayed at an appropriate timing. Therefore, according to the first embodiment, the labor of the user when diagnosing a heart disease or formulating a treatment plan can be reduced.

[0055] (Modification Example 1 of the First Embodiment) In addition, in the first embodiment described above, an example of switching and displaying the FFR and WSS according to the degree of coronary artery disease has been described, but the embodiment is not limited to this.

[0056] Generally, depending on the calculation method, FFR is known to have one-dimensional FFR (hereinafter referred to as 1D-FFR) and three-dimensional FFR (hereinafter referred to as 3D-FFR). Similarly, depending on the calculation method, WSS is known to have one-dimensional WSS (hereinafter referred to as 1D-WSS) and three-dimensional WSS (hereinafter referred to as 3D-WSS). Specifically, 3D-FFR is a method for calculating the FFR at each position within a blood vessel, and 1D-FFR is a method for calculating the FFR at each cross-sectional position of the blood vessel based on the centerline of the blood vessel. Similarly, 3D-WSS is a method for calculating the WSS at each position within a blood vessel, and 1D-WSS is a method for calculating the WSS at each cross-sectional position of the blood vessel based on the centerline of the blood vessel.

[0057] Here, 3D-FFR and 3D-WSS have the merit of being able to provide more accurate information for calculating the WSS and FFR at local positions. On the other hand, they have the demerit of high computational costs such as calculation time, computer processing, and the amount of memory area used. In contrast, 1D-FFR and 1D-WSS have the demerit of reduced accuracy of information compared to 3D-FFR and 3D-WSS. On the other hand, they have the merit of low computational costs such as calculation time, computer processing, and the amount of memory area used.

[0058] Therefore, for example, as a modification 1 of the first embodiment, the medical image processing apparatus 150 may switch and display at least one of 1D-FFR and 1D-WSS and at least one of 3D-FFR and 3D-WSS according to the degree of disease indicating the degree of coronary artery disease.

[0059] Specifically, the calculation function 155b calculates 1D-FFR and 1D-WSS, and 3D-FFR and 1D-WSS as information regarding the blood flow in the coronary artery based on the coronary artery CT image of the subject.

[0060] Then, when the degree of the coronary artery disease indicated by the disease degree is high, the display control function 155d displays at least one of the 1D-FFR and 1D-WSS calculated by the calculation function 155b. Further, when the degree of the coronary artery disease indicated by the disease degree is low, the display control function 155d displays at least one of the 3D-FFR and 3D-WSS calculated by the calculation function 155b.

[0061] FIG. 4 is a diagram showing an example of information display performed by the display control function 155d according to Modification 1 of the first embodiment.

[0062] For example, as shown in FIG. 4, the display control function 155d determines the type of information to be displayed on the display 154 based on the probability of myocardial ischemia extracted by the extraction function 155c. At this time, for example, when the probability of myocardial ischemia is higher than the threshold value, the display control function 155d determines the type of information to be displayed as 1D-FFR and 1D-WSS. Further, when the probability of myocardial ischemia is lower than the threshold value, the display control function 155d determines the type of information to be displayed as 3D-FFR and 3D-WSS.

[0063] That is, when the probability of myocardial ischemia is high, the display control function 155d determines to display 1D-FFR and 1D-WSS, which are information that can be calculated in a shorter time, because it is necessary to make a judgment on the indication for urgent treatment and formulate a treatment plan, and a situation where there is no time margin is assumed. Further, when the probability of myocardial ischemia is low, the display control function 155d determines to display 3D-FFR and 3D-WSS, which are more accurate information, because a situation with a time margin is assumed.

[0064] Note that the display examples of FFR and WSS according to this modification example are not limited to this. For example, when the probability of myocardial ischemia is higher than the threshold, the display control function 155d may determine the type of information to be displayed to be either 1D-FFR or 1D-WSS. When the probability of myocardial ischemia is lower than the threshold, the display control function 155d may determine the type of information to be displayed to be either 3D-FFR or 3D-WSS. Here, for example, in each case, the display control function 155d determines to display the information specified by the user among FFR and WSS. Also, for example, the display control function 155d further provides a threshold larger than the above-described threshold, and when the probability of myocardial ischemia is higher than the further provided threshold, the type of information to be displayed may be determined to be only 1D-FFR.

[0065] (Modification Example 2 of the First Embodiment) Also, in the above-described first embodiment, an example of changing the type of information to be displayed according to the degree of coronary artery disease has been described, but the embodiment is not limited to this.

[0066] For example, as a modification example 2 of the first embodiment, the medical image processing apparatus 150 may change the size of the display area of the information to be displayed according to the degree of coronary artery disease.

[0067] Specifically, the display control function 155d simultaneously displays the FFR and WSS calculated by the calculation function 155b. Then, when the disease degree indicating the degree of coronary artery disease is high, the display control function 155d makes the display area of FFR larger than the display area of WSS. When the disease degree indicating the degree of coronary artery disease is low, the display control function 155d makes the display area of WSS larger than the display area of FFR.

[0068] FIG. 5 is a diagram showing an example of information display performed by the display control function 155d according to modification example 2 of the first embodiment.

[0069] For example, as shown in FIG. 5, the display control function 155d determines the type of information to be displayed on the display 154 based on the probability of myocardial ischemia extracted by the extraction function 155c. At this time, for example, when the probability of myocardial ischemia is high, the display control function 155d determines to increase the display size of the FFR color map image and decrease the display size of the WSS color map image. Also, when the probability of myocardial ischemia is low, the display control function 155d determines to decrease the display size of the FFR color map image and increase the display size of the WSS color map image.

[0070] Note that the display examples of FFR and WSS according to this modification are not limited to this. For example, instead of changing the size of the display area between FFR and WSS, the display control function 155d may change the display color, transparency, or display position of the display area. For example, the display control function 155d may arrange FFR and WSS side by side horizontally, and determine to display FFR on the left side when the probability of myocardial ischemia is high, and display WSS on the left side when the probability of myocardial ischemia is low.

[0071] (Modification Example 3 of the First Embodiment) Also, in the above-described first embodiment, an example in which FFR and WSS are displayed as color map images based on a color arrangement (color lookup table) has been described, but the embodiment is not limited to this.

[0072] For example, when FFR and WSS are displayed as color maps based on the same color arrangement, very similar images are generated, and there is a possibility that the user may mistake FFR for WSS.

[0073] Therefore, for example, as a modification example 3 of the first embodiment, the medical image processing apparatus 150 may display FFR and WSS in different display forms.

[0074] Specifically, the display control function 155d displays the FFR and WSS calculated by the calculation function 155b in different display forms.

[0075] 6 and 7 are diagrams showing an example of information display performed by the display control function 155d according to the third modification of the first embodiment.

[0076] For example, as shown in the left and center of FIG. 6, when the FFR image and the WSS image are displayed simultaneously, the display control function 155d displays one of them as a color map image to which a color is assigned (expressed in color), and displays the other as an image to which a texture is assigned (expressed in texture). Alternatively, as shown in the right side of FIG. 6, the display control function 155d may display the WSS image as an image showing the size and direction of the WSS with the number and direction of arrows, respectively (expressed with the number and direction of arrows). In this case, for example, if the display form of each piece of information can be arbitrarily set by the user using the user interface as described above, the display control function 155d may display a warning when the user sets the display form of each image to the same or similar display form. Alternatively, the display control function 155d may control so that the user cannot select the same or similar display form to prevent misidentification.

[0077] Alternatively, for example, as shown in Fig. 7, the display control function 155d may display different characters or marks on the FFR image and the WSS image. At this time, for example, the display control function 155d may erase the characters or marks on the image that is the observation target when one of the images becomes the observation target of the user (for example, when the user performs an action such as activating the display window, viewing (browsing) the image, or directing the gaze to the image) since the displayed characters or marks may be an obstacle to observation. Also, for example, when the images are displayed in conjunction with each other as described above, the display control function 155d may perform control so that the characters or marks on the image that is the observation target are erased and the characters or marks on the image that is not the observation target are not erased.

[0078] (Fourth Modification of the First Embodiment) Further, for example, in the above-described first embodiment, an example of displaying FFR and WSS using a three-dimensional image (such as a VR image or an SR image) of the coronary artery was described, but the embodiment is not limited thereto.

[0079] For example, as a modification 4 of the first embodiment, the medical image processing apparatus 150 may display FFR and WSS using another image showing the coronary artery.

[0080] Specifically, the display control function 155d displays an image showing the coronary artery, and superimposes or arranges and displays the FFR and WSS calculated by the calculation function 155b on the image.

[0081] For example, the display control function 155d superimposes and displays the WSS and FFR corresponding to each position in the coronary artery CT image.

[0082] FIGS. 8 and 9 are diagrams showing an example of information display performed by the display control function 155d according to Modification 4 of the first embodiment.

[0083] For example, as shown on the left side of FIG. 8, the display control function 155d may reconstruct a curved MPR image in which the coronary artery is represented linearly by curved MPR (Multi Planar Reconstruction), and assign and display the WSS or FFR corresponding to each position of the curved MPR image.

[0084] Alternatively, for example, as shown on the right side of FIG. 8, when the display control function 155d displays the curved MPR image, it may display the right half of the blood vessel in a display form corresponding to FFR and the left half in a display form corresponding to WSS. Thereby, the position of the blood vessel, FFR, and WSS can be efficiently observed simultaneously.

[0085] Note that the example of separately displaying FFR and WSS on the left and right is not limited to the example using curved MPR. For example, the display control function 155d may use VR images or SR images. In that case, for example, the display control function 155d divides the VR image or SR image into left and right parts with the display direction of the display screen (for example, the direction from the front to the back of the screen) as the axis, so that even when the VR image or SR image is rotated, FFR and WSS are always displayed on the left and right of each vascular limb. Note that this example is effective when a calculation method having the same value at the same vascular cross-section, such as 1D-FFR or 1D-WSS, is used.

[0086] Alternatively, for example, the display control function 155d may display FFR and WSS using the polar coordinate display (also called a polar map) of the myocardial segments. Here, the polar coordinate display of the myocardial segments is an image that schematically represents the unfolded myocardium. For example, as shown in the upper part of FIG. 9, the basal, mid, and apical parts of the myocardium are each represented by an annular region centered on the short axis, and further, the regions of each part are divided into a plurality of segments in the circumferential direction and represented as an image. And in the polar coordinate display of the myocardial segments, each segment is classified into any one of the regions dominated by the Left Anterior Descending artery (LAD), the Left CircumfleX artery (LCX), and the Right Coronary Artery (RCA). In this case, for example, as shown in the lower part of FIG. 9, the display control function 155d divides the region corresponding to each segment in the polar coordinate display of the myocardial segments into upper and lower halves, displays FFR on either one, and displays WSS on the other. At this time, for example, the display control function 155d identifies the corresponding blood vessels for each segment in the polar coordinate display of the myocardial segments, calculates representative values such as the average value and the maximum value of FFR and WSS at each position of the identified blood vessels, and assigns them to each segment.

[0087] (Modification Example 5 of the First Embodiment) In the above-described first embodiment, an example of determining the type of information to be displayed on the display 154 according to the degree of coronary artery disease has been described. However, the embodiment is not limited to this.

[0088] For example, as a modification 5 of the first embodiment, the medical image processing apparatus 150 may determine the type of information to be displayed on the display 154 according to an instruction from the user.

[0089] Specifically, the display control function 155d receives an operation for selecting the type of information to be displayed on the display 154 from the user, and displays at least one of the FFR and WSS calculated by the calculation function 155b on the display 154 according to the received operation.

[0090] For example, the display control function 155d presents the probability of myocardial ischemia in the coronary CT image to the user using the user interface realized by the input interface 153 and the display 154. Further, the display control function 155d receives an operation for selecting the type of information to be displayed on the display 154 from the user using the user interface. Then, the display control function 155d displays the information of the type selected by the user on the display 154 according to the received operation.

[0091] (Modification 6 of the First Embodiment) In the above-described first embodiment, when the disease degree indicating the degree of coronary artery disease is higher than the first threshold, only the FFR is displayed, and when the disease degree indicating the degree of coronary artery disease is lower than the second threshold, only the WSS is displayed. However, the embodiment is not limited to this.

[0092] For example, as a modification 6 of the first embodiment, the medical image processing apparatus 150 may switch from the display of only one of the FFR and WSS to the display of the other according to an instruction from the user.

[0093] Specifically, the display control function 155d receives from the user an operation for switching the display between FFR and WSS, and switches the display from a state in which either one of the FFR and WSS calculated by the calculation function 155b is displayed to a state in which the other is displayed according to the received operation.

[0094] For example, when only one of FFR and WSS is displayed, the display control function 155d receives from the user an operation for switching those displays via the input interface 153. Then, the display control function 155d switches the display from FFR to WSS or from WSS to FRR according to the received operation.

[0095] (Second Embodiment) In the above-described first embodiment, an example in which FFR or WSS is displayed according to the degree of coronary artery disease has been described, but the embodiment is not limited to this.

[0096] For example, when the imaging time point of the medical image is before the treatment of the subject, virtual treatment for the blood vessel may be performed using the medical image, and the predicted FFR or predicted WSS after the treatment may be displayed. Hereinafter, such an example will be described as the second embodiment. In the following, the configuration of the medical image processing system and the medical image processing apparatus according to the second embodiment will be mainly described with respect to the points different from the first embodiment, and the same reference numerals will be given to the common configurations and the detailed description will be omitted.

[0097] FIG. 10 is a diagram showing a configuration example of a medical image processing system and a medical image processing apparatus according to the second embodiment.

[0098] For example, as shown in FIG. 10, the medical image processing system 200 according to the present embodiment includes an X-ray CT apparatus 110, a medical image storage apparatus 120, an electronic medical record system 130, a medical information display apparatus 140, and a medical image processing apparatus 250. Here, each apparatus and system are communicably connected via a network 160.

[0099] The medical image processing apparatus 250 performs various types of image processing on a subject. Specifically, the medical image processing apparatus 250 acquires a CT image from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the network 160, acquires medical data from the electronic medical record system 130, and performs various types of image processing using the CT image and the medical data. For example, the medical image processing apparatus 250 is realized by a computer device such as a server or a workstation.

[0100] For example, the medical image processing apparatus 250 includes an NW interface 151, a storage circuit 152, an input interface 153, a display 154, and a processing circuit 255.

[0101] In this embodiment, the processing circuit 255 of the medical image processing apparatus 250 has an acquisition function 155a, an identification function 255e, a calculation function 155b, a prediction function 255f, and a display control function 255d. Here, the identification function 255e is an example of an identification unit. Also, the prediction function 255f is an example of a prediction unit. Also, the display control function 255c is an example of a display control unit.

[0102] The identification function 255e identifies whether the imaging time point of the coronary artery CT image of the subject acquired by the acquisition function 155a is before or after the treatment of the subject.

[0103] For example, based on the imaging time of the coronary CT image, the identification function 255e determines whether to perform the processing of the next step. At this time, for example, the identification function 255e obtains the patient information of the subject from the electronic medical record system 130 via the NW interface 151, and based on the obtained information, identifies the imaging time of the coronary CT image. Note that the identification function 255e may obtain patient information from HIS, RIS, etc. Then, when the identification function 255e identifies that the imaging time is before the subject's surgery, it determines that the processing of the next step can be performed, and when it identifies that the imaging time is after the surgery, it determines that the processing of the next step cannot be performed. Or, when the identification function 255e identifies that the imaging time is before the subject takes medicine, it determines that the processing of the next step can be performed, and when it identifies that the imaging time is after taking medicine, it determines that the processing of the next step cannot be performed. Here, treatment and taking medicine are examples of treatment.

[0104] Note that the method for identifying the imaging time is not limited to this, and various methods can be used. For example, the identification function 255e may detect a treatment device from the coronary CT image by a known method, and identify whether the imaging time is before or after treatment according to the presence or absence of the treatment device.

[0105] When the prediction function 255f identifies that the imaging time of the coronary CT image of the subject is before the treatment of the subject by the identification function 255e, at least one of the predicted FFR, which is the FFR after treatment, and the predicted WSS, which is the WSS after treatment, is calculated by performing a virtual treatment on the coronary artery using the coronary CT image. Here, the predicted FFR is an example of the first prediction index value, and the predicted WSS is an example of the second prediction index value.

[0106] For example, when the prediction function 255f determines that the next-step process can be performed by the identification function 255e, it performs a virtual treatment on the coronary artery of the subject on a computer using the coronary artery CT image of the subject, and predicts and calculates the FFR and WSS at each position of the blood vessel after the treatment. For example, the prediction function 255f performs a virtual treatment by a method shown in Gijsen, Frank JH, et al. “Simulation of stent deployment in a realistic human coronary artery”, Biomedical engineering online 7.1 (2008): 23. Here, since the process of virtual treatment generally requires a large amount of computer processing cost and processing time, it may be performed using a dedicated calculation processing device. When the identification function 255e determines that the next-step process cannot be performed, the prediction function 255f does not perform a virtual treatment.

[0107] When the display control function 255d identifies that the imaging time of the coronary artery CT image of the subject is before the treatment of the subject by the identification function 255e, it displays at least one of the predicted FFR and the predicted WSS calculated by the prediction function 255f on the display 154.

[0108] Specifically, when the imaging time is identified as before the treatment of the subject, the display control function 255d displays at least one of the FFR and the WSS calculated based on the coronary artery CT image of the subject by the calculation function 155b and at least one of the predicted FFR and the predicted WSS calculated by the prediction function 255f. Further, when the imaging time is identified as after the treatment of the subject, the display control function 255d displays at least one of the FFR and the WSS calculated based on the coronary artery CT image of the subject by the calculation function 155b.

[0109] FIGS. 11 and 12 are diagrams showing an example of information display performed by the display control function 255d according to the second embodiment.

[0110] For example, as shown in FIG. 11, the display control function 255d determines the type of information to be displayed on the display 154 based on the imaging time point of the coronary CT image identified by the identification function 255e. At this time, for example, when the imaging time point is identified by the identification function 255e as being before the subject's treatment, the display control function 255d determines the type of information to be displayed as the WSS (pre-treatment WSS) calculated by the calculation function 155b and the predicted WSS (post-treatment predicted WSS) calculated by the prediction function 255f. Further, when the imaging time point is identified by the identification function 255e as being after the subject's treatment, the display control function 255d determines the type of information to be displayed as the WSS (post-treatment WSS) calculated by the calculation function 155b.

[0111] Here, for example, when the display control function 255d displays the WSS calculated by the calculation function 155b, it may further determine to display the FFR calculated by the calculation function 155b. Also, for example, when the display control function 255d displays the predicted WSS calculated by the prediction function 255f, it may further determine to display the predicted FFR calculated by the prediction function 255f.

[0112] Then, the display control function 255d displays the determined type of information on the display 154. For example, the display control function 255d displays the determined type of information in the same manner as in the first embodiment and its modifications. At this time, for example, the display control function 255d may simultaneously display information such as the subject's treatment history, medication history, and blood test values (hematocrit value, etc.) based on the patient information of the subject obtained by the identification function 255e. For example, as shown in FIG. 12, when the imaging time point is after treatment, the display control function 255d simultaneously displays information such as the type of treatment device (biological stent, etc.) and the placement position based on the surgical record, etc. included in the patient information of the subject.

[0113] Further, for example, the display control function 255d may calculate image features related to coronary artery diseases (for example, information related to calcium score and vessel diameter) by performing known image processing on the coronary artery CT image, and simultaneously display the image features. Further, for example, the display control function 255d may simultaneously display the incidental information of the image (imaging time, cardiac position, etc.) obtained from the information of the DICOM header associated with the coronary artery CT image. Further, for example, the display control function 255d may simultaneously display the calculation reliability in the calculation of WSS and FFR and the calculation reliability in the calculation of treatment simulation. In this case, the reliability can be calculated, for example, from the magnitude of the deviation from the learning model in the target data when using machine learning.

[0114] Further, for example, the display control function 255d may display the FFR and WSS calculated by the calculation function 155b separately on the left and right using curved MPR as in Modification Example 4 of the first embodiment, or may display the predicted FFR and predicted WSS calculated by the prediction function 255f separately on the left and right. Further, for example, the display control function 255d may display the FFR and WSS calculated by the calculation function 155b separately above and below using the polar coordinate display of the myocardial segment, or may display the predicted FFR and predicted WSS calculated by the prediction function 255f separately above and below.

[0115] FIG. 13 is a flowchart showing the processing procedure of the processing performed by each processing function included in the processing circuit 255 of the medical image processing apparatus 250 according to the second embodiment.

[0116] For example, as shown in FIG. 13, in the present embodiment, when the acquisition function 155a receives an instruction to start processing from the user via the input interface 153 (step S201, Yes), the acquisition function 155a acquires the coronary artery CT image of the subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 (step S202). This processing is realized, for example, by the processing circuit 255 calling and executing a program corresponding to the acquisition function 155a from the storage circuit 152.

[0117] Subsequently, the identification function 255e identifies whether the imaging time point of the coronary CT image of the subject acquired by the acquisition function 155a is before or after the treatment of the subject (step S203). This process is realized, for example, by the processing circuit 255 calling and executing a program corresponding to the identification function 255e from the storage circuit 152.

[0118] Subsequently, the calculation function 155b calculates FFR and WSS as information on the blood flow in the coronary artery based on the coronary CT image of the subject acquired by the acquisition function 155a (step S204). This process is realized, for example, by the processing circuit 255 calling and executing a program corresponding to the calculation function 155b from the storage circuit 152.

[0119] Subsequently, when the prediction function 255f identifies that the imaging time point of the coronary CT image of the subject is before the treatment of the subject by the identification function 255e (step S205, Yes), at least one of the predicted FFR and the predicted WSS after the treatment is calculated by performing a virtual treatment on the coronary artery using the coronary CT image (step S206). This process is realized, for example, by the processing circuit 255 calling and executing a program corresponding to the prediction function 255f from the storage circuit 152.

[0120] Subsequently, when the display control function 255d determines that the imaging time point is before the treatment of the subject as identified by the identification function 255e (step S205, Yes), it displays at least one of the FFR and WSS calculated based on the coronary artery CT image of the subject by the calculation function 155b and at least one of the predicted FFR and predicted WSS calculated by the prediction function 255f (step S207). Also, when the display control function 255d determines that the imaging time point is after the treatment of the subject as identified by the identification function 255e (step S205, No), it displays at least one of the FFR and WSS calculated based on the coronary artery CT image of the subject by the calculation function 155b (step S208). This process is realized, for example, when the processing circuit 255 calls and executes a program corresponding to the display control function 255d from the storage circuit 152.

[0121] As described above, in the second embodiment, when the imaging time point of the medical image is before the treatment of the subject, the medical image processing apparatus 250 performs virtual treatment on the blood vessel using the medical image, thereby calculating and displaying the predicted FFR and predicted WSS after the treatment. Thereby, when diagnosing a heart disease or formulating a treatment plan, information indicating the effect of the treatment can be automatically displayed. Therefore, according to the second embodiment, the labor of the user when diagnosing a heart disease or formulating a treatment plan can be reduced.

[0122] (Modification Example 1 of the Second Embodiment) Note that, in the second embodiment described above, an example of displaying the predicted FFR and predicted WSS after the treatment when the imaging time point of the coronary artery CT image of the subject is before the treatment of the subject has been described, but the embodiment is not limited to this.

[0123] For example, as a modification example 1 of the second embodiment, the medical image processing apparatus 250 may switch and display at least one of 1D-FFR and 1D-WSS and at least one of 3D-FFR and 3D-WSS according to the imaging time point of the coronary artery CT image.

[0124] Specifically, when the imaging time is identified by the identification function 255e as being before the treatment of the subject, the display control function 255d displays at least one of the 3D-FFR and 3D-WSS calculated by the calculation function 155b. Further, when the imaging time is identified by the identification function 255e as being after the treatment of the subject, the display control function 255d displays at least one of the 1D-FFR and 1D-WSS calculated by the calculation function 155b.

[0125] FIG. 14 is a diagram showing an example of information display performed by the display control function 255d according to Modification 1 of the second embodiment.

[0126] For example, as shown in FIG. 14, when the imaging time is identified by the identification function 255e as being before the treatment of the subject, the display control function 255d determines the type of information to be displayed to the 3D-FFR and 3D-WSS calculated by the calculation function 155b. Further, when the imaging time is identified by the identification function 255e as being after the treatment of the subject, the display control function 255d determines the type of information to be displayed to the 1D-WSS calculated by the calculation function 155b.

[0127] Note that the display examples of FFR and WSS according to this modification are not limited to this. For example, when the imaging time is identified as being before the treatment of the subject, the display control function 255d may determine the type of information to be displayed to either one of the 3D-FFR and 3D-WSS, or when the imaging time is identified as being before the treatment of the subject, the display control function 255d may determine the type of information to be displayed to the 1D-FFR, or both the 1D-FFR and 3D-WSS. Here, for example, the display control function 255d may determine to display the information specified by the user among FFR and WSS in each case.

[0128] (Modification 2 of the Second Embodiment) In addition, in the second embodiment described above, an example in which predicted FFR or predicted WSS is calculated before determining the type of information to be displayed has been described, but the embodiment is not limited to this.

[0129] For example, as a modification 2 of the second embodiment, the medical image processing apparatus 250 may calculate predicted FFR or predicted WSS after determining the type of information to be displayed.

[0130] Specifically, the prediction function 255f calculates at least one of the predicted FFR and the predicted WSS after it is determined by the display control function 255d to display at least one of the predicted FFR and the predicted WSS.

[0131] (Modification 3 of the second embodiment) Also, in the above-described second embodiment, an example in which predicted FFR or predicted WSS after treatment is calculated without input from the user by performing virtual treatment on the coronary artery using a coronary CT image has been described, but the embodiment is not limited to this.

[0132] Generally, when performing virtual treatment, it is necessary to assume and set various parameters. For example, anatomical features such as the hardness of blood vessels, physical properties of blood (hematocrit value), shape of blood vessels after treatment (curvature of blood vessel branches, etc.), properties of plaques, etc., and treatment methods such as the type of treatment device, type and amount of medication, etc. are assumed and set.

[0133] Therefore, for example, as a modification 3 of the second embodiment, the medical image processing apparatus 250 may receive parameters used when performing virtual treatment from the user.

[0134] Specifically, the prediction function 255f receives an operation for inputting parameters used when performing virtual treatment from the user, and calculates at least one of the predicted FFR and the predicted WSS using the received parameters.

[0135] For example, the prediction function 255f receives input of each parameter used when implementing virtual treatment using the user interface realized by the input interface 153 and the display 154. At this time, for example, the prediction function 255f may allow the numerical values of each parameter to be directly specified, or may allow the user to arbitrarily select from a plurality of candidate parameter sets determined in advance. Then, the prediction function 255f calculates the predicted FFR and the predicted WSS by implementing virtual treatment using the input parameters, and presents the calculated predicted FFR and WSS to the user using the user interface.

[0136] FIGS. 15 to 17 are diagrams showing an example of a user interface used by the prediction function 255f according to Modification Example 3 of the second embodiment.

[0137] For example, as shown in FIGS. 15 to 17, the prediction function 255f displays on the display 154 an image assigned with the predicted WSS (predicted post-treatment WSS) calculated using the input parameters and a slider bar corresponding to the value of each parameter. Here, the prediction function 255f enables the user to set arbitrary parameters by receiving an operation to adjust the slider bar from the user via the input interface 153. Then, when the parameters are adjusted by the user, the prediction function 255f calculates the predicted WSS using the adjusted parameters, and updates the image displayed on the display 154 based on the calculated predicted WSS.

[0138] At this time, for example, the prediction function 255f may change the items of the parameters that can be set by the slider bar according to the magnification rate of the image. For example, when the entire coronary artery is observed by the user at a low magnification rate, since it is expected that the parameters affecting the whole will be changed, as shown in FIG. 15, parameter items such as "dosage" that affect the entire coronary artery are set. Also, for example, when each position of the blood vessel is observed by the user at a high magnification rate, since it is expected that the parameters affecting each position will be changed, as shown in FIG. 16, parameter items such as "curvature" that affect each position of the blood vessel are set.

[0139] Also, for example, as shown in FIG. 17, the prediction function 255f may display the slider bar in a curved shape by curving it along the shape of the blood vessel. At this time, for example, the prediction function 255f may be able to set various curvatures with a single slider bar by setting change points for each location having a specific curvature. For example, the prediction function 255f may set one change point for each segment of the coronary artery classified by a society or the like. Also, for example, the prediction function 255f may restrict the movement (for example, the width and speed at which the change point can be moved) of the change point on the slider bar according to the conditions related to the structure of the blood vessel and the conditions related to the treatment device. Also, for example, the prediction function 255f may display characters, marks, scales, etc. at the position of the predicted WSS corresponding to the threshold value for determining the necessity of treatment on the slider bar.

[0140] Also, for example, the prediction function 255f may accept the input of parameters other than the parameters used when performing virtual treatment. In this case, for example, the prediction function 255f accepts the input of the heart rate, estimates the change in blood pressure from the input heart rate, and calculates the predicted WSS based on the estimated blood pressure.

[0141] In FIGS. 15 to 17, an example of the user interface in the case of calculating and displaying the predicted WSS has been shown. However, for example, the prediction function 255f may calculate and display the predicted FFR by receiving the input of parameters using a similar user interface.

[0142] (Modification Example 4 of the Second Embodiment) In addition, in the above-described second embodiment, an example of the case of displaying information at one point in time obtained from the coronary artery CT image to be analyzed has been described. However, the embodiment is not limited to this.

[0143] For example, as a modification example 4 of the second embodiment, the medical image processing apparatus 250 may display information at a plurality of time points.

[0144] Specifically, when the imaging time point is identified by the identification function 255e as being after the treatment of the subject, the display control function 255d displays at least one of the FFR and WSS calculated based on the coronary artery CT image of the subject before treatment by the calculation function 155b and at least one of the FFR and WSS calculated based on the coronary artery CT image of the subject after treatment by the calculation function 155b.

[0145] FIG. 18 is a diagram showing an example of information display performed by the display control function 255d according to modification example 4 of the second embodiment.

[0146] For example, as shown in FIG. 18, when the imaging time point is identified by the identification function 255e as being after the treatment of the subject, the display control function 255d determines the types of information to be displayed as the WSS (pre-treatment WSS) calculated based on the coronary artery CT image before treatment by the calculation function 155b and the WSS calculated based on the coronary artery CT image after treatment. At this time, for example, the display control function 255d may determine the WSS based on the coronary artery CT image after treatment as the WSS at a plurality of time points after treatment. For example, the display control function 255d determines the types of information to be displayed as the WSS calculated based on the coronary artery CT image one week after treatment and the WSS calculated based on the coronary artery CT image one month after treatment.

[0147] Also, for example, when it is identified that the imaging time point is after the subject's load, the display control function 255d may determine the type of information to be displayed based on the WSS calculated based on the coronary artery CT image before the load and the WSS calculated based on the coronary artery CT image after the load.

[0148] Also, for example, for after treatment, the display control function 255d may display the WSS calculated regularly after treatment over time for determining the treatment effect, or may calculate the difference in WSS before and after treatment and display an image assigned with the calculated difference.

[0149] In FIG. 18, an example of displaying WSS has been described. However, for example, the display control function 255d may display the FFR at multiple time points, or both the FFR and WSS at multiple time points, by the same method.

[0150] (Third Embodiment) In the above-described first embodiment, an example of displaying FFR or WSS according to the degree of coronary artery disease has been described. However, the embodiment is not limited to this.

[0151] For example, for each coronary artery branch, the position and rupture probability of the plaque generated in each branch may be calculated, and FFR or WSS may be displayed according to the rupture probability. Hereinafter, such an example will be described as the third embodiment. In the following, the configuration of the medical image processing system and the medical image processing apparatus according to the third embodiment will be mainly described focusing on the differences from the first embodiment, and the detailed description of the common configurations will be omitted by assigning the same reference numerals.

[0152] FIG. 19 is a diagram showing a configuration example of a medical image processing system and a medical image processing apparatus according to the third embodiment.

[0153] For example, as shown in FIG. 19, a medical image processing system 300 according to this embodiment includes an X-ray CT apparatus 110, a medical image storage apparatus 120, an electronic medical record system 130, a medical information display apparatus 140, and a medical image processing apparatus 350. Here, each apparatus and system is communicably connected via a network 160.

[0154] The medical image processing apparatus 350 performs various image processes on a subject. Specifically, the medical image processing apparatus 350 acquires a CT image from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the network 160, acquires medical data from the electronic medical record system 130, and performs various image processes using the CT image and the medical data. For example, the medical image processing apparatus 350 is realized by a computer device such as a server or a workstation.

[0155] For example, the medical image processing apparatus 350 includes a NW interface 151, a storage circuit 152, an input interface 153, a display 154, and a processing circuit 355.

[0156] In this embodiment, the processing circuit 355 of the medical image processing apparatus 350 has an acquisition function 155a, a calculation function 155b, a derivation function 355g, and a display control function 355d. Here, the derivation function 355g is an example of a derivation unit. Also, the display control function 355c is an example of a display control unit.

[0157] Based on the coronary artery CT image of the subject acquired by the acquisition function 155a, the derivation function 355g derives the position and rupture probability of the plaque generated in each blood vessel branch for each blood vessel branch of the coronary artery.

[0158] For example, the derivation function 355g analyzes the coronary artery CT image of the subject to derive the position and rupture probability of the plaque for each coronary artery branch. For example, the derivation function 355g derives the position and rupture probability of the plaque from the information on the blood vessel diameter of the coronary artery. For example, the derivation function 355g derives the position and rupture probability of the plaque by threshold processing using the coronary artery CT image. Or, for example, the derivation function 355g may derive the position and rupture probability of the plaque using a discriminator that has previously learned the characteristics of the pixel value distribution inside the plaque by means of machine learning techniques.

[0159] The display control function 355d displays the FFR or WSS calculated by the calculation function 355b on the display 154 according to the position and rupture probability of the plaque derived by the derivation function 355g for each coronary artery branch.

[0160] Specifically, the display control function 355d displays the FFR for the artery branch where there is a plaque with a high rupture probability derived by the derivation function 355g. Also, the display control function 355d displays the WSS for the artery branch where there is no plaque or there is a plaque with a low rupture probability.

[0161] FIG. 20 is a diagram showing an example of information display performed by the display control function 355d according to the third embodiment.

[0162] For example, as shown in FIG. 20, the display control function 355d determines the type of information corresponding to each blood vessel limb displayed on the display 154 based on the position and rupture probability of the plaque derived by the derivation function 355g. For example, for the blood vessel limb with a high plaque rupture probability (the range indicated by the solid arrow in FIG. 20), the display control function 355d determines the type of information to be displayed as FFR. Also, for the blood vessel limb where there is no plaque or there is a low rupture probability (the range indicated by the dashed arrow in FIG. 20), the display control function 355d determines the type of information to be displayed as WSS.

[0163] Then, the display control function 355d displays the determined type of information on the display 154. For example, the display control function 355d displays the determined type of information in the same manner as in the first embodiment and its modifications. However, in this modification, the display control function 355d displays an image in which FFR and WSS are mixed. At this time, for example, the display control function 355d may display FFR and WSS in different display forms as in Modification 3 of the first embodiment.

[0164] Also, for example, the display control function 355d may simultaneously display the position and rupture probability of the plaque derived by the derivation function 355g. Also, for example, the display control function 355d may calculate the dominant region of each coronary artery by a known method and simultaneously display the calculated dominant regions of the respective coronary arteries. In this way, by simultaneously displaying the dominant regions of the respective coronary arteries, the dominant region that recovers by treatment can be specified, and the plaque to be treated can be specified more accurately. Also, for example, the display control function 355d may identify the region where inflammation has occurred from the distribution of pixel values in the myocardial region around the coronary artery and simultaneously display the region. Here, for example, when the position of the inflammation is known from another medical image such as a myocardial SPECT image, the display control function 355d may acquire the other medical image and align the medical image with the coronary artery CT image to identify the region where the inflammation has occurred.

[0165] FIG. 21 is a flowchart showing the processing procedure of the processing performed by each processing function included in the processing circuit 355 of the medical image processing apparatus 350 according to the third embodiment.

[0166] For example, as shown in FIG. 21, in this embodiment, when the acquisition function 155a receives an instruction to start processing from the user via the input interface 153 (step S301, Yes), the acquisition function 155a acquires a coronary artery CT image of the subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 (step S302). This processing is realized, for example, by the processing circuit 355 calling and executing a program corresponding to the acquisition function 155a from the storage circuit 152.

[0167] Subsequently, based on the coronary CT image of the subject acquired by the acquisition function 155a, the calculation function 155b calculates FFR and WSS as information regarding the blood flow in the coronary artery (step S303). This process is realized, for example, by the processing circuit 355 calling and executing a program corresponding to the calculation function 155b from the storage circuit 152.

[0168] Subsequently, based on the coronary CT image of the subject acquired by the acquisition function 155a, the derivation function 355g derives the position and rupture probability of the plaque generated in each coronary artery branch for each coronary artery branch (step S304). This process is realized, for example, by the processing circuit 355 calling and executing a program corresponding to the derivation function 355g from the storage circuit 152.

[0169] Subsequently, for the coronary artery branch where there is a plaque with a high rupture probability derived by the derivation function 355g, the display control function 355d displays the FFR calculated by the calculation function 355b (step S305), and for the coronary artery branch where there is no plaque or there is a plaque with a low rupture probability, the display control function 355d displays the WSS calculated by the calculation function 355b (step S306). This process is realized, for example, by the processing circuit 355 calling and executing a program corresponding to the display control function 355d from the storage circuit 152.

[0170] As described above, in the third embodiment, the medical image processing apparatus 350 displays FFR and WSS for each coronary artery branch according to the position and rupture probability of the plaque generated in each branch. Thereby, when diagnosing heart diseases and formulating treatment plans, WSS and FFR can be automatically displayed for each coronary artery branch. Therefore, according to the third embodiment, the labor of the user when diagnosing heart diseases and formulating treatment plans can be reduced.

[0171] (Modification Example 1 of the Third Embodiment) In the above-described third embodiment, an example in which FFR or WSS is displayed for each coronary artery branch has been described, but the embodiment is not limited to this.

[0172] For example, as a first modification of the third embodiment, the medical image processing apparatus 350 may display a representative value of FFR or a representative value of WSS for each coronary artery branch.

[0173] Specifically, the display control function 355d displays a first representative value of FFR or WSS in the branch where a plaque with a high rupture probability derived by the derivation function 355g exists. Also, the display control function 355d displays a second representative value different from the first representative value of FFR or WSS in the branch where no plaque exists and the branch where a plaque with a low rupture probability exists.

[0174] FIG. 22 is a diagram showing an example of information display performed by the display control function 355d according to the first modification of the third embodiment.

[0175] For example, as shown in FIG. 22, the display control function 355d displays a representative value of WSS (maximum WSS, minimum WSS, etc.) at a position corresponding to each blood vessel according to the position and rupture probability of the plaque derived by the derivation function 355g for each branch. For example, there is a report that low WSS correlates with the progression risk of plaque and high WSS correlates with the plaque rupture risk. Therefore, for example, the display control function 355d displays the maximum WSS in the branch where a plaque with a high rupture probability exists at a position corresponding to the branch. Also, the display control function 355d displays the minimum WSS in the branch where no plaque exists and the branch where a plaque with a low rupture probability exists at a position corresponding to the branch.

[0176] Note that in FIG. 22, an example in which a representative value of WSS is displayed has been described. However, for example, the display control function 355d may display a representative value of FFR or representative values of both FFR and WSS by the same method.

[0177] (Modification Example 2 of the Third Embodiment) In addition, in the above-described third embodiment, an example in the case of displaying information (such as FFR and WSS) calculated from coronary CT has been described, but the embodiment is not limited thereto.

[0178] For example, as a modification example 2 of the third embodiment, the medical image processing apparatus 350 may display a medical image captured by another medical image diagnostic apparatus or information obtained from the medical image.

[0179] Specifically, the display control function 355d displays a medical image captured by the first medical image diagnostic apparatus or information obtained from the medical image for a blood vessel branch in which a plaque with a high rupture probability derived by the derivation function 355g exists. In addition, the display control function 355d displays a medical image captured by a second medical image diagnostic apparatus different from the first medical image diagnostic apparatus or information obtained from the medical image for a blood vessel branch in which no plaque exists and a blood vessel branch in which a plaque with a low rupture probability exists.

[0180] For example, for a blood vessel branch in which a plaque with a high rupture probability exists, the display control function 355d displays a HIP (Hiper Intencity Praque) image captured by an MRI apparatus, an IntraVascular UltraSound (IVUS) image captured by an ultrasonic diagnostic apparatus, an optical coherence tomography (OCT) image in the blood vessel, etc.

[0181] FIG. 23 is a diagram showing an example of information display performed by the display control function 355d according to Modification Example 2 of the Third Embodiment.

[0182] For example, as shown in FIG. 23, when the display control function 355d displays an IVUS image or an intravascular OCT image, a color indicating WSS or FFR corresponding to each position of the blood vessel may be superimposed and displayed around the blood vessel in the IVUS image or the intravascular OCT image.

[0183] (Fourth Embodiment) In the above-described first embodiment, an example of displaying FFR or WSS according to the degree of a disease related to the heart has been described. However, the embodiments are not limited to this.

[0184] For example, according to the degree of a disease related to the heart, FFR or WSS calculated based on a medical image of a specific cardiac phase may be displayed. Hereinafter, such an example will be described as the fourth embodiment. In the following, the configuration of the medical image processing system and the medical image processing apparatus according to the fourth embodiment will be mainly described with respect to the differences from the first embodiment, and the same reference numerals will be given to the common configurations and the detailed description thereof will be omitted.

[0185] FIG. 24 is a diagram showing a configuration example of a medical image processing system and a medical image processing apparatus according to the fourth embodiment.

[0186] For example, as shown in FIG. 24, the medical image processing system 400 according to the present embodiment includes an X-ray CT apparatus 110, a medical image storage apparatus 120, an electronic medical record system 130, a medical information display apparatus 140, and a medical image processing apparatus 450. Here, each apparatus and system are communicably connected via a network 160.

[0187] The medical image processing apparatus 450 performs various image processes related to a subject. Specifically, the medical image processing apparatus 450 acquires a CT image from the X-ray CT apparatus 110 or the medical image storage apparatus 120 via the network 160, acquires medical data from the electronic medical record system 130, and performs various image processes using the CT image and the medical data. For example, the medical image processing apparatus 450 is realized by a computer device such as a server or a workstation.

[0188] For example, the medical image processing apparatus 450 includes a NW interface 151, a storage circuit 152, an input interface 153, a display 154, and a processing circuit 455.

[0189] In this embodiment, the processing circuit 455 of the medical image processing apparatus 450 has an acquisition function 155a, an extraction function 455c, a calculation function 455b, and a display control function 455d. Here, the extraction function 455c is an example of an extraction unit. Also, the display control function 455d is an example of a display control unit.

[0190] The extraction function 455c extracts the degree of a heart-related disease from the coronary artery CT image of the subject acquired by the acquisition function 155a.

[0191] For example, as the degree of a heart-related disease, the extraction function 455c extracts the degree of myocardial bridging from the coronary artery CT image of the subject acquired by the acquisition function 155a.

[0192] Specifically, the extraction function 455c analyzes the coronary artery CT image of the subject to extract the disease degree indicating the degree of myocardial bridging. Also, for example, as the disease degree indicating the degree of myocardial bridging, the extraction function 455c extracts the probability of existence of myocardial bridging. At this time, for example, the extraction function 455c may extract the probability of existence based on the distribution of CT values in each myocardial region, or may extract the probability of existence using a discriminator that has previously learned the characteristics of images with and without myocardial bridging by machine learning techniques.

[0193] Note that in this embodiment, the disease degree indicating the degree of myocardial bridging extracted by the extraction function 455c is not limited to the probability of existence, and may be any value as long as it is what the user requires for controlling the display of FFR and WSS described later. For example, the extraction function 455c may directly assign a value to be used as the disease degree from the result of a diagnosis separately performed on the subject by a user such as a doctor, or may extract a value indicating the severity of myocardial bridging from the Perfusion Index obtained from the coronary artery CT image as the disease degree.

[0194] The calculation function 455b reconstructs coronary CT images of a specific cardiac phase from the coronary CT images of the subject acquired by the acquisition function 155a according to the degree of the disease extracted by the extraction function 455c, and calculates FFR and WSS based on the reconstructed images.

[0195] Specifically, when the degree of the disease indicating the degree of the myocardial bridge extracted by the extraction function 455c is high, the calculation function 455b reconstructs the coronary CT image at the end-diastolic phase, and calculates at least one of FFR and WSS based on the reconstructed coronary CT image. In addition, when the degree of the disease indicating the degree of the myocardial bridge extracted by the extraction function 455c is low, the calculation function 455b reconstructs the coronary CT image at the end-diastolic phase and the coronary CT image at the end-systolic phase, and calculates at least one of FFR and WSS based on each coronary CT image.

[0196] For example, the calculation function 455b reconstructs the coronary CT image of a specific cardiac phase according to the probability of the existence of the myocardial bridge calculated by the extraction function 455c, and calculates FFR and WSS based on the coronary CT image. At this time, for example, when the probability of the existence of the myocardial bridge is higher than a preset threshold value, the calculation function 455b reconstructs the coronary CT image at the end-diastolic phase, and calculates FFR and WSS based on the coronary CT image. In addition, when the probability of the existence of the myocardial bridge is lower than the threshold value, the calculation function 455b reconstructs the coronary CT image at the end-diastolic phase and the coronary CT image at the end-systolic phase, and calculates FFR and WSS based on each image.

[0197] This is because usually, FFR and WSS are calculated from the images at the end-systolic phase. However, in the state of the myocardial bridge (the state where the coronary artery is buried in the myocardium), at the end-systolic phase, strong pressure is applied to the coronary artery from the myocardium outside the coronary artery, so it may not be possible to calculate FFR and WSS based on the influence of blood flow.

[0198] The display control function 455d displays at least one of the FFR and WSS calculated based on a specific cardiac phase coronary CT image reconstructed according to the degree of the disease by the calculation function 455b on the display 154.

[0199] Specifically, when the degree of the disease indicating the degree of myocardial bridging is high, the display control function 455d displays at least one of the FFR and WSS calculated based on the coronary CT image at the end of diastole by the calculation function 455b. When the degree of the disease indicating the degree of myocardial bridging is low, the display control function 455d displays at least one of the FFR and WSS calculated based on the coronary CT image at the end of diastole and the coronary CT image at the end of systole by the calculation function 455b.

[0200] FIG. 25 is a diagram showing an example of information display performed by the display control function 455d according to the fourth embodiment.

[0201] For example, as shown in FIG. 25, the display control function 455d determines the type of information to be displayed on the display 154 based on the probability of the presence of myocardial bridging extracted by the extraction function 455c. At this time, for example, when the probability of the presence of myocardial bridging is higher than a preset threshold, the display control function 455d determines the type of the image to be displayed as the WSS calculated from the coronary CT image at the end of diastole by the calculation function 455b. Also, when the probability of the presence of myocardial bridging is lower than the threshold, the display control function 455d determines the type of the image to be displayed as the WSS calculated from the coronary CT image at the end of diastole and the WSS calculated from the coronary CT image at the end of systole by the calculation function 455b. Note that, for example, the calculation function 455b may determine the type of the image to be displayed as the FFR, or may determine it as both the FFR and the WSS.

[0202] Then, the display control function 455d displays the determined type of information on the display 154. For example, the display control function 455d displays the determined type of information in the same manner as in the first embodiment and its modified examples. At this time, for example, when the display control function 455d displays both the WSS calculated from the coronary artery CT image at the end of diastole and the WSS calculated from the coronary artery CT image at the end of systole, these pieces of information may be displayed side by side, or after aligning them, the difference between the FFR and the WSS at each time point may be calculated, and an image of the difference between the FFR and the WSS may be displayed.

[0203] FIG. 26 is a flowchart showing the processing procedure of the processing performed by each processing function included in the processing circuit 455 of the medical image processing apparatus 450 according to the fourth embodiment.

[0204] For example, as shown in FIG. 26, in the present embodiment, when the acquisition function 155a receives an instruction to start processing from the user via the input interface 153 (step S401, Yes), the acquisition function 155a acquires a coronary artery CT image of the subject from the X-ray CT apparatus 110 or the medical image storage apparatus 120 (step S402). This processing is realized, for example, by the processing circuit 455 calling and executing a program corresponding to the acquisition function 155a from the storage circuit 152.

[0205] Subsequently, the extraction function 455c extracts the degree of disease indicating the myocardial bridge from the coronary artery CT image of the subject acquired by the acquisition function 155a (step S403). This processing is realized, for example, by the processing circuit 455 calling and executing a program corresponding to the extraction function 455c from the storage circuit 152.

[0206] Subsequently, when the calculation function 455b determines that the degree of myocardial bridging extracted by the extraction function 455c indicates a high disease level (step S404, Yes), it reconstructs the coronary CT image at the end of diastole and calculates at least one of FFR and WSS based on the reconstructed coronary CT image (step S405). Further, when the degree of myocardial bridging extracted by the extraction function 455c indicates a low disease level (step S404, No), the calculation function 455b reconstructs the coronary CT image at the end of diastole and the coronary CT image at the end of systole, and calculates at least one of FFR and WSS based on each coronary CT image (step S406). This process is realized, for example, by the processing circuit 455 calling and executing a program corresponding to the calculation function 455b from the storage circuit 152.

[0207] Subsequently, when the display control function 455d determines that the degree of myocardial bridging indicates a disease level higher than the threshold (step S404, Yes), it displays at least one of FFR and WSS calculated based on the coronary CT image at the end of diastole by the calculation function 455b (step S407). Further, when the degree of myocardial bridging indicates a disease level lower than the threshold (step S404, No), the display control function 455d displays at least one of FFR and WSS calculated based on each of the coronary CT image at the end of diastole and the coronary CT image at the end of systole by the calculation function 455b (step S408). This process is realized, for example, by the processing circuit 455 calling and executing a program corresponding to the display control function 455d from the storage circuit 152.

[0208] As described above, in the fourth embodiment, the medical image processing apparatus 450 displays FFR or WSS calculated based on a medical image of a specific cardiac phase according to the degree of a heart-related disease. Thereby, when making a diagnosis or formulating a treatment plan for a heart disease, information on a cardiac phase suitable for each disease can be automatically displayed. Therefore, according to the fourth embodiment, the labor of the user when making a diagnosis or formulating a treatment plan for a heart disease can be reduced.

[0209] (Modification Example 1 of the Fourth Embodiment) In the above-described fourth embodiment, an example in which the cardiac phase of the coronary CT image for displaying FFR or WSS is determined according to the degree of myocardial bridging has been described. However, the embodiment is not limited to this.

[0210] For example, as a modification example 1 of the fourth embodiment, the medical image processing apparatus 150 may display FFR or WSS according to the degree of valvular disease of each valve included in the heart valve.

[0211] For example, the extraction function 455c extracts the degree of valvular disease of each valve included in the heart valve from the coronary CT image of the subject acquired by the acquisition function 155a as the degree of the disease related to the heart.

[0212] Specifically, the extraction function 455c extracts the disease degree indicating the degree of valvular disease of each valve by analyzing the coronary CT image of the subject. Further, for example, the extraction function 455c extracts the presence probability as the disease degree indicating the degree of valvular disease. At this time, for example, the extraction function 455c may extract the presence probability based on the CT value distribution in each valve, or may extract the presence probability using a discriminator that has previously learned the characteristics of images with and without valvular disease by a machine learning technique.

[0213] Note that in this modification example, the disease degree indicating the degree of valvular disease extracted by the extraction function 455c is not limited to the presence probability, and any value may be used as long as it is what the user requires for controlling the display of FFR and WSS described later. For example, the extraction function 455c may directly assign a value to be used as the disease degree from the result of a diagnosis separately performed on the subject by a user such as a doctor, or may extract a value indicating the severity of valvular disease from the Perfusion Index obtained from the coronary CT image as the disease degree.

[0214] Further, when the degree of valvular disease indicating the degree of aortic valve valvular disease extracted by the extraction function 455c is high, the calculation function 455b reconstructs the coronary CT image at the end of systole, and based on the reconstructed coronary CT image, calculates at least one of FFR and WSS. Further, when the degree of valvular disease indicating the degree of mitral valve valvular disease extracted by the extraction function 455c is high, the calculation function 455b reconstructs the coronary CT image at the end of diastole, and based on the reconstructed coronary CT image, calculates at least one of FFR and WSS.

[0215] For example, the calculation function 455b reconstructs the coronary CT image at a specific cardiac phase according to the probability of valvular disease of each valve extracted by the extraction function 455c, and calculates FFR and WSS based on the coronary CT image. At this time, for example, when the probability of aortic valve valvular disease is higher than a preset threshold, the calculation function 455b reconstructs the coronary CT image at the end of systole, and calculates FFR and WSS based on the coronary CT image. Further, when the probability of mitral valve valvular disease is lower than the threshold, the calculation function 455b reconstructs the coronary CT image at the end of diastole, and calculates FFR and WSS based on the coronary CT image. This is to facilitate the evaluation of the influence of FFR and WSS on the opening and closing of various valves.

[0216] Then, when the degree of valvular disease indicating the degree of aortic valve valvular disease is high, the display control function 455d displays at least one of FFR and WSS calculated based on the coronary CT image at the end of systole by the calculation function 455b. Further, when the degree of valvular disease indicating the degree of mitral valve valvular disease is low, the display control function 455d displays at least one of FFR and WSS calculated based on the coronary CT image at the end of diastole by the calculation function 455b.

[0217] FIG. 27 is a diagram showing an example of information display performed by the display control function 455d according to Modification 1 of the fourth embodiment.

[0218] For example, as shown in FIG. 27, the display control function 455d determines the type of information to be displayed on the display 154 based on the probability of the presence of valvular disease of each valve extracted by the extraction function 455c. At this time, for example, when the probability of the presence of valvular disease of the aortic valve is higher than a preset threshold value (aortic valve abnormality), the display control function 455d determines the type of the image to be displayed based on the WSS calculated from the coronary artery CT image at the end-systolic point by the calculation function 455b. Further, when the probability of the presence of valvular disease of the mitral valve is higher than a preset threshold value (mitral valve abnormality), the display control function 455d determines the type of the image to be displayed based on the WSS calculated from the coronary artery CT image at the end-diastolic point by the calculation function 455b. Note that, for example, the calculation function 455b may determine the type of the image to be displayed based on the FFR, or may determine it based on both the FFR and the WSS.

[0219] Then, the display control function 455d displays the determined type of information on the display 154. For example, the display control function 455d displays the determined type of information in the same manner as in the first embodiment and its modification.

[0220] Note that in the above-described fourth embodiment and its modification, an example in which the determination regarding the display of the FFR and the WSS is made according to the degree of myocardial bridging and the degree of valvular disease of each valve included in the heart valve has been described, but the embodiment is not limited thereto. For example, if it is possible to determine the cardiac phase to be reconstructed based on information obtained in advance (before the calculation of the FFR and the WSS) such as the original image and patient information, the determination regarding the display of the FFR and the WSS may be made according to any state.

[0221] (Fifth Embodiment) Further, for example, in the above-described first embodiment, an example in which the WSS is displayed using an image showing the coronary artery has been described, but the embodiment is not limited thereto.

[0222] For example, the medical image processing apparatus 150 may display the relationship between the distance along the coronary artery from a reference position at a predetermined position on the coronary artery and the magnitude of the WSS at the predetermined position. A graph may be used as the display form. Hereinafter, such an example will be described as the fifth embodiment. In the following, the configuration of the medical image processing system and the medical image processing apparatus according to the fifth embodiment will be mainly described with respect to the differences from the first embodiment, and the same reference numerals will be given to the common configurations, and detailed descriptions thereof will be omitted.

[0223] In the present embodiment, for example, when the degree of the coronary artery disease extracted by the extraction function 155c is low, the display control function 155d displays a graph on the display 154 with the vertical axis representing the magnitude of the WSS and the horizontal axis representing the distance along the coronary artery from the reference position. Further, information indicating the range of the distance at which the third index value related to the blood vessel is an abnormal value is displayed on the display 154 together with the graph.

[0224] Here, for example, the third index value is an index value indicating a lesion portion generated in the coronary artery. For example, the third index value is the CT value of the coronary artery wall, and when the index value indicates the CT value in the range indicating a plaque or the CT value in the range indicating calcium, it is determined as an abnormal value.

[0225] FIG. 28 is a diagram showing an example of information display performed by the display control function 155d according to the fifth embodiment.

[0226] For example, as shown in FIG. 28, the display control function 155d displays a graph showing the relationship between the magnitude of the WSS and the distance with a curve having the vertical axis representing the magnitude of the WSS and the horizontal axis representing the distance along the coronary artery from the reference position, based on the WSS calculated by the calculation function 155b.

[0227] Further, the display control function 155d superimposes and displays information indicating the range of the distance at which the third index value is an abnormal value at a position on the graph indicating the distance.

[0228] For example, as shown in FIG. 28, based on the coronary artery CT image of the subject acquired by the acquisition function 155a, the display control function 155d displays information indicating the distance along the coronary artery from a reference position at a position on the coronary artery having a CT value indicating plaque and information indicating the distance along the coronary artery from a reference position at a position on the coronary artery having a CT value indicating calcium, superimposed on positions on a graph indicating the distance.

[0229] For example, the display control function 155d displays information indicating the distance along the coronary artery from a reference position at a position on the coronary artery having a CT value indicating plaque and information indicating the distance along the coronary artery from a reference position at a position on the coronary artery having a CT value indicating calcium in different display modes. For example, the display control function 155d displays regions indicating respective ranges in different colors, patterns, or textures.

[0230] Here, an example of the case where information indicating a range in which the third index value is an abnormal value is superimposed and displayed on a graph has been described, but the embodiment is not limited to this. For example, the display control function 155d may display information indicating a range in which the third index value is an abnormal value side by side above or below a graph corresponding to a position of the distance along the coronary artery from the reference position.

[0231] Also, here, an example of the case where the third index value is an index value indicating a lesion occurring in the coronary artery has been described, but the embodiment is not limited to this.

[0232] For example, the third index value may be an index value calculated from changes in blood pressure, blood flow, shape, or position of the coronary artery. For example, the third index value may be a value of a fluid parameter such as FFR, pressure, or flow velocity. Also, for example, the third index value may be a value of a shape parameter such as the curvature, stenosis rate, outer diameter, inner diameter, or cross-sectional area of the blood vessel. Also, for example, the third index value may be the amount of movement of the blood vessel accompanying the movement of the heart.

[0233] Furthermore, for example, the third index value may be an index value predicted by performing virtual surgery or treatment on the coronary artery using a coronary CT image. For example, the third index value may be a value such as a fluid parameter or a shape parameter after surgery or treatment predicted by performing a virtual surgery simulation or a treatment simulation using a coronary CT image.

[0234] In this case, for example, the display control function 155d receives from the operator the position where a treatment device such as a stent or a balloon is to be placed on the coronary artery using a coronary CT image, and displays information indicating the position where the treatment device is to be placed on a graph showing the relationship between the distance along the coronary artery from a reference position at a predetermined position on the coronary artery and the magnitude of the WSS at the predetermined position. Then, the display control function 155d further overlays and displays on the graph information indicating a range in which values such as fluid parameters and shape parameters after placement of the treatment device calculated by performing a surgery simulation or a treatment simulation are abnormal values.

[0235] (Modification of the Fifth Embodiment) Note that in the above-described fifth embodiment, an example of the case of displaying a graph showing the relationship between the distance along the coronary artery from a reference position at a predetermined position on the coronary artery at one point in time and the magnitude of the WSS at the predetermined position has been described, but the embodiment is not limited thereto.

[0236] For example, when the degree of the coronary artery disease extracted by the extraction function 155c is low, the display control function 155d may create a graph showing the relationship between the magnitude of the WSS and the distance along the coronary artery from the reference position, with the magnitude of the WSS on the vertical axis and the distance along the coronary artery from the reference position on the horizontal axis, at each of a plurality of different points in time, and display it on the display 154 for each of the points in time.

[0237] FIG. 29 is a diagram showing an example of information display performed by the display control function 155d according to a modification of the fifth embodiment.

[0238] For example, as shown in FIG. 29, the display control function 155d creates, for each of a plurality of different cardiac phases included in one heartbeat, a graph showing the relationship between the magnitude of the WSS and the distance along the coronary artery from a reference position, with the vertical axis being the magnitude of the WSS and the horizontal axis being the distance along the coronary artery from the reference position, based on the WSS calculated from the coronary CT images of a plurality of time phases by the calculation function 155b, and overlays and displays the respective graphs.

[0239] Also, for example, the display control function 155d further displays, together with the graph, information indicating a range in which the temporal variation amount of the WSS exceeds a threshold value at a distance along the coronary artery from the reference position. For example, the display control function 155d overlays and displays, on the graph, information indicating a range in which the temporal variation amount of the WSS exceeds a threshold value at a distance along the coronary artery from the reference position, at a position indicating the distance.

[0240] For example, as information indicating a range in which the temporal variation amount of the WSS exceeds a threshold value, the display control function 155d displays a region indicating the range in a predetermined display mode. For example, the display control function 155d displays a region indicating the range in a predetermined color, pattern, or texture.

[0241] Here, for example, the display control function 155d may further display, together with the graph, information indicating a range of the distance along the coronary artery from a reference position where a third index value related to the blood vessel has an abnormal value, in the same manner as in the fifth embodiment described above.

[0242] Note that, here, an example in which information indicating changes in the WSS is displayed for each of a plurality of different cardiac phases included in one heartbeat as a plurality of different time points has been described, but the embodiment is not limited to this. For example, the plurality of different time points may be time points before and after surgery or treatment (for example, drug treatment, etc.), or may be time points at predetermined time intervals (for example, fixed intervals such as one month).

[0243] In addition, in the above-described fifth embodiment and modification, an example of the case where information indicating the change in WSS for one blood vessel is displayed has been described, but the embodiment is not limited thereto. For example, for a plurality of blood vessels, information indicating the change in WSS may be displayed. Here, for example, the plurality of blood vessels may be a plurality of branches of the coronary artery included in the coronary artery.

[0244] In this case, for example, the display control function 155d displays information such as WSS and the third index value for each of the plurality of blood vessels by the display method described in the above-described fifth embodiment or modification. At this time, for example, the display control function 155d arranges information indicating the change in WSS for the plurality of blood vessels in a plurality of graphs or displays them superimposed in one graph.

[0245] In addition, in the above-described fifth embodiment and modification, for example, the display control function 155d may further display a cross-sectional image of the coronary artery corresponding to the position of the distance along the coronary artery from the reference position. Here, for example, the cross-sectional image may be a curved MPR image of the coronary artery.

[0246] (Sixth Embodiment) In addition, each of the above-described embodiments and modifications may be implemented independently, or one or a plurality of embodiments and modifications may be appropriately combined and implemented.

[0247] For example, after displaying FFR or WSS by any of the methods described in the above-described embodiments and modifications, when a predetermined condition is satisfied, FFR or WSS may be further displayed automatically or in response to an instruction from the user by another method.

[0248] As a specific example, for example, in the first embodiment, when the disease degree indicating the degree of coronary artery disease is higher than the first threshold value, the display control function 155d may receive an instruction from the user to display FFR and display FFR or WSS by any of the methods of Modifications 1 to 6 while displaying FFR. Then, the display control function 155d may further display FFR and WSS by the method instructed by the user.

[0249] Also, for example, in the second embodiment, when the imaging time of the coronary CT image is before the treatment of the subject, the display control function 255d may display the predicted FFR and predicted WSS, and receive an instruction from the user to display the FFR and WSS by any one of Modification Examples 1 to 4. Then, the display control function 255d may further display the FFR and WSS by the method instructed by the user.

[0250] Also, for example, in the third embodiment, when the display control function 355d displays the FFR and WSS for each coronary artery branch, it may receive an instruction from the user to display the FFR and WSS for each branch by any one of Modification Examples 1 to 2. Then, the display control function 355d may further display the FFR and WSS by the method instructed by the user.

[0251] Also, for example, in the fourth embodiment, when the disease degree indicating the degree of myocardial bridge is higher than the threshold value, the display control function 455d may display the FFR and WSS calculated based on the coronary CT image at the end of diastole, and receive an instruction from the user to display the FFR and WSS by the method of Modification Example 1. Then, when the display control function 455d receives the instruction from the user, it may further display the FFR and WSS according to the disease degree indicating the degree of valvular disease of each valve.

[0252] Also, for example, in a state where the display control function displays the FFR and WSS by any one of the methods of the first to fifth embodiments, it may receive an instruction from the user to display the FFR and WSS by any one of the other embodiments or modification examples. Also in this case, the display control function may further display the FFR and WSS by the method instructed by the user.

[0253] In any of the above examples, when a predetermined condition is satisfied in a state where the display control function displays the FFR and WSS by any method, the display control function may automatically further display the FFR and WSS by another predetermined method.

[0254] (Seventh Embodiment) In the above-described embodiments and modifications, an example in which the medical image processing apparatus displays FFR and WSS on a display provided in the apparatus itself has been described. However, the embodiments are not limited to this.

[0255] For example, the medical information display apparatus may acquire and display FFR and WSS from the medical image processing apparatus via a network.

[0256] Specifically, in the present embodiment, the medical image processing apparatus extracts the degree of coronary artery disease from a medical image in response to a request transmitted from the medical information display apparatus, and based on the medical image, as information related to blood flow, when the degree of coronary artery myocardial disease is high, calculates FFR, and when the degree of coronary artery disease is low, calculates WSS. Then, the medical information display apparatus acquires information related to blood flow from the medical image processing apparatus and displays it on a display provided in the apparatus itself.

[0257] In this case, for example, the medical image processing apparatus and the medical information display apparatus may be realized as a client-server system in which the medical image processing apparatus is a server and the medical information processing apparatus is a client.

[0258] (Other Embodiments) In the above-described embodiments and modifications, an example in which a coronary CT image is used as the medical image has been described. However, the embodiments are not limited to this. For example, any type of medical image may be used as long as it is an image from which information such as the shape of blood vessels and flow information such as blood flow velocity can be calculated. For example, an ultrasonic image obtained by an ultrasonic diagnostic image or an MR image obtained by an MRI apparatus may be used. Further, the target site may be not only the blood vessels of the heart but also the blood vessels of other sites such as cerebral blood vessels, hepatic arteries, and portal veins.

[0259] In addition, in the above-described embodiments and modifications, an example in which FFR is used as the first index value that is switched or simultaneously displayed with the WSS has been described. However, the embodiments are not limited to this. For example, any index value related to blood vessels calculated from blood pressure or blood flow may be used.

[0260] According to the above-described embodiments and modifications, for example, since the WSS and information related to various blood flows can be displayed at an appropriate time or in an appropriate display form, the labor of the user can be reduced. Also, for example, since the information to be displayed can be automatically changed according to the characteristics of the coronary CT image that is the analysis source image, the user can obtain the necessary information at the necessary timing. Further, for example, since the WSS calculated from the coronary CT image can be displayed together with different information related to the coronary artery, it is possible to more appropriately support diagnosis by a doctor, formulation of a treatment plan, determination of treatment effect, and the like.

[0261] Note that, in the above-described embodiments and modifications, an example in which the extraction unit, display control unit, identification unit, prediction unit, and derivation unit in this specification are realized by the extraction function, display control function, identification function, prediction function, and derivation function of a processing circuit has been described. However, the embodiments are not limited to this. For example, the extraction unit, display control unit, identification unit, prediction unit, and derivation unit in this specification may realize the same functions not only by the extraction function, display control function, identification function, prediction function, and derivation function described in the embodiments, but also by only hardware, only software, or a combination of hardware and software.

[0262] Also, the term "processor" used in the description of the above-described embodiments means, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or a circuit such as an application specific integrated circuit (ASIC), a programmable logic device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)). Here, instead of storing a program in a storage circuit, the program may be directly incorporated into the circuit of the processor. In this case, the processor realizes its function by reading and executing the program incorporated in the circuit. Also, each processor of the present embodiment is not limited to being configured as a single circuit for each processor, and a plurality of independent circuits may be combined to be configured as one processor to realize its function.

[0263] Here, the program executed by the processor is provided by being pre - incorporated into a ROM (Read Only Memory), a memory circuit, or the like. Note that this program may be provided by being recorded on a computer - readable non - transitory storage medium such as a CD (Compact Disk) - ROM, an FD (Flexible Disk), a CD - R (Recordable), a DVD (Digital Versatile Disk) in a form installable or executable on these devices. Also, this program may be stored on a computer connected to a network such as the Internet and provided or distributed by being downloaded via the network. For example, this program is composed of modules including the above - described respective processing functions. As actual hardware, the CPU reads the program from a storage medium such as a ROM and executes it, whereby each module is loaded onto the main storage device and generated on the main storage device.

[0264] Also, in the above - described embodiments and modifications, each component of each illustrated device is conceptually functional and does not necessarily have to be physically configured as shown in the figures. That is, the specific form of the dispersion or integration of each device is not limited to that shown in the figures, and all or part of it can be functionally or physically dispersed or integrated in any unit according to various loads, usage situations, etc. Furthermore, all or any part of each processing function performed by each device can be realized by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware by wired logic.

[0265] Also, among the respective processes described in the above - described embodiments and modifications, all or part of the processes described as being automatically performed can be manually performed, or all or part of the processes described as being manually performed can be automatically performed by a known method. In addition, regarding the processing procedures, control procedures, specific names, information including various data and parameters shown in the above - mentioned documents and drawings, they can be arbitrarily changed unless otherwise specified.

[0266] According to at least one of the embodiments described above, it is possible to reduce the labor of the user when making a diagnosis regarding heart disease, formulating a treatment plan, and the like.

[0267] Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and their modifications are included in the scope and gist of the invention, as well as in the invention described in the claims and the equivalent scope thereof.

[0268] Regarding the above embodiments, the following supplementary notes are disclosed as one aspect and selective features of the invention.

[0269] (Supplementary Note 1) An extraction unit that extracts the degree of a disease related to the heart from a medical image, As information regarding the blood flow of blood vessels calculated based on the medical image, when the degree of the disease related to the heart is high, a first index value related to the blood vessels calculated from blood pressure or blood flow is displayed, and when the degree of the disease related to the heart is low, wall shear stress is displayed as a second index value related to the blood vessels, and a display control unit. Medical image processing apparatus. (Supplementary Note 2) The display control unit may display the first index value when the degree of the disease related to the heart is higher than a first threshold value, display the second index value when the degree of the disease related to the heart is lower than a second threshold value smaller than the first threshold value, and display the first index value and the second index value when the degree of the disease related to the heart is between the first threshold value and the second threshold value. (Supplementary Note 3) When the degree of the disease related to the heart is high, the display control unit may further display at least one of the one-dimensional first index value and the one-dimensional second index value. When the degree of the disease related to the heart is low, the display control unit may further display at least one of the three-dimensional first index value and the three-dimensional second index value. (Appendix 4) The display control unit may further display the first index value and the second index value simultaneously. When the degree of the disease related to the heart is high, the display area of the first index value may be made larger than the display area of the second index value. When the degree of the disease related to the heart is low, the display area of the second index value may be made larger than the display area of the first index value. (Appendix 5) The display control unit may display the first index value and the second index value in different display forms. (Appendix 6) The display control unit may further display an image showing the blood vessel, and may display the first index value and the second index value on the image either superimposed or side by side. (Appendix 7) The display control unit may further receive an operation for selecting the type of information to be displayed from the user, and may display at least one of the first index value and the second index value according to the received operation. (Appendix 8) The display control unit may further receive an operation for switching the display of the first index value and the second index value from the user, and may switch from a state of displaying either one of the first index value and the second index value to a state of displaying the other according to the received operation. (Appendix 9) The medical image processing apparatus an identification unit that identifies whether the imaging time of the medical image is before or after the treatment of the subject; a prediction unit that, when it is identified that the imaging time of the medical image is before the treatment of the subject, calculates at least one of a first predicted index value that is a first index value after treatment and a second predicted index value that is a second index value after treatment by performing virtual treatment on the blood vessel using the medical image may further include when the imaging time of the medical image is identified to be before the treatment of the subject, the display control unit may further display at least one of the first prediction index value and the second prediction index value. (Appendix 10) When the imaging time is identified to be before the treatment of the subject, the display control unit displays at least one of the first index value and the second index value calculated based on the medical image, and at least one of the first prediction index value and the second prediction index value; when the imaging time is identified to be after the treatment of the subject, the display control unit may display at least one of the first index value and the second index value calculated based on the medical image. (Appendix 11) When the imaging time is identified to be before the treatment of the subject, the display control unit may further display at least one of the three-dimensional first index value and the three-dimensional second index value; when the imaging time is identified to be after the treatment of the subject, the display control unit may further display at least one of the one-dimensional first index value and the one-dimensional second index value. (Appendix 12) After it is determined by the display control unit to display at least one of the first prediction index value and the second prediction index value, the prediction unit may calculate at least one of the first prediction index value and the second prediction index value. (Appendix 13) The prediction unit may receive an operation of inputting parameters used when performing the virtual treatment from a user, and calculate at least one of the first prediction index value and the second prediction index value using the received parameters. (Appendix 14) When the imaging time is identified to be after the treatment of the subject, the display control unit may further display at least one of the first index value and the second index value calculated based on the pre-treatment medical image and at least one of the first index value and the second index value calculated based on the post-treatment medical image. (Appendix 15) The medical image processing apparatus Based on the medical image, a derivation unit may be further provided to derive the position and rupture probability of the plaque generated in each blood vessel branch of the coronary artery for each blood vessel branch. The display control unit may display the first index value or the second index value according to the position and rupture probability of the plaque for each blood vessel branch. (Appendix 16) For the blood vessel branch where the plaque with a high rupture probability exists, the display control unit may display the first index value, and for the blood vessel branch where no plaque exists or the plaque with a low rupture probability exists, the display control unit may display the second index value. (Appendix 17) For the blood vessel branch where the plaque with a high rupture probability exists, the display control unit may display a first representative value of the first index value or the second index value in the blood vessel branch, and for the blood vessel branch where no plaque exists and the blood vessel branch where the plaque with a low rupture probability exists, the display control unit may display a second representative value different from the first representative value of the first index value or the second index value in the blood vessel branch. (Appendix 18) For the blood vessel branch where the plaque with a high rupture probability exists, the display control unit may further display a medical image captured by a first medical imaging device or information obtained from the medical image, and for the blood vessel branch where no plaque exists and the blood vessel branch where the plaque with a low rupture probability exists, the display control unit may further display a medical image captured by a second medical imaging device different from the first medical imaging device or information obtained from the medical image. (Appendix 19) The display control unit may further display at least one of the first index value and the second index value calculated based on a medical image of a specific cardiac phase reconstructed according to the degree of the disease related to the heart. (Appendix 20) The extraction unit extracts the degree of myocardial bridging as the degree of the disease related to the heart. When the degree of the myocardial bridge is high, the display control unit displays at least one of a first index value and a second index value calculated based on a medical image at the end of diastole, and when the degree of the myocardial bridge is low, at least one of a first index value and a second index value calculated based on each of a medical image at the end of diastole and a medical image at the end of systole may be displayed. (Appendix 21) The extraction unit extracts, as the degree of the disease related to the heart, the degree of valvular disease of each valve included in the heart valve. When the degree of valvular disease of the aortic valve is high, the display control unit displays at least one of a first index value and a second index value calculated based on a medical image at the end of systole, and when the degree of valvular disease of the mitral valve is low, at least one of a first index value and a second index value calculated based on a medical image at the end of diastole may be displayed. (Appendix 22) When the degree of the disease related to the heart is low, the display control unit displays a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis, and further, information indicating a range of the distance at which a third index value related to the blood vessel is an abnormal value may be displayed together with the graph. (Appendix 23) When the degree of the disease related to the heart is low, the display control unit may display, for each of a plurality of different time points, a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis. (Appendix 24) The display control unit may further display, together with the graph, information indicating a range in which the temporal variation amount of the wall shear stress exceeds a threshold value at the distance. (Appendix 25) The display control unit may further display, together with the graph, information indicating a range in which a third index value related to the blood vessel is an abnormal value at the distance. (Appendix 26) The display control unit may also display information indicating a range in which the third index value is an abnormal value at the distance, superimposed on the graph at the position indicating the distance. (Appendix 27) The third index value may be an index value indicating a lesion generated in the blood vessel, an index value calculated from changes in blood pressure, blood flow, shape, or position of the blood vessel, or an index value predicted by performing virtual surgery or treatment on the blood vessel using the medical image. (Appendix 28) A display control unit is provided that displays, as information regarding the blood flow of a blood vessel calculated based on a medical image, a first index value regarding the blood vessel calculated from blood pressure or blood flow and wall shear stress as a second index value regarding the blood vessel. The display control unit switches and displays the first index value and the second index value based on information regarding the subject. Medical image processing apparatus. (Appendix 29) A medical image processing system including a medical image processing apparatus and a medical information display apparatus, wherein the medical image processing apparatus extracts the degree of a disease related to the heart from a medical image, and, as information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the disease related to the heart is high, calculates a first index value regarding the blood vessel calculated from blood pressure or blood flow, and when the degree of the disease related to the heart is low, calculates wall shear stress as a second index value regarding the blood vessel. wherein the medical information display apparatus acquires and displays information regarding the blood flow of the blood vessel from the medical image processing apparatus. Medical image processing system. (Appendix 30) Extracts the degree of a disease related to the heart from a medical image, As information regarding the blood flow in blood vessels calculated based on the medical image, when the degree of the disease related to the heart is high, display a first index value related to the blood vessels calculated from blood pressure or blood flow, and when the degree of the disease related to the heart is low, display wall shear stress as a second index value related to the blood vessels. A medical image processing method including this.

Explanation of symbols

[0270] 100, 200, 300, 400 Medical image processing system 140 Medical information display device 150, 250, 350, 450 Medical image processing device 155, 255, 355, 455 Processing circuit 155c, 455c Extraction function 155d, 255d, 355d, 455d Display control function 255e Identification function 255f Prediction function 355g Derivation function

Claims

1. An extraction unit that extracts the degree of a heart-related disease from a medical image, As information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the heart-related disease is high, a first index value regarding the blood vessel calculated from blood pressure or blood flow is displayed, and when the degree of the heart-related disease is low, wall shear stress is displayed as a second index value regarding the blood vessel. A display control unit, An identification unit that identifies whether the imaging time of the medical image is before or after the treatment of the subject, When it is identified that the imaging time of the medical image is before the treatment of the subject, by performing virtual treatment on the blood vessel using the medical image, at least one of a first predicted index value that is a first index value after treatment and a second predicted index value that is a second index value after treatment is calculated. A prediction unit Comprising, When it is identified that the imaging time of the medical image is before the treatment of the subject, the display control unit further displays at least one of the first predicted index value and the second predicted index value. A medical image processing apparatus.

2. An extraction unit that extracts the degree of a heart-related disease from a medical image, As information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the heart-related disease is high, a first index value regarding the blood vessel calculated from blood pressure or blood flow is displayed, and when the degree of the heart-related disease is low, wall shear stress is displayed as a second index value regarding the blood vessel. A display control unit Comprising, When the degree of the heart-related disease is low, the display control unit displays, for each of a plurality of different time points, a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis. A medical image processing apparatus.

3. When the disease degree indicating the degree of the heart-related disease is higher than a first threshold value, the display control unit displays the first index value, and when the disease degree indicating the degree of the heart-related disease is lower than a second threshold value lower than the first threshold value, the display control unit displays the second index value. When the disease degree indicating the degree of the heart-related disease is between the first threshold value and the second threshold value, the display control unit displays the first index value and the second index value. The medical image processing apparatus according to Claim 1 or 2.

4. When the degree of disease indicating the degree of the disease related to the heart is high, the display control unit further displays at least one of the one-dimensional first index value and the one-dimensional second index value. When the degree of disease indicating the degree of the disease related to the heart is low, the display control unit further displays at least one of the three-dimensional first index value and the three-dimensional second index value. The medical image processing apparatus according to any one of claims 1 to 3.

5. The display control unit further simultaneously displays the first index value and the second index value, and when the degree of disease indicating the degree of the disease related to the heart is high, makes the display area of the first index value larger than the display area of the second index value. When the degree of disease indicating the degree of the disease related to the heart is low, makes the display area of the second index value larger than the display area of the first index value. The medical image processing apparatus according to any one of claims 1 to 4.

6. The display control unit displays the first index value and the second index value in different display forms. The medical image processing apparatus according to any one of claims 1 to 5.

7. The display control unit further displays an image showing the blood vessel, and superimposes or arranges the first index value and the second index value on the image. The medical image processing apparatus according to any one of claims 1 to 6.

8. The display control unit further receives from the user an operation for selecting the type of information to be displayed, and in response to the received operation, displays at least one of the first index value and the second index value. The medical image processing apparatus according to any one of claims 1 to 7.

9. The display control unit further receives from the user an operation for switching the display of the first index value and the second index value, and in response to the received operation, switches from a state of displaying either the first index value or the second index value to a state of displaying the other. The medical image processing apparatus according to any one of claims 1 to 8.

10. An identification unit that identifies whether the imaging time point of the medical image is before or after the treatment of the subject; A prediction unit that, when it is identified that the imaging time point of the medical image is before the treatment of the subject, calculates at least one of a first predicted index value that is the first index value after treatment and a second predicted index value that is the second index value after treatment by performing virtual treatment on the blood vessel using the medical image. The medical image processing apparatus further comprises: When it is identified that the imaging time of the medical image is before the treatment of the subject, the display control unit further displays at least one of the first predicted index value and the second predicted index value. The medical image processing apparatus according to claim 2.

11. When it is identified that the imaging time is before the treatment of the subject, the display control unit displays at least one of the first index value and the second index value calculated based on the medical image and at least one of the first predicted index value and the second predicted index value; when it is identified that the imaging time is after the treatment of the subject, the display control unit displays at least one of the first index value and the second index value calculated based on the medical image. The medical image processing apparatus according to claim 1 or 10.

12. When it is identified that the imaging time is before the treatment of the subject, the display control unit further displays at least one of the three-dimensional first index value and the three-dimensional second index value; when it is identified that the imaging time is after the treatment of the subject, the display control unit further displays at least one of the one-dimensional first index value and the one-dimensional second index value. The medical image processing apparatus according to claim 1, 10 or 11.

13. After it is determined by the display control unit to display at least one of the first predicted index value and the second predicted index value, the prediction unit calculates at least one of the first predicted index value and the second predicted index value. The medical image processing apparatus according to any one of claims 1, 10 to 12.

14. The prediction unit receives, from the user, an operation of inputting parameters used when performing the virtual treatment, and calculates at least one of the first predicted index value and the second predicted index value using the received parameters. The medical image processing apparatus according to any one of claims 1, 10 to 13.

15. When it is identified that the imaging time is after the treatment of the subject, the display control unit further displays at least one of the first index value and the second index value calculated based on the pre-treatment medical image and at least one of the first index value and the second index value calculated based on the post-treatment medical image. The medical image processing apparatus according to any one of claims 1, 10 to 14.

16. The apparatus further includes a derivation unit that derives, for each coronary artery branch based on the medical image, the position and rupture probability of plaque generated in each branch. The display control unit displays the first index value or the second index value according to the position and rupture probability of the plaque for each blood vessel branch. The medical image processing apparatus according to any one of claims 1 to 15.

17. The display control unit displays the first index value for a blood vessel branch in which a plaque with a high rupture probability exists, and displays the second index value for a blood vessel branch in which no plaque exists or a plaque with a low rupture probability exists. The medical image processing apparatus according to claim 16.

18. The display control unit displays a first representative value of the first index value or the second index value in the blood vessel branch for a blood vessel branch in which a plaque with a high rupture probability exists, and for a blood vessel branch in which no plaque exists and a blood vessel branch in which a plaque with a low rupture probability exists, displays a second representative value different from the first representative value of the first index value or the second index value in the blood vessel branch. The medical image processing apparatus according to claim 16.

19. The display control unit further displays a medical image captured by a first medical image diagnostic apparatus or information obtained from the medical image for a blood vessel branch in which a plaque with a high rupture probability exists, and for a blood vessel branch in which no plaque exists and a blood vessel branch in which a plaque with a low rupture probability exists, further displays a medical image captured by a second medical image diagnostic apparatus different from the first medical image diagnostic apparatus or information obtained from the medical image. The medical image processing apparatus according to any one of claims 16 to 18.

20. The display control unit further displays at least one of a first index value and a second index value calculated based on a medical image of a specific cardiac phase reconstructed according to the degree of the disease related to the heart. The medical image processing apparatus according to any one of claims 1 to 19.

21. The extraction unit extracts the degree of myocardial bridging as the degree of the disease related to the heart. When the disease degree indicating the degree of myocardial bridging is high, the display control unit displays at least one of a first index value and a second index value calculated based on a medical image at the end of diastole, and when the disease degree indicating the degree of myocardial bridging is low, displays at least one of a first index value and a second index value calculated based on each of a medical image at the end of diastole and a medical image at the end of systole. The medical image processing apparatus according to claim 20.

22. The extraction unit extracts the degree of valvular disease of each valve included in the heart valve as the degree of the disease related to the heart. When the degree of disease indicating the degree of valvular disease of the aortic valve is high, the display control unit displays at least one of a first index value and a second index value calculated based on a medical image at the end of systole. When the degree of disease indicating the degree of valvular disease of the mitral valve is low, the display control unit displays at least one of a first index value and a second index value calculated based on a medical image at the end of diastole. The medical image processing apparatus according to claim 20.

23. When the degree of the disease related to the heart is low, the display control unit displays a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis. Further, the display control unit displays information indicating a range of the distance at which a third index value related to the blood vessel is an abnormal value, together with the graph. The medical image processing apparatus according to any one of claims 1 to 3.

24. When the degree of the disease related to the heart is low, the display control unit displays, for each of a plurality of different time points, a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis. The medical image processing apparatus according to claim 1.

25. The display control unit further displays, together with the graph, information indicating a range in which the temporal variation amount of the wall shear stress exceeds a threshold value at the distance. The medical image processing apparatus according to claim 2 or 24.

26. The display control unit further displays, together with the graph, information indicating a range in which a third index value related to the blood vessel is an abnormal value at the distance. The medical image processing apparatus according to claim 2, 24 or 25.

27. The display control unit displays, overlapping with the graph at a position indicating the distance, information indicating a range in which the third index value is an abnormal value at the distance. The medical image processing apparatus according to claim 23 or 26.

28. The third index value is an index value indicating a lesion portion generated in the blood vessel, an index value calculated from changes in blood pressure, blood flow, shape, or position of the blood vessel, or an index value predicted by performing a virtual surgery or treatment on the blood vessel using the medical image. The medical image processing apparatus according to any one of claims 23, 26, and 27.

29. As information regarding the blood flow in blood vessels calculated based on a medical image, a display control unit that displays a first index value regarding the blood vessels calculated from blood pressure or blood flow and wall shear stress as a second index value regarding the blood vessels; An identification unit that identifies whether the imaging time point of the medical image is before or after the treatment of the subject; When the imaging time point of the medical image is before the treatment of the subject, by performing a virtual treatment on the blood vessels using the medical image, at least one of a first predicted index value that is the first index value after treatment and a second predicted index value that is the second index value after treatment is calculated. A prediction unit; Comprising; When the imaging time point of the medical image is before the treatment of the subject, the display control unit displays at least one of the first predicted index value and the second predicted index value calculated by the prediction unit as information regarding the subject. Medical image processing apparatus.

30. The first index value is a value corresponding to the blood flow reserve ratio. The medical image processing apparatus according to claim 29.

31. When the imaging time point is identified as being before the treatment of the subject, the display control unit displays at least one of the first index value and the second index value calculated based on the medical image and at least one of the first predicted index value and the second predicted index value. When the imaging time point is identified as being after the treatment of the subject, at least one of the first index value and the second index value calculated based on the medical image is displayed. The medical image processing apparatus according to claim 29 or 30.

32. When the imaging time point is identified as being before the treatment of the subject, the display control unit displays at least one of the three-dimensional first index value and the three-dimensional second index value. When the imaging time point is identified as being after the treatment of the subject, the display control unit displays at least one of the one-dimensional first index value and the one-dimensional second index value. The medical image processing apparatus according to any one of claims 29 to 31.

33. After it is determined that the display control unit displays at least one of the first predicted index value and the second predicted index value, the prediction unit calculates at least one of the first predicted index value and the second predicted index value. The medical image processing apparatus according to any one of claims 29 to 32.

34. The prediction unit receives an operation for inputting parameters used when performing the virtual treatment from a user, and calculates at least one of the first prediction index value and the second prediction index value using the received parameters. The medical image processing apparatus according to any one of Claims 29 to 33.

35. When it is identified that the imaging time point is after the treatment of the subject, the display control unit displays at least one of the first index value and the second index value calculated based on the medical image before the treatment and at least one of the first index value and the second index value calculated based on the medical image after the treatment. The medical image processing apparatus according to any one of Claims 29 to 34.

36. A display control unit that displays, as information regarding the blood flow of a blood vessel calculated based on a medical image, a first index value regarding the blood vessel calculated from blood pressure or blood flow and wall shear stress as a second index value regarding the blood vessel. The display control unit displays the wall shear stress as the second index value obtained at each of a plurality of different time points based on information regarding the subject, and displays the wall shear stress as a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the vertical axis being the magnitude of the wall shear stress and the horizontal axis being the distance. Medical image processing apparatus.

37. The display control unit displays information indicating a range of the distance at which a third index value regarding the blood vessel has an abnormal value together with the graph. The medical image processing apparatus according to Claim 36.

38. The display control unit displays information indicating a range in which the temporal variation amount of the wall shear stress exceeds a threshold value at the distance together with the graph. The medical image processing apparatus according to Claim 37.

39. The display control unit displays information indicating a range in which a third index value regarding the blood vessel has an abnormal value at the distance together with the graph. The medical image processing apparatus according to Claim 37 or 38.

40. The display control unit displays information indicating a range in which the third index value has an abnormal value at the distance by overlapping it on the graph at a position indicating the distance. The medical image processing apparatus according to any one of Claims 37 to 39.

41. The third index value is an index value indicating a lesion occurring in the blood vessel, an index value calculated from changes in blood pressure, blood flow, shape, or position of the blood vessel, or an index value predicted by performing virtual surgery or treatment on the blood vessel using the medical image. The medical image processing apparatus according to any one of Claims 37 to 40.

42. Extract the degree of a disease related to the heart from a medical image, As information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the disease related to the heart is high, display a first index value related to the blood vessel calculated from blood pressure or blood flow, and when the degree of the disease related to the heart is low, a display control step of displaying wall shear stress as a second index value related to the blood vessel; An identification step of identifying whether the imaging time point of the medical image is before or after the treatment of the subject; When it is identified that the imaging time point of the medical image is before the treatment of the subject, by performing virtual treatment on the blood vessel using the medical image, at least one of a first predicted index value that is a first index value after treatment and a second predicted index value that is a second index value after treatment is calculated A prediction step; including When it is identified that the imaging time point of the medical image is before the treatment of the subject, the display control step further displays at least one of the first predicted index value and the second predicted index value. A medical image processing method.

43. An extraction step of extracting the degree of a disease related to the heart from a medical image, and As information regarding the blood flow of a blood vessel calculated based on the medical image, when the degree of the disease related to the heart is high, display a first index value related to the blood vessel calculated from blood pressure or blood flow, and when the degree of the disease related to the heart is low, a display control step of displaying wall shear stress as a second index value related to the blood vessel; including When the degree of the disease related to the heart is low, the display control step displays, for each of a plurality of different time points, a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the magnitude of the wall shear stress on the vertical axis and the distance on the horizontal axis. A medical image processing method.

44. A display control step of displaying, as information regarding the blood flow in a blood vessel calculated based on a medical image, a first index value regarding the blood vessel calculated from blood pressure or blood flow and wall shear stress as a second index value regarding the blood vessel; An identification step of identifying whether the time point of shooting the medical image is before or after the treatment of the subject; A prediction step of calculating at least one of a first predicted index value which is the first index value after treatment and a second predicted index value which is the second index value after treatment by performing a virtual treatment on the blood vessel using the medical image when the time point of shooting the medical image is before the treatment of the subject; comprising; The display control step displays, as information regarding the subject, at least one of the first predicted index value and the second predicted index value calculated by the prediction step when the time point of shooting the medical image is before the treatment of the subject; A medical image processing method.

45. A medical image processing method including a display control step of displaying, as information regarding the blood flow in a blood vessel calculated based on a medical image, a first index value regarding the blood vessel calculated from blood pressure or blood flow and wall shear stress as a second index value regarding the blood vessel; The display control step displays the wall shear stress as the second index value obtained at each of a plurality of different time points based on information regarding the subject, and displays the wall shear stress as a graph showing the relationship between the magnitude of the wall shear stress and the distance along the blood vessel from a reference position, with the vertical axis being the magnitude of the wall shear stress and the horizontal axis being the distance; A medical image processing method.

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