Dynamic image analysis device, dynamic image processing system, and diagnostic index providing program

Abstract

To provide a diagnostic index that can objectively diagnose respiratory conditions during quiet breathing and has high accuracy and reproducibility. [Solution] The dynamic image analysis device includes an acquisition unit that acquires respiratory information related to breathing and diaphragm information related to the diaphragm from dynamic images taken by irradiating the chest of a subject while the subject is breathing quietly, and an output unit that calculates and outputs an index indicating the respiratory state based on the respiratory information and diaphragm information.

Description

[Technical Field]

[0001] The present invention relates to a dynamic image analyzer, a dynamic image processing system, and a diagnostic index providing program. [Background technology]

[0002] Many patients admitted to intensive care units (ICUs) require mechanical ventilation with tracheal intubation. For patients on mechanical ventilation, prolonged tracheal intubation carries the risk of respiratory complications, so early weaning (extubation) from the ventilator is desirable. Currently, extubation decisions are made using criteria such as the Spontaneous Breathing Trial (SBT). However, SBTs involve numerous evaluation items and require subjective judgment, which can be difficult for physicians to make and places a significant psychological burden. [Prior art documents] [Non-patent literature]

[0003] [Non-Patent Document 1] S. Spadaro et al., “Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index,” Critical Care, 2016 Summary of the Invention [Problem to be solved by the invention]

[0004] As an objective indicator of extubation, the Rapid Shallow Breathing Index (RSBI), which is calculated by dividing the number of breaths per minute by the tidal volume, has been proposed. However, it has been reported that the RSBI is not very accurate as an indicator for determining extubation (Non-Patent Document 1). This is because, although the diaphragm muscle is the main muscle responsible for breathing, other muscles may compensate for the breathing, and therefore the ventilation volume does not necessarily represent the patient's respiratory capacity.

[0005] Instead of the RSBI, there is also an index called D-RSBI, which is expressed as the number of breaths per minute divided by diaphragm displacement (Non-Patent Document 1). In D-RSBI, an ultrasound diagnostic device is used to measure diaphragm displacement during breathing. However, because the ultrasound diagnostic device measures diaphragm displacement using a probe, the measured value changes depending on the position and angle at which the probe is applied, and the reproducibility of the measurement is poor.

[0006] As such, currently, it is not possible to provide an index that can objectively diagnose respiratory conditions and has high accuracy and reproducibility, and it is desirable to provide an index that can objectively diagnose respiratory conditions and has high accuracy and reproducibility.

[0007] An object of the present invention is to provide a dynamic image analysis device, a dynamic image processing system, and a diagnostic index providing program that can objectively diagnose respiratory conditions during quiet breathing and provide diagnostic indexes with high accuracy and reproducibility. [Means for solving the problem]

[0008] The dynamic image analysis device according to the present invention comprises: Radiation is irradiated onto the chest of the subject while breathing quietly. Lung field From the captured dynamic images Respiratory rate and Diaphragm displacement an acquisition unit that acquires the Used to determine whether to remove the ventilator Respiratory status indicators and the value obtained by dividing the respiratory rate by the diaphragm displacement amount. an output unit that calculates and outputs Equipped with.

[0009] The dynamic image processing system according to the present invention comprises: a medical examination cart having a dynamic imaging device that irradiates radiation onto the chest of a subject during quiet breathing to capture dynamic images, and a movable cart on which the dynamic imaging device is mounted; The dynamic image analyzer, Equipped with.

[0010] The diagnostic index providing program according to the present invention comprises: The computer of the dynamic image analyzer Radiation is irradiated onto the chest of the subject while breathing quietly. Lung field From the captured dynamic images Respiratory rate and Diaphragm displacement and and Used to determine whether to remove the ventilator Respiratory status indicators and the value obtained by dividing the respiratory rate by the diaphragm displacement amount. and outputting the Execute the following. [Effects of the Invention]

[0011] According to the present invention, it is possible to objectively diagnose the respiratory condition during quiet breathing, and to provide a diagnostic index with high accuracy and reproducibility. [Brief explanation of the drawings]

[0012] [Figure 1] FIG. 1 is a diagram showing an example of the overall configuration of a dynamic image processing system. [Figure 2] FIG. 2 is a block diagram showing the functional configuration of the main body of the dynamic image capturing device. [Figure 3] FIG. 3 is a block diagram illustrating an example of the functional configuration of a dynamic image analysis device. [Figure 4] FIG. 4 illustrates safety criteria for SBT initiation and SBT success criteria in a ventilator weaning protocol. [Figure 5] FIG. 5 is a flowchart illustrating a method for providing a diagnostic index performed by a dynamic image analyzer. [Figure 6]FIG. 6 is a diagram for explaining a method for determining the number of breaths per minute and the amount of diaphragm displacement from dynamic images captured by a dynamic image capturing device. [Figure 7] FIG. 7 is a diagram showing an analysis summary including the number of breaths per minute, the amount of diaphragm displacement, and the diagnostic index obtained by the method described in FIG. [Figure 8] FIG. 8 is a flowchart illustrating another method for providing a diagnostic index performed by a dynamic image analyzer. [Figure 9] FIG. 9 is a diagram for explaining another method for determining the number of breaths per minute and the amount of diaphragm displacement from dynamic images captured by a dynamic image capturing device. [Figure 10] FIG. 10 is a diagram showing an analysis summary including the number of breaths per minute, the amount of diaphragm displacement, and the diagnostic index obtained by the method described in FIG. [Figure 11] FIG. 11 is a diagram showing an analysis summary including respiratory information and heart rate information obtained from dynamic images captured by a dynamic image capturing device. DETAILED DESCRIPTION OF THE INVENTION

[0013] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[0014] [Dynamic image processing system] FIG. 1 is a diagram showing an example of the overall configuration of a dynamic image processing system 1. As shown in FIG.

[0015] The dynamic image processing system 1 includes at least a dynamic image capturing device 10 and a dynamic image analyzing device 40. The dynamic image processing system 1 may further include an image management device 50, a client terminal 60, and the like.

[0016] The dynamic image capturing device 10 is configured as a medical cart, for example, and is mobile as described below, making it suitable for making rounds on a patient P (subject) who has difficulty being moved to another room. The dynamic image capturing device 10 performs dynamic imaging to capture dynamic images of the patient P, and is suitable for dynamic imaging of a patient P who has entered an ICU and has difficulty being moved to another room, for example, as shown in FIG.

[0017] Here, dynamic imaging refers to obtaining multiple frame images by repeatedly irradiating (pulsed irradiation) a patient P with pulsed radiation (e.g., X-rays) at a predetermined frame rate. Dynamic images refer to a series of frame images obtained by dynamic imaging. Dynamic analysis, which will be described later, refers to analytical processing performed on dynamic images, and includes processing for analyzing the movement of a subject based on dynamic images, as well as processing for analyzing dynamic images to emphasize or attenuate (remove) predetermined structures.

[0018] The dynamic images captured by the dynamic image capturing device 10 are transmitted to the dynamic image analyzing device 40. The dynamic image analyzing device 40 performs dynamic analysis on the dynamic images transmitted from the dynamic image capturing device 10. Details of the dynamic image analyzing device 40 will be described later.

[0019] The dynamic images captured by the dynamic image capturing device 10 and the results of the dynamic analysis performed by the dynamic image analyzer 40 are transmitted to the image management device 50. The image management device 50 manages the dynamic images in association with the results of the dynamic analysis of the dynamic images. The image management device 50 is a medical image management system, such as a PACS (Picture Archiving and Communication System).

[0020] The client terminal 60 is a terminal used by medical personnel such as doctors, and reads dynamic images and analysis results from the image management device 50 based on the operation of the medical personnel, and presents them so that the medical personnel can view them.

[0021] [Dynamic imaging device] The dynamic image capturing device 10 includes a device main body 11, a radiation source 12, and an FPD (Flat Panel Detector) 13.

[0022] The device main body 11, which will be described in detail later, is a device that performs dynamic radiography of dynamic images using radiation. The device main body 11 is mounted on a cart that is configured to be movable by wheels or the like, and is configured as a medical cart that can be moved close to the patient P. The dynamic image capturing device 10 may be a portable device that is easily transportable, in which case it does not need to have wheels. The dynamic image capturing device 10 may also be placed in an imaging room, in which case the patient P that is capable of moving is the subject of imaging.

[0023] Furthermore, the device main body 11 is connected to a network N such as an in-hospital LAN (Local Area Network) via an AP (Access Point) 20 installed in the hospital by communication, for example, wireless communication. The device main body 11 can transmit and receive data to and from other devices via the network N. The other devices are the dynamic image analysis device 40, image management device 50, client terminal 60, etc., described above.

[0024] The radiation source 12 irradiates radiation (X-rays) to a region of the patient P to be imaged based on control from the apparatus main body 11. In the case of dynamic imaging, the radiation source 12 irradiates the patient P with, for example, pulsed radiation. Although not shown in the figure, the radiation source 12 is attached to, for example, an arm of the apparatus main body 11. The arm is configured to be movable so that the radiation source 12 can be positioned opposite the region of the patient P to be imaged.

[0025] The FPD 13 is a portable radiation detector compatible with dynamic radiography, and detects radiation that has passed through a region of the patient P to be radiographed. Various known FPDs can be used as the FPD 13. The radiation irradiation from the radiation source 12 and the radiography by the FPD 13 are configured to be synchronized in timing by known synchronization control, for example, by time correction using time synchronous communication.

[0026] The FPD 13 includes, for example, radiation detection elements arranged two-dimensionally on a glass substrate. The radiation detection elements are composed of semiconductor image sensors such as photodiodes. The radiation detection elements detect radiation that is irradiated from the radiation source 12 and passes through the patient P according to its intensity, and convert the detected radiation into an electrical signal and store it. A switching unit such as a TFT (Thin Film Transistor) is connected to each radiation detection element, and the storage and readout of the electrical signal can be controlled by the switching unit to output it as image data.

[0027] The patient P is a patient fitted with an artificial respirator 30. The artificial respirator 30 is an example of a respiratory assistance device.

[0028] Here, a brief explanation will be given of the ventilator 30. The ventilator 30 is a device that performs mechanical ventilation or artificial respiration by feeding breathing gas into and out of the lungs to assist the breathing of a patient P who is unable to breathe or whose breathing is insufficient. There are several methods for attaching the ventilator 30, but for a patient P in an ICU, for example, tracheal intubation, in which a tube 31 is inserted into the trachea from the mouth or nose, or tracheostomy, in which the trachea is incised and the tube 31 is inserted into the trachea, is used.

[0029] The dynamic image capturing device 10 irradiates the patient P with radiation from the radiation source 12 in a state where the FPD 13 is disposed at a position facing the radiation source 12 with the patient P in between, thereby capturing dynamic images of the patient P.

[0030] FIG. 2 is a block diagram showing the functional configuration of the device main body 11. As shown in FIG.

[0031] The device main body 11 functions as a console (imaging control device) and also functions as a computer. As shown in Fig. 2, the device main body 11 is configured to include a control unit 101, an operation unit 102, a display unit 103, a storage unit 104, a communication unit 105, a drive unit 106, a battery 107, a connector 108, a charging unit 109, etc. The various units of the device main body 11 are connected via a bus 110.

[0032] The control unit 101 is composed of a CPU (Central Processing Unit), RAM (Random Access Memory), etc. In response to input from the operation unit 102, the CPU reads out a system program and various processing programs stored in the storage unit 104, expands them in the RAM, and executes various processes according to the expanded programs.

[0033] The control unit 101 controls the dynamic image capturing device 10, and may include an analysis unit 101a having the same function as the dynamic image analysis device 40 described later.

[0034] The operation unit 102 has a touch panel or the like in which transparent electrodes are arranged in a grid pattern so as to cover the surface of the display unit 103. The touch panel detects a position pressed by a finger, a touch pen, or the like, and inputs the position information to the control unit 101 as operation information. The operation unit 102 also has an exposure switch 102a. The exposure switch 102a is a switch that the user uses to instruct radiation irradiation and imaging by the radiation source 12.

[0035] The display unit 103 is configured by a monitor such as an LCD (Liquid Crystal Display) or a CRT (Cathode Ray Tube), etc. The display unit 103 performs display in accordance with an instruction of a display signal input from the control unit 101.

[0036] The storage unit 104 is configured by a non-volatile semiconductor memory, a hard disk, etc. The storage unit 104 stores various programs executed by the control unit 101, parameters required for executing processes by the programs, data of the processing results, etc.

[0037] The communication unit 105 transmits and receives data to and from the FPD 13 via wired or wireless communication, and also transmits and receives data to and from the dynamic image analysis device 40, image management device 50, client terminal 60, etc. connected to the network N via the AP 20.

[0038] The driving unit 106 is a circuit that drives the radiation source 12. The driving unit 106 and the radiation source 12 are connected via a cable.

[0039] The battery 107 supplies power to each part of the device main body 11 and the radiation source 12. The battery 107 can be charged externally via an AC cable 111.

[0040] The connector 108 is provided inside the housing portion 120 and electrically connects to the FPD 13 housed in the housing portion 120 .

[0041] The charging unit 109 charges the FPD 13 connected via the connector 108 with power supplied from the battery 107 under the control of the control unit 101 .

[0042] Dynamic image capturing device 10 having the above configuration captures dynamic images by irradiating the chest of patient P during quiet breathing with radiation. Then, as will be described below, dynamic image analyzer 40 performs dynamic analysis of the dynamic images and outputs diagnostic indices indicating the respiratory state of patient P. The diagnostic indices output by dynamic image analyzer 40 may be displayed on display unit 103 of dynamic image capturing device 10 as analysis summaries AS1 and AS2, which will be described later.

[0043] [Dynamic image analysis device] The dynamic image analysis device 40 is, for example, a computer such as a PC, a workstation, etc. The dynamic image analysis device 40 may be a desktop computer or a portable computer such as a notebook computer or a tablet computer.

[0044] The dynamic image analysis device 40 performs dynamic analysis of the dynamic images captured by the dynamic image capturing device 10.

[0045] 3 is a block diagram illustrating an example of the functional configuration of dynamic image analyzer 40. Dynamic image analyzer 40 has a control unit 41, an operation unit 42, a display unit 43, a storage unit 44, and a communication unit 45. The components of dynamic image analyzer 40 are connected by a bus 36.

[0046] The control unit 41 is composed of a CPU, RAM, etc. In the control unit 41, the CPU reads out the system program and various processing programs stored in the storage unit 44 in response to the operation of the operation unit 42, expands them in the RAM, and performs operation control of each unit of the dynamic image analysis device 40, dynamic analysis, etc. based on the expanded programs.

[0047] The control unit 41 includes an acquisition unit 411 and an output unit 412 .

[0048] The acquisition unit 411 performs a dynamic analysis set in the setting information on the dynamic image and acquires the analysis result. For example, the acquisition unit 411 performs the dynamic analysis based on signal changes in a plurality of frame images.

[0049] The acquisition unit 411 has, as types of dynamic analysis, for example, a blood flow analysis mode, a ventilation analysis mode, an adhesion analysis mode, a diaphragm movement amount analysis mode, an orthopedic-related measurement mode, etc. Each mode will be briefly described below.

[0050] The blood flow analysis mode visualizes signal changes within the lung field that are synchronized with the heartbeat.

[0051] The ventilation analysis mode is a mode in which signal changes in the time direction in a specific time frequency band are extracted and the behavior of lung tissue during breathing is visualized.

[0052] The adhesion analysis mode is a mode for visualizing the degree of tissue adhesion.

[0053] The diaphragm movement amount analysis mode is a mode that automatically tracks the up and down movement of the diaphragm that accompanies breathing and quantifies the amount of up and down movement of the diaphragm.

[0054] The orthopedic measurement mode is a mode in which, for example, the positional change of a designated bone in a limb or the like is measured and the trajectory of the movement is displayed.

[0055] In this embodiment, the control unit 41 executes a diagnostic index providing program and a respiratory condition information providing program as processing programs, and the acquisition unit 411 and output unit 412 perform the following processes.

[0056] Specifically, in the diagnostic index providing program, the acquisition unit 411 performs processing to acquire respiratory information related to respiration and diaphragm information related to the diaphragm from dynamic images captured by irradiating the chest of the patient P during quiet breathing. The acquisition unit 411 can acquire diaphragm information using the diaphragm movement amount analysis mode described above, and can acquire respiratory information and diaphragm information collectively by dynamic analysis of the dynamic images. The output unit 412 performs processing to determine and output diagnostic indices indicating the respiratory state based on the acquired respiratory information and diaphragm information.

[0057] Furthermore, in the respiratory status information providing program, the acquisition unit 411 performs processing to acquire multiple types of information related to respiration from dynamic images captured by irradiating the chest of the patient P during quiet breathing. The multiple types of information related to respiration are, for example, the respiratory information and diaphragm information described above, and the acquisition unit 411 can acquire the diaphragm information using the diaphragm movement amount analysis mode described above, and can acquire multiple types of information collectively through dynamic analysis of the dynamic images. The output unit 412 performs processing to output the acquired multiple types of information as a list. The output unit 412 may output the list including diagnostic indices calculated based on the respiratory information and diaphragm information.

[0058] More specifically, the respiratory information acquired by the acquisition unit 411 from the dynamic image is the number of breaths per minute, as will be described later, and this respiratory information is acquired for each of the left and right lungs. Also, the diaphragm information acquired by the acquisition unit 411 from the dynamic image is the amount of diaphragm displacement, as will be described later, and this diaphragm information is also acquired for each of the left and right lungs.

[0059] The diagnostic index output by the output unit 412 is a value obtained by dividing the respiratory rate by the amount of diaphragm displacement, as will be described later, and this diagnostic index is calculated for each of the left and right lungs. The output unit 412 then outputs the diagnostic index together with the dynamic image as analysis summaries AS1 and AS2 on one screen displayed by the display unit 43, as shown in Figs. 7 and 10, which will be described later.

[0060] The operation unit 42 is an operation device such as a keyboard equipped with cursor keys, numeric input keys, and various function keys, a pointing device such as a mouse or a trackball, and a touch panel. The operation unit 42 generates instruction signals based on input by the operator and outputs them to the control unit 41. The operation unit 42 may also be equipped with a touch panel on the display screen of the display unit 43, in which case the operation unit 42 outputs instruction signals input via the touch panel to the control unit 41.

[0061] The display unit 43 is composed of a display device such as a CRT, a liquid crystal display, an organic EL display, etc. In accordance with the instruction of a display signal input from the control unit 41, the display unit 43 displays input instructions from the operation unit 42, data generated by the dynamic image capturing device 10 and the dynamic image analysis device 40 (dynamic images, analysis results, etc.), etc.

[0062] The storage unit 44 is configured with a non-volatile semiconductor memory, a hard disk, etc. The storage unit 44 stores various programs executed by the control unit 41, parameters required for executing processing by the programs, or data such as processing results (dynamic images, analysis results, etc.). The various programs are stored in the form of readable program code, and the control unit 41 sequentially executes operations in accordance with the program code.

[0063] The communication unit 45 transmits and receives data to and from the dynamic image capturing device 10, the image management device 50, the client terminal 60, and the like.

[0064] [Ventilator weaning protocol] The weaning protocol for removing the tube 31 of the ventilator 30 from the patient P includes protocols for a Spontaneous Awakening Trial (SAT) and a Spontaneous Breathing Trial (SBT). The protocol for the SAT includes determining safety criteria for initiating the SAT, implementing the SAT, and determining criteria for success of the SAT. The protocol for the SBT includes determining safety criteria for initiating the SBT, implementing the SBT, and determining criteria for success of the SBT.

[0065] The judgment of the safety criteria for initiating SAT determines whether it is acceptable to discontinue or reduce the administration of sedative drugs to patient P. If it is judged that the safety criteria for initiating SAT are met, SAT is performed.

[0066] SAT evaluates whether patient P can be awakened after discontinuing or reducing the administration of sedatives to patient P. After SAT is performed, if it is determined that the SAT success criteria are met, a protocol for SBT will be initiated.

[0067] Since the dynamic image analysis device 40 having the above configuration is used for SBT, detailed explanations of the SAT initiation safety criteria, SAT, and SAT success criteria will be omitted, but well-known SAT initiation safety criteria, SAT, and SAT success criteria can be used.

[0068] The SBT initiation safety criteria are determined to determine whether or not it is acceptable to transition to a state where the patient P is not assisted by the ventilator 30. If it is determined that the SBT initiation safety criteria shown in Figure 4 are met, SBT is implemented.

[0069] The SBT evaluates the spontaneous breathing of the patient P without assistance from the ventilator 30. After the SBT is performed, if it is determined that the SBT success criteria shown in Figure 4 are met, the doctor considers extubating the tube 31 of the ventilator 30.

[0070] Here, the main items of the SBT initiation safety standards are the following (A1) to (A5), as shown in FIG. (A1) Adequate oxygenation. (A2) Hemodynamics are stable. (A3) There is sufficient inspiratory effort. (A4) No abnormal breathing patterns are observed. (A5) The patient's overall condition is stable.

[0071] The above main items (A1) to (A5) have various sub-items, but detailed explanations of these will be omitted here. Among the above main items (A1) to (A5), "(A3) There is sufficient inspiratory effort" has a sub-item called RSBI (Rapid Shallow Breathing Index), but as mentioned above, it has been reported that RSBI has low accuracy as an index for determining extubation. There is also an index called D-RSBI instead of RSBI, but as mentioned above, this also has poor measurement reproducibility.

[0072] Therefore, in this embodiment, instead of RSBI or D-RSBI, the dynamic image analyzer 40 provides the diagnostic index described below as an index that can objectively diagnose the respiratory condition during quiet breathing and has high accuracy and reproducibility.

[0073] [Providing diagnostic indicators] The diagnostic indexes provided by the dynamic image analyzer 40 will be described below with reference to FIGS.

[0074] Fig. 5 is a flowchart illustrating a method for providing a diagnostic index performed by the dynamic image analysis device 40. Fig. 6 is a diagram illustrating a method for determining the number of breaths per minute and the amount of diaphragm displacement from dynamic images captured by the dynamic image capturing device 10.

[0075] As described above, if it is determined that the SAT success criteria are met, the protocol for SBT is initiated, and first, the SBT initiation safety criteria are determined. When the SBT initiation safety criteria are determined, in this embodiment, dynamic image capturing apparatus 10 captures dynamic images of patient P during quiet breathing to objectively assess respiratory effort. Then, dynamic image analyzer 40 outputs a diagnostic index indicating the respiratory state of patient P during quiet breathing using the method described below.

[0076] (Step S11) The control unit 41 of the dynamic image analysis device 40 acquires dynamic images of the chest of the patient P obtained by dynamic imaging. The control unit 41 acquires, for example, dynamic images captured by the dynamic image capturing device 10 and stored in the storage unit 104 via the network N.

[0077] (Step S12A) The acquisition unit 411 of the control unit 41 recognizes the lung field region in each of the plurality of frame images constituting the dynamic image and identifies the position of the diaphragm. The lung field region may be recognized using, for example, known image processing such as edge detection, or may be recognized using machine learning, etc. Furthermore, the diaphragm may be identified, for example, by identifying the lower edge portion of the recognized lung field region as the diaphragm.

[0078] The acquisition unit 411 recognizes lung field areas LL and RL of the left and right lungs, and identifies the lower edge portions of the lung field areas LL and RL as the left and right diaphragms LD and RD, as shown in frame image F in Fig. 6. The position of the left diaphragm LD is identified taking into consideration the position of the heart.

[0079] Position information of the diaphragms LD and RD is stored in the storage unit 44 for each frame image, and the positions of the diaphragms LD and RD are also displayed when the frame image F is displayed in the analysis summary AS1 shown in Fig. 7. As with the diaphragms LD and RD, position information of the lung field regions LL and RL may also be stored in the storage unit 44 for each frame image, and the positions of the lung field regions LL and RL may be displayed when the frame image F is displayed in the analysis summary AS1 shown in Fig. 7.

[0080] (Step S13A) The acquisition unit 411 obtains the number of breaths per minute and the amount of displacement of the diaphragm from the displacement of the position of the diaphragm and the period of the displacement in the dynamic image. The number of breaths per minute is an example of respiratory information related to breathing, and the amount of displacement of the diaphragm is an example of diaphragm information related to the diaphragm.

[0081] The acquisition unit 411 creates a graph of the displacement of the diaphragm position over time (frame number of the frame image), for example, as shown in graph G in Fig. 6, and obtains the number of breaths per minute and the amount of displacement of the diaphragm from the created graph. Note that graph G in Fig. 6 illustrates the right diaphragm as an example, but the left diaphragm can also be graphed in the same way, and the number of breaths per minute and the amount of displacement of the diaphragm can be obtained from the created graph.

[0082] For example, the acquisition unit 411 detects the period of displacement in graph G, calculates the number of breaths per minute from the detected period of displacement, and calculates the amount of diaphragm displacement from the minimum and maximum values ​​of displacement in one period. If multiple periods are detected, the acquisition unit 411 may calculate the number of breaths per minute from the multiple periods, or may calculate the average amount of displacement from the amount of diaphragm displacement in each period.

[0083] The acquisition unit 411 may, for example, calculate the similarity of the waveforms of the graph G and set an analysis interval so as to include continuous waveforms with high similarity, or may allow the user to set the analysis interval using the operation unit 42. In this case, the number of breaths per minute and the displacement of the diaphragm are obtained in the set interval.

[0084] (Steps S14 and S15) The output unit 412 of the control unit 41 calculates a diagnostic index from the number of breaths per minute and the amount of diaphragm displacement acquired by the acquisition unit 411 by dividing (the number of breaths per minute) by (the amount of diaphragm displacement), and outputs the calculated diagnostic index. The output diagnostic index is stored in the memory unit 44 together with the number of breaths per minute and the amount of diaphragm displacement acquired, and is displayed as an analysis result in the analysis summary AS1 shown in FIG.

[0085] The number of breaths per minute and the amount of diaphragm displacement are obtained from dynamic images of the entire chest captured using radiation, and therefore, unlike with an ultrasound diagnostic device, the measured values ​​do not change depending on the position or angle of the probe, and highly reproducible values ​​can be obtained. Furthermore, the number of breaths per minute and the amount of diaphragm displacement are obtained by dynamically analyzing the dynamic images to identify the left and right lung fields and the left and right diaphragms, so highly accurate values ​​can be obtained. As a result, the diagnostic index obtained by the above calculation is a diagnostic index with high accuracy and reproducibility, allowing a doctor to objectively diagnose the respiratory condition of patient P during quiet breathing.

[0086] FIG. 7 is a diagram showing an analysis summary AS1 including the number of breaths per minute, the amount of diaphragm displacement, and the diagnostic index DI obtained by the method described in FIG.

[0087] The output unit 412 displays, for example, the analysis summary AS1 shown in Fig. 7 on the display unit 103. The analysis summary AS1 includes frame images F of the left and right diaphragms, a graph G, an analysis result AR, and a summary SM.

[0088] The output unit 412 displays, as frame images F, for example, a frame image when the displacement is at its minimum value and a frame image when the displacement is at its maximum value. At this time, the output unit 412 also displays the diaphragms LD and RD identified in the displayed frame images. This allows the user to visually grasp the positions of the diaphragms LD and RD in the frame images. Note that the output unit 412 may display dynamic images instead of the frame images F, and in this case, it is sufficient to display the diaphragms LD and RD.

[0089] Furthermore, the output unit 412 displays, for example, dashed lines indicating the times of the maximum and minimum points along with the graph G. This allows the user to visually grasp the period and amount of displacement in the graph G.

[0090] Furthermore, the output unit 412 displays the average displacement of the diaphragm, the period of the displacement, the number of breaths per minute, and the diagnostic index DI calculated as described above as numerical values ​​as the analysis results AR, thereby allowing the user to objectively grasp the analysis results in numerical values.

[0091] Furthermore, the output unit 412 displays the numerical values ​​of the diagnostic indexes DI for the left and right diaphragms and a bar graph BG as a summary SM. The bar graph BG is a graph that visually displays the diagnostic index DI, and here, the diagnostic index DI for the right diaphragm is displayed above the bar graph BG, and the diagnostic index DI for the left diaphragm is displayed below the bar graph BG. In the bar graph BG, the range of numerical values ​​to the left of the threshold TV is acceptable, and the range of numerical values ​​to the right of the threshold TV is unacceptable.

[0092] In this way, the output unit 412 displays the analysis summary AS1 on one screen of the display unit 43, so that the doctor can check various information including the diagnostic indices DI for the left and right diaphragms and objectively diagnose the respiratory condition of the patient P during quiet breathing.

[0093] Here, the dynamic image capturing device 10 and the dynamic image analyzer 40 are used to determine the SBT initiation safety criteria, but the dynamic image capturing device 10 and the dynamic image analyzer 40 may also be used to diagnose the respiratory condition of the patient P before and after the SBT protocol. In this case, the settings of the ventilator 30 may be changed based on the respiratory condition of the patient P, for example, the diagnostic index DI.

[0094] Furthermore, here, the dynamic image analysis device 40 acquires the diagnostic index DI from the dynamic image acquired from the dynamic image capturing device 10. However, if the dynamic image capturing device 10 has the above-described analysis unit 101a, the diagnostic index DI may be acquired by the dynamic image capturing device 10. For example, the analysis unit 101a may acquire frame images constituting the dynamic image in real time when capturing the dynamic image, and calculate the diagnostic index DI for each respiratory cycle. In this case, the dynamic image capturing device 10 will display, for example, an analysis summary AS1 including the diagnostic index DI on the display unit 103.

[0095] [summary] As described above, the dynamic image analysis device 40 according to this embodiment has the above-mentioned acquisition unit 411 and output unit 412 in the control unit 41.

[0096] According to the dynamic image analyzer 40 of this embodiment, the diagnostic index DI based on the respiratory information (number of breaths per minute) and the diaphragm information (amount of diaphragm displacement) has high accuracy and reproducibility as described above, and therefore, a diagnostic index with high accuracy and reproducibility can be provided. Such a diagnostic index DI allows a doctor to objectively diagnose the respiratory condition of the patient P during quiet breathing, and can support the doctor in making a decision on extubation when considering extubation of the tube 31 of the ventilator 30. Furthermore, compared to the conventional method, it is easier to determine whether or not to extubate, and the psychological burden on the doctor can be reduced.

[0097] Furthermore, the dynamic image analyzer 40 according to this embodiment outputs a list of multiple types of information related to breathing, such as respiratory information (number of breaths per minute), diaphragm information (amount of diaphragm displacement), and diagnostic index DI. This makes it possible to provide a list of information useful for diagnosing the respiratory condition of the patient P during quiet breathing, allowing a doctor to objectively diagnose the respiratory condition of the patient P and supporting the doctor's decision-making regarding extubation when considering extubation of the tube 31 of the ventilator 30. Furthermore, compared to conventional methods, it becomes easier to determine whether or not to extubate, and the psychological burden on the doctor can be reduced.

[0098] Furthermore, a patient P who is fitted with a ventilator 30 (e.g., a patient P in an ICU) is difficult to move. It is difficult to move such a patient P to an X-ray room, such as a CT (Computed Tomography) room, and CT scans cannot be performed, making it difficult to obtain high-precision images. Therefore, currently, when determining whether to extubate a patient P, methods such as an ultrasound diagnostic device or visual inspection by a doctor have been required, and there has been no means for visualizing the respiratory status in an image including the entire lungs. In this embodiment, the dynamic image capturing device 10 can be brought to the patient P's side by a mobile cart equipped with the dynamic image capturing device 10. Therefore, the dynamic image processing system 1 according to this embodiment can capture dynamic images including the entire lungs without moving the patient P, and can obtain diagnostic indices indicating the respiratory status.

[0099] <Variation 1> Fig. 8 is a flowchart illustrating another method for providing diagnostic indices performed by the dynamic image analysis device 40. Fig. 9 is a diagram illustrating another method for determining the number of breaths per minute and the amount of diaphragm displacement from dynamic images captured by the dynamic image capturing device 10.

[0100] In this modification, the dynamic image capturing device 10 and the dynamic image analyzing device 40 described in the above embodiment are also used, but the method of providing diagnostic indices performed by the dynamic image analyzing device 40 is different from that of the above embodiment. Specifically, the method of dynamic analysis of captured dynamic images is different, and will be described below with reference to Figs. 8 and 9.

[0101] In this modification, as described above, when determining whether the SBT initiation safety criterion is met, in order to objectively assess respiratory effort, dynamic image capturing device 10 captures dynamic images of patient P during quiet breathing. Dynamic image analyzer 40 then outputs a diagnostic index indicating the respiratory condition of patient P during quiet breathing using the method described below.

[0102] (Step S11) This step S11 is the same as step S11 described in FIG. 5, so the same reference numerals are used and redundant description will be omitted.

[0103] (Step S12B) The acquisition unit 411 of the control unit 41 recognizes left and right lung field regions LL, RL in each of the multiple frame images constituting the dynamic image, locates the positions of the left and right diaphragms, and sets left and right pixel regions LP, RP extending in the vertical direction of the human body across the diaphragm. Recognition of the lung field regions LL, RL and locating the position of the diaphragm may be performed by the method described in step S12A of Fig. 5. The pixel regions LP, RP have a size of, for example, one pixel in the horizontal direction of the human body and 100 to 200 pixels in the vertical direction of the human body. The pixel regions LP, RP are sized in the vertical direction so that the diaphragm is always included, even if the diaphragm is displaced.

[0104] The acquisition unit 411 recognizes the lung field regions LL and RL, for example, as shown in frame image F in Figure 9, identifies the lower edge portions of the lung field regions LL and RL as the left and right diaphragms (symbols omitted), and sets pixel regions LP and RP that extend in the vertical direction of the human body across the diaphragms.

[0105] Position information of the pixel regions LP, RP is stored in the storage unit 44, and the positions of the pixel regions LP, RP are also displayed when the frame image F is displayed in the analysis summary AS2 shown in Fig. 10. Position information of the lung field regions LL, RL may be stored in the storage unit 44 for each frame image, and the positions of the lung field regions LL, RL may be displayed when the frame image F is displayed in the analysis summary AS2 shown in Fig. 10.

[0106] (Step S13B) The acquisition unit 411 obtains the displacement amount of the diaphragm and the number of breaths per minute from a mapping image M obtained by mapping the pixel regions LP and RP along the time axis.

[0107] The acquisition unit 411 forms a mapping image M by two-dimensionally arranging pixel values ​​in a pixel region RP of each frame image along a time axis (frame number of the frame image), as shown in the mapping image M in Fig. 9, for example. The acquisition unit 411 then performs image analysis on the mapping image M, for example, to detect the displacement of the density boundary (edge) of the pixel values ​​along the time axis, that is, the displacement of the diaphragm position along the time axis, and obtains the number of breaths per minute and the amount of displacement of the diaphragm from the displacement of the density boundary along the time axis. Note that while the mapping image M in Fig. 9 illustrates the right diaphragm as an example, the left diaphragm is also mapped in the same way, and the number of breaths per minute and the amount of displacement of the diaphragm are obtained from the created mapping image.

[0108] For example, the acquisition unit 411 detects a period of displacement in the mapping image M, calculates the number of breaths per minute from the detected period of displacement, and calculates the amount of displacement of the diaphragm from the minimum and maximum values ​​of the displacement in one period. If multiple periods are detected, the acquisition unit 411 may calculate the number of breaths per minute from the multiple periods, or may calculate an average amount of displacement from the amount of displacement of the diaphragm in each period.

[0109] The acquisition unit 411 may, for example, calculate the similarity of the waveforms of the detected edges and set an analysis interval so as to include continuous waveforms with high similarity, or may allow the user to set the analysis interval using the operation unit 42. In this case, the number of breaths per minute and the displacement of the diaphragm are obtained in the set interval.

[0110] In dynamic images, if the contour of the diaphragm is unclear, for example, due to low image contrast, it may be difficult to identify the boundary between light and dark pixel values, i.e., the position of the diaphragm, making it difficult to automatically track the position of the diaphragm between frame images. In this case, in step S12B, the acquisition unit 411 defines the pixel regions LP and RP in the left-right direction of the human body as multiple pixels rather than a single pixel, and averages the pixel values ​​of the multiple pixels in the left-right direction of the human body. Then, in step S13B, the acquisition unit 411 maps the pixel regions LP and RP, in which the pixel values ​​of the multiple pixels in the left-right direction of the human body are averaged, along the time axis to create a mapping image M. This improves the contrast resolution in the up-down direction of the human body, making it possible to identify the position of the diaphragm and automatically track the position of the diaphragm between frame images, even when the contour of the diaphragm is unclear in dynamic images.

[0111] (Steps S14 and S15) These steps S14 and S15 are the same as steps S14 and S15 described in FIG. 5, so the same reference numerals are used and redundant description will be omitted.

[0112] In this modification, the number of breaths per minute and the amount of diaphragm displacement are obtained from dynamic images of the entire chest captured using radiation, so that the measured values ​​do not change depending on the position or angle of the probe, as in an ultrasound diagnostic device, and highly reproducible values ​​can be obtained. Furthermore, the number of breaths per minute and the amount of diaphragm displacement are obtained by dynamically analyzing the dynamic images to identify the left and right lung fields and the left and right diaphragms, so highly accurate values ​​can be obtained. As a result, the diagnostic index obtained by the above calculation is a diagnostic index with high accuracy and reproducibility, allowing a doctor to objectively diagnose the respiratory condition of patient P during quiet breathing.

[0113] FIG. 10 is a diagram showing an analysis summary AS2 including the number of breaths per minute, the amount of diaphragm displacement, and the diagnostic index DI obtained by the method described in FIG.

[0114] The output unit 412 displays, for example, the analysis summary AS2 shown in Fig. 10 on the display unit 43. The analysis summary AS2 includes frame images F of the left and right diaphragms, a mapping image M, an analysis result AR, and a summary SM.

[0115] The output unit 412 displays, as frame images F, for example, a frame image when the displacement is at its minimum value and a frame image when the displacement is at its maximum value. At this time, the output unit 412 also displays the pixel regions LP and RP set in the displayed frame images. This allows the user to visually grasp the position of the diaphragm in the frame images and the pixel regions LP and RP. Note that the output unit 412 may display a dynamic image instead of the frame image F, and in that case, it is sufficient to display the pixel regions LP and RP.

[0116] The output unit 412 also displays, for example, dashed lines indicating the times of the minimum points and dashed lines indicating the maximum and minimum values ​​of the displacement, along with displaying the mapping image M. This allows the user to visually grasp the period and amount of displacement in the mapping image M.

[0117] In the analysis summary AS2, the analysis result AR and summary SM are the same as those in the analysis summary AS1 shown in FIG. 7, so a duplicated description will be omitted.

[0118] In this way, the output unit 412 displays the analysis summary AS2 on one screen of the display unit 43, so that the doctor can check various information including the diagnostic indices DI for the left and right diaphragms and objectively diagnose the respiratory condition of the patient P during quiet breathing.

[0119] Therefore, in this modification, the dynamic image analyzer 40 can provide a diagnostic index DI with high accuracy and reproducibility, as described above. Such a diagnostic index DI allows a doctor to objectively diagnose the respiratory condition of the patient P during quiet breathing, and can support the doctor in making a decision on extubation when considering extubation of the tube 31 of the ventilator 30. Furthermore, compared to the conventional method, it becomes easier to determine whether or not to extubate, and the psychological burden on the doctor can be reduced.

[0120] <Variation 2> FIG. 11 is a diagram showing an analysis summary AS3 including respiratory information and heart rate information obtained from dynamic images captured by the dynamic image capturing device 10. As shown in FIG.

[0121] In this modification, the dynamic image capturing device 10 and dynamic image analyzing device 40 described in the above embodiment are also used, but the target area for dynamic analysis by the dynamic image analyzing device 40 includes not only the diaphragm but also the heart. The dynamic image analyzing device 40 acquires respiratory information and heart rate information by dynamic analysis of the diaphragm and heart area in the dynamic images.

[0122] Therefore, in this modification, the control unit 41 executes a program for providing information for determining whether to remove the tube as a processing program, and the acquisition unit 411 and the output unit 412 perform the following processing.

[0123] Specifically, in the extubation determination information provision program, the acquisition unit 411 performs processing to acquire information that allows for evaluation of whether or not the ventilator 30 can be extubated from dynamic images captured by irradiating radiation on the chest of a patient P attached to the ventilator 30 while the patient is in a state of quiet breathing. The information is respiratory information related to breathing and heart rate information related to heart rate, and the acquisition unit 411 can acquire the respiratory information and heart rate information together by dynamic analysis of the dynamic images, as will be described later. The output unit 412 performs processing to output the respiratory information and heart rate information as a list.

[0124] In this modification, the respiratory information acquired by the acquisition unit 411 from the dynamic image includes the number of breaths, the amount of diaphragm displacement, and the respiratory pattern, as will be described later, and this information is acquired for each of the left and right lungs. Furthermore, the heartbeat information acquired by the acquisition unit 411 from the dynamic image includes the heart rate, as will be described later.

[0125] In this modification, the respiratory information output by the output unit 412 includes the respiratory rate, diaphragmatic displacement, respiratory pattern, and diagnostic index, as will be described later, and this information is obtained for each of the left and right lungs. The diagnostic index indicates the respiratory state of the patient P and is also an index capable of evaluating respiratory effort. The heartbeat information output by the output unit 412 includes the heart rate. Then, as shown in FIG. 11 , the output unit 412 outputs a list of information indicating the respiratory rate, diaphragmatic displacement, respiratory pattern, diagnostic index, and heart rate together with the dynamic image as an analysis summary AS3 within one screen displayed by the display unit 43.

[0126] Here, the main evaluation items to be specifically evaluated for the SBT success criteria shown in Figure 4 are listed below. (B1)Respiration rate (B2) Oxygen saturation (SpO2) (B3) Carbon dioxide partial pressure (PaCO2) (B4) Heart rate (B5) Blood Pressure (B6) Breathing effort (B7) Breathing pattern

[0127] Of the above evaluation items (B1) to (B7), the four evaluation items (B1) respiratory rate, (B4) heart rate, (B6) respiratory effort, and (B7) breathing pattern can be obtained by performing dynamic analysis of dynamic images using a dynamic image analyzer 40, as described below.

[0128] (B1) Regarding the respiratory rate, as described above, the dynamic image analysis device 40 can obtain a graph G and a mapping image M showing the displacement of the diaphragm, and the number of breaths per minute is calculated from the obtained graph G and mapping image M.

[0129] Furthermore, as described above, the dynamic image analyzer 40 recognizes the lung field regions LL and RL in the frame image F, and is therefore able to determine changes in lung field area, thereby obtaining the graph LG showing changes in lung field area as shown in Figure 11. The dynamic image analyzer 40 can also determine the number of breaths per minute from the obtained graph LG. In this way, the dynamic image analyzer 40 determines the respiratory rate from the displacement of the diaphragm and changes in lung field area, and can therefore provide the physician with more reliable and useful information about the respiratory rate.

[0130] (B6) Regarding respiratory effort, as described above, the dynamic image analyzer 40 obtains a diagnostic index DI indicating the respiratory condition from the graph G indicating the displacement of the diaphragm and the mapping image M. The diagnostic index DI is an index indicating the respiratory effort of the patient P as the respiratory condition.

[0131] Furthermore, as described above, the dynamic image analyzer 40 can also obtain a graph LG, and from the obtained graph LG, a diagnostic index LI indicating the respiratory condition can be obtained by performing a calculation similar to that for the diagnostic index DI. The diagnostic index LI is obtained, for example, by dividing the number of breaths per minute by the change in lung field area. The diagnostic index LI is also an index indicating the respiratory effort of the patient P as a respiratory condition.

[0132] In the dynamic image analyzer 40, the output unit 412 of the control unit 41 displays the amount of change in lung field area, period, number of breaths per minute, and diagnostic index LI as numerical values ​​as the analysis results L-AR, thereby allowing the user to objectively grasp the analysis results numerically.

[0133] Similarly to the diagnostic index DI, the output unit 412 may also display bar graphs L-BG of the diagnostic indexes LI for the left and right lung fields. The bar graph L-BG is a graph that visually displays the diagnostic index LI, and here, the diagnostic index LI for the right lung field is displayed above the bar graph L-BG, and the diagnostic index LI for the left lung field is displayed below the bar graph L-BG. In the bar graph L-BG, the range of values ​​to the left of the threshold L-TV is acceptable, and the range of values ​​to the right of the threshold L-TV is unacceptable.

[0134] In this way, the dynamic image analyzer 40 calculates the diagnostic indices DI and LI from the displacement of the diaphragm and the change in lung field area, and can provide the physician with more reliable and useful information on respiratory effort.

[0135] (B7) As for the breathing pattern, as described above, the dynamic image analysis device 40 can obtain the graph G and mapping image M showing the displacement of the diaphragm, and therefore the breathing pattern can be obtained from the graph G and mapping image M. In this modification, the dynamic image analysis device 40 stores in advance a plurality of breathing patterns indicative of breathing abnormalities in the memory unit 44. The dynamic image analysis device 40 then determines whether the breathing pattern from the graph G or the mapping image M is present or whether there is a corresponding breathing abnormality by pattern matching with the plurality of breathing patterns stored in the memory unit 44. Note that the dynamic image analysis device 40 may determine whether the breathing pattern is present or whether there is a corresponding breathing abnormality, for example, using a classifier that has machine-learned a plurality of breathing patterns indicative of breathing abnormalities.

[0136] Furthermore, as described above, the dynamic image analyzer 40 can also obtain the graph LG, from which the breathing pattern can be obtained. As described above, the dynamic image analyzer 40 also uses pattern matching or a classifier to determine whether the breathing pattern obtained from the graph LG is valid or not, and whether there is a breathing abnormality. In this way, the dynamic image analyzer 40 determines the breathing pattern from the displacement of the diaphragm and the change in lung field area, and therefore can provide the physician with more reliable and useful information on the validity of the breathing pattern and breathing abnormalities.

[0137] (B4) Regarding the heart rate, the dynamic image analysis device 40 applies the above-described diaphragm movement amount analysis mode to the myocardial wall, for example, identifying the position of the myocardial wall for each frame image F and creating a graph of the displacement of the myocardial wall position over time (frame number of the frame image). Furthermore, as in the first modification, the dynamic image analysis device 40 may set a pixel region CP that spans the myocardial wall and create a mapping image CM by mapping the pixel region CP along the time axis. Figure 11 shows an example of a mapping image CM created.

[0138] The dynamic image analysis device 40 may recognize the lung field region and the cardiac region, for example, using edge detection or machine learning, and then identify the position of the myocardial wall and set the pixel region CP based on the recognized lung field region and cardiac region.

[0139] The dynamic image analyzer 40 can then determine the amount of myocardial wall displacement, the period of the displacement, and the number of displacements per minute from the graph of myocardial wall position displacement and mapping image CM in the same manner as described above for graph G and mapping image M. In this way, the dynamic image analyzer 40 determines the heart rate from the graph of myocardial wall position displacement and mapping image CM, and also determines the amount of myocardial wall displacement, so that the heart rate can be provided to doctors as more reliable and useful information.

[0140] The dynamic image analyzer 40 may calculate a diagnostic index CI indicating the state of the heart from the amount of movement displacement of the myocardial wall, the period of the movement displacement, and the number of movement displacements per minute. The diagnostic index CI is calculated, for example, by dividing the number of movements per minute by the amount of movement displacement of the myocardial wall.

[0141] The output unit 412 displays the amount of motion displacement of the myocardial wall, the period of the motion displacement, the number of motion displacements per minute, and the diagnostic index CI as numerical values ​​as the analysis result C-AR, thereby allowing the user to objectively grasp the analysis result numerically.

[0142] Similarly to the diagnostic index DI, the output unit 412 may display a bar graph C-BG of the cardiac diagnostic index CI. The bar graph C-BG is a graph that visually displays the diagnostic index CI, and here, the cardiac diagnostic index CI is displayed above the bar graph C-BG. In the bar graph C-BG, the range of values ​​to the left of the threshold C-TV is acceptable, and the range of values ​​to the right of the threshold C-TV is unacceptable.

[0143] As described above, the dynamic image analyzer 40 can simultaneously acquire and provide a list of four evaluation items among the evaluation items (B1) to (B7): (B1) respiratory rate, (B4) heart rate, (B6) respiratory effort, and (B7) respiratory pattern. As described above, (B1) respiratory rate, (B4) heart rate, (B6) respiratory effort, and (B7) respiratory pattern are highly reliable and useful information. Therefore, information useful for determining whether to extubate the ventilator can be provided to the physician in a single list. This allows the physician to objectively diagnose the respiratory condition of the patient P and assists the physician in making a decision regarding extubation when considering extubation of the tube 31 of the ventilator 30. Furthermore, compared to conventional methods, the physician can more easily determine whether to extubate the patient, and the physician's psychological burden can be reduced.

[0144] The above-described embodiments are merely examples of specific embodiments for carrying out the present invention, and the technical scope of the present invention should not be construed as being limited by these embodiments. In other words, the present invention can be carried out in various forms without departing from the gist or main features thereof. [Explanation of symbols]

[0145] 1 Dynamic image processing system 10 Dynamic imaging device 11 Device body 12 Radiation source 13 FPD 20 AP 30 Respirator 40 Dynamic image analysis device 41 Control Unit 42 Operation section 43 Display section 44 Storage section 45 Communications Department 50 Image management device 60 client terminals 411 Acquisition Department 412 Output section

Claims

1. an acquisition unit that acquires the respiratory rate and the amount of diaphragm displacement from dynamic images of the lung field obtained by irradiating the chest of the subject during quiet breathing; an output unit that calculates and outputs a value obtained by dividing the number of breaths by the amount of diaphragm displacement as an index indicating a respiratory state used for determining whether to extubate the artificial respirator; Equipped with Dynamic image analysis device.

2. The acquisition unit creates a graph showing the displacement of the diaphragm position over time, and acquires the respiratory rate and the diaphragm displacement amount from an analysis interval set in the graph. The dynamic image analyzer according to claim 1 .

3. The respiratory rate is the number of breaths per minute. The dynamic image analyzer according to claim 1 .

4. the acquisition unit recognizes the lung field and identifies the position of the diaphragm in each of a plurality of frame images constituting the dynamic image, and calculates the number of breaths per minute and the amount of displacement of the diaphragm based on the displacement of the position of the diaphragm with respect to time. The dynamic image analyzer according to claim 3 .

5. the acquisition unit recognizes the lung field and identifies the position of the diaphragm in each of the plurality of frame images constituting the dynamic image, sets a pixel region extending in the up-down direction of the human body across the diaphragm, forms an image in which pixel values ​​in the pixel region are two-dimensionally arranged along a time axis, and calculates the number of breaths per minute and the amount of diaphragm displacement based on the displacement of a density boundary of pixel values ​​in the formed image with respect to the time axis. The dynamic image analyzer according to claim 3 .

6. the output unit calculates the index for each of the left lung and the right lung. The dynamic image analyzer according to claim 1 .

7. Further comprising a display unit, the output unit outputs the indicator together with the dynamic image within one screen displayed by the display unit. The dynamic image analyzer according to claim 1 .

8. The dynamic image is a dynamic image of a subject wearing an artificial respirator during quiet breathing. The dynamic image analyzer according to claim 1 .

9. The dynamic image is a dynamic image of the subject breathing quietly while wearing an artificial respirator but without respiratory assistance by the artificial respirator. The dynamic image analyzer according to claim 1 .

10. a medical examination cart having a dynamic imaging device that irradiates radiation onto the chest of a subject during quiet breathing to capture dynamic images, and a movable cart on which the dynamic imaging device is mounted; The dynamic image analyzer according to claim 1 ; Equipped with Dynamic image processing system.

11. The computer of the dynamic image analyzer A process of acquiring the respiratory rate and the amount of diaphragm displacement from dynamic images of the lung field obtained by irradiating the chest of the subject during quiet breathing; a process of outputting a value obtained by dividing the number of breaths by the amount of diaphragm displacement as an index indicating a respiratory condition used for determining whether to extubate the ventilator; Execute Diagnostic indicator provision program.

Images