Medical information processing device, medical information processing program, medical information processing system, and medical information processing method

Abstract

To provide an index capable of evaluating resistance in a capillary vessel.SOLUTION: According to an embodiment, a medical information processing device includes an acquisition part and a calculation part. The acquisition part acquires blood vessel blood flow in a coronary artery, and myocardial blood flow in a cardiac muscle region to which blood is supplied by the coronary artery. The calculation part combines the blood vessel blood flow and the myocardial blood flow to calculate an index showing a capillary vessel resistance amount in the capillary vessel that supplies blood to the cardiac muscle region.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] Embodiments of the present invention relate to a medical information processing device, a medical information processing program, and a medical information processing system. and medical information processing method

Background Art

[0002] Conventionally, when evaluating the ischemic state of the myocardium, in addition to the blood flow volume of the coronary artery and the blood flow volume of the myocardium, it is known that it is important to evaluate the vascular resistance (microcirculation resistance) of the capillaries in the myocardium. Here, as a method for evaluating the microcirculation resistance, a method of applying a laser beam to a fingertip or the like to evaluate the blood flow in the capillaries of the finger or the like is known.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] The problem to be solved by the present invention is to provide an index capable of evaluating the resistance in capillaries.

Means for Solving the Problems

[0005] The medical information processing device according to the embodiment includes an acquisition unit and a calculation unit. The acquisition unit acquires the blood flow volume in the coronary artery and the blood flow volume in the myocardial region supplied with blood by the coronary artery. The calculation unit combines the blood flow volume in the blood vessel and the blood flow volume in the myocardium to calculate an index indicating the amount of capillary resistance in the capillaries that supply the blood to the myocardial region.

Brief Description of the Drawings

[0006] [Figure 1] ​Figure 1 shows an example of the configuration of a medical information processing device according to the first embodiment. [Figure 2] Figure 2 is a diagram illustrating an example of the calculation of capillary resistance index by a medical information processing device according to the first embodiment. [Figure 3] Figure 3 is a diagram illustrating an example of the calculation of capillary resistance index by the medical information processing device according to the first embodiment. [Figure 4] Figure 4 is a diagram illustrating an example of the calculation of capillary resistance index by a medical information processing device according to the first embodiment. [Figure 5A] Figure 5A is a diagram illustrating an example of the calculation of capillary resistance index by a medical information processing device according to the first embodiment. [Figure 5B] Figure 5B is a diagram illustrating an example of the calculation of capillary resistance index by a medical information processing device according to the first embodiment. [Figure 6] Figure 6 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 7A] Figure 7A shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 7B] Figure 7B shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 8A] Figure 8A shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 8B] Figure 8B shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 9] Figure 9 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 10] Figure 10 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 11] Figure 11 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 12]Figure 12 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 13] Figure 13 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 14] Figure 14 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 15] Figure 15 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 16] Figure 16 shows an example of the display format of the capillary resistance index according to the first embodiment. [Figure 17] Figure 17 is a diagram illustrating an example of criteria for determining the treatment plan according to the first embodiment. [Figure 18] Figure 18 is a flowchart showing the processing procedure by the medical information processing device according to the first embodiment. [Modes for carrying out the invention]

[0007] Embodiments of the medical information processing device, medical information processing program, and medical information processing system according to the present application will be described in detail below with reference to the attached drawings. However, the medical information processing device, medical information processing program, and medical information processing system according to the present application are not limited to the embodiments shown below.

[0008] (First Embodiment) Figure 1 shows an example of the configuration of the medical information processing device 300 according to the first embodiment. As shown in Figure 1, the medical information processing device 300 according to the first embodiment is connected to the medical image diagnostic device 100 and the server device 200 via the network 400. Note that the example shown in Figure 1 is merely an example, and various other devices (for example, terminal devices, etc.) may be connected to the network 400.

[0009] The medical imaging diagnostic device 100 includes an X-ray diagnostic device, an X-ray CT (Computed Tomography) device, an MRI (Magnetic Resonance Imaging) device, an ultrasound diagnostic device, a SPECT (Single Photon Emission Computed Tomography) device, a PET (Positron Emission Computed Tomography) device, a SPECT-CT device which integrates a SPECT device and an X-ray CT device, a PET-CT device which integrates a PET device and an X-ray CT device, or a group of these devices. Furthermore, the medical imaging diagnostic device 100 according to the first embodiment is capable of generating three-dimensional medical image data (volume data).

[0010] Here, the medical imaging diagnostic device 100 collects medical image data that can quantify the blood flow rate of the coronary arteries or the blood flow rate of the myocardium. For example, the X-ray CT scanner, which is the medical imaging diagnostic device 100, rotates the X-ray tube and X-ray detector around the heart of a subject to which a contrast agent has been administered, and detects the X-rays that have passed through the subject to collect projection data. Then, the X-ray CT scanner generates time-series three-dimensional CT image data (volume data) based on the collected projection data. To give one example, the X-ray CT scanner collects coronary angiography CT image data for calculating the blood flow rate of the coronary arteries by fluid analysis, and myocardial angiography CT image data for calculating the blood flow rate of the myocardium by perfusion analysis.

[0011] The medical imaging diagnostic device 100 then transmits the collected medical image data to the medical information processing device 300 in response to a request from the medical information processing device 300. The medical imaging diagnostic device 100 can also transmit the results of various analyses performed on the collected medical image data to the medical information processing device 300.

[0012] The server device 200 is a device that stores medical image data (for example, CT image data and CT images collected by an X-ray CT scanner) and various examination information (for example, intravascular pressure information measured by a pressure wire) collected by a medical imaging diagnostic device, and performs various image processing on the medical image data. Here, the server device 200 stores the medical image data and various examination information acquired from the medical imaging diagnostic device 100 via the network 400 into a memory circuit provided inside or outside the device. Then, in response to a request from the medical information processing device 300, the server device 200 transmits the medical image data and various examination information stored in the memory circuit to the medical information processing device 300.

[0013] The medical information processing device 300 acquires medical image data from the medical imaging diagnostic device 100 and the server device 200 via the network 400 and processes the acquired image data. The medical information processing device 300 also acquires various examination information from the server device 200 via the network 400 and performs various processes using the acquired examination information. For example, the medical information processing device 300 can be implemented using computer equipment such as a workstation.

[0014] For example, as shown in Figure 1, the medical information processing device 300 includes a communication interface 310, a memory circuit 320, an input interface 330, a display 340, and a processing circuit 350.

[0015] The communication interface 310 is connected to the processing circuit 350 and controls the transmission and communication of various data between the medical imaging diagnostic device 100 or server device 200 connected via the network 400. For example, the communication interface 310 can be implemented using a network card, network adapter, NIC (Network Interface Controller), etc. To give one example, the communication interface 310 receives medical image data and examination information from the medical imaging diagnostic device 100 or server device 200 and outputs the received medical image data and examination information to the processing circuit 350.

[0016] The memory circuit 320 is connected to the processing circuit 350 and stores various types of data. The memory circuit 320 also stores various information used in the processing of the processing circuit 350, the processing results of the processing circuit 350, and various programs that the processing circuit 350 reads and executes to realize various functions. For example, the memory circuit 320 can be implemented using semiconductor memory elements such as RAM (Random Access Memory) or flash memory, or a hard disk or optical disk. In this embodiment, the memory circuit 320 stores medical image data and examination information received from the medical image diagnostic device 100 or the server device 200.

[0017] The input interface 330 is connected to the processing circuit 350 and converts input operations received from the operator into electrical signals, which are then output to the processing circuit 350. In this specification, the input interface 330 is not limited to those equipped with physical operating components such as a mouse or keyboard. For example, an electrical signal processing circuit that receives electrical signals corresponding to input operations from an external input device located separately from the device and outputs these electrical signals to a control circuit is also included as an example of an input interface.

[0018] The display 340 is connected to the processing circuit 350 and displays various information and images output from the processing circuit 350. For example, the display 340 can be implemented as an LCD monitor, a CRT (Cathode Ray Tube) monitor, a touch panel, etc. For example, the display 340 can display a GUI (Graphical User Interface) for receiving operator instructions, various display images, and various processing results from the processing circuit 350.

[0019] The processing circuit 350 controls each component of the medical information processing device 300 in response to input operations received from the operator via the input interface 330. For example, the processing circuit 350 is implemented by a processor. In this embodiment, the processing circuit 350 stores medical image data and examination information output from the communication interface 310 in the storage circuit 320. The processing circuit 350 also reads medical image data and examination information from the storage circuit 320, performs various processes, and displays the processing results on the display 340.

[0020] Under this configuration, the medical information processing device 300 according to this embodiment is able to provide an index that can evaluate resistance in capillaries. Specifically, the medical information processing device 300 uses the vascular blood flow in the coronary arteries and the myocardial blood flow in the myocardium to calculate a capillary resistance index for evaluating the resistance (microcirculatory resistance) in the capillaries that supply blood flowing from the coronary arteries to the myocardium.

[0021] As shown in Figure 1, the processing circuit 350 according to this embodiment performs a control function 351, an acquisition function 352, an image generation function 353, a calculation function 354, and a determination function 355. Here, the control function 351 is an example of a display control unit. The acquisition function 352 is an example of an acquisition unit. The calculation function 354 is an example of a calculation unit.

[0022] The control function 351 performs overall control of the medical information processing device 300. Specifically, the control function 351 controls the device to perform processing in response to various requests input via the input interface 330. For example, the control function 351 controls the transmission and reception of medical image data, etc., via the communication interface 310, the storage of information in the memory circuit 320, and the display of information (e.g., display images and analysis results) on the display 340.

[0023] The acquisition function 352 acquires vascular blood flow in the coronary arteries and myocardial blood flow in the myocardial region supplied with blood by the coronary arteries. Specifically, the acquisition function 352 acquires vascular blood flow in the coronary arteries and myocardial blood flow in the myocardial region supplied with blood by the coronary arteries based on medical image data and examination information acquired from the medical image diagnostic device 100 and the server device 200.

[0024] For example, the acquisition function 352 acquires vascular blood flow in the coronary arteries by performing fluid analysis on coronary angiography CT image data acquired from the medical imaging diagnostic device 100, which is an X-ray CT device, or from the server device 200. In addition to acquiring vascular blood flow through fluid analysis, the acquisition function 352 can also acquire vascular blood flow in the coronary arteries by using FFR (Fractional Flow Reserve) measured by a pressure wire, instantaneous FFR, or fluid analysis on coronary angiography MR image data. The following will explain, as an example, how to acquire vascular blood flow in the coronary arteries by performing fluid analysis on coronary angiography CT image data.

[0025] FFR and instantaneous FFR are indices that estimate the degree of blood flow obstruction, and are defined as the ratio of blood flow at the origin to blood flow at the periphery of a blood vessel. In actual FFR measurement, the relationship between blood flow and pressure in the blood vessel is made proportional, thereby replacing blood flow with pressure. For example, in FFR measurement, adenosine is administered to induce a state of maximum congestion (stress state), thereby making the relationship between blood flow and pressure in the blood vessel proportional, and replacing the blood flow that defines FFR with pressure. Similarly, in instantaneous FFR measurement, without administering adenosine, a time phase is used where the relationship between blood flow and pressure in the blood vessel is proportional in a resting state, thereby replacing the blood flow that defines instantaneous FFR with pressure. The acquisition function 352 then obtains vascular blood flow in the coronary arteries by converting the pressure value measured by the pressure wire into a blood flow value.

[0026] When performing fluid analysis based on coronary angiography CT image data to obtain vascular blood flow, the acquisition function 352 reads out multiple time-series coronary angiography CT image data collected over time from the memory circuit 320, and extracts time-series vascular shape data by performing image processing on the read out multiple time-series coronary angiography CT image data.

[0027] Here, the acquisition function 352 sets a target area for calculating index values ​​in the vascular region included in the coronary angiography CT image data. Specifically, the acquisition function 352 sets the target area in the vascular region by instruction via the input interface 330 by the operator or by image processing. Details of setting the target area will be described in detail later. The acquisition function 352 then extracts vascular shape data for the set target area from the coronary angiography CT image data, such as the core line of the vessel (coordinate information of the core line), the cross-sectional area of ​​the vessel and lumen in a section perpendicular to the core line, and the distance from the core line to the inner wall and the distance from the core line to the outer wall in the cylindrical direction in a section perpendicular to the core line.

[0028] Furthermore, the acquisition function 352 sets the analysis conditions for the fluid analysis. Specifically, the acquisition function 352 sets the physical properties of blood, the iterative calculation conditions, and the initial values ​​of the analysis as analysis conditions. For example, the acquisition function 352 sets the viscosity and density of blood as physical properties of blood. The acquisition function 352 also sets the maximum number of iterations in the iterative calculation, the relaxation coefficient, and the allowable value of the residual as conditions for the iterative calculation. The acquisition function 352 also sets the blood flow rate, pressure, fluid resistance, and the initial value of the pressure boundary as initial values ​​of the analysis. The various values ​​used by the acquisition function 352 may be pre-programmed into the system or defined interactively by the operator.

[0029] The acquisition function 352 then calculates index values ​​related to blood flow in blood vessels by performing fluid analysis using coronary angiography CT image data. Specifically, the acquisition function 352 performs fluid analysis using blood vessel shape data and analysis conditions to calculate index values ​​related to blood flow in the target region of the blood vessel. For example, based on blood vessel shape data such as the contour of the lumen and outer wall of the blood vessel, the cross-sectional area and core line of the blood vessel, and setting conditions such as physical properties of blood, iterative calculation conditions and initial values ​​for analysis, the acquisition function 352 calculates index values ​​such as pressure, blood flow rate, blood flow velocity, vector, and shear stress for each predetermined location in the blood vessel. In this way, the acquisition function 352 can acquire blood flow rates for each location in the coronary artery.

[0030] Furthermore, for example, the acquisition function 352 acquires myocardial blood flow in the myocardium by performing perfusion analysis on myocardial contrast-enhanced CT image data acquired from the medical imaging diagnostic device 100, which is an X-ray CT device, or from the server device 200. In addition to acquiring myocardial blood flow through perfusion analysis based on myocardial contrast-enhanced CT image data, the acquisition function 352 can also acquire myocardial blood flow in the myocardium by using myocardial scintigraphy using a SPECT device, quantitative analysis of myocardial blood flow using a PET device, or perfusion analysis on myocardial contrast-enhanced MR image data. The following will explain, as an example, the case in which myocardial blood flow in the myocardium is acquired by performing perfusion analysis on myocardial contrast-enhanced CT image data.

[0031] When performing perfusion analysis based on myocardial contrast-enhanced CT image data to acquire myocardial blood flow, the acquisition function 352 reads out myocardial contrast-enhanced CT image data of multiple time phases collected over a period of multiple heartbeats from the memory circuit 320, and calculates myocardial blood flow by performing image processing on the read out myocardial contrast-enhanced CT image data of multiple time phases. For example, the acquisition function 352 calculates the TDC (Time Density Curve) for each pixel in the left ventricular cavity (or aorta) and myocardium based on the myocardial contrast-enhanced CT image data of multiple time phases collected over a period of multiple heartbeats. Then, the acquisition function 352 calculates the myocardial blood flow for each pixel in the myocardium based on the correspondence between the TDC (Time Density Curve) for each pixel in the myocardium and the calculated TDC (Time Density Curve) in the left ventricular cavity (or aorta). In this way, the acquisition function 352 can acquire the blood flow for each location in the myocardium. The acquisition function 352 can also calculate the average value of the myocardial blood flow of a group of pixels included in a predetermined region of the myocardium as the myocardial blood flow in the predetermined region.

[0032] As described above, the acquisition function 352 can acquire vascular blood flow for each location in the coronary arteries and myocardium by calculating vascular blood flow and myocardial blood flow using CT image data. Here, the acquisition function 352 acquires vascular blood flow and myocardial blood flow at locations specified by the operator. Specifically, the acquisition function 352 acquires vascular blood flow at coronary artery locations and myocardial blood flow in myocardial regions corresponding to the target region for calculating the capillary resistance index. For example, the acquisition function 352 acquires vascular blood flow and myocardial blood flow at corresponding locations, such as the terminal region of a coronary artery where stenosis is observed, the myocardial region where ischemia is observed, or the myocardial region that is the subject of medical treatment, as the target region for calculating the capillary resistance index.

[0033] For example, the acquisition function 352 acquires the vascular blood flow rate in the coronary arteries selected by the operator from among the coronary arteries included in the display image generated by the image generation function 353. The acquisition function 352 then identifies the myocardial region to which blood is supplied by the selected coronary artery and acquires the myocardial blood flow rate in the identified myocardial region. Here, the operator can also specify the location in the coronary artery from which to acquire the vascular blood flow rate. That is, the operator can select the coronary artery from which to acquire the vascular blood flow rate, and further specify the location within the selected vessel from which to calculate the vascular blood flow rate.

[0034] Furthermore, if the location for acquiring vascular blood flow is not specified (i.e., only the coronary arteries are selected), the acquisition function 352 may calculate the vascular blood flow at the branch origins of the selected coronary arteries. In addition, the supply area of ​​the selected coronary arteries is identified, for example, by the Voronoi method. That is, the acquisition function 352 identifies the supply area of ​​the selected coronary arteries by performing region expansion based on the shape of the selected coronary arteries.

[0035] Furthermore, for example, if a myocardial region is specified by the operator, the acquisition function 352 first identifies the coronary arteries that supply blood to the myocardial region specified by the operator. For example, the acquisition function 352 identifies the coronary arteries that supply blood to the specified myocardial region based on the morphological positional relationship between the coronary arteries and the myocardium. Here, the acquisition function 352 can further specify the range of coronary arteries that supply blood to the specified myocardial region. Then, by performing region expansion based on the shape of the identified coronary arteries, the acquisition function 352 further identifies the supply area of ​​the selected coronary arteries and acquires the myocardial blood flow in the identified supply area.

[0036] Furthermore, if the coronary arteries supplying blood to a specified myocardial region are identified, the acquisition function 352 calculates, for example, the blood flow rate at the branching point of the identified coronary artery. Additionally, if the range of coronary arteries supplying blood to a specified myocardial region is further identified, the acquisition function 352 calculates, for example, the blood flow rate at the branching end within the identified range of coronary arteries.

[0037] The image generation function 353 reads medical image data stored by the memory circuit 320 and generates display images from the read medical image data. For example, the image generation function 353 reads CT image data and performs various image processing on the read CT image data to generate display images showing the entire heart, coronary arteries, or partial myocardial regions. To give one example, the image generation function 353 performs image processing on CT image data to generate volume rendering images, CPR (Curved Multi-Planer Reconstruction) images, MPR (Multi-Planer Reconstruction) images, SPR (Stretched Multi-Planer Reconstruction) images, polar maps, etc.

[0038] Furthermore, the image generation function 353 generates display information using test results such as vascular blood flow, myocardial blood flow, and FFR acquired by the acquisition function 352, and capillary resistance index calculated by the calculation function 354. For example, the image generation function 353 generates perfusion images showing myocardial blood flow and graphs showing capillary resistance index.

[0039] The calculation function 354 combines vascular blood flow and myocardial blood flow to calculate a capillary resistance index, which indicates the amount of capillary resistance in the capillaries supplying blood to the myocardial region. For example, the calculation function 354 calculates a capillary resistance index based on the ratio of vascular blood flow to myocardial blood flow. Figure 2 is a diagram illustrating an example of the calculation of the capillary resistance index by the medical information processing device 300 according to the first embodiment.

[0040] Here, Figure 2 shows the case where vascular blood flow at coronary artery location P1 and myocardial blood flow at myocardial region R1 are obtained. As mentioned above, location P1 and region R1 may be determined by the operator specifying the coronary artery, or they may be determined by the operator specifying the myocardial region.

[0041] The calculation function 354 uses the vascular blood flow at coronary artery location P1 and the myocardial blood flow at myocardial region R1 to calculate the capillary resistance index corresponding to coronary artery location P1 and myocardial region R1. For example, the calculation function 354 calculates the capillary resistance index using the following formula.

[0042] Capillary resistance index = Myocardial blood flow (Q myo ) / vascular blood flow (Q vessel )

[0043] In other words, the calculation function 354 calculates the blood supply capacity from the coronary arteries to the myocardial region (the degree of obstruction of blood flow in the capillaries between the coronary arteries and the myocardium) by calculating the ratio of the vascular blood flow in the coronary arteries to the myocardial blood flow in the myocardial region supplied by those coronary arteries. Here, for example, if the capillary resistance is high, the blood supply from the coronary arteries to the myocardial region decreases, so the capillary resistance index becomes less than "1". On the other hand, if the capillary resistance is low, the blood supply from the coronary arteries to the myocardial region does not decrease, so the capillary resistance index approaches "1".

[0044] For example, the calculation function 354 calculates the "vascular blood flow rate (Q)" at position P1 obtained by the acquisition function 352. vessel ) and "myocardial blood flow (Q)" in the myocardial region R1 myo Based on the above formula, the capillary resistance index corresponding to position P1 and myocardial region R1 is calculated.

[0045] The above-described embodiment explains the case in which the capillary resistance index is calculated for a single coronary artery and region. However, the embodiment is not limited thereto, and the medical information processing device 300 can also calculate the capillary resistance index for myocardial regions supplied by multiple coronary arteries. In such a case, for example, the acquisition function 352 acquires multiple vascular blood flows in multiple coronary arteries and a single myocardial blood flow, which is a combination of multiple myocardial blood flows in multiple myocardial regions supplied with blood by multiple coronary arteries. The calculation function 354 then calculates the capillary resistance index by combining the multiple vascular blood flows and the single myocardial blood flow.

[0046] Figure 3 illustrates an example of the calculation of capillary resistance index by the medical information processing device 300 according to the first embodiment. Here, Figure 3 shows the case in which the capillary resistance index of a myocardial region supplied by two coronary arteries is calculated. For example, in the example of Figure 3, once the target region for which the capillary resistance index is to be calculated is specified, the acquisition function 352 identifies the range of the two coronary arteries that supply blood to the specified target region. Then, the acquisition function 352 identifies the vascular blood flow rate "Q" at position P2 of the branch end of each of the two identified coronary arteries. vessel1 " and vascular blood flow at position P3 "Q vessel2 Obtain "".

[0047] Furthermore, the acquisition function 352 identifies the respective supply areas of the two identified coronary arteries using the Voronoi method, and extracts a single region R2 that combines the identified supply areas. Then, the acquisition function 352 calculates the myocardial blood flow "Q" in the extracted region R2. myo The acquisition function 352 obtains the location P2, location P3, and region R2 described above. Note that the determination of location P2, location P3, and region R2 described above is merely an example. For example, location P2 and location P3 may be specified by the operator, and the acquisition function 352 may identify region R2 based on the specified location P2 and location P3.

[0048] As described above, the acquisition function 352 acquires the vascular blood flow rate "Q" at position P2. vessel1" and the blood flow volume of the blood vessel "Q" at the position P3 vessel2 ", and the myocardial blood flow volume "Q" in the region R2 myo " and ", when obtaining them, the calculation function 354, for example, calculates the capillary resistance index in the region R2 by "(myocardial blood flow volume (Q myo )) / (blood flow volume of the blood vessel (Q vessel1 )) + blood flow volume of the blood vessel (Q vessel2 ))".

[0049] In the above example, when specifying the range for supplying blood to the myocardial region, the case of specifying only the end portion on the bifurcation start side has been described. However, the embodiment is not limited to this, and for example, the case of specifying the end portion on the bifurcation start side and the end portion on the peripheral side may be applicable. In such a case, the acquisition function 352 acquires the blood flow volume of the blood vessel at the upstream end portion of the range of the coronary artery that supplies blood to the myocardial region and the blood flow volume of the blood vessel at the downstream end portion, and the myocardial blood flow volume in the specified myocardial region. Then, the calculation function 354 calculates an index by combining the difference between the blood flow volume of the blood vessel at the upstream end portion and the blood flow volume of the blood vessel at the downstream end portion, and the myocardial blood flow volume in the specified myocardial region.

[0050] FIG. 4 is a diagram for explaining an example of calculating the capillary resistance index by the medical information processing apparatus 300 according to the first embodiment. Here, in FIG. 4, the case of calculating the capillary resistance index of the myocardial region dominated by a predetermined range in one coronary artery is shown. For example, in the example of FIG. 4, since the target region for calculating the capillary resistance index is specified within a predetermined range in one coronary artery, the acquisition function 352 specifies the range of the coronary artery (the end portion on the bifurcation start side and the end portion on the peripheral side of the coronary artery) that supplies blood to the specified target region. Then, the acquisition function 352 acquires the blood flow volume of the blood vessel "Q" at the position P4 of the end portion on the bifurcation start side and the blood flow volume of the blood vessel "Q" at the position P5 in each of the specified coronary artery ranges. Further, the acquisition function 352 calculates " vessel3 " - " vessel4 " as the blood flow volume of the blood vessel in the coronary artery from the position P4 to the position P5.

[0051] ​​​​ Then, the acquisition function 352 identifies the myocardial region R3 supplied by the identified coronary artery area using the Voronoi method. The acquisition function 352 then records the myocardial blood flow "Q" in the identified region R3. myo The acquisition function 352 obtains the location P4, location P5, and region R3. Note that the determination of location P4, location P5, and region R3 described above is merely an example; for example, location P4 and location P5 may be specified by the operator, and the acquisition function 352 may identify region R3 based on the specified location P4 and location P5.

[0052] As described above, the acquisition function 352 acquires the vascular blood flow "Q" in the coronary arteries from position P4 to position P5. vessel3 -Q vessel4 " and myocardial blood flow in region R3 "Q myo When the following is obtained, the calculation function 354 calculates, for example, "myocardial blood flow in region R3 (Q myo ) / (vascular blood flow (Q vessel3 )-vascular blood flow (Q vessel4 The capillary resistance index corresponding to the coronary arteries and region R3 from position P4 to position P5 is calculated using the following method.

[0053] The above example describes the case where the capillary resistance index is calculated for a single myocardial region. However, the embodiments are not limited to this, and for example, the myocardial region may be divided into sub-regions, and the capillary resistance index may be calculated for each divided sub-region. In such a case, the acquisition function 352 divides the coronary arteries and the myocardial region supplied with blood by the coronary arteries into multiple ranges, and for each divided range, it acquires the vascular blood flow at the upstream end of the range, the vascular blood flow at the downstream end of the range, and the myocardial blood flow in the myocardial region corresponding to that range. Then, the calculation function 354 combines the difference between the vascular blood flow at the upstream end and the vascular blood flow at the downstream end with the myocardial blood flow in the myocardial region corresponding to the range to calculate the capillary resistance index for each divided range.

[0054] Figure 5A is a diagram illustrating an example of the calculation of capillary resistance index by the medical information processing device 300 according to the first embodiment. In Figure 5A, the myocardial region supplied by the coronary arteries is divided into multiple sub-regions, and the capillary resistance index is calculated for each sub-region. For example, in the example of Figure 5A, once the target region for which the capillary resistance index is calculated is specified, the acquisition function 352 identifies the range of coronary arteries that supply blood to the specified target region (the position P6 of the branch ends of the coronary arteries). The acquisition function 352 then identifies the myocardial region R4 supplied by the identified range of coronary arteries using the Voronoi method.

[0055] Subsequently, the acquisition function 352 acquires the core lines of the coronary arteries within the specified range and divides the coronary artery and myocardial region R4 into multiple regions in a direction perpendicular to the core lines. For example, the acquisition function 352 divides region R4 into partial regions R411 and R412 by a line segment perpendicular to the core lines of the coronary arteries and passing through position P61. In other words, the acquisition function 352 divides the coronary artery region from position P6 to position P61, and the region including partial regions R411 and R412, from the coronary artery and region R4 by a line segment passing through position P61.

[0056] Furthermore, the acquisition function 352 divides region R4 into partial regions R421 and R422 by line segments perpendicular to the core line of the coronary artery and passing through position P62, and also divides the region from the coronary artery to position P61 and position P62. Similarly, the acquisition function 352 divides partial regions R431 to R492 and partial region R42 by line segments passing through positions P63 to P610.

[0057] The acquisition function 352 then acquires vascular blood flow and myocardial blood flow for each of the divided areas. For example, the acquisition function 352 acquires vascular blood flow and myocardial blood flow for the area including the coronary artery region from position P6 to position P61, and the sub-regions R411 and R412. For example, the acquisition function 352 acquires the vascular blood flow "Q" at position P6. vessel6 " and vascular blood flow at position P61 "Q vessel61Furthermore, acquisition function 352 obtains "Q" as the vascular blood flow in the coronary arteries from position P6 to position P61. vessel6 -Q vessel61 The acquisition function 352 calculates the myocardial blood flow "Q" in the partial region R411. myo411 " and myocardial blood flow in partial region R421 "Q myo421 " and obtain.

[0058] Similarly, the acquisition function 352 acquires vascular blood flow and myocardial blood flow for each range from the coronary artery region from position P61 to position P62, including the partial regions R421 and R422, to the coronary artery region from position P610 to the terminal coronary artery, including the partial region R42.

[0059] The calculation function 354 uses the vascular blood flow rate for each range and the myocardial blood flow rate in each subregion, acquired by the acquisition function 352, to calculate the capillary resistance index for each subregion. For example, the calculation function 354 uses "Q" as the capillary resistance index for subregion R411. myo411 / (Q vessel6 -Q vessel61 The calculation function 354 calculates "Q" as the capillary resistance index in the partial region R421. myo421 / (Q vessel6 -Q vessel61 The calculation function 354 may also calculate the average of the capillary resistance index in partial region R411 and the capillary resistance index in partial region R421 as a capillary resistance index corresponding to the coronary arteries from position P6 to position P61.

[0060] Similarly, the calculation function 354 calculates the capillary resistance index for each sub-region for each range from the coronary artery region from position P61 to position P62, including sub-regions R421 and R422, to the coronary artery region from position P610 to the terminal coronary artery, including sub-region R42. For the range from the coronary artery region from position P610 to the terminal coronary artery, including sub-region R42, one capillary resistance index is calculated from the myocardial blood flow in the coronary artery region from position P610 to the terminal coronary artery and the myocardial blood flow in sub-region R42.

[0061] Here, the example of division shown in Figure 5A is merely an example, and the embodiment is not limited to this. That is, the number of subregions when dividing region R4 is not limited to the number shown in Figure 5A. For example, it may be divided into more subregions than the number shown in Figure 5A, or it may be divided into fewer subregions than the number shown in Figure 5A.

[0062] The above example described the case of dividing the supply area of ​​a single coronary artery. Below, we will describe the case of dividing the supply area of ​​a region where a coronary artery branches. Figure 5B is a diagram illustrating an example of the calculation of the capillary resistance index by the medical information processing device 300 according to the first embodiment. Here, Figure 5B shows a magnified view of the region where the coronary artery branches. That is, even in the case shown in Figure 5B, the extent of the coronary artery and the myocardial region supplied by that coronary artery are actually identified, just as in Figure 5A.

[0063] For example, in the example shown in Figure 5B, the acquisition function 352 first divides the coronary artery region from position P71 to position P72 into an area including sub-regions R511 and R512, and an area including the coronary artery region from position P72 to position P73, and sub-regions R521 and R522. Then, the acquisition function 352 further divides sub-region R522, which includes branches, into multiple areas. For example, the acquisition function 352 divides sub-region R522 into an area including the coronary artery region from position P721 to position P722, and sub-regions R5221 and R5222. Similarly, the acquisition function 352 divides sub-region R522, which includes branches, into multiple areas.

[0064] As described above, once the region is divided, the acquisition function 352 acquires vascular blood flow and myocardial blood flow for each region. That is, for each divided region, the acquisition function 352 acquires vascular blood flow of the coronary arteries and myocardial blood flow for each sub-region. For example, for the region including the coronary artery region from position P71 to position P72 and sub-regions R511 and R512, the acquisition function 352 acquires vascular blood flow and myocardial blood flow in the same manner as described in Figure 5A.

[0065] Furthermore, the acquisition function 352 acquires the blood flow rate for each region, for example, as follows, for the coronary artery region from position P72 to position P73, and the region including partial region R521 and partial region R522 which includes branches. First, as the blood flow rate for calculating the capillary resistance index in partial region R521 which does not include branches, the acquisition function 352 acquires the vascular blood flow rate "Q" at position P72, as explained in Figure 5A. vessel72 " and vascular blood flow at position P73 "Q vessel73 Furthermore, acquisition function 352 obtains "Q" as the vascular blood flow in the coronary artery from position P72 to position P73. vessel72 -Q vessel73 The acquisition function 352 calculates the myocardial blood flow "Q" in the partial region R521. myo521 Obtain "".

[0066] On the other hand, to calculate the capillary resistance index in the subregion R522 including the branching, the acquisition function 352 uses the vascular blood flow "Q" at position P72 as the blood flow rate. vessel72 " and the vascular blood flow at branch position P721 "Q vessel721 " and the vascular blood flow at position P73 "Q vessel73 " and the vascular blood flow at position P722 "Q vessel722 " and the vascular blood flow at position P723 "Q vessel723 " and the vascular blood flow at position P724 "Q vessel724 The acquisition function 352 then acquires the vascular blood flow "Q" in the coronary arteries from position P72 to position P721. vessel72 -Q vessel721 ", vascular blood flow in the coronary arteries from position P721 to position P73 "Q vessel721 -Q vessel73 ", vascular blood flow in the coronary arteries from position P721 to position P722 "Q vessel721 -Q vessel722 ", vascular blood flow in the coronary arteries from position P722 to position P723 "Q vessel722 -Q vessel723 ", vascular blood flow in the coronary arteries from position P723 to position P724 "Q vessel723 -Q vessel724 Calculate ".

[0067] Furthermore, the acquisition function 352 acquires the myocardial blood flow "Q" in the partial region R5221. myo5221 " and myocardial blood flow in partial region R5221 "Q myo5221 The myocardial blood flow is obtained for each subregion separated from the subregion R522 which includes "[ ]".

[0068] As described above, once the blood flow rate in each region is obtained, the calculation function 354 uses each blood flow rate to calculate the capillary resistance index for each divided range. For example, the calculation function 354 calculates the capillary resistance index for the range including the coronary artery region from position P71 to position P72, and the sub-regions R511 and R512, in the same manner as explained in Figure 5A.

[0069] On the other hand, for the range including the subregion R522 which includes branches, the calculation function 354 calculates the capillary resistance index as follows, for example. First, for the capillary resistance index in the subregion R521 which does not include branches, the calculation function 354 calculates "Q" as explained in Figure 5A. myo521 / (Q vessel72 -Q vessel73 Calculate ")".

[0070] Furthermore, regarding the capillary resistance index in each subregion included in the subregion R522 which includes branches, the calculation function 354 calculates, for example, the capillary resistance index in subregion R5221 as "Q myo5221 / ((Q vessel72 -Q vessel721 )+(Q vessel721 -Q vessel722 The calculation function 354 calculates the capillary resistance index, which takes into account the blood supply from the coronary arteries from position P72 to position P721 and the blood supply from the coronary arteries from position P721 to position P722.

[0071] Similarly, the calculation function 354 calculates, for example, a capillary resistance index "Q" in a partial region R5222, which takes into account the blood supply from the coronary arteries from position P721 to position P73 and the blood supply from the coronary arteries from position P721 to position P722. myo5222 / ((Q vessel721 -Q vessel73 )+(Q vessel721 -Q vessel722 The calculation for the range thereafter is performed in the same manner as above. That is, for example, the calculation function 354 calculates the vascular blood flow in the coronary arteries from position P722 to position P723 relative to the myocardial blood flow in the partial regions on both sides, "Q vessel722 -Q vessel723 By calculating each of these values, the capillary resistance index for each region of the armpit is calculated.

[0072] It should be noted that the example of division shown in Figure 5B is merely an example, and the embodiment is not limited to this. In other words, the number of sub-regions when dividing is not limited to the number shown in Figure 5B. For example, it may be divided into more sub-regions than the number shown in Figure 5B, or it may be divided into fewer sub-regions than the number shown in Figure 5B.

[0073] As described above, the acquisition function 352 and calculation function 354 according to this embodiment calculate the capillary resistance index from the vascular blood flow in the coronary arteries and the myocardial blood flow in the myocardium. Here, the calculation of the capillary resistance index described above can be applied to the entire heart. That is, the acquisition function 352 and calculation function 354 can calculate the capillary resistance index for the myocardium of the entire heart, as well as for the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex coronary artery (LCX), which include all branching vessels.

[0074] Furthermore, the operator can arbitrarily set the target region for calculating the capillary resistance index, whether or not to divide the target region, and the number of divisions if divided. For example, these settings can be arbitrarily set each time the capillary resistance index is calculated. In addition, conditions may be pre-set for each target region for which the capillary resistance index is calculated. In such cases, for example, if the myocardial region at the apex of the heart is set as the target region, it may be pre-set to calculate the capillary resistance index using the vascular blood flow in the three vessels: RCA, LAD, and LCX.

[0075] Furthermore, the vascular blood flow rate and myocardial blood flow rate mentioned above may be acquired under either a stressed or resting state. In other words, the acquisition function 352 and calculation function 354 according to this embodiment can calculate the capillary resistance index under a stressed state and the capillary resistance index under a resting state.

[0076] Returning to Figure 1, the judgment function 355 determines the state of the target region based on the capillary resistance index calculated by the calculation function 354. For example, the judgment function 355 determines whether sufficient microcirculation is maintained in the blood supply to the myocardium by comparing the calculated capillary resistance index value with a threshold. To give one example, if the capillary resistance index value is lower than a predetermined threshold, the judgment function 355 determines that blood supply in the capillaries is impaired.

[0077] Furthermore, for example, the judgment function 355 can also determine the condition of the target area by comparing the capillary resistance index calculated under stress and rest conditions. For instance, the judgment function 355 compares the capillary resistance index calculated under stress and rest conditions in an area where ischemia is occurring, and if there is no difference between the two, it determines that there is damage to the coronary arteries.

[0078] Furthermore, for example, the diagnostic function 355 can also determine the treatment plan using the capillary resistance index and other test information. The determination of the treatment plan will be described in detail later.

[0079] As described above, the medical information processing device 300 according to this embodiment can calculate a capillary resistance index for the entire heart. Furthermore, the medical information processing device 300 can display the calculated capillary resistance index in various forms. That is, the control function 351 can display information regarding the capillary resistance index calculated by the calculation function 354 on the display 340. Below, examples of display forms of the capillary resistance index according to this embodiment will be described using Figures 6 to 16. Figures 6 to 16 are diagrams showing examples of display forms of the capillary resistance index according to the first embodiment.

[0080] For example, the control function 351 controls the display of a display image showing information about the capillary resistance index calculated by the calculation function 354 on a medical image that includes at least one of the myocardial region and the coronary arteries. For example, as shown in Figure 6, the control function 351 displays a color image in which region R1 on a volume rendering image showing the entire heart is shown in a color corresponding to the calculated capillary resistance index value.

[0081] In such cases, the image generation function 353 generates, for example, a volume rendering image of the entire heart from the acquired CT image data. The control function 351 displays a color image in which the region R1 of the generated volume rendering image is colored according to the calculated capillary resistance index value. The color assignment to the capillary resistance index can be arbitrary. Note that the example shown in Figure 6 is merely one example, and various other images can be used as the display image. For example, a surface rendering image may be used.

[0082] Furthermore, the control function 351 displays the color corresponding to the capillary resistance index calculated for each divided area, and controls the display of the assigned color image on the 3D image representing the myocardial region or coronary artery. For example, when the target region is divided into sub-regions and the capillary resistance index for each sub-region is calculated, the control function 351 displays a color image for region R1 on the volume rendering image representing the myocardium, with the color corresponding to the value of the capillary resistance index calculated for each divided sub-region, as shown in Figure 7A.

[0083] Furthermore, for example, if the target area is divided into sub-regions and a capillary resistance index is calculated for each sub-region, the control function 351 displays a color image showing each region corresponding to each area of ​​the coronary artery on the volume rendering image showing the coronary artery, with the color corresponding to the value of the capillary resistance index, as shown in Figure 7B. In such cases, the image generation function 353 generates a volume rendering image of the coronary artery from the acquired CT image data, for example. The control function 351 displays a color image showing each region of the coronary artery in the generated volume rendering image, with the color corresponding to the value of the capillary resistance index.

[0084] Here, when the range includes multiple subregions (for example, the range including subregions R411 and R412 in Figure 5A), the capillary resistance index value assigned to the coronary artery region within that range (for example, the region from position P1 to position P61 in Figure 5A) may be the average of the capillary resistance indices in each subregion, or it may be the lowest capillary resistance index among the capillary resistance indices of each subregion.

[0085] Furthermore, if multiple capillary resistance indices are precisely calculated along the coronary arteries through fine division, the control function 351 can display a graph showing the capillary resistance indices for each location in the coronary arteries. For example, the control function 351 controls the display to show a display image of the coronary arteries along the long axis on a two-dimensional plane, and a graph showing the changes in the indices calculated for each range of the coronary arteries, with the location in the display image corresponding to the location in the graph.

[0086] For example, the control function 351 displays a graph showing the capillary resistance index on the vertical axis and the position of the coronary arteries on the horizontal axis, as shown in Figure 8A. Furthermore, the control function 351 displays an SPR image aligned with the position of the coronary arteries on the horizontal axis, corresponding to the graph. In such a case, the image generation function 353 generates, for example, an SPR image of the coronary artery from which the capillary resistance index has been calculated, from the CT image data. Furthermore, the image generation function 353 generates a graph of the capillary resistance index at a scale that corresponds to the position of the coronary artery in the generated SPR image and the position on the horizontal axis of the graph. The control function 351 displays the graph and SPR image generated by the image generation function 353 in correspondence, as shown in Figure 8A.

[0087] Furthermore, the control function 351 can also be controlled to display the results of myocardial perfusion on the displayed image. For example, as shown in Figure 8B, the control function 351 displays a color image in which the myocardial region of the SPR image is shown in a color corresponding to the myocardial blood flow result calculated by the acquisition function 352.

[0088] Furthermore, the medical information processing device 300 can use a polar map to display the entire myocardium. For example, the control function 351 controls the display to show the coronary arteries and myocardial regions in an identifiable manner on a display image in which the myocardium is displayed in polar coordinates, and to display a color image in which the calculated indices for each divided range are shown in color. To give one example, as shown in Figure 9, the control function 351 displays a display image in which the target region for which the coronary arteries and capillary resistance indices have been calculated is superimposed on a polar map in which the entire myocardium is displayed in polar coordinates.

[0089] In such cases, the image generation function 353 generates images of the coronary arteries and the target region with shapes that match the position on the polar map. Then, the control function 351 overlays the generated coronary artery images and target region images onto the corresponding positions on the polar map and displays them. Here, as shown in Figure 9, the control function 351 displays a color image by indicating each sub-region of the target region with a color corresponding to the capillary resistance index value calculated by the calculation function 354.

[0090] As described above, the control function 351 can display the capillary resistance index in various display formats. Here, the control function 351 can display various display images in the formats described above in appropriate combinations. For example, the control function 351 can display all of the display images shown in Figures 6 to 9 side by side, or display multiple display images selected from each of the display images side by side.

[0091] Here, the control function 351 can display markers indicating the positional relationship between images when multiple display images are shown side by side. For example, when the control function 351 displays color images, graphs and SPR images, polar maps, etc., side by side, it can place and display markers that indicate approximately the same position for each of these images.

[0092] For example, as shown in Figure 10, the control function 351 displays a graph showing the capillary resistance index on the vertical axis and the position of the coronary arteries on the horizontal axis, as well as an SPR image with the coronary artery positions aligned on the horizontal axis, and a color image using a volume rendering image of the coronary arteries. In doing so, it displays markers M1 and M2 indicating approximately the same position on the coronary arteries.

[0093] Specifically, the control function 351 acquires information on the positional relationship between the position on the horizontal axis of the graph (SPR image) and the position of the coronary artery in the volume rendering image, based on the coordinate information generated when the SPR image and volume rendering image are generated by the image generation function 353. Then, based on the acquired positional relationship information, the control function 351 places marker M1, which indicates approximately the same position on the coronary artery, on the horizontal axis of the graph (or SPR image), and places marker M2 on the coronary artery in the volume rendering image.

[0094] Here, the display of the marker may start simultaneously with the display of multiple display images, or it may start in response to a marker display start instruction from the operator via the input interface 330. Furthermore, the marker is moved in response to a movement instruction from the operator via the input interface 330. That is, the control function 351 moves the marker to a position corresponding to the marker movement operation via the input interface 330 and displays it. At this time, the control function 351 moves multiple markers placed on each display image in conjunction. For example, if the operator performs an operation to move marker M1, the control function 351 also moves marker M2 in conjunction.

[0095] Furthermore, the control function 351 can also display a short-axis cross-sectional image of a specified location in the coronary artery. For example, when a marker is placed on a coronary artery, the control function 351 controls the system to display a short-axis cross-sectional image of the coronary artery at the placed location. For example, as shown in Figure 10, when marker M1 is placed on a coronary artery, the image generation function 353 first generates a cross-cut image (a cross-sectional image perpendicular to the core line) of the location where marker M1 is placed. The control function 351 then displays the generated short-axis cross-sectional image at the location corresponding to marker M1 on the horizontal axis of the SPR image (or graph).

[0096] The above example described how to display the capillary resistance index in various display formats. However, the medical information processing device 300 can also display index values ​​other than the capillary resistance index.

[0097] For example, the control function 351 superimposes a 3D image showing the coronary arteries and a color image showing range-specific indicators in color on the 3D image showing the myocardial region, and further controls the display of a marker indicating the position in the coronary arteries and the coronary flow reserve ratio at the position of the marker. To give one example, as shown in Figure 11, the control function 351 displays marker M3 on a superimposed image obtained by superimposing a volume rendering image showing the coronary arteries and a volume rendering image of region R6 from which the capillary resistance index was calculated. Then, the control function 351 further displays the FFR value "0.8" at marker M3.

[0098] In other words, the control function 351 obtains the FFR value at the position of marker M3 from the results of the fluid analysis performed by the acquisition function 352 and displays it at the position of marker M3 in the superimposed image. Here, the position of marker M3 is moved by a movement operation performed by the operator via the input interface 330. Each time marker M3 is moved by the movement operation, the control function 351 obtains the FFR value at the new position of marker M3 and displays it at the position of marker M3 in the superimposed image.

[0099] Furthermore, for example, the control function 351 controls the display of a three-dimensional image showing the coronary arteries, markers indicating their positions in the coronary arteries, and the capillary resistance index and coronary flow reserve ratio at the positions of the markers. For example, as shown in Figure 12, the control function 351 displays markers M3 and M4 on a volume rendering image showing the coronary arteries. The control function 351 then further displays the FFR value of "0.8" at marker M3 and the capillary resistance index value of "0.9" at marker M4.

[0100] Here, the positions of markers M3 and M4 are moved by a movement operation performed by the operator via the input interface 330. Each time marker M3 is moved by the movement operation, the control function 351 obtains the FFR value at the new position of marker M3 and displays it at the position of marker M3 in the volume rendering image. Similarly, each time marker M4 is moved by the movement operation, the control function 351 obtains the capillary resistance index value at the new position of marker M4 and displays it at the position of marker M4 in the volume rendering image. It is also possible to control markers M3 and M4 so that the other moves in conjunction with the movement operation of either one. In other words, markers M3 and M4 can be moved independently or in conjunction with each other.

[0101] Furthermore, for example, the control function 351 displays the results of myocardial perfusion on a display image in which the myocardium is shown in polar coordinates, and controls the display to make areas in the myocardial region included in the display image where the capillary resistance index is lower than a threshold identifiable. For example, as shown in Figure 13, the control function 351 assigns a color to the polar map corresponding to the myocardial blood flow value obtained by myocardial perfusion, and further displays areas where the capillary resistance index is lower than a threshold identifiable. Here, the control function 351 makes areas with lower values ​​identifiable by, for example, surrounding them with a frame or masking them with a different color.

[0102] Furthermore, for example, the control function 351 displays the results of myocardial perfusion on a three-dimensional image representing the myocardium, and controls the display of areas within the myocardial region included in the three-dimensional image where the index is lower than a threshold, in a way that makes them identifiable. For example, as shown in Figure 14, the control function 351 assigns a color to the polar map corresponding to the myocardial blood flow value obtained by myocardial perfusion, and further displays areas where the capillary resistance index is lower than a threshold, in a way that makes them identifiable. Here, the control function 351 displays areas where the index is lower than a threshold, for example, by surrounding them with a frame or masking them with a different color.

[0103] Furthermore, for example, the control function 351 displays a three-dimensional image showing the coronary arteries, and when it receives a request to specify a location on the coronary artery relative to the three-dimensional image, it controls the system to display the coronary flow reserve ratio at the specified location, the results of myocardial perfusion in the myocardial region supplied with blood by the coronary artery at the specified location, the capillary resistance index at the specified location, and a value based on the pixel value at the specified location side by side. In other words, the control function 351 can simultaneously display various indicators when a location is specified on the coronary artery.

[0104] For example, as shown in Figure 15, the control function 351 places and displays a marker M5 in the coronary artery within the volume rendering image of the coronary artery to specify its position in the coronary artery. The control function 351 then displays "FFR: aaa", "MBF: bbb", "Capillary Resistance Index: ccc", and "TAG: ddd" side by side at the position of the marker M5.

[0105] MBF (Myocardial Blood Flow) is the myocardial blood flow rate, and it displays the myocardial blood flow rate in the myocardium adjacent to the position of marker M5. TAG (Transluminal Attenuation Gradient) is a value based on the pixel value (HU value) in the coronary artery, and it is the slope (spatial rate of change of HU value) in a graph where the horizontal axis is the distance from the upstream side to the downstream side along the core line of the coronary artery, and the vertical axis is the HU value at each distance.

[0106] For example, when a contrast agent is injected and travels the distance between two points on the coronary artery, the slower the blood flow, the longer it takes for the contrast agent to move. Therefore, the difference in contrast enhancement is greater in vessels where blood flow is reduced due to a lesion, and the slower the blood flow, the larger the TAG (Transitional Artery Gradient). The TAG is calculated using coronary angiography CT image data and acquisition function 352.

[0107] Furthermore, for example, the control function 351 displays a three-dimensional image of the myocardium, and when it receives a request to specify a myocardial region in the three-dimensional image, it controls the system to display the coronary flow reserve ratio in the coronary arteries supplying blood to the specified myocardial region, the results of myocardial perfusion in the specified myocardial region, and the capillary resistance index in the specified myocardial region side by side.

[0108] For example, as shown in Figure 16, when a region R1 is specified for calculating the capillary resistance index for the myocardium in the volume rendering image of the heart, the control function 351 displays the "FFR:eee" at the position P1 of the coronary artery supplying blood to region R1, the "MBF:fff" in region R1, and the "capillary resistance index:ggg" in region R1 side by side.

[0109] Furthermore, for example, the control function 351 displays a recommended treatment plan for at least one of the received location and the received myocardial region, based on the comparison result between each of the displayed items and the threshold set for each displayed item. For example, as shown in Figures 15 and 16, the control function 351 can display a recommended treatment plan when multiple displayed items (such as FFR and MBF) are displayed side by side.

[0110] In such cases, the judgment function 355 first determines the recommended treatment plan by comparing each displayed item with a threshold value. For example, the judgment function 355 determines the recommended treatment plan based on the judgment criteria shown in Figure 17. Figure 17 is a diagram illustrating an example of the judgment criteria for determining the treatment plan according to the first embodiment. Here, Figure 17 shows the judgment criteria used to determine the treatment plan using FFR, MBF, and capillary resistance index. Also, in Figure 17, an upward arrow (↑) indicates that the value is higher than the threshold, and a downward arrow (↓) indicates that the value is lower than the threshold.

[0111] The judgment criteria shown in Figure 17 are pre-set and stored in the memory circuit 320. That is, the judgment function 355 makes a judgment by referring to the judgment criteria stored in the memory circuit 320. In addition, the threshold values ​​used for judging each display item are pre-set by the operator or other user.

[0112] For example, as shown in Figure 17, the judgment function 355 determines "catheter treatment" as the "recommended treatment" when "FFR:↓, MBF:↓, capillary resistance index:↑". Also, as shown in Figure 17, the judgment function 355 determines "drug therapy" as the "recommended treatment" when "FFR:↑, MBF:↓, capillary resistance index:↓". Also, as shown in Figure 17, the judgment function 355 determines "no treatment needed" as the "recommended treatment" when "FFR:↓, MBF:↑, capillary resistance index:↑". Also, as shown in Figure 17, the judgment function 355 determines "catheter treatment" and "drug therapy" as the "recommended treatment" when "FFR:↓, MBF:↓, capillary resistance index:↓".

[0113] The control function 351 displays the results (recommended treatment) determined by the judgment function 355, further associating them with each display item in the displayed image. The above-mentioned determination of recommended treatment can be performed for each coronary artery location or for each myocardial region. That is, each time the operator moves the marker M5 using the input interface 330 or specifies the target area for calculating the capillary resistance index, the judgment function 355 determines the recommended treatment plan for each new location, and the control function 351 displays the determination result.

[0114] It should be noted that the criteria shown in Figure 17 are merely an example, and the embodiment is not limited to this. For example, TAG or other indicators may be used as items to compare with the threshold.

[0115] Next, the processing procedure of the medical information processing device 300 according to the first embodiment will be described. Figure 18 is a flowchart showing the processing procedure of the medical information processing device 300 according to the first embodiment. Here, steps S101 and S111 in Figure 18 are realized, for example, by the processing circuit 350 calling and executing a program corresponding to the control function 351 from the storage circuit 320. Steps S103 to S108 are realized, for example, by the processing circuit 350 calling and executing a program corresponding to the acquisition function 352 from the storage circuit 320. Step S109 is realized, for example, by the processing circuit 350 calling and executing a program corresponding to the calculation function 354 from the storage circuit 320. Steps S102 and S110 are realized, for example, by the processing circuit 350 calling and executing programs corresponding to the control function 351 and the image generation function 353 from the storage circuit 320.

[0116] In the medical information processing device 300 according to this embodiment, first, the processing circuit 350 acquires CT image data (step S101). Then, the processing circuit 350 generates and displays an image of the heart from the CT image data (step S102). Next, the processing circuit 350 determines whether or not it has received a specification of a location relative to the coronary artery (step S103). If it has received a specification of a location relative to the coronary artery (affirmative in step S103), the processing circuit 350 identifies the myocardial region to which the specified coronary artery supplies blood (step S104), and calculates the vascular blood flow rate in the specified coronary artery and the myocardial blood flow rate in the identified myocardial region (step S105).

[0117] On the other hand, if the location relative to the coronary artery is not specified in step S103 (step S103 negated), the processing circuit 350 determines whether or not the specification of a region relative to the myocardium has been accepted (step S106). If the specification of a region relative to the myocardium has been accepted (step S106 affirmed), the processing circuit 350 identifies the coronary artery that supplies blood to the specified myocardial region (step S107) and calculates the myocardial blood flow rate in the specified myocardial region and the vascular blood flow rate in the identified coronary artery (step S108). If the specification of a region relative to the myocardium is not accepted in step S106 (step S106 negated), the processing circuit 350 returns to step S103 and continues the determination.

[0118] In step S105 or step S108, when the vascular blood flow rate and myocardial blood flow rate are calculated, the processing circuit 350 calculates the capillary resistance index using the vascular blood flow rate and myocardial blood flow rate (step S109). The processing circuit 350 then generates and displays information regarding the calculated capillary resistance index (step S110). After that, the processing circuit 350 determines whether or not the calculation of the capillary resistance index has been completed (step S111), and if it has been completed (step S111 affirmative), it terminates the process. On the other hand, if it has not been completed (step S111 negative), the processing circuit 350 returns to step S103 and continues the determination.

[0119] As described above, according to the first embodiment, the acquisition function 352 acquires the vascular blood flow rate in the coronary arteries and the myocardial blood flow rate in the myocardial region supplied with blood by the coronary arteries. The calculation function 354 combines the vascular blood flow rate and the myocardial blood flow rate to calculate an index indicating the amount of capillary resistance in the capillaries that supply blood to the myocardial region. Therefore, the medical information processing device 300 according to the first embodiment can calculate the blood supply capacity from the coronary arteries to the myocardial region (the degree of obstruction of blood flow in the capillaries between the coronary arteries and the myocardium), and can provide an index that can evaluate resistance in the capillaries.

[0120] For example, Coronary Flow Reserve (CFR) is a well-known indicator for diagnosing myocardial ischemia. The capillary resistance index described in this application has a similar clinical meaning to CFR. However, since CFR is the ratio of myocardial blood flow under stress to myocardial blood flow under rest, calculating it from CT image data requires two scans, one under stress and one at rest, resulting in a high radiation dose. Furthermore, calculating CFR requires the use of vasodilators to stress the blood vessels, which places a burden on the subject.

[0121] In contrast, the capillary resistance index according to the present invention can be calculated by acquiring CT image data from multiple time phases for multiple heartbeats, thereby reducing radiation exposure. Furthermore, since the capillary resistance index according to the present invention can be calculated in a resting state, it does not impose the burden of drug administration on the subject. In other words, the capillary resistance index according to the present invention can be calculated even for subjects who cannot be administered vasodilators.

[0122] Furthermore, since the capillary resistance index according to this invention uses coronary artery blood flow and myocardial blood flow, which can be calculated by various methods, it can be calculated for a variety of subjects.

[0123] Furthermore, according to the first embodiment, the acquisition function 352 acquires multiple vascular blood flows in multiple coronary arteries and a single myocardial blood flow that combines multiple myocardial blood flows in multiple myocardial regions supplied with blood by multiple coronary arteries. The calculation function 354 calculates a capillary resistance index by combining the multiple vascular blood flows and the single myocardial blood flow. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide a capillary resistance index that more accurately reflects the supply of blood from the coronary arteries to the myocardium.

[0124] Furthermore, according to the first embodiment, the acquisition function 352 acquires the vascular blood flow at the upstream end and the vascular blood flow at the downstream end of the range of coronary arteries supplying blood to the myocardial region, as well as the myocardial blood flow in a specified myocardial region. The calculation function 354 calculates a capillary resistance index by combining the difference between the vascular blood flow at the upstream end and the vascular blood flow at the downstream end, and the myocardial blood flow in the specified myocardial region. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide a more accurate capillary resistance index.

[0125] Furthermore, according to the first embodiment, the acquisition function 352 divides the coronary arteries and the myocardial region supplied with blood by the coronary arteries into multiple ranges, and for each divided range, it acquires the vascular blood flow rate at the upstream end of the range, the vascular blood flow rate at the downstream end of the range, and the myocardial blood flow rate in the myocardial region corresponding to that range. The calculation function 354 combines the difference between the vascular blood flow rate at the upstream end and the vascular blood flow rate at the downstream end with the myocardial blood flow rate in the myocardial region corresponding to the range to calculate a capillary resistance index for each divided range. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide a capillary resistance index for finer regions.

[0126] Furthermore, according to the first embodiment, the control function 351 controls the display of a display image showing information about the capillary resistance index calculated by the calculation function 354 on a medical image that includes at least one of the myocardial region and the coronary artery. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide more easily understandable information about the capillary resistance index.

[0127] Furthermore, according to the first embodiment, the control function 351 displays the capillary resistance index calculated for each divided range in color and controls the display of the assigned color image on a three-dimensional image representing the myocardial region or coronary artery. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide more easily understandable information about the capillary resistance index in each region.

[0128] Furthermore, according to the first embodiment, the control function 351 controls the display of a display image showing the coronary artery along the long axis on a two-dimensional plane and a graph showing the change in the capillary resistance index calculated for each range of the coronary artery, so that the position in the display image corresponds to the position in the graph.Therefore, the medical information processing device 300 according to the first embodiment makes it possible to display the relationship between the properties of the myocardium and the capillary resistance index in an easier-to-understand manner.

[0129] Furthermore, according to the first embodiment, the control function 351 controls the display image to show the results of myocardial perfusion. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide more easily understandable information about the relationship between myocardial blood flow and capillary resistance index.

[0130] Furthermore, according to the first embodiment, the control function 351 controls the display to make the coronary artery and myocardial regions identifiable on a display image in which the myocardium is represented in polar coordinates, and to display a color image in which the calculated index for each divided range is shown in color.Therefore, the medical information processing device 300 according to the first embodiment makes it possible to provide more easily understandable information about the capillary resistance index of the target region while allowing the user to grasp the entire myocardium.

[0131] Furthermore, according to the first embodiment, the control function 351 controls the display of at least two of the following: a first color image that displays the capillary resistance index calculated for each divided range in color and is assigned to a three-dimensional image showing the myocardial region or coronary arteries; a display image that shows the coronary arteries on a two-dimensional plane along the long axis and a graph showing the change in the capillary resistance index calculated for each range of the coronary arteries; and a second color image that displays the coronary arteries and myocardial region in polar coordinates and displays the capillary resistance index calculated for each divided range in color. In addition, the control function 351 controls the display of at least two of the displayed first color image, display image and graph, and second color image by placing markers indicating substantially the same position.Therefore, the medical information processing device 300 according to the first embodiment enables diagnosis by comparing multiple display images and clarifies the positional relationship between multiple images. Furthermore, by comparing the morphology of the myocardium and coronary arteries with capillary resistance indices, it becomes possible to distinguish between ischemia and myocardial infarction and determine the treatment plan.

[0132] Furthermore, according to the first embodiment, when a marker is placed on a coronary artery, the control function 351 controls the system to display a short-axis cross-sectional image of the coronary artery at the placement location. Therefore, the medical information processing device 300 according to the first embodiment is able to provide more detailed morphological information.

[0133] Furthermore, according to the first embodiment, the control function 351 superimposes a three-dimensional image showing the coronary arteries and a color image showing capillary resistance indices for each range in color on the three-dimensional image showing the myocardial region, and further controls the display of a marker indicating the position in the coronary arteries and the coronary blood flow reserve ratio at the position of the marker. Thus, the medical information processing device 300 according to the first embodiment makes it possible to compare and observe the capillary resistance index and the FFR value.

[0134] Furthermore, according to the first embodiment, the control function 351 controls the display of a three-dimensional image showing the coronary arteries, a marker indicating the position in the coronary arteries, and the capillary resistance index and coronary flow reserve ratio at the position of the marker. Accordingly, the medical information processing device 300 according to the first embodiment makes it possible to compare and observe the capillary resistance index and the FFR value.

[0135] Furthermore, according to the first embodiment, the control function 351 displays the results of myocardial perfusion on a display image in which the myocardium is shown in polar coordinates, and controls the display to identify and show areas in the myocardial region included in the display image where the capillary resistance index is lower than a threshold. The control function 351 also displays the results of myocardial perfusion on a three-dimensional image showing the myocardium, and controls the display to identify and show areas in the myocardial region included in the three-dimensional image where the capillary resistance index is lower than a threshold. Therefore, the medical information processing device 300 according to the first embodiment allows for comparative observation of the myocardial blood flow results and the capillary resistance index, making it possible to identify myocardial regions that will be restored by reperfusion and determine a treatment strategy.

[0136] Furthermore, according to the first embodiment, when the control function 351 displays a three-dimensional image showing the coronary arteries and receives a specification operation to specify a location in the coronary arteries relative to the three-dimensional image, it controls the system to display the coronary flow reserve ratio at the specified location, the result of myocardial perfusion in the myocardial region supplied with blood by the coronary arteries at the specified location, the capillary resistance index at the specified location, and a value based on the pixel value at the specified location side by side. In addition, when the control function 351 displays a three-dimensional image showing the myocardium and receives a specification operation to specify a myocardial region relative to the three-dimensional image, it controls the system to display the coronary flow reserve ratio of the coronary arteries supplying blood to the specified myocardial region, the result of myocardial perfusion in the specified myocardial region, and an index in the specified myocardial region side by side.Therefore, the medical information processing device 300 according to the first embodiment makes it possible to identify the cause of ischemia, which is difficult to judge based on specific indicators alone, and to determine a treatment plan.

[0137] Furthermore, according to the first embodiment, the control function 351 displays a recommended treatment plan for at least one of the received location and the received myocardial region, based on the comparison result between each of the displayed items and the threshold set for each display item. Thus, the medical information processing device 300 according to the first embodiment makes it possible to support the determination of a treatment plan.

[0138] Furthermore, according to the first embodiment, the calculation function 354 calculates a capillary resistance index based on the ratio of vascular blood flow to myocardial blood flow. Therefore, the medical information processing device 300 according to the first embodiment makes it possible to easily provide an index for evaluating capillary resistance.

[0139] (Second embodiment) Now, although the first embodiment has been described, it may be implemented in various other forms besides the first embodiment described above.

[0140] The above-described embodiment explains how to calculate the capillary resistance index based on the ratio of vascular blood flow to myocardial blood flow. However, the embodiment is not limited to this; any method that uses two values ​​for calculation, such as taking a logarithmic ratio or adding or multiplying coefficients to the numerator or denominator, is acceptable.

[0141] For example, blood flow velocity, blood viscosity, and the total ejection fraction and ejection volume of the heart may be multiplied as correction factors. In such cases, the calculation function 354 obtains information on flow velocity and viscosity from the results of the fluid analysis performed by the acquisition function 352. The calculation function 354 also calculates the total ejection fraction and ejection volume of the heart based on time-series CT image data collected at multiple time phases over one or more heartbeats.

[0142] Here, when calculation function 354 uses blood flow velocity, for example, it uses blood flow velocity as a correction factor so that the capillary resistance index becomes lower when the flow velocity is high. Also, when calculation function 354 uses blood viscosity, for example, it uses blood viscosity as a correction factor so that the capillary resistance index becomes lower when the viscosity is high. Here, when blood viscosity is used as a correction factor, it is also possible to calculate changes in myocardial blood flow when blood viscosity decreases due to, for example, improvement of lifestyle-related diseases. Also, when calculation function 354 uses the total ejection fraction and ejection volume of the heart, for example, it uses the total ejection fraction and ejection volume of the heart as a correction factor so that the capillary resistance index changes regularly in accordance with changes in the total ejection fraction and ejection volume of the heart.

[0143] Furthermore, the above-described embodiment explained the case in which information is displayed using the capillary resistance index as is. However, the embodiment is not limited to this, and for example, a value obtained by multiplying the capillary resistance index by other coefficients may also be used. For example, the calculation function 354 may display the various display information described above using a value obtained by multiplying the calculated capillary resistance index by an index value indicating the "ease of blood flow between cells". This makes it possible for the medical information processing device 300 to provide information indicating the myocardial infarction area and its progression.

[0144] Furthermore, the embodiments described above explained the use of myocardial perfusion results for SPR images and polar maps. However, the embodiments are not limited to these, and other values ​​indicating myocardial function may be used instead. For example, local myocardial movement may be extracted by ultrasound imaging of the heart, and the magnitude of this movement may be used instead of the myocardial perfusion results.

[0145] Furthermore, the medical information processing device 300 according to this application can also perform machine learning using the calculated vascular blood flow rate and myocardial blood flow rate. For example, the medical information processing device 300 constructs a classifier by performing machine learning on the relationship between vascular blood flow rate and myocardial blood flow rate and the CFR value in the target region. The constructed classifier outputs the CFR value in response to new inputs of vascular blood flow rate and myocardial blood flow rate. This makes it possible to estimate the CFR from vascular blood flow rate and myocardial blood flow rate. In other words, it makes it possible to obtain the CFR value while avoiding increased radiation exposure and administration of vasodilators. Note that in the machine learning described above, values ​​measured by capillary resistance tests or the like may be used instead of CFR.

[0146] Furthermore, the above-described embodiment explained the case in which the medical information processing device 300 alone performs various processes. However, the embodiment is not limited thereto, and for example, the processing circuit 350 may realize its functions by utilizing the processor of an external device connected via a network. For example, the processing circuit 350 reads and executes programs corresponding to each function from the memory circuit 320, and realizes the functions shown in Figure 1 by utilizing a group of servers (cloud) connected to the medical information processing device 300 via a network as computing resources. Alternatively, for example, the memory circuit 320 may be realized by a group of servers (cloud) connected to the medical information processing device 300 via a network.

[0147] In the embodiments described above, an example was explained in which each processing function is realized by a single processing circuit (processing circuit 350), but the embodiments are not limited to this. For example, the processing circuit 350 may be composed of a combination of multiple independent processors, with each processor realizing each processing function by executing each program. Furthermore, each processing function of the processing circuit 350 may be realized by being appropriately distributed or integrated across one or more processing circuits.

[0148] Furthermore, the term "processor" used in the descriptions of each embodiment above refers to circuits such as a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an Application Specific Integrated Circuit (ASIC), or a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)). Here, instead of storing the program in a memory circuit, the processor may be configured to directly incorporate the program into its circuitry. In this case, the processor realizes its function by reading and executing the program incorporated into the circuitry. Moreover, each processor in this embodiment is not limited to being configured as a single circuit; multiple independent circuits may be combined to form a single processor and realize its function.

[0149] Here, the program executed by the processor is provided pre-installed in ROM (Read Only Memory) or memory circuits. This program may also be provided as a file in an installable or executable format on computer-readable storage media such as CD (Compact Disk)-ROM, FD (Flexible Disk), CD-R (Recordable), or DVD (Digital Versatile Disk). Furthermore, this program may be stored on a computer connected to a network such as the Internet and provided or distributed by downloading it via the network. For example, this program consists of modules, each containing a functional unit as described later. In actual hardware, the CPU reads the program from a storage medium such as ROM and executes it, loading each module onto main memory and generating it in main memory.

[0150] According to at least one embodiment described above, it is possible to provide an index that can evaluate resistance in capillaries.

[0151] While several embodiments of the present invention have been described, these embodiments are presented as examples only and are not intended to limit the scope of the invention. These embodiments can be carried out in a variety of other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their variations are included in the scope and spirit of the invention, as well as in the claims and their equivalents. [Explanation of Symbols]

[0152] 300 Medical Information Processing Devices 351 Control Functions 352 Acquisition function 353 Image generation function 354 Calculation function 355 Judgment Function

Claims

1. An acquisition unit that acquires an index value for vascular blood flow in the coronary arteries estimated based on the shape data of the coronary arteries of the subject, and an index value for myocardial blood flow calculated based on contrast-enhanced images targeting the myocardial region to which blood is supplied by the coronary arteries, A calculation unit that calculates a risk index for the capillaries supplying blood to the myocardial region based on a comparison of an index value for vascular blood flow and an index value for myocardial blood flow, A medical information processing device equipped with [a specific feature].

2. The medical information processing apparatus according to claim 1, further comprising a display control unit that identifies a myocardial region corresponding to a capillary for which the risk index has been calculated in a medical image including the myocardium, and controls the display of the risk index within the identified myocardial region.

3. The medical information processing apparatus according to claim 1, further comprising a display control unit that identifies a coronary artery region corresponding to a capillary for which the risk index has been calculated in a medical image including the coronary artery, and controls the display of the risk index within the identified coronary artery region.

4. The medical information processing apparatus according to claim 1, further comprising a display control unit that controls the display of a graph showing the change in the risk index calculated for each range of the coronary artery, along with a display image showing the coronary artery on a two-dimensional plane along its long axis.

5. The medical information processing apparatus according to claim 4, wherein the display control unit controls the display image to display an index value related to myocardial blood flow.

6. The medical information processing apparatus according to claim 1, further comprising a display control unit that controls the display of the coronary arteries and the myocardial region in an identifiable manner on a display image in which the myocardium is shown as a pole, and to display the risk indicator within the myocardial region.

7. The medical information processing apparatus according to claim 1, further comprising a display control unit that controls the display of a three-dimensional image showing the coronary arteries, a marker indicating a position in the coronary arteries, and a numerical value of the risk indicator at the position of the marker.

8. The medical information processing apparatus according to claim 1, further comprising a display control unit that controls the display of an index value relating to the vascular blood flow in the coronary arteries that supply blood to the myocardial region and an index value of the risk indicator side by side.

9. The medical information processing apparatus according to claim 1, wherein the risk indicator corresponds to the resistance of the capillaries.

10. The acquisition unit acquires an index value for myocardial blood flow which is a combination of multiple index values ​​for vascular blood flow in multiple coronary arteries and multiple index values ​​for myocardial blood flow in multiple myocardial regions to which blood is supplied by the multiple coronary arteries. The medical information processing apparatus according to claim 1, wherein the calculation unit calculates the risk index by combining the multiple index values ​​for vascular blood flow and the single index value for myocardial blood flow.

11. The acquisition unit acquires an index value for vascular blood flow at the upstream end and the downstream end of the range of coronary arteries that supply blood to the myocardial region, and an index value for myocardial blood flow in the myocardial region. The medical information processing apparatus according to claim 1, wherein the calculation unit calculates the risk index by combining the difference between an index value for vascular blood flow at the upstream end and an index value for vascular blood flow at the downstream end, and an index value for myocardial blood flow in the myocardial region.

12. The acquisition unit divides the coronary artery and the myocardial region supplied with blood by the coronary artery into multiple ranges, and for each divided range, acquires an index value for vascular blood flow at the upstream end of the range, an index value for vascular blood flow at the downstream end of the range, and an index value for myocardial blood flow in the myocardial region corresponding to that range. The medical information processing apparatus according to claim 1, wherein the calculation unit combines the difference between an index value for vascular blood flow at the upstream end and an index value for vascular blood flow at the downstream end with an index value for myocardial blood flow in the myocardial region corresponding to the range to calculate the risk index for each of the divided ranges.

13. The medical information processing apparatus according to claim 1, further comprising a display control unit that controls the display of a display image showing information regarding the risk index calculated by the calculation unit on a medical image including at least one of the myocardial region and the coronary artery.

14. The medical information processing apparatus according to claim 12, further comprising a display control unit that controls the display of a color image assigned to a three-dimensional image representing the myocardial region or the coronary artery, which indicates the risk index calculated for each of the divided ranges using color.

15. The medical information processing apparatus according to claim 4, wherein the display control unit controls the display image and the graph to display them in correspondence between the position in the display image and the position in the graph.

16. The medical information processing apparatus according to claim 12, further comprising a display control unit that controls the display of the coronary arteries and the myocardial region in an identifiable manner on a display image of the myocardium in polar coordinates, and displays a color image showing the calculated risk index for each of the divided ranges in color.

17. The system further includes a display control unit that controls the display of at least two of the following: a first color image assigned to a three-dimensional image showing the myocardial region or the coronary artery, a display image showing the coronary artery on a two-dimensional plane along the long axis, a graph showing the change in the risk index calculated for each range of the coronary artery, and a second color image showing the coronary artery and the myocardial region in an identifiable manner on a display image showing the myocardium in polar coordinates, and the risk index calculated for each divided range, respectively. The medical information processing apparatus according to claim 12, wherein the display control unit controls the display to place markers indicating substantially the same position on at least two of the displayed first color image, the display image and the graph, and the second color image.

18. The medical information processing apparatus according to claim 17, wherein the display control unit controls the display control unit to further display a short-axis cross-sectional image of the coronary artery at the position where the marker is placed relative to the coronary artery.

19. The medical information processing apparatus according to claim 12, further comprising a display control unit that superimposes a three-dimensional image showing the coronary arteries and a color image showing indicators for each range in color on the three-dimensional image showing the myocardial region, and further controls the display of a marker indicating a position in the coronary arteries and the coronary blood flow reserve ratio at the position of the marker.

20. The medical information processing apparatus according to claim 12, further comprising a display control unit that controls the display of a three-dimensional image showing the coronary arteries, a marker indicating a position in the coronary arteries, and the risk index and coronary blood flow reserve ratio at the position of the marker.

21. The medical information processing apparatus according to claim 12, further comprising a display control unit that displays the results of myocardial perfusion on a display image of myocardium in polar coordinates, and controls the display to identify and display areas in the myocardial region included in the display image where the risk indicator is lower than a threshold.

22. The medical information processing apparatus according to claim 12, further comprising a display control unit that displays the results of myocardial perfusion on a three-dimensional image showing myocardium, and controls the display of areas in the myocardial region included in the three-dimensional image in a manner that allows for the identification of areas where the risk indicator is lower than a threshold.

23. The medical information processing apparatus according to claim 12, further comprising a display control unit that displays a three-dimensional image showing the coronary arteries, and when a specification operation is received to specify a position in the coronary arteries relative to the three-dimensional image, controls the display to show, in order, the coronary blood flow reserve ratio at the specified position, the result of myocardial perfusion in the myocardial region supplied with blood by the coronary artery at the specified position, the risk index at the specified position, and a value based on the pixel value at the specified position.

24. The medical information processing apparatus according to claim 12, further comprising a display control unit that displays a three-dimensional image showing the myocardium, and when a specification operation is received to specify a myocardial region in the three-dimensional image, controls the display to show, side by side, the coronary blood flow reserve ratio in the coronary arteries supplying blood to the specified myocardial region, the result of myocardial perfusion in the specified myocardial region, and the risk indicator in the specified myocardial region.

25. The medical information processing apparatus according to claim 23 or 24, wherein the display control unit displays a recommended treatment plan for at least one of the received position and the received myocardial region based on the comparison result between each of the displayed items and a threshold set for each display item.

26. The medical information processing device according to any one of claims 1 to 25, wherein the calculation unit calculates the risk index based on the ratio of the index value for vascular blood flow and the index value for myocardial blood flow.

27. An index value for vascular blood flow in the coronary arteries, estimated based on the shape data of the subject's coronary arteries, and an index value for myocardial blood flow, calculated based on contrast-enhanced images targeting the myocardial region to which blood is supplied by the coronary arteries, are obtained. Based on a comparison of the index value for vascular blood flow and the index value for myocardial blood flow, a risk index for the capillaries that supply blood to the myocardial region is calculated. A medical information processing program that instructs a computer to perform various processes.

28. An acquisition unit that acquires an index value for vascular blood flow in the coronary arteries estimated based on the shape data of the coronary arteries of the subject, and an index value for myocardial blood flow calculated based on contrast-enhanced images targeting the myocardial region to which blood is supplied by the coronary arteries, A calculation unit that calculates a risk index for the capillaries supplying blood to the myocardial region based on a comparison of an index value for vascular blood flow and an index value for myocardial blood flow, A medical information processing system equipped with [the following features].

29. An index value for vascular blood flow in the coronary arteries, estimated based on the shape data of the subject's coronary arteries, and an index value for myocardial blood flow, calculated based on contrast-enhanced images targeting the myocardial region to which blood is supplied by the coronary arteries, are obtained. Based on a comparison of the index value for vascular blood flow and the index value for myocardial blood flow, a risk index for the capillaries that supply blood to the myocardial region is calculated. A medical information processing method, including the following.

30. An acquisition unit that acquires an index value for vascular blood flow in the coronary arteries estimated based on the shape data of the coronary arteries of the subject, and an index value for myocardial blood flow calculated based on an image of the myocardial region to which blood is supplied by the coronary arteries, A calculation unit that calculates a risk index for the capillaries supplying blood to the myocardial region based on a comparison of an index value for vascular blood flow and an index value for myocardial blood flow, A medical information processing device equipped with [a specific feature].

31. An index value for vascular blood flow in the coronary arteries, estimated based on the shape data of the subject's coronary arteries, and an index value for myocardial blood flow, calculated based on images of the myocardial region to which blood is supplied by the coronary arteries, are obtained. Based on a comparison of the index value for vascular blood flow and the index value for myocardial blood flow, a risk index for the capillaries that supply blood to the myocardial region is calculated. A medical information processing program that instructs a computer to perform various processes.

32. An acquisition unit that acquires an index value for vascular blood flow in the coronary arteries estimated based on the shape data of the coronary arteries of the subject, and an index value for myocardial blood flow calculated based on an image of the myocardial region to which blood is supplied by the coronary arteries, A calculation unit that calculates a risk index for the capillaries supplying blood to the myocardial region based on a comparison of an index value for vascular blood flow and an index value for myocardial blood flow, A medical information processing system equipped with [the following features].

33. An index value for vascular blood flow in the coronary arteries, estimated based on the shape data of the subject's coronary arteries, and an index value for myocardial blood flow, calculated based on images of the myocardial region to which blood is supplied by the coronary arteries, are obtained. Based on a comparison of the index value for vascular blood flow and the index value for myocardial blood flow, a risk index for the capillaries that supply blood to the myocardial region is calculated. A medical information processing method, including the following.

Images