JP3004682B2 - X-ray diagnostic equipment - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an X-ray diagnostic apparatus capable of arbitrarily setting an X-ray irradiation direction on a subject and performing fluoroscopic imaging of the subject from multiple directions. An X that can automatically reproduce a corresponding position of the support device when an X-ray image has been previously taken in an arbitrary X-ray irradiation direction and selectively display a taken image corresponding to the position.
The present invention relates to a line diagnostic device.

[Conventional technology]

As a method of treating blood vessel stenosis due to thrombus, etc., a contrast agent is injected into a patient's blood vessel, X-ray imaging is performed with an X-ray diagnostic apparatus, and the position of the blood vessel stenosis is grasped. There is a method of treating a patient by inserting a catheter and injecting a thrombolytic agent or inflating a balloon to expand the stenosis. In such a treatment method, in order to accurately grasp the position of a stenotic portion of a blood vessel, a blood vessel having a stenosis is imaged and photographed from multiple directions to grasp the position, and the obtained contrast image is used as a guide image. The treatment is performed by accurately inserting a treatment catheter into the stenotic portion of the blood vessel while referring to the blood vessel. For this purpose, the fluoroscopic imaging position (angle) observed when the therapeutic catheter is actually inserted and the fluoroscopic imaging position (angle) obtained when the referenced guide image is obtained are exactly matched. Need to be.

Conventionally, as an X-ray diagnostic apparatus for addressing such a demand, an X-ray diagnostic apparatus capable of operating a positional relationship between a subject and an X-ray image information collection system as described in Japanese Patent Application Laid-Open No. 1-181846 is known. In the diagnostic apparatus, an image storage unit for adding position information of the subject and the X-ray image information collection system at the time of collection to the collected X-ray image information in frame units and storing the same, and a frame from the image storage unit There has been proposed an apparatus having image calling means for calling an image by using the position information as an index and providing the image for display. That is, the X-ray diagnostic apparatus according to the conventional proposal operates the positional relationship of the X-ray image information collection system with respect to the subject,
When the fluoroscopic imaging angle is set to a certain angle in order to insert a therapeutic catheter into a blood vessel, a contrast image photographed at an angle close to the set position from the image storage means by the image recall means using the set position information as an index. Was selected as a guide image and automatically called.

[Problems to be solved by the invention]

However, in such a conventional X-ray diagnostic apparatus,
When a therapeutic catheter is inserted into a blood vessel of a subject, the position of the X-ray image information collection system with respect to the subject is manually operated by an operator such as a doctor to appropriately set the fluoroscopic imaging angle, and the set position is set. Since the image captured at an angle close to is selected as a guide image from the image storage means and automatically called, the perspective imaging angle set by the above-mentioned operator by manual operation is added to the image previously stored in the image storage means. It is good when the angles match, but when they do not match, it is sometimes impossible to select an image with a different shooting angle or to call up the image. Therefore, automatic invocation of the guide image at the time of insertion of the catheter for treatment is inaccurate or difficult. For this reason, the insertion operation of the catheter for treatment may not be performed smoothly.

Therefore, the present invention solves such a problem, and automatically reproduces a corresponding position of the supporting device when an X-ray image is previously taken in an arbitrary X-ray irradiation direction, and also takes a photographed image corresponding to the position. It is an object of the present invention to provide an X-ray diagnostic apparatus capable of selectively displaying the X-ray diagnostic information.

[Means for solving the problem]

In order to achieve the above object, an X-ray diagnostic apparatus according to the present invention has a support capable of arbitrarily setting an X-ray irradiating direction on a subject located between an X-ray tube and an image-related apparatus by opposing and supporting the X-ray tube and the imaging system. In an X-ray diagnostic apparatus having an apparatus and an image collection and display system for collecting a transmission X-ray image of the subject and displaying the same as a fluoroscopic image or a captured image, the fluoroscopic image collected in an arbitrary X-ray irradiation direction is collected by the image collection. Means for displaying on the display system and selectively inputting a perspective image to be used for diagnosis from the displayed perspective images as a guide image, and storing the selected and input guide image and positional information of the supporting device which has collected the guide image. Means for reading a guide image from the storage means when a new captured image is collected and displaying the guide image on the image collection and display system; and reading position information of the support device from the storage means and collecting the guide image. Those having a and means for resetting the support device in position.

(Operation)

The X-ray diagnostic apparatus configured as described above displays a fluoroscopic image collected in an arbitrary X-ray irradiation direction on the image collection and display system, and uses a fluoroscopic image to be used for diagnosis from among the displayed fluoroscopic images as a guide image. Selectively input, store the selected and input guide image and positional information of the support device that has collected the guide image, and when collecting a new captured image, read out the guide image from the storage unit and read the image collection and display system. , And reads the position information of the support device from the storage means, and operates to reset the support device to the collection position of the guide image.

〔Example〕

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

FIG. 1 is a block diagram showing an embodiment of an X-ray diagnostic apparatus according to the present invention. The X-ray diagnostic apparatus is capable of arbitrarily setting an X-ray irradiation direction on a subject and performing fluoroscopic imaging of the subject from multiple directions. The X-ray diagnostic apparatus includes a table 1, a support device 2, an image collection and display system 3, , A support device controller 4 and an operation device 5.

The table 1 lays the subject 6 on the upper surface thereof, is provided on the upper surface side of the drive mechanism 7, and is movable forward and backward and up and down by the drive mechanism 7.

The supporting device 2 supports the X-ray tube 16 and the imaging device 20 to be described later facing each other, and can arbitrarily set the direction of X-ray irradiation to the subject 6 located therebetween, and serves as a base. Arrows A and A are attached to the support 8 and the bearing 9 provided at the upper end of the support 8.
A rotating shaft 10 is rotatably supported as shown by B, and a C-shaped arm 11 is supported at the tip of the rotating shaft 10 so as to be movable in an arc direction as shown by arrows C and D. The rotation of the rotary shaft 10 in the directions of arrows A and B is driven by a first motor 12 provided at the rear end thereof, and the rotation angle is detected by a first encoder 13. The above C
The movement of the arm 11 in the directions of arrows C and D is driven by a second motor 14 provided at the tip of the rotating shaft 10, and the movement angle in the arc direction is detected by a second encoder 15. ing.

The image collection and display system 3 collects a transmission X-ray image of the subject 6 and displays an X-ray image of a diagnostic site. The image collection and display system 3 is provided at one end of the C-arm 11 and emits X-rays to the subject 6. X to do
An image intensifier 17 for converting a transmission X-ray image of the subject 6 into an optical image, a light distributor 18, and converting the optical image into an electric signal. A video system device 20 including a TV camera 19, an A / D converter 21 for digitizing a video signal from the TV camera 19, and image data digitized by the A / D converter 21 stored in frame units. A frame memory 22
A freeze memory 23 for transferring and storing data of an image selected from a plurality of images in the frame memory 22, and an image output from the frame memory 22 and a freeze memory
Video switch for switching between images output from 23
24, a display interface 25 for sending image data input via the video changeover switch 24 to the display,
A first television monitor 26 for directly inputting a video signal from the television camera 19 and displaying it as an image, and a second television monitor 27 for inputting a video signal from the display interface 25 and displaying it as an image, And a system controller 28 that controls the whole of the elements. An X-ray aperture 29 is provided on the front side of the X-ray tube 16 for X-ray radiation. A third motor 30 is provided at a base of the image intensifier 17 to be attached to the C-shaped arm 11. By driving the third motor 30, the image intensifier 17 moves as shown by arrows E and F. It moves up and down, and the amount of this movement is detected by the third encoder 31.

The support device controller 4 is for digitally controlling the support device 2, and includes a support device including angle information output from the first encoder 13, the second encoder 15, and the third encoder 31. A position information memory 32 for storing the position information of No. 2 in association with an identification code described below;
It comprises a central processing unit (CPU) 33 for controlling the operation and an interface 34 for inputting and outputting signals to and from other devices.

Furthermore, the operating device 5 assigns a common identification code to the position information of the support device 2 when the X-ray image is seen through in any X-ray irradiation direction and the fluoroscopy or imaging of the X-ray image obtained at that time. , The storage and readout of the identification code,
A specific image is selected from a plurality of X-ray images, and an identification code setting switch 35 and an identification code writing switch
36 and image operation switches to move the image forward / stop / back
37 and an image selection switch 38.

Reference numeral 39 indicates an operator such as a doctor. Further, the support device controller 4, the first motor 12, the second motor 14, and the third motor 30 correspond to a specific identification code using the identification code from the identification code setting switch 35 as a key. This is a means for reading the position information of the support device 2 from the storage means and reproducing the corresponding position. Furthermore, the operating device 5
, The system controller 28, the freeze memory 23,
The display interface 25 and the second television monitor 27 serve as means for selectively displaying a captured image corresponding to the reproduction position of the support device 2 on the image collection and display system in correspondence with the specific identification code.

Next, the operation of the X-ray diagnostic apparatus thus configured will be described with reference to the flowcharts shown in FIGS. First, in FIG. 1, the table 1 is appropriately moved to set the subject 6 at an appropriate position in the X-ray irradiation range from the X-ray tube 16. Next, X-rays are emitted from the X-ray tube 16 by the operation of an X-ray generator (not shown),
The X-ray image transmitted through is incident on the image intensifier 17. Then, the incident transmitted X-ray image is converted into an optical image by an image intensifier 17, and the optical image is incident on a television camera 19 via a light distributor 18 and is captured, and the first television The image is input to the monitor 26 and displayed as a perspective image.

In this state, the support device 2 is operated by an operation mechanism (not shown), and the support device 2 is set at a position where the stenosis part of the target blood vessel is easily seen, and an image is taken (step in FIG. 2). When the position of the support device 2 is determined in this manner, the operator 39 simultaneously presses, for example, the key “A” and the identification code writing switch 36 among the identification code setting switches 35 of the operating device 5 (step). As a result, an identification code “A” is given to the set position of the support device 2, and the angle information from the encoders 13, 15, 31 provided on the respective operating axes of the support device 2 is used as the support device at that time. 2 is stored in the area corresponding to the identification code "A" of the position information memory 32 in the support device controller 4 (step). At the same time, the signal of the code "A" from the identification code setting switch 35 and the write signal from the identification code
The system controller 28 issues a preparation command for giving the identification code "A" to the image to be taken to the frame memory 22 and other necessary units (step). Next, the operator 39 injects a contrast medium into the subject 6 to perform imaging, assigns an identification code “A” to the frame memory 22 and stores the captured image sequentially in a frame cycle (step). The captured image captured at this time is stored with an image number with an identification code such as A ₁ , A ₂ ,. In this state, the image changeover switch 24 is connected to the contact L side, and the image being shot is displayed not only on the first TV monitor 26 but also on the second TV monitor 27, and the image being shot is displayed. You can check.

Next, in a step, the operator 39 determines whether or not to end the photographing, and moves the supporting device 2 to another position to continue the photographing, proceeds to the “NO” side and returns to the previous step. And
In a step, the support device 2 is set at another position where the stenotic part of the blood vessel is easily seen. In this state, the operator 39 simultaneously presses, for example, the key “B” and the identification code writing switch 36 among the identification code setting switches 35 (step). Thereby, the identification code “B” is given to the position of the support device 2 set above, and the encoder 1 provided on each operation shaft of the support device 2 is provided.
The angle information from 3, 15, 31 is stored as the position information of the support device 2 in the area corresponding to the identification code "B" of the position information memory 32 in the support device controller 4 (step). Hereinafter, proceed to step → in the same manner as described above,
It is determined in step whether or not the shooting is completed.

In this way, when the position of the support device 2 is changed and set, and the required photographing is completed, the operator 39 determines that the photographing is completed, and advances the step to the “YES” side. Then, the operator 39 operates the image operation switch 37 of the operating device 5 to display the best-contrast image from a series of photographed images (for example, A _{1 to} An, B _{1 to} Bn,...) As a guide image. And press the image selection switch 38. With this, the image selection switch
The display image when the button 38 is pressed, for example, A ₁₀ , B ₅ ,... Is stored as a guide image in the area corresponding to the identification codes “A”, “B”,.

After the guide images have been selected from each of the series of captured images as described above, a catheter for treatment is inserted into a stenotic portion of an actual blood vessel, and the treatment is started. The operation at this time will be described with reference to FIG. First, the operator 39 presses, for example, the key “A” of the identification code setting switch 35 of the operating device 5 to reproduce the photographing position (Step A). When only the identification code setting switch 35 is depressed in this manner, a data read signal is transmitted from the operating device 5 to the support device controller 4 and the system controller 28. Therefore, a reading signal of data corresponding to the identification code "A" is sent to the support device controller 4 and the system controller 28. Thereby, the support device controller 4
Reads the position information of the support device 2 corresponding to the identification code "A" from the position information memory 32, and automatically moves the support device 2 to the position (step B). At this time, from the position information memory 32, the first motor 12
And position information (angle information) corresponding to each operation axis is sent to the second motor 14 and the third motor 30;
Each operation axis is driven by an angle corresponding to the position information. On the other hand, the system controller 28 stores the data of the captured image (A ₁₀ ) corresponding to the identification code “A” in the freeze memory 23.
And display it on the second television monitor 27 (step C). At this time, the video changeover switch 24 is set to the contact F
Connected to the side. As a result, the support device 2 is accurately reproduced at the position where the contrast agent was injected and photographed, and
Guide image A ₁₀ taken at the position is automatically selected and displayed.

Therefore, the operator 39 uses the image displayed on the second television monitor 27 as a guide image while watching the fluoroscopic image displayed on the first television monitor 26, and moves the treatment catheter to the target site of the blood vessel. Proceed (Step D). Then, in order to view the stenosis portion of the blood vessel from a different angle position as necessary, it is determined in step E whether another guide image is used,
Proceed to the “YES” side and return to before step A. And the operator
39, for example, presses the key "B" of the identification code setting switch 35 of the operating device 5 to reproduce the operation position (Step A). Then, a data read signal corresponding to the identification code “B” is sent to the support device controller 4 and the system controller 28. Thereby, the support device controller 4
Reads the position information of the support device 2 corresponding to the identification code "B" from the position information memory 32, and automatically moves the support device 2 to the position (step B). Thereafter, in the same manner as described above, the data of the photographed image (B ₅ ) corresponding to the identification code “B” is called from the freeze memory 23 and displayed on the second television monitor 27 in step C. Furthermore, a new image B ₅ in Step D with the guide image, advancing the catheter to the target site of the blood vessel. If this is the case, step E proceeds to the “NO” side and reaches step F. In this step F, it is determined whether or not the insertion of the catheter is completed.
Proceed to the “O” side and return to before step D.
Proceed to S "side to finish treatment.

Although FIG. 1 shows an example in which the freeze memory 23 is provided for storing the guide image, the present invention is not limited to this, and an image with an identification code added to the image selected as the guide image is provided. A memory for storing the numbers A ₁₀ , B ₅ ,... _May be provided.

〔The invention's effect〕

Since the present invention is configured as described above, a fluoroscopic image collected in an arbitrary X-ray irradiation direction is displayed on the image collection and display system, and a fluoroscopic image to be provided for diagnosis from the displayed fluoroscopic image is used as a guide image. Selectively input, store the selected and input guide image and positional information of the support device that has collected the guide image, and when collecting a new captured image, read out the guide image from the storage unit and read the image collection and display system. And the position information of the support device is read out from the storage means, and the support device can be reset to the collection position of the guide image. Therefore, for example, when collecting a captured image and treating a stenosis of a blood vessel due to a thrombus or the like, it is easy and easy to automatically call a guide image when resetting the position of the support device when inserting a therapeutic catheter into the blood vessel. Can be done accurately. From this, the operation of inserting the catheter for treatment performed using the X-ray diagnostic apparatus can be performed smoothly.

In addition, a guide image based on “perspective” for irradiating the subject with X-rays having low energy is used to plan “imaging” for irradiating X-rays with higher energy than “perspective”. By setting a diagnostic region to be subjected to “imaging”, unnecessary “imaging” is not performed, and as a result, X-ray exposure to the subject and the operator close to the subject during the above-described vascular treatment can be reduced. Can be reduced.

[Brief description of the drawings]

FIG. 1 is a block diagram showing an embodiment of an X-ray diagnostic apparatus according to the present invention, and FIGS. 2 and 3 are flowcharts for explaining the operation thereof. DESCRIPTION OF SYMBOLS 1 ... Table 2 ... Support device 3 ... Image collection and display system 4 ... Support device controller 5 ... Operation device 6 ... Subject 10 ... Rotating axis 11 ... C type Arm, 12, 14, 30 ... motor, 13, 15, 31 ... encoder, 16 ... X-ray tube, 20 ...
Video system device, 22 frame memory, 23 freeze memory, 26, 27 TV monitor, 28 system controller, 32 position information memory, 35 identification code setting switch, 36 identification code Write switch, 37 ... Image operation switch, 38 ... Image selection switch.

Claims (1)

(57) [Claims] An X-ray tube and an imaging system are arranged and supported in opposition to each other, and a supporting device capable of arbitrarily setting an X-ray irradiation direction to a subject located therebetween is provided. An X-ray diagnostic apparatus having an image collection and display system for collecting and displaying as a fluoroscopic image or a captured image, wherein a fluoroscopic image collected in an arbitrary X-ray irradiation direction is displayed on the image collection and display system, and the displayed fluoroscopic image is displayed. Means for selecting and inputting a fluoroscopic image to be used for diagnosis as a guide image from the inside; means for storing the selected and input guide image and position information of the supporting device which has collected the guide image; and Means for reading a guide image from the storage means and displaying the guide image on the image collection and display system, and means for reading position information of a support device from the storage means and resetting the support device to a collection position of the guide image. Equipment X-ray diagnostic apparatus characterized by a.