JP5209245B2 - Diagnostic index acquisition method - Google Patents
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本発明は診断指標取得方法に関し、詳しくは、被験者の腹部領域の断面画像から被験者の肥満の状態を示す診断指標を得る診断指標取得方法に関するものである。 The present invention relates to a diagnostic index acquisition method, and more particularly to a diagnostic index acquisition method for obtaining a diagnostic index indicating a subject's obesity state from a cross-sectional image of a subject's abdominal region.
従来より、体重に占める体脂肪の重さの割合を示す体脂肪率を測定する種々の方式が知られている。上記体脂肪率を求める方式としては、例えば、人体の水中での体重と陸上での体重との違いを測定して得られた体密度から体脂肪率を推定する方式や、人体に微小電流を流したときの電気抵抗が体脂肪の量に応じて変化することを利用して体脂肪率を推定するインピーダンス法等が知られている。なお、体脂肪は、内臓脂肪と皮下脂肪とを合わせたものであり人体を構成する脂肪の総称である。 Conventionally, various methods for measuring the body fat percentage indicating the ratio of the weight of body fat to the body weight are known. As a method for obtaining the body fat percentage, for example, a method for estimating the body fat percentage from the body density obtained by measuring the difference between the weight of the human body in water and the weight on the land, or a minute current to the human body. There is known an impedance method or the like for estimating the body fat percentage by utilizing the fact that the electric resistance when flowing is changed according to the amount of body fat. In addition, body fat is a general term for fat constituting a human body, which is a combination of visceral fat and subcutaneous fat.
また、体脂肪の一部である内臓脂肪の人体に占める比率を推定する方式も知られている（特許文献１参照）。この方式は、Ｘ線ＣＴを用いた人体の断層撮影により、内臓脂肪を示す領域の境界を明確に識別できるようにした断面画像を得、この断面画像中の内臓脂肪を示す領域の面積と他の領域の面積とから人体に占める内臓脂肪の比率を求めて内臓脂肪率を推定するものである。上記方式は、人体のへそを通る１枚の断面画像から内臓脂肪率を推定するものである。 A method for estimating the ratio of visceral fat, which is a part of body fat, to the human body is also known (see Patent Document 1). This method obtains a cross-sectional image in which the boundary of a region showing visceral fat can be clearly identified by tomography of a human body using X-ray CT, and the area of the region showing visceral fat in this cross-sectional image and other areas. The ratio of visceral fat occupying the human body is obtained from the area of the region and the visceral fat ratio is estimated. In the above method, the visceral fat rate is estimated from one cross-sectional image passing through the navel of the human body.
また、被験者の腹部領域中の１断面を示す1枚の断面画像からこの被験者の内臓脂肪や皮下脂肪を示す領域の面積を求めて被験者の肥満の状態を示す診断情報を得るような手法も知られている（特許文献２参照）。 Also known is a technique for obtaining diagnostic information indicating the state of obesity of the subject by obtaining the area of the region indicating the visceral fat or subcutaneous fat of the subject from one cross-sectional image showing one section in the abdominal region of the subject. (See Patent Document 2).
このように、体脂肪率、内臓脂肪率、および皮下脂肪率等は、直接測定することが困難なので、間接的に得られた種々の測定データから推定して求めている。
ところで、近年、腹部領域における皮下脂肪や内臓脂肪の偏在による健康への悪影響について検討されており、このような皮下脂肪や内臓脂肪の偏在を考慮して被験者の肥満の状態を診断したいという要請がある。特に、下腹部と上腹部とにおける皮下脂肪や内臓脂肪の分布状態の違いをも考慮した診断指標を得たいという要請がある。しかしながら、被験者の腹部領域中の１断面を示す断面画像を用いた診断では下腹部と上腹部の両方の部位についての各脂肪領域の分布状態を把握することが難しいという問題がある。 By the way, in recent years, adverse effects on health due to the uneven distribution of subcutaneous fat and visceral fat in the abdominal region have been examined, and there is a demand for diagnosing the obesity state of a subject in consideration of such uneven distribution of subcutaneous fat and visceral fat. is there. In particular, there is a demand for obtaining a diagnostic index that also considers the difference in the distribution of subcutaneous fat and visceral fat between the lower abdomen and the upper abdomen. However, there is a problem that it is difficult to grasp the distribution state of each fat region for both the lower abdominal region and the upper abdominal region in the diagnosis using a cross-sectional image showing one cross section in the subject's abdominal region.
本発明は、上記事情に鑑みてなされたものであり、被験者の肥満の状態を示す診断指標の品質を高めることができる診断指標取得方法を提供することを目的とするものである。 This invention is made | formed in view of the said situation, and it aims at providing the diagnostic parameter | index acquisition method which can improve the quality of the diagnostic parameter | index which shows the test subject's obesity state.
本発明の診断指標取得方法は、被験者の体脂肪に関する診断指標を取得する診断指標取得方法であって、被験者の腹部領域中における頭部側の１つ以上の断面を示す断面画像とこの腹部領域中における脚部側の１つ以上の断面を示す断面画像とを用意し、その断面画像を用いて、腹部領域中の互に対向する部位間における皮下脂肪領域の大きさの比率、および内臓脂肪領域の大きさの比率を求め、これらの２種類の比率を予め定められた基準値と比較して、被験者の肥満の状態を示す診断指標を得ることを特徴とするものである。 The diagnostic index acquisition method of the present invention is a diagnostic index acquisition method for acquiring a diagnostic index related to the body fat of a subject, and includes a cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject and the abdominal region A cross-sectional image showing one or more cross-sections on the leg side in the inside, and using the cross-sectional image, the ratio of the size of the subcutaneous fat region between the mutually opposed sites in the abdominal region, and visceral fat A ratio of the size of the region is obtained, and these two kinds of ratios are compared with a predetermined reference value to obtain a diagnostic index indicating the obesity state of the subject.
前記互に対向する部位を、腹部領域中の頭部側の部位と脚部側の部位とし、前記診断指標を、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標とすることができる。すなわち、本発明の診断指標取得方法は、被験者の体脂肪に関する診断指標を取得する診断指標取得方法であって、被験者の腹部領域中の頭部側の１つ以上の断面を示す断面画像とこの腹部領域中の脚部側の１つ以上の断面を示す断面画像とを用意し、前記頭部側および脚部側の断面画像を用いて、腹部領域中の頭部側の皮下脂肪領域と脚部側の皮下脂肪領域との大きさの比率、および腹部領域中の頭部側の内臓脂肪領域と脚部側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標を得るものとすることができる。 The mutually opposing parts can be the head part and the leg part in the abdominal region, and the diagnostic index can be a diagnostic index indicating the state of upper abdominal obesity or lower abdominal obesity of the subject. . That is, the diagnostic index acquisition method of the present invention is a diagnostic index acquisition method for acquiring a diagnostic index related to the body fat of a subject, and includes a cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject. A cross-sectional image showing one or more cross sections on the leg side in the abdominal region, and using the cross-sectional images on the head side and the leg side, the subcutaneous fat region and the leg on the head side in the abdominal region The ratio of the size to the subcutaneous fat region on the side and the size ratio between the visceral fat region on the head side and the visceral fat region on the leg side in the abdominal region are obtained, and two types of ratios are determined in advance. In comparison with the reference value, a diagnostic index indicating the state of upper abdominal obesity or lower abdominal obesity of the subject can be obtained.
前記互に対向する部位を、腹部領域中の背側の部位と腹側の部位とし、前記診断指標を、被験者の背側肥満あるいは腹側肥満の状態を示す診断指標とすることもできる。すなわち、本発明の診断指標取得方法は、被験者の体脂肪に関する診断指標を取得する診断指標取得方法であって、被験者の腹部領域中における頭部側の１つ以上の断面を示す断面画像と前記腹部領域中における脚部側の１つ以上の断面を示す断面画像とを用意し、前記頭部側および脚部側の断面画像を用いて、腹部領域中の背側の皮下脂肪領域と腹側の皮下脂肪領域との大きさの比率、および腹部領域中の背側の内臓脂肪領域と腹側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して被験者の背側肥満あるいは腹側肥満の状態を示す診断指標を得るものとすることができる。 The mutually opposing parts may be a dorsal part and an abdominal part in the abdominal region, and the diagnostic index may be a diagnostic index indicating the state of the subject's back obesity or ventral obesity. That is, the diagnostic index acquisition method of the present invention is a diagnostic index acquisition method for acquiring a diagnostic index related to the body fat of a subject, the cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject, and A cross-sectional image showing one or more cross sections on the leg side in the abdominal region, and using the cross-sectional images on the head side and the leg side, the dorsal subcutaneous fat region and the ventral side in the abdominal region Obtain the ratio of the size to the subcutaneous fat area and the ratio of the size of the dorsal visceral fat area to the abdominal visceral fat area in the abdominal area, and compare the two types of ratios with predetermined reference values. Thus, a diagnostic index indicating the state of dorsal obesity or ventral obesity of the subject can be obtained.
前記頭部側の断面は、腹部領域中の、被験者のへそ部を通り身長方向に対して直交する断面よりも頭部の側の断面とし、前記脚部側の断面は、腹部領域中の、へそ部を通る断面よりも脚部の側の断面とすることができる。 The cross section on the head side is a cross section on the head side of a cross section orthogonal to the height direction through the subject's navel in the abdominal region, and the cross section on the leg side is in the abdominal region, It can be a cross section on the side of the leg part rather than a cross section passing through the navel part.
前記頭部側の断面は、腹部領域中の、この腹部領域の重心を通り身長方向に対して直交する断面よりも頭部の側の断面とし、脚部側の断面は、腹部領域中のその重心を通る断面よりも脚部の側の断面とすることができる。 The cross section on the head side is a cross section on the head side from the cross section that passes through the center of gravity of the abdominal region and is orthogonal to the height direction in the abdominal region, and the cross section on the leg side is that in the abdominal region. The cross section passing through the center of gravity can be a cross section closer to the leg.
前記診断指標取得方法は、断面画像を複数回に亘って時系列的に取得されるものとし、診断指標を肥満の状態の経時変化を示すものとすることができる。 In the diagnostic index acquisition method, cross-sectional images are acquired in a time series over a plurality of times, and the diagnostic index can indicate a change with time in the obesity state.
また、被検者の腹部領域は、この被検者の肝臓上部辺縁、横隔膜下部、脊椎の椎間のうちのいずれかを通り被検者の身長方向に対して垂直な断面と、腸骨上部、腸骨下部、仙骨下部のうちのいずれかを通り被検者の身長方向に対して垂直な断面との間の領域とすることができる。 The abdominal region of the subject has a cross section perpendicular to the height direction of the subject through any one of the upper margin of the liver, the lower diaphragm, and the vertebrae of the spine, and the iliac bone. It can be set as a region between a section perpendicular to the height direction of the subject through any one of the upper part, the lower part of the iliac bone, and the lower part of the sacrum.
本発明の診断指標取得方法によれば、用意した腹部領域中における頭部側の１つ以上の断面を示す断面画像とこの腹部領域中における脚部側の１つ以上の断面を示す断面画像とを用いて、腹部領域中の互に対向する部位間における皮下脂肪領域の大きさの比率、および内臓脂肪領域の大きさの比率を求め、これらの２種類の比率を予め定められた基準値と比較して、被験者の肥満の状態を示す診断指標を得るようにしたので、被験者の肥満の状態を示す診断指標の品質を高めることができる。 According to the diagnostic index acquisition method of the present invention, a cross-sectional image showing one or more cross sections on the head side in the prepared abdominal region, and a cross-sectional image showing one or more cross sections on the leg side in the abdominal region; Is used to obtain the ratio of the size of the subcutaneous fat region and the size of the visceral fat region between the mutually facing parts in the abdominal region, and these two types of ratios are determined as a predetermined reference value and In comparison, since the diagnostic index indicating the obesity state of the subject is obtained, the quality of the diagnostic index indicating the obesity state of the subject can be improved.
すなわち、被験者の腹部領域中の頭部側を示す断面画像と脚部側を示す断面画像とから、腹部領域中の互に対向する部位間における皮下脂肪領域の大きさの比率、およびこの腹部領域中の互に対向する部位間における内臓脂肪領域の大きさの比率を求めることができるので、腹部領域中の１断面を示す断面画像からこのような比率を得る場合に比して、互に対向する両方の部位における皮下脂肪領域や内臓脂肪領域の分布状態をより正確に把握することができ、両部位間における各脂肪領域の分布状態の違いをも考慮した診断をより正確に行うことができる。これにより、被験者の肥満の状態をより正確に示す診断指標を得ることができ、被験者の肥満の状態を示す診断指標の品質を高めることができる。 That is, from the cross-sectional image showing the head side and the cross-sectional image showing the leg side in the abdominal region of the subject, the ratio of the size of the subcutaneous fat region between the mutually facing parts in the abdominal region, and the abdominal region Since the ratio of the size of the visceral fat region between the mutually facing parts in the inside can be obtained, it is opposed to each other as compared with the case where such a ratio is obtained from the sectional image showing one section in the abdominal region. It is possible to more accurately grasp the distribution state of the subcutaneous fat region and visceral fat region in both parts, and to make a diagnosis more accurately considering the difference in the distribution state of each fat region between the two parts. . As a result, a diagnostic index that more accurately indicates the state of obesity of the subject can be obtained, and the quality of the diagnostic index that indicates the state of obesity of the subject can be improved.
また、用意した腹部領域中の頭部側および脚部側の断面画像を用いて、腹部領域中の頭部側の皮下脂肪領域と脚部側の皮下脂肪領域との大きさの比率、および腹部領域中の頭部側の内臓脂肪領域と脚部側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標を得るようにすれば、被験者の肥満の状態を示す診断指標の品質を高めることができる。 Further, using the prepared head-side and leg-side cross-sectional images in the abdominal region, the ratio of the size of the subcutaneous fat region on the head side and the subcutaneous fat region on the leg side in the abdominal region, and the abdomen Determine the ratio of the size of the visceral fat region on the head side and the visceral fat region on the leg side in the region, and compare the two types of ratios with a predetermined reference value to determine whether the subject has upper abdominal obesity or lower If a diagnostic index indicating the state of abdominal obesity is obtained, the quality of the diagnostic index indicating the state of obesity of the subject can be improved.
すなわち、被験者の腹部領域中の頭部側を示す断面画像と脚部側を示す断面画像とから、頭部側の皮下脂肪領域と脚部側の皮下脂肪領域との大きさの比率および頭部側の内臓脂肪領域と脚部側の内臓脂肪領域との大きさの比率を求めることができるので、腹部領域中の１断面を示す断面画像からこのような比率を得る場合に比して、頭部側と脚部側との両方の部位における皮下脂肪領域や内臓脂肪領域の分布状態をより正確に把握することができ、頭部側と脚部側の両部位間における各脂肪領域の分布状態の違いをも考慮した診断をより正確に行うことができる。これにより、被験者の上腹部肥満あるいは下腹部肥満の状態をより正確に示す診断指標を得ることができ、被験者の肥満の状態を示す診断指標の品質を高めることができる。 That is, from the cross-sectional image showing the head side and the cross-sectional image showing the leg side in the subject's abdominal region, the ratio of the size of the subcutaneous fat region on the head side and the subcutaneous fat region on the leg side and the head Since the ratio of the size of the visceral fat region on the side and the visceral fat region on the leg side can be obtained, the head is compared with a case where such a ratio is obtained from a cross-sectional image showing one cross section in the abdominal region. The distribution state of the subcutaneous fat area and visceral fat area in both the head and leg parts can be grasped more accurately, and the distribution state of each fat area between both the head side and the leg side parts Diagnosis considering the difference can be made more accurately. As a result, a diagnostic index that more accurately indicates the state of upper abdominal obesity or lower abdominal obesity of the subject can be obtained, and the quality of the diagnostic index that indicates the state of obesity of the subject can be improved.
また、用意した腹部領域中の頭部側および脚部側の断面画像を用いて、腹部領域中の背側の皮下脂肪領域と腹側の皮下脂肪領域との大きさの比率、および腹部領域中の背側の内臓脂肪領域と腹側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して被験者の背側肥満あるいは腹側肥満の状態を示す診断指標を得るようにすれば、上記と同様の理由により、背側と腹側の両部位間における各脂肪領域の分布状態の違いをも考慮した診断をより正確に行うことができるので、被験者の肥満の状態を示す診断指標の品質を高めることができる。 Also, using the prepared cross-sectional images of the head side and the leg side in the abdominal region, the ratio of the size of the dorsal subcutaneous fat region and the abdominal subcutaneous fat region in the abdominal region, and the abdominal region The ratio of the size of the dorsal visceral fat region and the ventral visceral fat region is obtained, and the two types of ratios are compared with a predetermined reference value to indicate the state of the subject's dorsal obesity or ventral obesity If the index is obtained, for the same reason as described above, it is possible to more accurately diagnose the difference in the distribution state of each fat region between the dorsal side and the ventral side. The quality of the diagnostic index indicating the state of
すなわち、被験者の腹部領域中の頭部側を示す断面画像と脚部側を示す断面画像とから、背側の皮下脂肪領域と腹側の皮下脂肪領域との大きさの比率および背側の内臓脂肪領域と腹側の内臓脂肪領域との大きさの比率を求めることができるので、腹部領域中の１断面を示す断面画像からこのような比率を得る場合に比して、背側と腹側との両方の部位における皮下脂肪領域や内臓脂肪領域の分布状態をより正確に把握することができ、背側と腹側の両部位間における各脂肪領域の分布状態の違いをも考慮した診断をより正確に行うことができる。これにより、被験者の背側の肥満あるいは腹側の肥満の状態をより正確に示す診断指標を得ることができ、被験者の肥満の状態を示す診断指標の品質を高めることができる。 That is, from the cross-sectional image showing the head side and the cross-sectional image showing the leg side in the subject's abdominal region, the ratio of the size of the dorsal subcutaneous fat region and the abdominal subcutaneous fat region and the visceral fat on the dorsal side Since the ratio of the size of the region and the visceral fat region on the ventral side can be obtained, both the dorsal side and the ventral side are compared with the case where such a ratio is obtained from a cross-sectional image showing one cross section in the abdominal region. It is possible to more accurately grasp the distribution state of the subcutaneous fat region and visceral fat region in the region, and make a diagnosis more accurately considering the difference in the distribution state of each fat region between the dorsal and ventral regions be able to. As a result, a diagnostic index that more accurately indicates the state of obesity on the back side or the abdominal side of the subject can be obtained, and the quality of the diagnostic index that indicates the state of obesity of the subject can be improved.
なお、背側は、腹部領域の重心を通り被験者の前後方向（背腹方法）に対して直交する断面よりも後方の側とし、腹側は、上記重心を通る断面よりも前方の側とすることができる。 The dorsal side is the rear side of the cross section that passes through the center of gravity of the abdominal region and is orthogonal to the subject's front-back direction (the dorsal abdominal method), and the ventral side is the front side of the cross section that passes through the center of gravity. be able to.
また、頭部側の断面を、腹部領域中の、被験者のへそ部を通り身長方向に対して直交する断面よりも頭部の側の断面とし、脚部側の断面を、腹部領域中の、へそ部を通る断面よりも脚部の側の断面とすれば、被験者の上腹部肥満あるいは下腹部肥満の診断をより確実に実施することができ、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標をより確実に取得することができる。 In addition, the cross section on the head side is a cross section on the head side of the abdominal region, the cross section on the head side through the navel of the subject and orthogonal to the height direction, and the cross section on the leg side is in the abdominal region, If the cross-section passing through the navel is a cross section on the leg side, the diagnosis of upper abdominal obesity or lower abdominal obesity of the subject can be more reliably performed. The indicated diagnostic index can be acquired more reliably.
また、頭部側の断面を、腹部領域中の、この腹部領域の重心を通り身長方向に対して直交する断面よりも頭部の側の断面とし、脚部側の断面を、腹部領域中のその重心を通る断面よりも脚部の側の断面とすれば、上記と同様に、被験者の上腹部肥満あるいは下腹部肥満の診断をより確実に実施することができ、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標をより確実に取得することができる。 Further, the cross section on the head side is a cross section on the head side from the cross section that passes through the center of gravity of the abdominal region and is orthogonal to the height direction in the abdominal region, and the cross section on the leg side is the cross section in the abdominal region. If the cross section passing through the center of gravity is on the side of the leg, the upper abdominal obesity or lower abdominal obesity can be diagnosed more reliably in the same manner as described above. A diagnostic index indicating the state of abdominal obesity can be obtained more reliably.
また、断面画像を複数回に亘って時系列的に取得されるものとし、診断指標を肥満の状態の経時変化を示すものとすれば、より多くの情報を用いて被験者の肥満の状態を診断することができ、上腹部肥満あるいは下腹部肥満の状態を示す診断指標を示すより正確な診断指標を得ることができるので、被験者の肥満の状態を示す診断指標の品質をさらに高めることができる。 In addition, if cross-sectional images are acquired in a time series over multiple times, and the diagnostic index is indicative of changes in obesity status over time, the obesity status of the subject can be diagnosed using more information Since a more accurate diagnostic index indicating the diagnostic index indicating the state of upper abdominal obesity or lower abdominal obesity can be obtained, the quality of the diagnostic index indicating the obesity status of the subject can be further enhanced.
以下、本発明の実施の形態による診断指標取得方法について説明する。はじめに、実施例１について以下に説明する。図１は断面画像が取得される腹部領域中の断面の位置を示す図、図２は互に異なる断面を表す各断面画像を示す図、図３は被験者の腹部領域中の断面を示す断面画像から上腹部肥満あるいは下腹部肥満の状態を示す診断指標を得る過程を示すフロー図である。 Hereinafter, a diagnostic index acquisition method according to an embodiment of the present invention will be described. First, Example 1 will be described below. FIG. 1 is a diagram showing a position of a cross section in an abdominal region from which a cross-sectional image is acquired, FIG. 2 is a diagram showing cross-sectional images representing different cross sections, and FIG. 3 is a cross-sectional image showing a cross section in the abdominal region of the subject. It is a flowchart which shows the process of obtaining the diagnostic parameter | index which shows the state of upper abdominal obesity or lower abdominal obesity.
上記診断指標取得方法は、被験者の腹部領域中における頭部側の１つ以上の断面を示す断面画像とこの腹部領域中における脚部側の１つ以上の断面を示す断面画像とを用いて、腹部領域中の互に対向する部位間における皮下脂肪領域の大きさの比率、および内臓脂肪領域の大きさの比率を求め、これら２種類の比率を予め定められた基準値と比較して、被験者の肥満の状態を示す診断指標を得るようにするものである。 The diagnostic index acquisition method uses a cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject and a cross-sectional image showing one or more cross sections on the leg side in the abdominal region, The ratio of the size of the subcutaneous fat area and the ratio of the size of the visceral fat area between the mutually opposed parts in the abdominal region are obtained, and the two types of ratios are compared with a predetermined reference value, It is intended to obtain a diagnostic index indicating the state of obesity.
実施例１は、被験者の腹部領域中の頭部側の１つ以上の断面を示す断面画像と腹部領域中の脚部側の１つ以上の断面を示す断面画像とを用い、これら頭部側および脚部側の断面画像について、腹部領域の中央部を通り身長方向に対して直交する断面よりも頭部側の皮下脂肪領域と脚部側の皮下脂肪領域との大きさの比率、およびこの断面よりも頭部側の内臓脂肪領域と脚部側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して、被験者の上腹部肥満あるいは下腹部肥満の状態を示す診断指標を得るものである。なお、被検者の身長方向はこの被験者の背骨の伸びる方向でもある。 Example 1 uses a cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject and a cross-sectional image showing one or more cross sections on the leg side in the abdominal region. And the leg-side cross-sectional image, the ratio of the size of the subcutaneous fat region on the head side and the subcutaneous fat region on the leg side relative to the cross-section passing through the center of the abdominal region and orthogonal to the height direction, and this Obtain the ratio of the size of the visceral fat region on the head side and the visceral fat region on the leg side of the cross section, and compare the two types of ratios with a predetermined reference value to determine whether the subject has upper abdominal obesity or lower A diagnostic index indicating the state of abdominal obesity is obtained. The height direction of the subject is also the direction in which the spine of the subject extends.
図１に示すように、はじめに、被検者Ｈの腹部領域Ｈｂ中の断面を示す互に異なる２つの断面画像、すなわち、被検者ＨのへそＨｎを通り身長方向（図中矢印Ｚ方向）に対して直交する断面Ｚｎよりも頭部側（図中矢印＋Ｚ側）の上腹部側断面Ｚｕを示す断面画像である上腹部側断面画像Ｇｕと、断面Ｚｎよりも脚部側（図中矢印−Ｚ側）の下腹部側断面Ｚｄを示す断面画像である下腹部側断面画像Ｇｄとを用意する。 As shown in FIG. 1, first, two different cross-sectional images showing the cross section in the abdominal region Hb of the subject H, that is, passing through the navel Hn of the subject H in the height direction (the arrow Z direction in the figure). An upper abdomen side cross-sectional image Gu which is a cross-sectional image showing the upper abdomen side cross section Zu on the head side (arrow + Z side in the figure) with respect to the cross section Zn orthogonal to the cross section Zn, and the leg side (arrow in the figure) A lower abdomen side cross-sectional image Gd, which is a cross-sectional image showing the lower abdomen side cross section Zd, is prepared.
ここで、各断面画像Ｇｕ、Ｇｄは、Ｘ線ＣＴによる断層撮影で得られたものとすることができる。 Here, the cross-sectional images Gu and Gd can be obtained by tomography by X-ray CT.
次に、図２に示すように、上腹部側断面画像Ｇｕについて、皮下脂肪領域Ｆｐの大きさを示す上腹部側皮下脂肪面積Ｓｐｕと、内臓脂肪領域Ｆｏの大きさを示す上腹部側内臓脂肪面積Ｓｏｕとを求める。 Next, as shown in FIG. 2, for the upper abdomen side cross-sectional image Gu, the upper abdomen side subcutaneous fat area Spu indicating the size of the subcutaneous fat region Fp and the upper abdomen side visceral fat indicating the size of the visceral fat region Fo. The area Sou is obtained.
また、下腹部側断面画像Ｇｄについて、皮下脂肪領域Ｆｐの大きさを示す下腹部側皮下脂肪面積Ｓｐｄと、内臓脂肪領域Ｆｏの大きさを示す下腹部側内臓脂肪面積Ｓｏｄとを求める。 Further, for the lower abdomen side cross-sectional image Gd, a lower abdomen side subcutaneous fat area Spd indicating the size of the subcutaneous fat region Fp and a lower abdomen side visceral fat area Sod indicating the size of the visceral fat region Fo are obtained.
さらに、図３に示すように、皮下脂肪領域Ｆｐについて、下腹部側皮下脂肪面積Ｓｐｄに対する上腹部側皮下脂肪面積Ｓｐｕの比率である上下腹部皮下脂肪比率Ｐｕｄを求める。ここで、上下腹部皮下脂肪比率Ｐｕｄは、Ｐｕｄ＝Ｓｐｕ／Ｓｐｄの式で表される値である。 Further, as shown in FIG. 3, for the subcutaneous fat region Fp, the upper and lower abdominal subcutaneous fat ratio Pud, which is the ratio of the upper abdominal subcutaneous fat area Spu to the lower abdominal subcutaneous fat area Spd, is obtained. Here, the upper and lower abdominal subcutaneous fat ratio Pud is a value represented by an equation of Pud = Spu / Spd.
また、内臓脂肪領域Ｆｏについて、下腹部側内臓脂肪面積Ｓｏｄに対する上腹部側内臓脂肪面積Ｓｏｕの比率である上下腹部内臓脂肪比率Ｏｕｄを求める。ここで、上下腹部内臓脂肪比率Ｏｕｄは、Ｏｕｄ＝Ｓｏｕ／Ｓｏｄの式で表される値である。 For the visceral fat region Fo, the upper and lower abdominal visceral fat area Oud, which is the ratio of the upper abdominal visceral fat area Sou to the lower abdominal visceral fat area Sod, is obtained. Here, the upper and lower abdominal visceral fat ratio Oud is a value represented by an expression of Oud = Sou / Sod.
上下腹部皮下脂肪比率Ｐｕｄの値が１のときには、下腹部側皮下脂肪面積Ｓｐｄと上腹部側皮下脂肪面積Ｓｐｕとが等しい。また、上下腹部皮下脂肪比率Ｐｕｄの値が１より大きいときには、下腹部側皮下脂肪面積Ｓｐｄよりも上腹部側皮下脂肪面積Ｓｐｕの方が大きい。 When the value of the upper and lower abdomen subcutaneous fat ratio Pud is 1, the lower abdomen side subcutaneous fat area Spd and the upper abdomen side subcutaneous fat area Spu are equal. When the value of the upper and lower abdominal subcutaneous fat ratio Pud is larger than 1, the upper abdominal side subcutaneous fat area Spu is larger than the lower abdominal side subcutaneous fat area Spd.
また、上下腹部内臓脂肪比率Ｏｕｄの値が１のときには、下腹部側内臓脂肪面積Ｓｏｄと上腹部側内臓脂肪面積Ｓｏｕとが等しい。また、上下腹部内臓脂肪比率Ｏｕｄの値が１より大きいときには、下腹部側内臓脂肪面積Ｓｏｄよりも上腹部側内臓脂肪面積Ｓｏｕの方が大きい。 When the value of the upper and lower abdominal visceral fat ratio Oud is 1, the lower abdominal visceral fat area Sod is equal to the upper abdominal visceral fat area Sou. When the value of the upper and lower abdominal visceral fat ratio Oud is larger than 1, the upper abdominal visceral fat area Sou is larger than the lower abdominal visceral fat area Sod.
次に、被検者Ｈについての上下腹部皮下脂肪比率Ｐｕｄと上下腹部内臓脂肪比率Ｏｕｄとを予め定められた基準値と比較して被験者Ｈの上腹部肥満あるいは下腹部肥満の状態を示す診断指標を得る。 Next, the diagnostic index indicating the state of upper abdominal obesity or lower abdominal obesity of the subject H by comparing the upper and lower abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud for the subject H with a predetermined reference value Get.
なお、予め定められた基準値は、上腹部肥満あるいは下腹部肥満の状態を示す診断指標に対応付けて設定されている。ここで、上記基準値は、皮下脂肪領域および内臓脂肪領域の大きさや分布状態が標準的な人体を示す人体モデルを用い、上述の手法と同様の手法によって求めた人体モデルについての上下腹部皮下脂肪比率と上下腹部内臓脂肪比率とを採用してもよい。すなわち、予め定められた基準値は、予め求めておいた人体モデルについての、頭部側の皮下脂肪領域と脚部側の皮下脂肪領域との大きさの比率、および頭部側の内臓脂肪領域と脚部側の内臓脂肪領域との大きさの比率としてもよい。 The predetermined reference value is set in association with a diagnostic index indicating the state of upper abdominal obesity or lower abdominal obesity. Here, the reference value is the upper and lower abdominal subcutaneous fat for a human body model obtained by a method similar to the above method using a human body model in which the size and distribution state of the subcutaneous fat region and the visceral fat region are standard. The ratio and the upper and lower abdominal visceral fat ratio may be employed. That is, the predetermined reference value is the ratio of the size of the subcutaneous fat region on the head side and the subcutaneous fat region on the leg side, and the visceral fat region on the head side for the human body model obtained in advance. And the ratio of the size of the visceral fat region on the leg side.
以下、予め定められた基準値と診断指標との対応付けについて説明する。 Hereinafter, the association between the predetermined reference value and the diagnostic index will be described.
診断指標は、ここでは、「カテゴリーＵ：上腹部肥満、カテゴリーＤ：下腹部肥満、カテゴリーＱ：上腹部肥満・下腹部肥満のいずれでもない」の３種類からなるものとする。 Here, the diagnosis index is composed of three types: “Category U: upper abdominal obesity, category D: lower abdominal obesity, category Q: neither upper abdominal obesity nor lower abdominal obesity”.
上腹部肥満であることを示すカテゴリーＵは、上下腹部皮下脂肪比率Ｐｕｄの値と上下腹部内臓脂肪比率Ｏｕｄの値とが共に、予め定められた基準値である１．５以上の値の範囲に含まれるときに対応する診断指標である。 Category U, which indicates upper abdominal obesity, has a value of 1.5 or more, which is a predetermined reference value, for both the value of the upper and lower abdominal subcutaneous fat ratio Pud and the value of the upper and lower abdominal visceral fat ratio Oud. It is a diagnostic index corresponding to when it is included.
なお、上下腹部皮下脂肪比率Ｐｕｄが１．５以上とは、上腹部側断面Ｚｕにおける上腹部側皮下脂肪面積Ｓｐｕの大きさが、下腹部側断面Ｚｄにおける下腹部側皮下脂肪面積Ｓｐｄの１．５倍以上であることを示している。上下腹部内臓脂肪比率Ｏｕｄについても上記上下腹部皮下脂肪比率Ｐｕｄの場合と同様である。 Note that the upper and lower abdominal subcutaneous fat ratio Pud is 1.5 or more means that the size of the upper abdominal side subcutaneous fat area Spu in the upper abdominal side section Zu is 1. It shows that it is 5 times or more. The upper and lower abdominal visceral fat ratio Oud is the same as the case of the upper and lower abdominal subcutaneous fat ratio Pud.
下腹部肥満であることを示すカテゴリーＤは、上下腹部皮下脂肪比率Ｐｕｄの値と上下腹部内臓脂肪比率Ｏｕｄの値とが共に、予め定められた基準値である０．５未満の範囲に含まれるときに対応する診断指標である。 Category D indicating lower abdominal obesity includes both the upper and lower abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud within a range of less than 0.5, which is a predetermined reference value. Sometimes a corresponding diagnostic indicator.
上腹部肥満・下腹部肥満のいずれでもないことを示すカテゴリーＱは、上下腹部皮下脂肪比率Ｐｕｄの値と上下腹部内臓脂肪比率Ｏｕｄの値とが、上記カテゴリーＵおよびカテゴリーＤのいずれにも属さない範囲であるときに対応する診断指標である。 Category Q, which indicates neither upper abdominal obesity nor lower abdominal obesity, the value of the upper and lower abdominal subcutaneous fat ratio Pud and the value of the upper and lower abdominal visceral fat ratio Oud do not belong to any of the above categories U and D It is a diagnostic index corresponding to the range.
上下腹部皮下脂肪比率Ｐｕｄと上下腹部内臓脂肪比率Ｏｕｄとが共に、予め定められた基準値である１．５以上であるときには、診断指標として「上腹部肥満であること」を示すカテゴリーＵが得られる。 When both the upper and lower abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud are not less than a predetermined reference value of 1.5, a category U indicating “upper abdominal obesity” is obtained as a diagnostic index. It is done.
上下腹部皮下脂肪比率Ｐｕｄと上下腹部内臓脂肪比率Ｏｕｄとが共に、予め定められた基準値である０．５未満であるときには、診断指標として「下腹部肥満であること」を示すカテゴリーＤが得られる。 When both the upper and lower abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud are less than a predetermined reference value of 0.5, a category D indicating “lower abdominal obesity” is obtained as a diagnostic index. It is done.
また、上下腹部皮下脂肪比率Ｐｕｄと上下腹部内臓脂肪比率Ｏｕｄとが共に、予め定められた基準値である１．５以上でなく、０．５未満でもないときには、診断指標として「上腹部肥満・下腹部肥満のいずれでもないこと」を示すカテゴリーＱが得られる。 When both the upper and lower abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud are not equal to or higher than a predetermined reference value of 1.5 or less than 0.5, the diagnostic index is “upper abdominal obesity / Category Q indicating "None of lower abdominal obesity" is obtained.
例えば、上下腹部皮下脂肪比率Ｐｕｄの値が１．８、かつ上下腹部内臓脂肪比率Ｏｕｄの値が２．３のときには、診断指標としてカテゴリーＵ（上腹部肥満）が得られる。 For example, when the value of the upper and lower abdominal subcutaneous fat ratio Pud is 1.8 and the value of the upper and lower abdominal visceral fat ratio Oud is 2.3, category U (upper abdominal obesity) is obtained as a diagnostic index.
また、上下腹部皮下脂肪比率Ｐｕｄの値が１．８、かつ上下腹部内臓脂肪比率Ｏｕｄの値が１．０のときには、診断指標は、カテゴリーＱ（上腹部肥満・下腹部肥満のいずれでもない）が得られる。 When the value of the upper and lower abdominal subcutaneous fat ratio Pud is 1.8 and the value of the upper and lower abdominal visceral fat ratio Oud is 1.0, the diagnostic index is category Q (neither upper abdominal obesity nor lower abdominal obesity) Is obtained.
なお、上下腹部皮下脂肪比率Ｐｕｄの値や上下腹部内臓脂肪比率Ｏｕｄの値は以下のように取得してもよい。 Note that the value of the upper and lower abdominal subcutaneous fat ratio Pud and the value of the upper and lower abdominal visceral fat ratio Oud may be acquired as follows.
すなわち、被検者ＨのへそＨｎを通り身長方向（図中矢印Ｚ方向）に対して直交する断面Ｚｎよりも頭部側（図中矢印＋Ｚ側）の複数の断面を示す上腹部側断面画像Ｇｕ１、Ｇｕ２、Ｇｕ３と、断面Ｚｎよりも脚部側（図中矢印−Ｚ側）の複数の断面を示す下腹部側断面画像Ｇｄ１、Ｇｄ２、Ｇｄ３を用意する。 That is, the upper abdomen side cross-sectional image showing a plurality of cross sections on the head side (arrow + Z side in the figure) from the cross section Zn passing through the navel Hn of the subject H and orthogonal to the height direction (arrow Z direction in the figure). Gu1, Gu2, and Gu3 and lower abdomen side cross-sectional images Gd1, Gd2, and Gd3 showing a plurality of cross sections on the leg side (arrow-Z side in the drawing) from the cross section Zn are prepared.
次に、上腹部側断面画像Ｇｕ１、Ｇｕ２、Ｇｕ３それぞれについて、皮下脂肪領域Ｆｐを示す上腹部側皮下脂肪面積Ｓｐｕ１、Ｓｐｕ２、Ｓｐｕ３と、内臓脂肪領域Ｆｏを示す上腹部側内臓脂肪面積Ｓｏｕ１、Ｓｏｕ２、Ｓｏｕ３とを求める。また、下腹部側断面画像Ｇｄ１、Ｇｄ２、Ｇｄ３それぞれについても同様に下腹部側皮下脂肪面積Ｓｐｄ１、Ｓｐｄ２、Ｓｐｄ３と、下腹部側内臓脂肪面積Ｓｏｄ１、Ｓｏｄ２、Ｓｏｄ３、とを求める。 Next, for each of the upper abdomen side cross-sectional images Gu1, Gu2, and Gu3, the upper abdomen side subcutaneous fat area Spu1, Spu2, Spu3 showing the subcutaneous fat region Fp, and the upper abdomen side visceral fat area Sou1, Sou2 showing the visceral fat region Fo. , Sou3. Similarly, the lower abdominal side subcutaneous fat areas Spd1, Spd2, and Spd3 and the lower abdominal side visceral fat areas Sod1, Sod2, and Sod3 are also obtained for the lower abdominal side sectional images Gd1, Gd2, and Gd3.
そして、上下腹部皮下脂肪比率のＰｕｄの値を、Ｐｕｄ＝（Ｓｐｕ１＋Ｓｐｕ２＋Ｓｐｕ３）／（Ｓｐｄ１+Ｓｐｄ２+Ｓｐｄ３）の式によって、また、上下腹部内臓脂肪比率Ｏｕｄの値を、Ｏｕｄ＝（Ｓｏｕ１+Ｓｏｕ２+Ｓｏｕ３）／（Ｓｏｄ１＋Ｓｏｄ２＋Ｓｏｄ３）の式によって求めるようにしてもよい。 Then, the value of Pud of the upper and lower abdominal subcutaneous fat ratio is calculated by the formula Pud = (Spu1 + Spu2 + Spu3) / (Spd1 + Spd2 + Spd3), and the value of the upper and lower abdominal visceral fat ratio Oud is calculated as ) / (Sod1 + Sod2 + Sod3).
このよにして、上下腹部皮下脂肪比率のＰｕｄおよび上下腹部内臓脂肪比率Ｏｕｄの値を得ることにより、上腹部肥満あるいは下腹部肥満の状態を示すより正確な診断情報を得ることができる。 Thus, by obtaining values of the upper and lower abdominal abdominal subcutaneous fat ratio Pud and the upper and lower abdominal visceral fat ratio Oud, more accurate diagnostic information indicating the state of upper abdominal obesity or lower abdominal obesity can be obtained.
なお、時系列的な診断指標を得るために、被験者の上腹部側断面画像および下腹部側断面画像を複数回に亘って時系列的に取得するようにしてもよい。すなわち、日付ｔ１（例えば、３月１日）、日付ｔ２（例えば、４月１日）、日付ｔ３（例えば、５月１日）・・・において断面画像を取得する。そして、日付ｔ１、ｔ２、ｔ３・・・で得られたそれぞれの上腹部側断面画像および下腹部側断面画像について、上記と同様の手法により上下腹部皮下脂肪比率と上下腹部内臓脂肪比率を求める。ここで、日付ｔ１時点における上下腹部皮下脂肪比率Ｐｕｄ１、日付ｔ２時点の上下腹部皮下脂肪比率Ｐｕｄ２、日付ｔ３時点の上下腹部皮下脂肪比率Ｐｕｄ３、日付ｔ４時点の上下腹部皮下脂肪比率Ｐｕｄ４、・・・とする。このようにして得られた時系列的な上下腹部皮下脂肪比率Ｐｕｄ１、Ｐｕｄ２、Ｐｕｄ３、・・・の値を、予め定められた時系列的な値の範囲を示す基準値とを比較して、皮下脂肪に関する被験者の上部肥満あるいは下部肥満の経時変化を示す診断指標を得るようにすることができる。 In addition, in order to obtain a time-series diagnostic index, the subject's upper abdomen side cross-sectional image and lower abdomen side cross-sectional image may be acquired in a time series over a plurality of times. That is, cross-sectional images are acquired at date t1 (for example, March 1), date t2 (for example, April 1), date t3 (for example, May 1),. Then, the upper and lower abdominal subcutaneous fat ratio and the upper and lower abdominal visceral fat ratio are obtained for the upper abdominal side sectional image and the lower abdominal side sectional image obtained on dates t1, t2, t3. Here, the upper and lower abdominal subcutaneous fat ratio Pud1 at the date t1, the upper and lower abdominal subcutaneous fat ratio Pud2 at the date t2, the upper and lower abdominal subcutaneous fat ratio Pud3 at the date t3, the upper and lower abdominal subcutaneous fat ratio Pud4 at the date t4,. And The time-series upper and lower abdominal subcutaneous fat ratios Pud1, Pud2, Pud3,... Thus obtained are compared with a reference value indicating a predetermined time-series value range, It is possible to obtain a diagnostic index indicating the temporal change of upper obesity or lower obesity of a subject relating to subcutaneous fat.
ここで、経時変化を示す診断指標は、上腹部肥満進行中、上腹部肥満解消中、下腹部肥満進行中、あるいは下腹部肥満解消中等とし、例えば、Ｐｕｄ１＝１．８、Ｐｕｄ２＝１．９、Ｐｕｄ３＝２．０、Ｐｕｄ４＝２．１であるときには、上下腹部皮下脂肪比率が単調増加しているので、皮下脂肪に関して上腹部肥満進行中であることを表す診断指標が与えられる。 Here, the diagnostic index indicating the change over time is, for example, Pud1 = 1.8, Pud2 = 1.9, during upper abdominal obesity progression, upper abdominal obesity elimination, lower abdominal obesity progression, lower abdominal obesity elimination, or the like. When Pud3 = 2.0 and Pud4 = 2.1, the upper and lower abdominal subcutaneous fat ratio monotonously increases, so that a diagnostic index indicating that upper abdominal obesity is in progress with respect to subcutaneous fat is given.
なお、上記実施例においては、へそを通り身長方向に対して直交する断面を腹部領域中の頭部側の領域と脚部側の領域との境界としたが、必ずしもそのような場合に限らず、例えば、腹部領域の重心を通り身長方向に対して直交する断面等を腹部領域中の頭部側の領域と脚部側の領域との境界としてもよい。 In the above embodiment, the cross section passing through the navel and perpendicular to the height direction is defined as the boundary between the head side region and the leg side region in the abdominal region, but this is not necessarily the case. For example, a cross section passing through the center of gravity of the abdominal region and orthogonal to the height direction may be used as the boundary between the region on the head side and the region on the leg side in the abdominal region.
以下、実施例２について図４から図６を用いて説明する。実施例２は、被験者の体脂肪に関する診断指標を取得する診断指標取得方法であって、被験者の腹部領域中の互に異なる２つ以上の断面を示す断面画像を用意し、用意した断面画像を用い、腹部領域の重心を通り被験者の前後方向に対して直交する断面よりも背側の皮下脂肪領域と腹側の皮下脂肪領域との大きさの比率、およびこの断面よりも背側の内臓脂肪領域と腹側の内臓脂肪領域との大きさの比率を求め、２種類の比率を予め定められた基準値と比較して、被験者の背側肥満あるいは腹側肥満の状態を示す診断指標を得るものである。図４は比率が求められる背側と腹側との境界となる断面の位置を示す図、図５は腹部領域中の互に異なる断面を示す各断面画像を示す図、図６は被験者の腹部領域の断面を示す断面画像から背側肥満あるいは腹側肥満の状態を示す診断指標を得る過程を示すフロー図である。 Hereinafter, Example 2 will be described with reference to FIGS. Example 2 is a diagnostic index acquisition method for acquiring a diagnostic index related to body fat of a subject, preparing sectional images showing two or more different sections in the abdominal region of the subject, and preparing the prepared sectional images The ratio of the size of the subcutaneous fat region on the dorsal side and the subcutaneous fat region on the ventral side of the cross section that passes through the center of gravity of the abdominal region and is orthogonal to the front-rear direction of the subject, and the visceral fat region on the back side of this cross section The ratio of the size of the body and the visceral fat region on the ventral side is obtained and the two types of ratios are compared with a predetermined reference value to obtain a diagnostic index indicating the state of dorsal obesity or ventral obesity of the subject. is there. 4 is a diagram showing the position of a cross section serving as a boundary between the dorsal side and the ventral side for which a ratio is required, FIG. 5 is a diagram showing cross-sectional images showing different cross sections in the abdominal region, and FIG. 6 is a subject's abdominal region. It is a flowchart which shows the process of obtaining the diagnostic parameter | index which shows the state of dorsal obesity or ventral obesity from the cross-sectional image which shows the cross section of this.
互に異なる２つ以上の断面を示す断面画像は、被験者の腹部領域中の頭部側の１つ以上の断面を示す断面画像とこの腹部領域中の脚部側の１つ以上の断面を示す断面画像とを含むものとすることが望ましく、頭部側と脚部側との境界は、へそ部、あるいは、腹部領域の重心を通り被験者の身長方向に対して直交する断面とすることができる。 A cross-sectional image showing two or more different cross-sections shows a cross-sectional image showing one or more cross-sections on the head side in the abdominal region of the subject and one or more cross-sections on the leg side in the abdominal region. It is desirable to include a cross-sectional image, and the boundary between the head side and the leg side may be a cross section that passes through the center of the navel or the abdominal region and is orthogonal to the height direction of the subject.
なお、被験者の前後方向（図中矢印Ｘ方向）は、被験者の背側と腹側とを結ぶ方向であって、被験者の身長方向（図中矢印Ｚ方向）および左右方向（図中矢印Ｙ方向）の両方向に対して直交する方向である。 The front-rear direction of the subject (arrow X direction in the figure) is a direction connecting the back side and the abdomen side of the subject, and the subject's height direction (arrow Z direction in the figure) and left-right direction (arrow Y direction in the figure). These directions are orthogonal to both directions.
図４に示すように、はじめに、被検者Ｈの腹部領域Ｈｂ中の断面を示す互に異なる２つの断面画像である、上記実施例１の場合と同様の上腹部側断面画像Ｇｕと下腹部側断面画像Ｇｄとを用意する。 As shown in FIG. 4, first, the upper abdomen side cross-sectional image Gu and the lower abdomen, which are two different cross-sectional images showing the cross section in the abdominal region Hb of the subject H, similar to the case of Example 1 above. A side cross-sectional image Gd is prepared.
次に、各断面画像Ｇｕ、Ｇｄについて、被験者Ｈの腹部領域の重心Ｊｏを通り被験者Ｈの前後方向である、背側と腹側とを結ぶ方向（図中矢印Ｘ方向）に対して直交する断面Ｚｊよりも背側（図中矢印−Ｘ側）の皮下脂肪領域と腹側（図中矢印＋Ｘ側）の皮下脂肪領域との大きさの比率、およびこの断面Ｚｊよりも背側の内臓脂肪領域と腹側の内臓脂肪領域との大きさの比率を求める。 Next, for each of the cross-sectional images Gu and Gd, a cross section that passes through the center of gravity Jo of the abdominal region of the subject H and that is orthogonal to the direction connecting the dorsal side and the abdominal side, which is the front-and-rear direction of the subject H. The ratio of the size of the subcutaneous fat region on the dorsal side (arrow -X side in the drawing) and the subcutaneous fat region on the ventral side (arrow + X side in the drawing) from Zj, and the visceral fat region and the belly on the dorsal side from this cross section Zj The ratio of the size with the visceral fat region on the side is obtained.
すなわち、図５に示すように、上腹部側断面画像Ｇｕについて、背側の皮下脂肪領域Ｆｐの大きさを示す背側皮下脂肪面積Ｓｕｂｐと、背側の内臓脂肪領域Ｆｏの大きさを示す背側内臓脂肪面積Ｓｕｂｏとを求め、さらに、腹側の皮下脂肪領域Ｆｐの大きさを示す腹側皮下脂肪面積Ｓｕｆｐと、腹側の内臓脂肪領域Ｆｏの大きさを示す腹側内臓脂肪面積Ｓｕｆｏとを求める。 That is, as shown in FIG. 5, for the upper abdomen side cross-sectional image Gu, the dorsal subcutaneous fat area Subp indicating the size of the dorsal subcutaneous fat region Fp and the dorsal indicating the size of the dorsal visceral fat region Fo. A side visceral fat area Subo, and a ventral subcutaneous fat area Sufp indicating the size of the ventral subcutaneous fat area Fp; and a ventral visceral fat area Sufo indicating the size of the ventral visceral fat area Fo; Ask for.
また、下腹部側断面画像Ｇｄについて、背側の皮下脂肪領域Ｆｐの大きさを示す背側皮下脂肪面積Ｓｄｂｐと、背側の内臓脂肪領域Ｆｏの大きさを示す背側内臓脂肪面積Ｓｄｂｏとを求め、さらに、腹側の皮下脂肪領域Ｆｐの大きさを示す腹側皮下脂肪面積Ｓｄｆｐと、腹側の内臓脂肪領域Ｆｏの大きさを示す腹側内臓脂肪面積Ｓｄｆｏとを求める。 Further, for the lower abdomen side cross-sectional image Gd, a dorsal subcutaneous fat area Sdbp indicating the size of the dorsal subcutaneous fat region Fp and a dorsal visceral fat area Sdbo indicating the size of the dorsal visceral fat region Fo are provided. Further, an abdominal subcutaneous fat area Sdfp indicating the size of the ventral subcutaneous fat region Fp and an abdominal visceral fat area Sdfo indicating the size of the ventral visceral fat region Fo are determined.
次に、図６に示すように、断面Ｚｊよりも背側の皮下脂肪領域と、断面Ｚｊよりも腹側の皮下脂肪領域との大きさの比率である背腹皮下脂肪比率Ｐｆｂ、および断面Ｚｊよりも背側の内臓脂肪領域と断面Ｚｊよりも腹側の内臓脂肪領域との大きさの比率である背腹内臓脂肪比率Ｏｆｂとを求める。 Next, as shown in FIG. 6, the dorsal abdominal subcutaneous fat ratio Pfb, which is the ratio of the size of the subcutaneous fat region on the back side of the cross section Zj, and the subcutaneous fat region on the ventral side of the cross section Zj, and the cross section Zj Further, a dorsal abdominal visceral fat ratio Ofb, which is a ratio of the size of the visceral fat region on the back side to the visceral fat region on the ventral side from the cross section Zj, is obtained.
ここで、背腹皮下脂肪比率Ｐｆｂは、Ｐｆｂ＝（Ｓｕｆｐ+Ｓｄｆｐ）／（Ｓｕｂｐ+Ｓｄｂｐ）の式で表される値である。 Here, the dorsal-abdominal subcutaneous fat ratio Pfb is a value represented by the formula Pfb = (Sufp + Sdfp) / (Subp + Sdbp).
また、背腹内臓脂肪比率Ｏｆｂは、Ｏｆｂ＝（Ｓｕｆｏ+Ｓｄｆｏ）／（Ｓｕｂｏ+Ｓｄｂｏ）の式で表される値である。 Further, the dorsal abdominal visceral fat ratio Ofb is a value represented by the formula Ofb = (Sufo + Sdfo) / (Subo + Sdbo).
背腹皮下脂肪比率Ｐｆｂの値が１のときには、上記断面画像の示す腹側の皮下脂肪領域Ｆｐの大きさと背側の皮下脂肪領域Ｆｐの大きさとが等しい。また、背腹皮下脂肪比率Ｐｆｂの値が１より小さいときには、上記断面画像の示す腹側の皮下脂肪領域Ｆｐの大きさが背側の皮下脂肪領域Ｆｐの大きさより小さい。 When the value of the dorsal abdominal subcutaneous fat ratio Pfb is 1, the size of the abdominal subcutaneous fat region Fp and the size of the dorsal subcutaneous fat region Fp shown in the cross-sectional image are equal. When the value of the dorsal abdominal subcutaneous fat ratio Pfb is smaller than 1, the size of the abdominal subcutaneous fat region Fp indicated by the cross-sectional image is smaller than the size of the dorsal subcutaneous fat region Fp.
また、背腹内臓脂肪比率Ｏｆｂの値が１のときには、上記断面画像の示す腹側の内臓脂肪領域Ｆｏの大きさと背側の内臓脂肪領域Ｆｏの大きさとが等しい。また、背腹内臓脂肪比率Ｏｆｂの値が１より小さいときには、上記断面画像の示す腹側の内臓脂肪領域Ｆｏの大きさが背側の内臓脂肪領域Ｆｏの大きさより小さい。 When the value of the dorsal abdominal visceral fat ratio Ofb is 1, the size of the abdominal visceral fat region Fo and the size of the dorsal visceral fat region Fo shown in the cross-sectional image are equal. When the value of the dorsal abdominal visceral fat ratio Ofb is smaller than 1, the size of the abdominal visceral fat region Fo indicated by the cross-sectional image is smaller than the size of the dorsal visceral fat region Fo.
次に、背腹皮下脂肪比率Ｐｆｂと背腹内臓脂肪比率Ｏｆｂとを予め定められた基準値と比較して被験者Ｈの腹側肥満あるいは背側肥満の状態を示す診断指標を得る。 Next, the dorsal abdominal subcutaneous fat ratio Pfb and the dorsal abdominal visceral fat ratio Ofb are compared with a predetermined reference value to obtain a diagnostic index indicating the abdominal obesity or the dorsal obesity state of the subject H.
なお、予め定められた基準値は、腹側肥満あるいは背側肥満の状態を示す診断指標に対応付けて設定されている。 Note that the predetermined reference value is set in association with a diagnostic index indicating the state of abdominal obesity or dorsal obesity.
以下、予め定められた基準値と診断指標との対応付けについて説明する。 Hereinafter, the association between the predetermined reference value and the diagnostic index will be described.
診断指標は、ここでは、「カテゴリーＦ：腹側肥満、カテゴリーＢ：背側肥満、カテゴリーＲ：腹側肥満・背側肥満のいずれでもない」の３種類からなるものとする。 Here, the diagnostic index is composed of three types: “Category F: ventral obesity, category B: dorsal obesity, category R: neither obesity nor dorsal obesity”.
腹側肥満であることを示すカテゴリーＦは、背腹皮下脂肪比率Ｐｆｂの値と背腹内臓脂肪比率Ｏｆｂの値とが共に、予め定められた基準値である１．５以上の範囲に含まれるときに対応する診断指標である。 The category F indicating ventral obesity includes both the value of the dorsal and ventral subcutaneous fat ratio Pfb and the value of the dorsal and ventral visceral fat ratio Ofb in a range of 1.5 or more which is a predetermined reference value. Sometimes a corresponding diagnostic indicator.
なお、背腹皮下脂肪比率Ｐｆｂの値が１．５以上とは、腹側における皮下脂肪面積（Ｓｕｆｐ+Ｓｄｆｐ）が、背側における皮下脂肪面積（Ｓｕｂｐ+Ｓｄｂｐ）の１．５倍であることを示している。背腹内臓脂肪比率Ｏｆｂについても上記背腹皮下脂肪比率Ｐｆｂの場合と同様である。 The value of the dorsal-abdominal subcutaneous fat ratio Pfb of 1.5 or more means that the subcutaneous fat area (Sufp + Sdfp) on the ventral side is 1.5 times the subcutaneous fat area (Subp + Sdbp) on the dorsal side. Is shown. The dorsal abdominal visceral fat ratio Ofb is the same as in the case of the dorsal abdominal subcutaneous fat ratio Pfb.
背側肥満であることを示すカテゴリーＢは、背腹皮下脂肪比率Ｐｆｂの値と背腹内臓脂肪比率Ｏｆｂの値とが共に、予め定められた基準値である０．５未満の範囲に含まれるときに対応する診断指標である。 Category B indicating dorsal obesity includes both the value of the dorsal abdominal subcutaneous fat ratio Pfb and the value of the dorsal abdominal visceral fat ratio Ofb within a range of less than 0.5 which is a predetermined reference value. Sometimes a corresponding diagnostic indicator.
腹側肥満・背側肥満のいずれでもないことを示すカテゴリーＲは、上記カテゴリーＦおよびカテゴリーＢのいずれにも属さない範囲のときに対応する診断指標である。 Category R, which indicates neither ventral obesity or dorsal obesity, is a diagnostic index corresponding to a range that does not belong to either category F or category B.
上記のことにより、背腹皮下脂肪比率Ｐｆｂと腹内臓脂肪比率Ｏｆｂとが共に、予め定められた基準値である１．５以上の範囲に含まれるときには、診断指標として「腹側肥満であること」を示すカテゴリーＦが得られる。 As described above, when both the dorsal abdominal subcutaneous fat ratio Pfb and the abdominal visceral fat ratio Ofb are included in the range of 1.5 or more which is a predetermined reference value, “being ventral obesity” as a diagnostic index. Is obtained.
また、背腹皮下脂肪比率Ｐｆｂと腹内臓脂肪比率Ｏｆｂとが共に、予め定められた基準値である０．５未満の範囲に含まれるときには、診断指標として「背側肥満であること」を示すカテゴリーＢが得られる。 In addition, when both the dorsal abdominal subcutaneous fat ratio Pfb and the abdominal visceral fat ratio Ofb are included in a range of less than 0.5, which is a predetermined reference value, a category indicating “being dorsal obesity” as a diagnostic index B is obtained.
さらに、背腹皮下脂肪比率Ｐｆｂと腹内臓脂肪比率Ｏｆｂとが共に、予め定められた基準値である１．５以上の範囲、および０．５未満の範囲のどちらにも含まれないときに、診断指標として「腹側肥満・背側肥満のいずれでもないこと」を示すカテゴリーＲが得られる。 Furthermore, when both the dorsal abdominal subcutaneous fat ratio Pfb and the abdominal visceral fat ratio Ofb are not included in a predetermined reference value range of 1.5 or more and less than 0.5, the diagnosis is performed. As an index, a category R indicating "Neither abdominal obesity nor dorsal obesity" is obtained.
例えば、背腹皮下脂肪比率Ｐｆｂの値が１．８、かつ腹内臓脂肪比率Ｏｆｂの値が２．３のときには、診断指標としてカテゴリーＦ（腹側肥満）が得られる。 For example, when the value of the dorsal abdominal subcutaneous fat ratio Pfb is 1.8 and the value of the abdominal visceral fat ratio Ofb is 2.3, category F (ventral obesity) is obtained as a diagnostic index.
また、背腹皮下脂肪比率Ｐｆｂの値が１．８、かつ腹内臓脂肪比率Ｏｆｂの値が１．０のときには、診断指標としてカテゴリーＲ（腹側肥満・背側肥満のいずれでもない）が得られる。 In addition, when the value of the dorsal abdominal subcutaneous fat ratio Pfb is 1.8 and the value of the abdominal visceral fat ratio Ofb is 1.0, category R (neither abdominal obesity nor dorsal obesity) is obtained as a diagnostic index. It is done.
なお、腹部領域の重心は、腹部領域中の正確に求められた１点を示す場合に限らず、この重心を示す１点の近傍の領域をも含むものを意味するものである。 It should be noted that the center of gravity of the abdominal region is not limited to the case where one point obtained accurately in the abdominal region is shown, but also includes the region in the vicinity of one point indicating the center of gravity.
また、実施例１，２における腹部領域中の断面を示す断面画像は、被検者の身長方向（背骨の伸びる方向）に対して垂直な断面とすることが望ましいが、必ずしもそのような場合に限らず、被検者の身長方向に対して傾斜した断面を示す断面画像を採用してもよい。 In addition, the cross-sectional image showing the cross section in the abdominal region in Examples 1 and 2 is preferably a cross section perpendicular to the height direction of the subject (the direction in which the spine extends), but in such a case, Not limited to this, a cross-sectional image showing a cross-section inclined with respect to the height direction of the subject may be employed.
また、被検者の腹部領域は、肝臓上部辺縁、横隔膜下部、脊椎の椎間のうちのいずれかを通る被検者の身長方向に対して垂直な断面と、腸骨上部、腸骨下部、仙骨下部のうちのいずれかを通る被検者の身長方向に対して垂直な断面との間の領域とすることができる。 The abdominal region of the subject includes a cross section perpendicular to the height direction of the subject passing through any of the upper margin of the liver, the lower diaphragm, and the vertebrae of the spine, and the upper iliac and lower iliac The region between the cross section perpendicular to the height direction of the subject passing through any of the lower sacrum can be used.
Ｈ 被験者
Ｈｂ 腹部領域
Ｚｎ 断面
Ｇｕ、Ｇｄ 断面画像
Ｆｓ 皮下脂肪領域
Ｆｏ 内臓脂肪領域
Ｐｕｄ 比率
Ｏｕｄ 比率
H Subject Hb Abdominal region Zn Cross section Gu, Gd Cross sectional image Fs Subcutaneous fat region Fo Visceral fat region Pud ratio Oud ratio
Claims (4)
前記被験者の腹部領域中における頭部側の１つ以上の断面を示す断面画像と前記腹部領域中における脚部側の１つ以上の断面を示す断面画像とを用意し、
前記断面画像を用いて、前記腹部領域中の互に対向する部位間における皮下脂肪領域の大きさの比率、および内臓脂肪領域の大きさの比率を求め、
前記２種類の比率を予め定められた基準値と比較して、前記被験者の肥満の状態を示す診断指標を得る診断指標取得方法において、
前記断面が身長方向に対して直交する断面であり、
前記互に対向する部位が、前記腹部領域中の背側の部位と腹側の部位であり、
前記診断指標が、前記被験者の背側肥満あるいは腹側肥満の状態を示す診断指標であって、背腹皮下脂肪比率Pfbと背腹内臓脂肪比率Ofbとを予め定められた基準値と比較して定められるものであることを特徴とする診断指標取得方法。
ただし、
Pfb：式［Pfb=(Sufp+Sdfp)/(Subp+Sdbp)］により求められる値
Sufp:上腹部側断面画像について腹側の皮下脂肪領域の大きさを示す腹側皮下脂肪面積
Sdfp:下腹部側断面画像について腹側の皮下脂肪領域の大きさを示す腹側皮下脂肪面積
Subp:上腹部側断面画像について背側の皮下脂肪領域の大きさを示す背側皮下脂肪面積
Sdbp:下腹部側断面画像について背側の皮下脂肪領域の大きさを示す背側皮下脂肪面積
Ofb：式［Ofb=(Sufo+Sdfo)/(Subo+Sdbo)］により求められる値
Sufo:上腹部側断面画像について腹側の内臓脂肪領域の大きさを示す腹側内臓脂肪面積
Sdfo:下腹部側断面画像について腹側の内臓脂肪領域の大きさを示す腹側内臓脂肪面積
Subo:上腹部側断面画像について背側の内臓脂肪領域の大きさを示す背側内臓脂肪面積
Sdbo:下腹部側断面画像について背側の内臓脂肪領域の大きさを示す背側内臓脂肪面積 A diagnostic index acquisition method for acquiring a diagnostic index related to body fat of a subject,
Preparing a cross-sectional image showing one or more cross sections on the head side in the abdominal region of the subject and a cross-sectional image showing one or more cross sections on the leg side in the abdominal region;
Using the cross-sectional image, to determine the ratio of the size of the subcutaneous fat region between the mutually opposed sites in the abdominal region, and the ratio of the size of the visceral fat region,
In the diagnostic index acquisition method for obtaining a diagnostic index indicating the obesity status of the subject by comparing the two types of ratios with a predetermined reference value,
The cross section is a cross section perpendicular to the height direction;
The parts facing each other are a dorsal part and a ventral part in the abdominal region,
The diagnostic index is a diagnostic index indicating the state of dorsal obesity or ventral obesity of the subject, comparing the dorsal abdominal subcutaneous fat ratio Pfb and the dorsal abdominal visceral fat ratio Ofb with a predetermined reference value A diagnostic index acquisition method characterized by being defined .
However,
Pfb: Value obtained from the formula [Pfb = (Sufp + Sdfp) / (Subp + Sdbp)]
Sufp: Ventral subcutaneous fat area showing the size of the ventral subcutaneous fat area in the upper abdominal side cross-sectional image
Sdfp: Ventral subcutaneous fat area showing the size of the ventral subcutaneous fat area in the lower abdominal side cross-sectional image
Subp: dorsal subcutaneous fat area showing the size of the dorsal subcutaneous fat area in the upper abdominal side cross-sectional image
Sdbp: Dorsal subcutaneous fat area showing the size of the dorsal subcutaneous fat area in the lower abdominal side cross-sectional image
Ofb: Value obtained from the expression [Ofb = (Sufo + Sdfo) / (Subo + Sdbo)]
Sufo: Ventral visceral fat area indicating the size of the ventral visceral fat area in the upper abdominal side cross-sectional image
Sdfo: Ventral visceral fat area indicating the size of the ventral visceral fat area in the lower abdominal side cross-sectional image
Subo: dorsal visceral fat area showing the size of the dorsal visceral fat area in the upper abdominal side cross-sectional image
Sdbo: Dorsal visceral fat area indicating the size of the dorsal visceral fat area in the lower abdominal side cross-sectional image
前記診断指標が、前記肥満の状態の経時変化を示すものであることを特徴とする請求項１から３のいずれか１項記載の診断指標取得方法。 The cross-sectional image is acquired in time series over a plurality of times,
The diagnostic index acquisition method according to any one of claims 1 to 3, wherein the diagnostic index indicates a change with time in the obesity state.
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