JP5429799B2 - Medical imaging device - Google Patents

Description

  The present invention relates to a medical image photographing apparatus for photographing a subject by injecting a contrast medium.

X-ray CT (Computed Tomography) equipment and MRI (Magnetic)
In a medical imaging apparatus such as a Resonance Imaging apparatus, a technique that enables a clearer diagnosis by performing so-called contrast imaging in which a contrast medium is injected into a subject to perform imaging has been generalized (Patent Literature) 1 etc.). In particular, contrast imaging has become almost indispensable for precise examination and definitive diagnosis, and recently, it is often used as a routine examination.

JP 2008-148919 A

  By the way, since contrast imaging is usually injected into a subject's body by extruding the contrast agent with a contrast agent (automatic) injection device, if the injection pressure increases for some reason, the contrast agent is Sometimes it leaks into the body and develops into an unexpected accident. Therefore, when the injection pressure of the contrast agent increases with time, it is very important to stop the contrast medium injection and stop the contrast imaging.

  On the other hand, even if the injection pressure of the contrast agent increases with time, depending on the rising slope of the injection pressure, it may be determined that it is safe to inject the contrast agent to the end. Depending on how the contrast medium is dyed and the progress of contrast imaging, it may be determined that imaging can be continued even if the injection of contrast medium is stopped. In such a case, it is also important to continue the contrast imaging while performing an appropriate treatment, thereby eliminating the need for re-imaging and reducing the burden on the subject.

  Accordingly, during contrast imaging, it is important to perform safe and efficient contrast imaging so that the temporal change in contrast agent injection pressure and contrast agent staining can be grasped instantaneously.

In view of the above circumstances, the present invention is capable of instantaneously grasping temporal changes in contrast agent injection pressure and contrast agent staining during contrast imaging, thereby enabling safe and efficient contrast imaging. The object is to provide a photographing apparatus.

  In a first aspect, the present invention relates to a medical image photographing apparatus having an imaging unit for photographing a subject, connected to the medical image photographing apparatus, and applying a contrast agent to the subject. Injection information acquisition means for sequentially acquiring injection information including an injection pressure at the time of injecting a contrast agent from an injection device to be injected, and a pixel value of a predetermined portion corresponding to a contrast agent in an image obtained by photographing the subject The pixel value acquisition means that sequentially acquires in accordance with imaging, a display device that displays an image, and the display so that the temporal change of the injection pressure and the temporal change of the pixel value are sequentially updated and displayed on the same screen. Provided is a medical image photographing apparatus provided with display control means for controlling the apparatus.

  In a second aspect, according to the present invention, the display control means displays a graph representing a change over time in the injection pressure and a graph representing a change over time in the pixel value with a horizontal axis as a common time. Thus, a medical image photographing apparatus according to the first aspect for controlling the display device is provided.

  In a third aspect, the present invention provides the display control unit, wherein the display control unit controls the display device so as to further display a graph representing the set timing of each photographing with the horizontal axis as a common time. A medical image photographing apparatus according to a second aspect is provided.

  In a fourth aspect, the present invention provides an injection pressure determination unit that sequentially determines whether or not the injection pressure exceeds a predetermined upper limit value according to acquisition of the injection information, and the injection pressure determination unit The medical image photographing according to any one of the first to third aspects, further comprising: a notifying unit that notifies that when the injection pressure exceeds the upper limit value. Providing equipment.

  In a fifth aspect, the present invention stops both the execution of the set contrast medium injection plan and the imaging plan when the injection pressure determination means determines that the injection pressure exceeds the upper limit value. Thus, the medical image photographing apparatus according to the fourth aspect, further comprising photographing control means for controlling the injection device and the photographing unit is provided.

  In a sixth aspect, the present invention provides that the injection information includes an index value of a total injection amount from the start of injection of a contrast agent injected into the subject, and the index value of the total injection amount is predetermined. An injection amount determination means for determining whether or not the value is greater than or equal to a value, and the injection pressure determination means determines that the injection pressure exceeds the upper limit value, and the injection amount determination means determines the total injection amount. When it is determined that the index value is equal to or greater than the predetermined value, the execution of the set contrast medium injection plan is stopped, but the execution of the set imaging plan is continued, and the injection pressure is determined by the injection pressure determination means. When it is determined that the upper limit is exceeded and the index value of the total injection amount is determined to be less than the predetermined value by the injection amount determination unit, the execution of the contrast agent injection plan and the imaging plan are both stopped. The injection device and the front To provide a medical imaging apparatus of the fourth aspect, further comprising a photographing control means for controlling the imaging unit.

  In a seventh aspect, according to the present invention, the injection information includes an index value of a total injection amount from the start of injection of a contrast agent injected into the subject, and the index value of the total injection amount is predetermined. An injection amount determination means for determining whether or not the value is greater than or equal to a value; information indicating that execution of the set contrast medium injection plan has been stopped from the injection device; and the injection amount determination means When it is determined that the index value of the total injection amount is equal to or greater than the predetermined value, the execution of the set imaging plan is continued, and information indicating that the execution of the contrast medium injection plan is stopped is acquired from the injection device. And when the injection amount determination means determines that the index value of the total injection amount is less than the predetermined value, an imaging control means for controlling the imaging unit to stop the execution of the imaging plan. From the first viewpoint The fourth aspect of any one aspect provides a medical imaging apparatus.

  In an eighth aspect, the present invention further includes a risk degree specifying unit that specifies a risk degree of contrast imaging based on at least the injection pressure. Any one of the first aspect to the seventh aspect is provided. Provided is a medical image photographing apparatus according to an aspect.

  In a ninth aspect, the present invention provides the medical image photographing apparatus according to any one of the first to eighth aspects, wherein the imaging unit performs X-ray CT imaging.

  In a tenth aspect, the present invention provides the medical image photographing apparatus according to the ninth aspect, wherein the display device is provided in the photographing unit.

  According to the present invention, the medical image photographing apparatus has the temporal change of the injection pressure of the contrast agent and the temporal change of the pixel value corresponding to the contrast agent in a predetermined part included in the image obtained by photographing the subject. Control means for sequentially updating and displaying the same on the same screen, it is possible to instantly grasp temporal changes in contrast agent injection pressure and contrast agent staining during contrast imaging. Accordingly, the contrast imaging can be stopped, or the contrast imaging can be continued while performing an appropriate treatment. Thereby, safe and efficient contrast imaging can be performed.

1 is a block diagram showing a schematic configuration of a medical imaging system (system) including an X-ray CT apparatus which is an embodiment of a medical imaging apparatus of the present invention. It is a figure which shows an example of contrast agent information. It is a figure which shows an example of injection | pouring information. It is a flowchart (flow chart) which shows the flow of the contrast imaging process in a medical image imaging system. It is a flowchart which shows the flow of a process when implementing a scanning plan. It is a figure which shows an example of the display screen in the predetermined time in contrast imaging. It is a figure which shows an example of the display screen in the time of completion | finish of contrast imaging. It is a figure which shows the 1st example of a display screen when injection pressure rises to abnormal pressure during contrast imaging. It is a figure which shows the 2nd example of a display screen when injection pressure rises to abnormal pressure during contrast imaging.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. Note that the present invention is not limited thereby.

  FIG. 1 is a block diagram showing a schematic configuration of a medical imaging system including an X-ray CT apparatus which is an embodiment of the medical imaging apparatus of the present invention.

  The medical imaging system 1 includes an X-ray CT apparatus 100 and an injector (injection apparatus) 200.

  The X-ray CT apparatus 100 includes a gantry 10, a table 20, and an operation console 30.

  The gantry 10 has a rotating part (not shown) on which an X-ray tube and an X-ray detector arranged opposite to each other are mounted. The gantry 10 irradiates the patient (subject) 90 conveyed to the imaging space between the X-ray tube and the X-ray detector with X-rays while rotating the rotating portion, and transmits the transmitted X-rays. Scan (photographing) is performed to detect projections, and projection data (data) is collected.

  The table 20 places the patient 90 and conveys it to the imaging space that is the opening of the gantry 10.

  The operation console 30 receives and sets a contrast imaging condition, that is, an injection plan (contrast medium injection plan) and a scan plan (imaging plan) in accordance with an operation from the operator. Further, the operation console 30 sends a control signal to the gantry 10, the table 20, and the injector 200 so as to execute the set injection plan and scan plan. Further, the operation console 30 acquires the projection data collected by the gantry 10, reconstructs the image, and displays the reconstructed image. In this example, while the injection plan and the scan plan are being executed, the operation console 30 displays the temporal change in the injection pressure at the time of injecting the contrast agent and the degree of staining of the contrast agent on the same screen. In addition, the operation console 30 detects an abnormality related to the injection of the contrast agent, and controls each unit to stop the execution of the injection plan or stop or continue the execution of the scan plan according to the situation at that time. Hereinafter, main components of the operation console 30 will be described in detail.

  The operation console 30 includes an imaging condition setting unit 31, an imaging control unit (imaging control unit) 32, a contrast agent information acquisition unit (contrast agent information acquisition unit) 33, and an injection information acquisition unit (injection information acquisition unit) 34. , A pixel value acquisition unit (pixel value acquisition unit) 35, an injection pressure determination unit (determination unit) 36, an injection amount determination unit (injection amount determination unit) 37, a display control unit (display control unit) 38, and a notification Unit (notification means) 39 and a display device 310.

  The shooting condition setting unit 31 sets shooting conditions according to an operation from the operator. The imaging conditions include an injection plan executed by the injector 200 and a scan plan executed by the X-ray CT apparatus 100. The injection plan includes a planned injection amount and a planned injection speed of the contrast medium. The scan plan includes the scan range or slice position, X-ray tube voltage, X-ray tube current, delay time from the start of contrast agent injection to scan start, the number of scans, the timing of each scan, etc. include. In addition, as described later, the setting of the predetermined portion when the pixel value acquisition unit 35 acquires the pixel value of the predetermined portion corresponding to the contrast agent in the image obtained by scanning the patient 90 is also included in the scan plan. included.

  The imaging control unit 32 controls the gantry 10, the table 20, and the injector 200 by sending control signals so that the set injection plan and scan plan are executed. In addition, when the injection plan and the scan plan are being executed, the imaging control unit 32 performs control corresponding to the case where the injection of the contrast medium into the patient 90 is stopped or a situation that should be stopped occurs. The imaging control unit 32 has two types of control modes as modes of control performed when the above situation occurs, and the operator can select one of the control modes. . In the first control mode, when the above situation occurs, control is performed so that both the injection plan and the scan plan are stopped. In the second control mode, when the above situation occurs, the execution of the injection plan is stopped, but if the amount of contrast medium injected into the patient 90 reaches a predetermined level at that time, the scan plan is continued. If it has not been reached, control is performed so that the execution of the scan plan is stopped. These control modes will be described more specifically later.

  The contrast agent information acquisition unit 33 acquires contrast agent information regarding the contrast agent to be injected into the patient 90 from the outside of the X-ray CT apparatus 100. In this example, contrast agent information J is acquired from the injector 200 connected to the X-ray CT apparatus 100.

  FIG. 2 is a diagram illustrating an example of contrast medium information. In this example, as shown in FIG. 2, the contrast agent information J includes information relating to manufacturing such as a product number, a product name, a product name, a manufacturer, and a manufacturing number, as well as the type of contrast agent (for example, iodine, gadolinium ( Gadolinium, etc.), concentration, content, expiry date, injection pressure upper limit value, and so on. The injection pressure upper limit value indicates an upper limit value that the injection pressure must not exceed when the contrast agent is injected, and is a value set by a manufacturer of the contrast agent, for example.

  The injection information acquisition unit 34 sequentially acquires the injection information U including the injection pressure Pr of the contrast agent from the injector 200 that injects the contrast agent into the patient 90.

  FIG. 3 is a diagram illustrating an example of the injection information U. In this example, as shown in FIG. 3, the injection information U includes the injection pressure and the injection speed when the contrast medium is injected into the patient 90, and the injection information from the start of the injection of the contrast medium injected into the patient 90 at that time. The total injection amount, the ratio of the total injection amount to the set scheduled injection amount (hereinafter referred to as injection ratio), the elapsed time from the start of the contrast agent injection, and the like are included.

  Moreover, the injection | pouring information acquisition part 34 receives and acquires the injection | pouring interruption notification information E from the injector 200 as emergency information. This injection interruption notification information E is information for informing when the injector 200 stops the execution of the injection plan in the middle, and is output from the injector 200 almost simultaneously with the stop of the execution of the injection plan. For example, when the operator detects the leakage of the contrast medium of the patient 90 and presses an emergency stop button (not shown) of the injector 200, or when the injection plan is stopped by the injector 200, the injector 200 is loaded. This is done when the safety function is activated, for example, when the syringe is disconnected or the injection pressure rises to an abnormal pressure.

  The pixel value acquisition unit 35 sequentially acquires the pixel value G of a predetermined portion corresponding to the contrast agent in the image obtained by scanning the patient 90 every time scanning is performed. This predetermined portion is, for example, a portion corresponding to the aorta or portal vein, and is set in advance by the operator. Thereby, the dyeing | staining degree of the contrast medium of the patient 90 can be known.

  The injection pressure determination unit 36 sequentially determines whether or not the injection pressure Pr included in the acquired injection information U exceeds a predetermined upper limit value according to the acquisition of the injection information U. Thereby, it can be determined whether the injection pressure of the contrast medium has increased to an abnormal pressure. In this example, the predetermined upper limit value is set as the injection pressure upper limit value PrL of the injection pressure included in the contrast medium information J. The predetermined upper limit value may be a value set by the operator.

  When the injection pressure determination unit 36 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL, or when the injection information acquisition unit 34 acquires the injection interruption notification information E Then, it is determined whether or not the amount of contrast medium injected into the patient 90 at that time has reached a predetermined level. The injection amount determination unit 37 performs the following determination, for example.

  In the first example, it is determined whether or not the first condition that the total injection amount (injection amount index value) Ac included in the injection information U is equal to or greater than a predetermined amount (predetermined value) Ath is satisfied.

  In the second example, it is determined whether or not the second condition that the injection ratio (injection amount index value) Rc included in the injection information U is equal to or greater than a predetermined ratio (predetermined value) Rth is satisfied.

  In the third example, it is determined whether or not both the first and second conditions are satisfied.

  In the fourth example, it is determined whether or not at least one of the first and second conditions is satisfied.

  Thereby, when the injection pressure of the contrast medium rises to an abnormal pressure, or when the injector 200 urgently stops the execution of the injection plan, the contrast imaging is performed even if the injection of the contrast medium is stopped at that time. It can be determined whether a sufficient amount of contrast agent has been injected into the patient 90 so that can continue. If only one of the total injection amount Ac and the injection ratio Rc is included in the injection information U, the determination is based on only one of the information. The predetermined amount Ath and the predetermined ratio Rth can be set by the operator. The predetermined amount Ath is, for example, in the range of 30 to 300 [mL], and the predetermined ratio Rth is, for example, in the range of 30 to 100 [%]. Can be set. In this example, the injection amount determination unit 37 performs the determination of the first example, and sets the predetermined amount Ath to 50 [mL].

  Here, the control mode of the imaging control unit 32 will be described more specifically. In the first control mode, when the injection pressure determination unit 36 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL, the injector 200 and the gantry are stopped so that both the injection plan and the scan plan are stopped. 10 and 20 are controlled. In addition, when the injection information acquisition unit 34 receives and acquires the injection interruption notification information E, the gantry 10 and the table 20 are controlled to stop the execution of the scan plan.

  In the second control mode, the injection pressure determination unit 36 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL, and the injection amount determination unit 37 determines that the total injection amount Ac is equal to or greater than the predetermined amount Ath. When it is determined, the injector 200, the gantry 10 and the table 20 are controlled so that the execution of the injection plan is stopped, but the execution of the scan plan is continued. On the other hand, when the injection pressure determination unit 36 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL and the injection amount determination unit 37 determines that the total injection amount Ac is less than the predetermined amount Ath, The injector 200, the gantry 10 and the table 20 are controlled so as to cancel both the injection plan and the scan plan. When the injection information acquisition unit 34 acquires the injection interruption notification information E and the injection amount determination unit 37 determines that the total injection amount Ac is equal to or greater than the predetermined amount Ath, the implementation of the injection plan is stopped. The injector 200, the gantry 10 and the table 20 are controlled so that the execution of the scan plan is continued. On the other hand, when the injection interruption notification information E is acquired by the injection information acquisition unit 34 and the total injection amount Ac is determined to be less than the predetermined amount Ath by the injection amount determination unit 37, the execution of the scan plan is stopped. The gantry 10 and the table 20 are controlled. In this example, it is assumed that the second control mode is selected.

  Based on the sequentially acquired injection information U and the pixel value G, the display control unit 38 displays the time-dependent change of the injection pressure Pr and the time-dependent change of the pixel value G so as to be sequentially updated and displayed on the same screen. The device 310 is controlled. In this example, the display control unit 38 displays a graph representing the temporal change of the injection pressure Pr and a graph representing the temporal change of the pixel value G on the same screen with the horizontal axis as a common time. To control. The display control unit 38 further controls the display device 310 to display a graph representing the timing of each scan according to the set scan plan on the same screen with the horizontal axis as the time common to the two graphs.

  When the injection pressure determination unit 36 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL, the notification unit 39 notifies that fact. In this example, a message indicating an abnormality in the injection pressure is displayed on the display screen of the display device 310. As a notification method, a method of outputting an alarm sound or sound from a speaker or lighting a lamp may be considered.

  When the display device is provided in the gantry 10 separately from the display device 310 of the operation console 30, the display control unit 38 may control to display these graphs on the display device of the gantry 10. Good. In addition, the notification unit 39 may display a message on the display device of the gantry 10. Normally, the gantry 10 is installed in the examination room, and the operation console 30 is installed in the operation room. The operator may ask the patient 90 who is the subject in the examination room in preparation for a situation such as leakage of the contrast medium from the start of the injection of the contrast medium to the start of the scan. At this time, if the operator can see these graphs with the display device provided in the gantry 10, while observing the patient 90, it is possible to know the injection pressure of the contrast medium, whether there is a warning, the timing of the scan, and the like. This is very convenient because it enables early detection of abnormal injection pressure and smooth retreat to the operation room.

  The injector 200 receives the control from the operation console 30 of the X-ray CT apparatus 100, implements the set injection plan, and injects a contrast medium into the patient 90. The injector 200 is configured so that a syringe 210 containing a contrast medium can be loaded. When injecting the contrast agent, the syringe 210 is loaded into the injector 200, and the syringe 210 and the patient 90 are connected by a tube with a syringe needle. Then, the piston (piston) portion of the syringe 210 is pressed to inject the contrast medium therein into the patient 90. The syringe 210 is attached with a syringe IC tag (tag) 211 in which contrast agent information regarding the contrast agent therein is written. The injector 200 has a syringe reader (reading unit) 201 that reads data stored in an IC tag. When the syringe 210 is loaded, the syringe 210 is attached to the syringe 210 by the syringe reader 201. The contrast agent information J is read from the IC tag 211. The read contrast agent information J is sent to the operation console 30.

  Further, the injection 200 is informed of the interruption of injection when the emergency stop button is pressed, the safety function is activated due to an abnormal increase in the injection pressure, the withdrawal of the syringe, etc., and the execution of the injection plan is stopped. E is output to the operation console 30.

  Hereafter, an example of the flow of contrast imaging processing in the medical image imaging system 1 will be described.

  FIG. 4 is a flowchart showing the flow of contrast imaging processing in the medical image imaging system 1.

  In step S1, the operator guides and places the patient 90, who is the subject, on the table 20, and operates the operation console 30 to input a scout scan start request. In response to this start request, the imaging control unit 32 sends a control signal to the gantry 10 and the table 20 to perform a scout scan of the patient 90. The display control unit 38 displays the scout image obtained by the scout scan on the display screen of the display device 310.

  In step S2, the operator operates the operation console 30 while referring to the displayed scout image, and inputs an injection plan and a scan plan. The shooting condition setting unit 31 sets these plans as shooting conditions.

  Here, the operator loads the syringe 210 into the injector 200. When the cylinder 210 is loaded, the injector 200 reads the contrast agent information J from the syringe IC tag 211 attached to the syringe 210 with the syringe reader 201 and sends the information to the operation console 30.

  In step S <b> 3, the contrast agent information acquisition unit 33 acquires the contrast agent information J sent from the injector 200, and the display control unit 38 displays the content on the display screen of the display device 310.

  Thereafter, after confirming the content of the displayed contrast agent information J, the operator connects the syringe 210 and the patient 90 with a tube to complete preparation for contrast imaging. Then, the operator operates the operation console 30 to input a contrast imaging start request.

  In step S4, the imaging control unit 32 sends a control signal to the gantry 10, the table 20, and the injector 200 so that the set injection plan and scan plan are executed in response to the start request.

  Note that the flow of processing when implementing a scan plan is as shown in FIG. 5, for example. First, in step T1, the imaging control unit 32 determines whether or not the current time is a scan timing. If it is determined that the scan timing is reached, the process proceeds to step T2, and the imaging control unit 32 controls the gantry 10 and the table 20 so that the scan is performed. On the other hand, when it is determined that it is not the scanning timing, the process proceeds to step T5. In step T3, the pixel value acquisition unit 35 performs image reconstruction based on the projection data obtained by scanning. In step T4, the pixel value acquisition unit 35 corresponds to the contrast agent in the reconstructed image. A pixel value of a predetermined part is acquired. In step T5, it is determined whether or not all scan plans have been executed. When it is determined that all scan plans have been executed, the scan plan execution is completed. On the other hand, when it is determined that not all of them are implemented, the process returns to step T1 and the processing is continued.

  The injector 200 implements an injection plan based on the control signal from the imaging control unit 32. Further, the injector 200 continues to send the contrast medium injection information U to the operation console 30 at least during the execution of the injection plan.

  Returning to FIG. 4, the description of the flow of contrast imaging processing will be continued.

  In step S5, the injection information acquisition unit 34 acquires the injection information U.

  In step S6, the injection pressure determination unit 36 determines whether or not the injection pressure Pr included in the injection information U exceeds the injection pressure upper limit value PrL included in the contrast agent information J. Here, if it is determined that the injection pressure Pr exceeds the injection pressure upper limit value PrL, it is determined that the injection pressure has reached an abnormal pressure, and the process proceeds to step S7, where the injection pressure Pr becomes equal to the injection pressure upper limit value PrL. If it is determined that the pressure does not exceed, it is determined that the injection pressure has not reached the abnormal pressure, and the process proceeds to step S8.

  In step S <b> 7, the notification unit 39 displays a warning message to that effect on the display screen of the display device 310. And the imaging | photography control part 32 controls the injector 200 so that implementation of an injection plan may be stopped. Thereafter, the process proceeds to step S9.

  In step S8, it is determined whether or not the injection interruption notification information E is acquired by the injection information acquisition unit 34. Here, if it is determined that the injection interruption notification information E has been acquired, the injector 200 determines that the injection plan has been stopped, and proceeds to step S9, where it is determined that the injection interruption notification information E has not been acquired. The injector 200 determines that the injection plan is being implemented, and proceeds to step S10.

  In step S9, it is determined whether or not the total injection amount Ac included in the injection information U is equal to or greater than a predetermined amount Ath. If it is determined that the total injection amount Ac is greater than or equal to the predetermined amount Ath, it is determined that sufficient contrast agent has been injected into the patient 90 so that contrast imaging can be continued, and the process proceeds to step S12. On the other hand, if it is determined that the total injection amount Ac is less than the predetermined amount Ath, it is determined that sufficient contrast agent is not injected into the patient 90 so that contrast imaging can be continued, and the process proceeds to step S14.

  In step S10, it is determined whether or not the execution of the injection plan has already been completed. If it is determined that the process is not completed, it is determined that both the injection plan and the scan plan are being implemented, and the process proceeds to step S11. On the other hand, if it is determined that it has been completed, it is determined that at least the injection plan has already been completed, and the process proceeds to step S12.

  In step S11, the display control unit 38 displays a graph indicating the temporal change in the injection pressure Pr up to the present time, a graph (TDC) indicating the temporal change in the pixel value G, and a graph indicating the timing of each scan. Are displayed (updated) on the screen of the display device 310 as a common time. In addition, in the graph showing the temporal change of the injection pressure Pr, a straight line indicating the injection pressure upper limit value PrL included in the contrast agent information J is also drawn. And it returns to step S5 and continues a process.

  In step S12, it is determined whether or not the scan plan has already been executed. If it is determined that the scan plan is not completed, it is determined that only the scan plan is being executed, and the process proceeds to step S13. On the other hand, if it is determined that it has been completed, it is determined that both the injection plan and the scan plan have been completed, and the process proceeds to step S15.

  In step S13, a graph (TDC) representing the temporal change of the pixel value G up to the present time and a graph representing the timing of each scan are displayed (updated) on the screen of the display device 310 with the horizontal axis as a common time. Display. And it returns to step S12 and continues a process.

  In step S14, the imaging control unit 32 controls to stop the execution of the scan plan. Then, the process proceeds to step S15.

  In step S <b> 15, the display control unit 38 displays a reconstructed image reconstructed based on the projection data obtained by scanning on the screen of the display device 310.

  FIG. 6 is a diagram illustrating an example of a display screen at a predetermined time during contrast imaging, and FIG. 7 is a diagram illustrating an example of a display screen at the end of contrast imaging. In this example, as shown in these drawings, the elapsed time t from the start of the injection of the contrast agent is taken on the horizontal axis, the graph Cp of the change over time of the injection pressure Pr in the upper stage, and the graph of the change over time of the pixel value G in the middle stage, that is, A time density curve TDC is shown, and a graph St showing the on / off timing of scanning is shown in the lower part. In this example, the contrast agent product name, product name, concentration, content, etc. included in the contrast agent information J are displayed on the same screen of the display device 310, and the contrast agent injection speed and total injection at that time are displayed. Display the amount and so on.

  From the graph Cp of the injection pressure Pr, the operator can instantly understand the injection pressure Pr at that time, the transition of the injection pressure Pr so far, the slope of the latest increase / decrease in the injection pressure Pr, and the like. As a result, it is possible to grasp the risk relating to the injection of the contrast agent at that time, or to predict a future risk change. Further, the operator can instantly understand the pixel value G at that time, the transition of the pixel value G so far, the rising / lowering slope of the latest pixel value G, and the like from the graph TDC of the pixel value G. . As a result, it is possible to grasp the degree of staining of the contrast medium at that time, or to predict future changes in the degree of staining of the contrast medium. Further, the operator can confirm the progress of contrast imaging, for example, about what percentage of the contrast imaging is completed from the graph St representing the timing of each scan and the graph Cp of the injection pressure Pr or the graph TDC of the pixel value G. , You can intuitively know how many percent are left.

  Based on this information, the operator should monitor contrast imaging and make a decision according to the situation, such as whether to stop or continue the injection plan, or whether to stop or continue the scan plan. Can do. For example, as shown in FIG. 6, when about 20 seconds have elapsed from the start of the injection of the contrast agent, if the change in the injection pressure Pr until then is gradual and the rising slope is small as shown by the curve Cp1, the contrast agent Therefore, it can be determined that the injection plan can be continued as it is. On the other hand, as shown by the curve Cp2, the rising slope of the injection pressure Pr is increased recently and is expected to soon exceed the injection pressure upper limit value PrL, but the pixel value G has already exceeded 200. Even if the injection of the agent is stopped, it is highly possible that an image effective for interpretation will be obtained in the subsequent scan. Therefore, it can be determined that the execution of the injection plan is stopped, but the execution of the scan plan may be continued.

  FIG. 8 is a diagram showing a first example of a display screen when the injection pressure rises to an abnormal pressure during contrast imaging, and FIG. 9 is a diagram showing the second example.

  In the first example, as shown in FIG. 8, the injection pressure Pr exceeds the injection pressure upper limit value PrL and becomes an abnormal pressure about 20 seconds after the start of the injection of the contrast agent. In this case, the total injection amount Ac of the contrast agent at the time when the injection pressure Pr exceeds the injection pressure upper limit value PrL is 66 [mL], which is equal to or greater than the predetermined amount Ath of 50 [mL]. Therefore, in this first example, the execution of the injection plan is stopped, but the execution of the scan plan is continued.

  On the other hand, in the second example, as shown in FIG. 9, the injection pressure Pr exceeds the injection pressure upper limit value PrL and becomes an abnormal pressure about 12 seconds after the start of contrast agent injection. In this case, the total injection amount Ac of the contrast agent when the injection pressure Pr exceeds the injection pressure upper limit value PrL is 40 [mL], which is less than the predetermined amount Ath of 50 [mL]. Therefore, in the second example, the implementation of the scan plan is stopped together with the implementation of the injection plan.

  As described above, according to the present embodiment, the X-ray CT apparatus 100 changes the temporal change in the contrast agent injection pressure Pr and the pixel value corresponding to the contrast agent in a predetermined part included in the image obtained by imaging the patient 90. Since the display control unit 37 that sequentially updates and displays G changes over time on the same screen is provided, the change over time in the contrast agent injection pressure Pr and the contrast agent dyeing condition can be grasped instantaneously during contrast imaging. The contrast imaging can be stopped according to these situations, or the contrast imaging can be continued while performing an appropriate treatment. Thereby, safe and efficient contrast imaging can be performed.

  In this embodiment, the X-ray CT apparatus 100 has an injection pressure determination unit 36 for determining whether or not the injection pressure Pr exceeds the injection pressure upper limit value PrL, and in this determination, the injection pressure Pr is the injection pressure upper limit value. When it is determined that it exceeds PrL, it is provided with a notification unit 39 that notifies that fact, so that the operator is unaware of the increase in the injection pressure Pr and the patient 90 is in a dangerous state. This can be notified to the operator, and safer contrast imaging can be performed.

  In the present embodiment, when the imaging control unit 32 determines that the injection pressure Pr exceeds the injection pressure upper limit value PrL, or when the injection interruption notification information E is acquired, as a result, Since it has the first control mode that controls to stop both the injection plan and the scan plan, the injection plan and scan plan are automatically stopped when an abnormality occurs in the injection of contrast medium. And safer contrast imaging can be performed.

Further, in the present embodiment, the imaging control unit 32 further includes an injection amount determination unit 37 that determines whether or not the amount of contrast medium injected into the patient 90 has reached a predetermined level.
When it is determined that the injection pressure Pr exceeds the injection pressure upper limit value PrL, or when the injection interruption notification information E is acquired, the execution of the injection plan is stopped as a result. Since it has a second control mode in which the execution of the scan plan is continued when the amount of the contrast medium injected into 90 reaches a predetermined level, and the scan plan is stopped when it does not reach the predetermined level. If it is judged that it is possible to continue the imaging, instead of stopping the contrast imaging uniformly even if an abnormality occurs in the injection of the contrast agent, only the injection plan is stopped and the scan plan Control can be continued so that re-imaging can be minimized, thereby preventing an increase in exposure and the amount of contrast medium injected, thereby reducing the burden on the subject.

  In this embodiment, since the injection pressure upper limit value PrL is the contrast agent information J read directly from the syringe IC tag 211 attached to the syringe 210, an artificial setting error of the upper limit value can be suppressed. Safer contrast imaging can be performed.

  Further, according to the present embodiment, the contrast medium information J is read by using an RFID (Radio Frequency IDentification) technique using an IC tag and its reader, which is non-contact reading, resistant to dirt, and easy to read automatically. Therefore, it is possible to suitably read information in a medical field where contamination with chemicals or body fluids is likely to occur.

  In the present embodiment, the RFID method using an IC tag and its reader is used to read the contrast medium information J, but other methods such as a barcode and a reader using the reader may also be used. Good.

  In the present embodiment, the determination of the first example is adopted as the determination performed by the injection amount determination unit 37. Of course, the determinations of other second to fourth examples may be adopted.

  Further, in this embodiment, the abnormality determination of the injection pressure Pr is performed based on the contrast agent information J and the injection information U. However, based on the contrast agent information J and the injection information U, that in contrast imaging is determined. A configuration may be provided that includes a risk level identifying unit that identifies the risk level at the time, and the display control unit 38 may display the identified risk level on the display screen of the display device 310. For example, the ratio of the actual injection pressure with respect to the injection pressure upper limit value, the fluctuation rate of the injection pressure during the most recent predetermined time, or the risk level is stored in association with each other. Then, referring to this stored information, the ratio of the injection pressure Pr included in the injection information U to the upper limit value Pr included in the contrast medium information J, the fluctuation rate of the injection pressure Pr during the most recent predetermined time, or The risk corresponding to these combinations is identified. In this way, the operator can grasp the danger at that point in the current contrast imaging by numerical values.

In the present embodiment, an X-ray CT apparatus has been described as an example of a medical imaging apparatus. However, the present invention can be similarly applied to other modalities as long as contrast imaging is performed. For example, the present invention includes an MRI apparatus, an ANGIO (angiography) apparatus, a PET (positron emission tomography) apparatus, and a SPECT (single).
It can also be applied to photon emission computed tomography equipment and ultrasonic equipment.

DESCRIPTION OF SYMBOLS 1 Medical imaging system 100 X-ray CT apparatus 10 Gantry 20 Table 30 Operation console 31 Imaging condition setting part 32 Imaging control part 33 Contrast agent information acquisition part 34 Injection information acquisition part 35 Pixel value acquisition part 36 Injection pressure determination part 37 Injection amount Determination unit 38 Display control unit 39 Notification unit 310 Display device 90 Patient 200 Injector 201 Syringe reader 210 Syringe 211 Syringe IC tag

Claims (9)

A medical imaging apparatus having an imaging unit for imaging a subject,
Injection information acquisition means connected to the medical imaging apparatus and sequentially acquiring injection information including an injection pressure and a total injection amount at the time of contrast agent injection from an injection device for injecting a contrast agent into the subject;

Pixel value acquisition means for sequentially acquiring pixel values of a predetermined portion corresponding to a contrast agent in an image obtained by imaging the subject, according to imaging;

A display device for displaying an image;
The graph showing the change over time of the injection pressure, the graph showing the change over time of the injection pressure, the graph showing the change over time of the pixel value with the horizontal axis as a common time, and the total injection amount are sequentially updated. Display control means for controlling the display device to display on the same screen ,

An imaging control unit capable of executing control for stopping execution of the set contrast medium injection plan and control for stopping execution of the set imaging plan for the injection device and the imaging unit, respectively;

A medical image photographing apparatus comprising: Wherein the display control unit, a graph showing the timing of each shot that is set so as to further display the horizontal axis as a common time, the medical imaging apparatus according to claim 1 for controlling the display device.
Injection pressure determination means for sequentially determining whether or not the injection pressure exceeds a predetermined upper limit value according to the acquisition of the injection information;
The medical image photographing according to claim 1, further comprising a notifying unit that notifies that when the injection pressure is determined by the injection pressure determining unit to exceed the upper limit value. apparatus.
When the injection pressure determining means determines that the injection pressure exceeds the upper limit value, the imaging control means causes the injection apparatus to stop both the execution of the set contrast medium injection plan and the imaging plan. The medical imaging device according to claim 3 , wherein the imaging unit is controlled.
The injection information includes an index value of the total injection amount from the start of injection of the contrast agent injected into the subject,
Injection amount determination means for determining whether or not the index value of the total injection amount is a predetermined value or more;
Set when the injection pressure determination means determines that the injection pressure exceeds the upper limit value and the injection volume determination means determines that the index value of the total injection volume is greater than or equal to a predetermined value. The execution of the contrast medium injection plan is stopped, but the execution of the set imaging plan is continued, the injection pressure determination means determines that the injection pressure exceeds the upper limit value, and the injection amount determination When the means determines that the index value of the total injection amount is less than a predetermined value, the imaging control unit causes the injection device and the imaging unit to stop the execution of the contrast agent injection plan and the imaging plan. The medical image photographing device according to claim 3 to be controlled.
The injection information includes an index value of the total injection amount from the start of injection of the contrast agent injected into the subject,
Injection amount determination means for determining whether or not the index value of the total injection amount is a predetermined value or more;
Information indicating that the execution of the set contrast medium injection plan has been stopped is acquired from the injection device, and the index value of the total injection amount is determined to be greater than or equal to a predetermined value by the injection amount determination unit Sometimes, the execution of the set imaging plan is continued, information indicating that the execution of the contrast medium injection plan is stopped from the injection device, and the index value of the total injection amount by the injection amount determination means medical but when it is determined to be less than the predetermined value, so as to stop the implementation of the shooting plan, according to any one of claims 1 to 3 for controlling the imaging unit by the imaging control unit Image shooting device.
The medical image photographing apparatus according to any one of claims 1 to 6 , further comprising a risk specifying unit that specifies a risk of contrast imaging based on at least the injection pressure.
The medical imaging apparatus according to any one of claims 1 to 7 , wherein the imaging unit performs X-ray CT imaging. The display device is provided in the imaging unit and the inspection outdoor operation console examination room,

In both the display devices, the display control device includes a graph representing a change over time in the injection pressure, a graph representing a change over time in the injection pressure, and a graph representing a change over time in the pixel value with the horizontal axis as a common time. The medical image photographing apparatus according to claim 8 , wherein the total injection amount is sequentially updated and displayed on the same screen .

Images