JP6364294B2 - Diagnosis support apparatus, diagnosis support method, and diagnosis support program - Google Patents

Description

  The present invention relates to a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program, and in particular, acquires an MRI image (tomographic image) from a tomographic imaging apparatus such as a breast MRI (Magnetic Resonance Imaging) apparatus that images a breast tomogram. The present invention relates to a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program for diagnosing an affected area such as a breast.

  Breast cancer imaging methods include mammography, ultrasound, and MRI. Among these, the mammography method and the ultrasound method are used for breast cancer screening as well as visual inspection. On the other hand, the MRI system may not be recommended for breast cancer screening because contrast agents may be used for the examination ("Breast MRI screening guidelines for breast cancer onset high risk group Ver.1.0" Japan Breast Cancer Screening Society 2012).

  However, the usefulness of breast MRI has been widely recognized overseas as a diagnostic purpose to examine the degree of progression and spread of cancer. Although it has not been recognized in Japan due to lack of evidence, In 2013, it was designated as Grade B (“Evidence (effective evidence / evidence) is recommended and recommended to be practiced in daily practice”) in the Breast Cancer Practice Guidelines of the Japan Breast Cancer Society. It came to be recognized.

  In addition, as awareness of usefulness spreads, the guidelines for breast MRI examination “BI-RADS-MRI”, which was born in the United States, have attracted attention. Currently, examination methods and interpretation based on the Japanese version of BI-RADS-MRI Methods and report description methods have been adopted by many facilities.

  One of the contents of the diagnostic report recommended by this BI-RADS-MRI is the item “Kinetic curve assessment, Signal intensity / time curve description”, which includes “Initial phase” and “Delayed phase”. It is recommended that a phase This examination for evaluation is called dynamic MR mammography.

  Note that the injection start time of the contrast medium is “T0”, the time when 60 to 120 seconds have elapsed from the time T0 is “T1”, and the time when 300 to 420 seconds have elapsed from the time T1 is “Tn”. The time phase from time T0 to time T1 corresponds to the “initial phase”, and the time phase from time T1 to time Tn corresponds to the “delay phase”. In addition, the signal strength change characteristics in the initial phase are classified into “Slow”, “Medium”, and “Fast”, and the signal strength change characteristics in the delayed phase are “Persistent”, “Plateau”, “Washout”. There are three categories.

Nakahara Hiroshi, “Breast MRI Diagnosis Using CAE”, Breast Cancer BOOK 2014, RadFan July 2014 Special Issue, p. 79-p. 81 Aze, Inc., “MRI Breast Cancer Analysis Software Diagnosed from Perfusion”, Monthly Inner Vision August 2014 issue, p. 77

  In order to perform interpretation in accordance with BI-RADS-MRI in breast MRI examination, it is ideal that the change characteristics of the signal intensity in each of the initial phase and the delayed phase can be easily and simultaneously evaluated in Kinetic curve assessment.

  However, at present, Kinetic curve assessment is performed by the conventional Time Intensity Curve measurement, so the measurement takes time and is not convenient. In addition, although there is an application that makes color intensity mapping using the amount or rate of change in signal intensity (pixel value) for each pixel that forms a tomographic image, and simplifies Time Intensity Curve measurement, the initial phase and the delayed phase are evaluated simultaneously. Difficult to do. As a result, at present, there is a limit in convenience when diagnosing the affected area.

  Therefore, a main object of the present invention is to provide a diagnosis support apparatus, a diagnosis support method, and a diagnosis support program, which can improve convenience when diagnosing an affected area.

The diagnosis support apparatus according to the present invention (10: reference numeral corresponding to the embodiment; the same applies hereinafter) is a tomographic imaging apparatus at each of a plurality of times (T0 to Tn) belonging to a time zone from the start to the end of one examination. (30) acquisition means acquires a tomographic image of the affected part captured (12), corresponding to a plurality of time phases Ru appear in the time zone from the start to the end of the defined based on a plurality of times and one of the test And a plurality of color maps (MP01, MP1n) each representing a different planar color distribution depending on the pixel value based on the tomographic image acquired by the acquisition means (S5, S9, S21, S31), pointer multiplexing means (S33, S33) for respectively multiplexing a plurality of pointers (PT01, PT1n) commonly pointing to desired positions on the tomography according to the pointer moving operation on the plurality of color maps displayed by the color map display means S43, S45) and multiple time phases Graph display means for displaying a plurality of graphs (G01, G1n) each representing temporal changes of pixel values at positions corresponding to and following the pointer movement operation based on the tomographic image acquired by the acquisition means (S15, S35 to S37, S63 to S65).

Preferably, time and pixel values are respectively assigned to the horizontal axis and the vertical axis of the graph, and color bar display means (S17) for displaying color bars indicating different colors according to the pixel values along the vertical axis of the graph. Further provided.

  Preferably, representative image display means (S3, S7, S19, S29) for displaying a plurality of representative images (IM01, IM1n) respectively representing a plurality of time phases based on the tomographic image acquired by the acquisition means is further provided. The color map display means includes color map multiplexing means (S21, S31) for multiplexing a plurality of color maps respectively on the plurality of representative images displayed by the representative image display means.

  Preferably, the plurality of time phases include an initial phase and a delay phase, and the plurality of graphs correspond to a first graph (G01) corresponding to the initial phase and representing a change in the pixel value from the initial value, and to the delay phase. In addition, a second graph (G1n) representing a change in pixel value from the initial value is included.

  More preferably, the tomographic imaging apparatus is an apparatus that assumes the injection of contrast medium into the affected area, and the plurality of times include the time before injecting the contrast medium into the affected area as a reference time (T0), and the graph display means includes Compensation means (S63) that compensates for the difference between the reference time and the time (T0 ') at which contrast agent injection is started, and first graph creation means (S65) that creates the first graph based on compensation by the compensation means Including.

  Preferably, the tomographic image acquired by the acquisition unit corresponding to each of the plurality of times represents each slice of the plurality of slice positions, and the color map display unit and the graph display unit include a common slice among the plurality of slice positions. Processing is executed for the position.

  More preferably, further provided is slice position changing means (S23 to S25, S39 to S41) for changing the slice position targeted by the color map display means and the graph display means in accordance with the slice position changing operation.

The diagnosis support method according to the present invention acquires a tomographic image of an affected area captured by the tomographic imaging apparatus (30) at each of a plurality of times (T0 to Tn) belonging to a time zone from the start to the end of one examination. a diagnosis support method performed by the diagnostic support device (10) comprising means (12), when the start of the defined based on a plurality of times and one of the test a plurality of Ru appear in the time zone to the end A color map display step for displaying a plurality of color maps (MP01, MP1n) each corresponding to a phase and representing different planar color distributions according to pixel values based on the tomographic image acquired by the acquisition means (S5, S9, S21, S31), pointer multiplexing that multiplexes a plurality of pointers (PT01, PT1n) commonly pointing to a desired position on the tomography according to the pointer movement operation, respectively, on a plurality of color maps displayed by the color map display step Step (S33, S43, S45), and a plurality of graphs (G01, G1n) each corresponding to a plurality of time phases and each representing a temporal change of a pixel value at a position following a pointer movement operation. A graph display step (S15, S35 to S37, S63 to S65) for displaying based on the tomographic image is provided.

The diagnosis support program according to the present invention acquires a tomographic image of an affected area captured by the tomographic imaging apparatus (30) at each of a plurality of times (T0 to Tn) belonging to a time zone from the start to the end of one examination. the processor (14) of the diagnosis support apparatus comprising means (12) (10), corresponding to a plurality of time phases Ru appear in the time zone from the start to the end of the defined based on a plurality of times and one of the test And a color map display step (S5, S9, S21, and a plurality of color maps (MP01, MP1n) each representing a different planar color distribution depending on the pixel value based on the tomographic image acquired by the acquiring means) S31), a pointer multiplexing step (S33, S33) for multiplexing each of a plurality of pointers (PT01, PT1n) commonly pointing to a desired position on the slice according to the pointer moving operation on the plurality of color maps displayed by the color map display step. S43, S45), And a plurality of graphs (G01, G1n) each corresponding to a plurality of time phases and each representing a temporal change of a pixel value at a position following a pointer movement operation, based on the tomographic image acquired by the acquisition means This is a diagnosis support program for executing steps (S15, S35 to S37, S63 to S65).

  In order to diagnose the affected area, it is necessary to grasp the blood flow state in a plurality of time phases, and each of the plurality of color maps and the plurality of graphs represents the blood flow state of the affected part corresponding to each of the plurality of time phases. . Specifically, the color map represents a different planar color distribution depending on the pixel value, and the graph represents the temporal change of the pixel value at a certain position on the slice. Thereby, the blood flow state in each of a plurality of time phases can be grasped from a plurality of viewpoints.

  Furthermore, the position to be noticed when displaying the graph is pointed by a plurality of pointers displayed in common on a plurality of color maps, and the pointing position of each pointer is changed according to the pointer movement operation. As a result, the display mode of the graph changes according to the pointer movement operation.

  The dynamic change in the pointing position of the pointer and the display mode of the graph, coupled with the fact that the color map and the graph represent the blood flow state from different viewpoints, leads to an improvement in convenience when diagnosing the affected area.

  The above object, other objects, features and advantages of the present invention will become more apparent from the following detailed description of embodiments with reference to the drawings.

It is a block diagram which shows an example of a structure of the medical diagnosis assistance system applied to this Example. (A) is an illustrative view showing an example of the structure of 200 DICOM (Digital Imaging and Communication in Medicine) files each containing 200 slice MRI images collected at time T0, and (B) is at time T1. It is an illustration figure which shows an example of the structure of 200 DICOM files each containing the acquired 200-slice MRI image, (C) is 200 pieces each containing the 200-slice MRI image acquired at the time T2. It is an illustration figure which shows an example of the structure of a DICOM file, (D) is an illustration figure which shows an example of the structure of 200 DICOM files each containing the 200 slice MRI image collected at the time T3, (E ) Shows an example of the structure of 200 DICOM files each containing 200 slice MRI images collected at time Tn. It is an illustrative view. (A) is an illustrative view showing an example of a complementary image representing the initial phase created by performing a complementary process on the MRI image at the head slice position, and (B) is a process for performing the complementary process on the MRI image at the head slice position. It is an illustration figure which shows an example of the complementary image representative of the delay phase produced in this way. (A) is an illustrative view showing an example of a color map created based on the complementary image shown in FIG. 3 (A), and (B) is a color created based on the complementary image shown in FIG. 3 (B). It is an illustration figure which shows an example of a map. It is an illustration figure which shows an example of the diagnostic image displayed on the display apparatus provided in the diagnostic assistance apparatus of this Example. (A) is an illustrative view showing an example of a complementary image representing an initial phase created by performing a complementary process on an MRI image at a desired slice position, and (B) is a complementary process on an MRI image at a desired slice position. It is an illustration figure which shows an example of the complementary image which represents the delay phase produced by giving. (A) is an illustrative view showing an example of a color map created based on the complementary image shown in FIG. 6 (A), and (B) is a color created based on the complementary image shown in FIG. 6 (B). It is an illustration figure which shows an example of a map. It is an illustration figure which shows another example of the diagnostic image displayed on the display apparatus provided in the diagnostic assistance apparatus of this Example. It is a graph which shows an example of the time change in the initial phase of the value of the pixel designated by the pointer. It is a graph which shows an example of the time change in the initial phase and delay phase of the value of the pixel designated by the pointer. It is a flowchart which shows a part of operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is a flowchart which shows a part of other operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is a flowchart which shows a part of other operation | movement of CPU provided in the diagnostic assistance apparatus of this Example. It is an illustration figure which shows an example of the setting of the graph display menu displayed on a display apparatus in another Example. It is an illustration figure which shows an example of the display mode of the graph according to the setting shown in FIG. It is an illustration figure which shows another example of the setting of the graph display menu displayed on a display apparatus in another Example. It is an illustration figure which shows an example of the display mode of the graph according to the setting shown in FIG. It is a flowchart which shows a part of operation | movement of CPU provided in the diagnostic assistance apparatus of the other Example.

[First embodiment]
With reference to FIG. 1, the medical diagnosis support system of this embodiment is configured by a diagnosis support apparatus 10 and an MRI apparatus 30 connected to each other via a communication network 40. In the diagnosis support apparatus 10, a communication I / F 12, a CPU 14, a keyboard 16, a mouse 18, a display device 20, a DRAM 22, and a main storage device 24 are connected to the bus BS1. The display device 20 is provided with a screen SCR.

  The MRI apparatus 30 is an apparatus that creates an MRI image of a patient's breast using a nuclear magnetic resonance phenomenon. Imaging is performed once before the contrast agent is injected into the breast (this is referred to as “plane imaging”), and once the contrast agent injection is started, it is performed four times at a rate of once every 60 seconds. The If the injection start time of the contrast medium is defined as “T0”, the four imaging times that come every 60 seconds thereafter are defined as “T1”, “T2”, “T3”, and “Tn”, respectively.

  Note that each imaging takes several seconds, and each of the times T0 to Tn strictly indicates an imaging start time. Further, in this embodiment, it is assumed that the contrast medium injection start time coincides with the plane imaging time, and the time T0 is also the plane imaging time. Furthermore, the time phase from time T0 to time T1 is called “initial phase”, and the time phase from time T1 to time Tn is called “delayed phase”.

  In the MRI apparatus 30, 200 frames of MRI images F0 to F199 respectively corresponding to 200 different slice positions P0 to P199 are created at times T0 to Tn. The value (= signal intensity) of each pixel forming the created MRI image reflects the concentration of the contrast agent flowing through the slice at the slice position during imaging, that is, the blood concentration.

  The MRI apparatus 30 stores the MRI image thus created in a DICOM file together with the file size, patient information, imaging time, and slice position. The imaging time is managed by a tag of collection time (0008, 0032) defined by the DICOM standard.

  As a result, 200 DICOM files shown in FIG. 2A are created at time T0, 200 DICOM files shown in FIG. 2B are created at time T1, and FIG. 2C is created at time T2. The 200 DICOM files shown are created. At time T3, 200 DICOM files shown in FIG. 2D are created, and at time Tn, 200 DICOM files shown in FIG. 2E are created.

  The communication I / F 12 provided in the diagnosis support apparatus 10 acquires a total of 1000 DICOM files created in this way from the diagnosis support apparatus 10 through the communication network 40. The acquired DICOM file is stored in the main storage device 24 via the bus BS1.

  The DICOM file may be managed by an external server (not shown). In this case, the diagnosis support apparatus 10 acquires a desired DICOM file from an external server at a desired timing.

  The CPU 14 executes processing according to the flowcharts shown in FIGS. 11 to 13 in order to display a diagnostic image on the screen SCR of the display device 20 based on the DICOM file stored in the main storage device 24. A program corresponding to this flowchart is stored in the main storage device 24 as a diagnosis support program.

  First, a variable K for identifying a slice position is set to “0” in step S1. In step S3, an MRI image representing a slice at the slice position PK at each of the times T0 and T1 is transferred from the main storage device 24 to the DRAM 22, and a complementary process is performed on the transferred two frames of the MRI image to create a complementary image IM01. To do. In step S5, a color map MP01 corresponding to the slice position PK is created based on the two-frame MRI image transferred to the DRAM 22 in step S3.

  In step S7, the MRI image representing the slice at the slice position PK at each of the times T1 to Tn is transferred from the main storage device 24 to the DRAM 22, and the complemented processing is performed on the transferred four-frame MRI image to create the complementary image IM1n. To do. In step S9, a color map MP1n corresponding to the slice position PK is created based on the four-frame MRI image transferred to the DRAM 22 in step S7.

  The complementary image IM01 corresponds to a representative image representing the initial phase, and the complementary image IM1n corresponds to a representative image representing the delayed phase. The color map MP01 corresponds to the initial phase and represents a planar color distribution corresponding to the value (signal intensity) of each pixel forming the complementary image IM01. The color map MP1n corresponds to the delay phase and represents a planar color distribution corresponding to the value (signal intensity) of each pixel forming the complementary image IM1n.

  In step S11, it is determined whether or not the variable K has reached “199”. If the determination result is NO, the variable K is incremented in step S13 and then the process returns to step S3. Proceed to S15. Therefore, the processing of steps S3 to S9 is repeated 200 times, and as a result, complementary images IM01 and IM1n and color maps MP01 and MP1n are created corresponding to each of slice positions P0 to P199.

  In step S15, a frame of the graph is drawn on the DRAM 22, and the display device 20 is requested to display the frame. In step S17, a color bar is drawn on the DRAM 22, and the display device 20 is requested to display the color bar.

  The display device 20 reads the frame and color bar of the graph from the DRAM 22, and displays the read frame and color bar on the upper stage of the screen SCR in the manner shown in FIG. According to FIG. 5, the frame of the graph is displayed in the upper center of the screen SCR, and the color bar is displayed along the vertical axis on the left side of the frame of the graph.

  Time and pixel values are assigned to the horizontal and vertical axes of the graph frame, respectively. Specifically, a time from time T0 described above to time Tn is assigned to the horizontal axis. In addition, up to 300% is assigned to the vertical axis, with the value of the target pixel forming the MRI image at the target slice position at time T0 as the initial value. In addition, the color bar displayed along the vertical axis indicates a different color depending on the pixel value.

  In step S19, the display device 20 is requested to display complementary images IM01 and IM1n corresponding to the head slice position (= slice position P0). In step S21, the display device 20 is requested to display multiple color maps MP01 and MP1n corresponding to the head slice position.

  The display device 20 reads the target complementary images IM01 and IM1n from the DRAM 22, and displays the read complementary images IM01 and IM1n on the screen SCR. The display device 20 also reads out the target color maps MP01 and MP1n from the DRAM 22, and multiplexes the read color maps MP01 and MP1n on the complementary images IM01 and IM1n displayed on the screen SCR, respectively.

  The complementary images IM01 and IM1n at the first slice position form the images shown in FIGS. 3A and 3B, and the color maps MP01 and MP1n at the first slice position are shown in FIGS. 4A and 4B. In the case of forming a map, the complementary images IM01 to IM1n and the color maps MP01 to MP1n are displayed on the screen SCR in the manner shown in FIG. That is, the complementary images IM01 and IM1n are displayed side by side at the lower position of the screen SCR, and the color maps MP01 and MP1n are multiplexed on the complementary images IM01 and IM1n, respectively.

  Note that the color of the color map MP01 corresponding to the initial phase is synchronized with the color of the color bar. As a result, by comparing the color map MP01 with the color bar, it becomes easy to grasp the rate of change of each pixel value in the initial phase.

  In step S23, it is repeatedly determined whether or not a slice position changing operation has been performed with the keyboard 16 and / or the mouse 18. When the determination result is updated from NO to YES, the value of the variable K is changed in step S25, and the display positions of the pointers PT01 and PT1n are initialized in step S27. By the initialization, the pointers PT01 and PT1n point to the initial positions on the tomography.

  In step S29, the display device 20 is requested to display complementary images IM01 and IM1n corresponding to the slice position PK. In step S31, the display device 20 is requested to display multiple color maps MP01 and MP1n corresponding to the slice position PK.

  The display device 20 reads the target complementary images IM01 and IM1n from the DRAM 22, and displays the read complementary images IM01 and IM1n on the screen SCR. The display device 20 also reads out the target color maps MP01 and MP1n from the DRAM 22, and multiplexes the read color maps MP01 and MP1n on the complementary images IM01 and IM1n displayed on the screen SCR, respectively.

  In step S33, a character image representing each of the pointers PT01 and PT1n (hereinafter simply referred to as “pointer PT01” or “pointer PT1n”) is developed in the DRAM 22, and the display device 20 is requested to display the pointers PT01 and PT1n. . The display device 20 reads the pointers PT01 and PT1n from the DRAM 22, and multiplex-displays the read pointers PT01 and PT1n on the color maps MP01 and MP1n on the screen SCR.

  The pointers PT01 and PT1n point to a common position on the slice, and the pointing position follows the processing in step S27 or step S45 described later. Therefore, when common coordinates are assigned to the color maps MP01 and MP1n, the coordinate value indicating the multiple position of the pointer PT01 matches the coordinate value indicating the multiple position of the pointer PT1n.

  The complementary images IM01 and IM1n at the slice position PK form the images shown in FIGS. 6A and 6B, and the color maps MP01 and MP1n at the slice position PK are shown in FIGS. 7A and 7B. In the case of making a map, the complementary images IM01 to IM1n and the color maps MP01 to MP1n are alternatively displayed on the screen SCR in the manner shown in FIG. The pointers PT01 and PT1n are multiplexed on the color maps MP01 and MP1n, respectively, so as to point to a common position on the slice.

  In step S35, the MRI image representing the slice at the slice position PK at each of the times T0 to Tn is transferred from the main storage device 24 to the DRAM 22, and the pixel to which the pointer PT01 or PT1n points from each of the transferred 6-frame MRI images. Extract the value of. In step S35, the graph G01 is created based on the two pixel values corresponding to the times T0 and T1, respectively, and the graph G1n is created based on the four pixel values corresponding to the times T1 to Tn.

  The graph G01 represents a temporal change in the initial phase of the pixel value pointed by the pointer PT01. The graph G1n represents a temporal change in the delay phase of the pixel value directed by the pointer PT1n. The created graphs G01 and G1n are drawn on the DRAM 22.

  According to the BI-RADS-MRI, the characteristic of the graph G01 corresponding to the initial phase is classified into “Slow”, “Medium” and “Fast”, and the characteristic of the graph G1n corresponding to the delay phase is “Persistent”. , “Plateau” and “Washout”.

  In FIG. 9 to FIG. 10, for convenience of explanation, a graph representing “Slow” characteristics in the initial phase is defined as “G01slw”, and a graph representing “Medium” characteristics in the initial phase is defined as “G01md”. A graph representing the characteristics of “Fast” in the initial phase is defined as “G01fst”. Also, a graph representing “Persistent” characteristics in the delay phase is defined as “G1npst”, a graph representing “Plateau” characteristics in the delay phase is defined as “G1nplt”, and “Washout” characteristics are represented in the delay phase. The graph is defined as “G1nsh”.

  Further, in FIG. 10, assuming that the graph G01fst is drawn in the initial phase, the graphs G1npst, G1nplt, and G1nwsh are continuously drawn on the graph G01fst. At this time, graphs G1npst, G1nplt, and G1nwsh indicate the increase / decrease rate of the pixel value from the initial value.

  In step S37, the display device 20 is requested to display the graphs G01 and G1n drawn on the DRAM 22. The display device 20 reads the graphs G01 and G1n from the DRAM 22, and displays the read graphs G01 and G1n on the screen SCR according to the frame displayed in step S15. The graphs G01 and G1n are displayed, for example, as shown in FIG.

  In step S39, it is determined whether or not a slice position changing operation has been performed with the keyboard 16 and / or the mouse 18. In step S43, it is determined whether or not a pointer moving operation has been performed with the mouse 18. If the determination result of step S39 is YES, the value of the variable K will be changed in step S41, and then the process returns to step S29. If the determination result of step S45 is YES, the positions of the pointers PT01 and PT1n are commonly changed in step S45, and then the process returns to step S33.

  Therefore, the display mode of the complementary images IM01 to IM1n and the muller maps MP01 to MP1n dynamically change according to the slice position change operation, and the display mode of the pointers PT01 to PT1n and the graphs G01 to G1n dynamically change according to the pointer movement operation. .

  As can be seen from the above description, the communication I / F 12 acquires an MRI image of the affected part (breast) captured by the MRI apparatus 30 at each of the times T0 to Tn. The CPU 14 displays, on the screen SCR, color maps MP01 and MP1n corresponding to the initial phase and the delayed phase, respectively, and representing different planar color distributions depending on the pixel values, based on the MRI image acquired by the communication I / F 12. (S5, S9, S21, S31). The CPU 14 also multiplexes pointers PT01 and PT1n that commonly point to desired positions on the slice according to the pointer movement operation on the color maps MP01 and MP1n displayed on the screen SCR, respectively (S33, S43, S45). The CPU 14 further displays graphs G01 and G1n corresponding to the initial phase and the delay phase, respectively, and each representing the temporal change of the pixel value at the position according to the pointer movement operation, based on the MRI image acquired by the communication I / F12. (S15, S35 to S37).

  In order to diagnose the affected area, it is necessary to grasp the blood flow state in the initial phase and the delayed phase. The color maps MP01 to MP1n and the graphs G01 to G1n all correspond to the initial phase and the delayed phase, respectively. Represents the flow state. Specifically, the color maps MP01 to MP1n represent different planar color distributions according to pixel values, and the graphs G01 to G1n represent temporal changes in pixel values at certain positions on the slice. Thereby, the blood flow state in each of the initial phase and the delayed phase can be grasped from a plurality of viewpoints.

  Further, the positions to be noted when displaying the graphs G01 to G1n are pointed by pointers PT01 to PT1n displayed in common on the color maps MP01 to MP1n, and the pointing positions of the pointers PT01 to PT1n are pointer movement operations. Will be changed according to. As a result, the display mode of the graphs G01 to G1n changes according to the pointer movement operation.

  The dynamic change in the pointing position of the pointers PT01 to PT1n and the display mode of the graphs G01 to G1n is coupled with the fact that the color maps MP01 to MP1n and the graphs G01 to G1n represent the blood flow state from different viewpoints. This leads to an improvement in convenience when diagnosing.

[Second Embodiment]
According to BI-RADS-MRI, the characteristics of the graph G1n corresponding to the delay phase are classified into “Persistent”, “Plateau”, and “Washout”, while the change in signal intensity or pixel value is noted. The characteristics of the graph G01 corresponding to the initial phase are classified into “Slow”, “Medium”, and “Fast”, and attention is paid to the signal intensity or the rate of change of the pixel value. Therefore, the slope of the graph G01 is important in performing the interpretation along the BI-RADS-MRI for the initial phase.

  On the other hand, a time lag of 10 seconds to several tens of seconds actually occurs from the end of the plain imaging to the start of the injection of the contrast agent depending on the preparation and the condition of the subject. Nevertheless, in the first embodiment, it is assumed that the injection start time of the contrast agent coincides with the plane imaging time. As a result, the slope of the graph G01 decreases due to this time lag, and it becomes difficult to appropriately evaluate the rate of change of the pixel value in the initial phase.

  Therefore, in this embodiment, processing according to the flowchart shown in FIG. 18 is added to the first embodiment in order to enable drawing of the graph G01 excluding the time lag from the end of plain imaging to the start of contrast agent injection. I am trying to execute it. In addition, it transfers to step S51 shown in FIG. 18 when the determination result of step S43 shown in FIG. 13 is NO.

  In step S51, it is determined whether or not a graph setting operation has been performed with the keyboard 16 and / or the mouse 18. If a determination result is NO, it will return to Step S39, and if a determination result is YES, it will progress to Step S53.

  In step S53, a menu image representing the graph setting menu (hereinafter simply referred to as “graph setting menu”) is developed in the DRAM 22 and the display device 20 is requested to display the graph setting menu. The display device 20 reads the graph setting menu from the DRAM 22 and multiplexly displays the read graph setting menu on the diagnostic image on the screen SCR.

  Referring to FIG. 14 or FIG. 16, in the graph setting menu, whether the plane imaging time (= T0) is the starting point on the horizontal axis or the injection start time (= T0 ′) of contrast medium is the starting point on the horizontal axis Can be selected. If the former is “item 1” and the latter is “item 2”, FIG. 14 shows a state in which a check mark is displayed in item 1, and FIG. 16 shows a state in which a check mark is displayed in item 2. The time T0 ′ can be arbitrarily set with reference to the time T1, and in FIG. 14 and FIG. 16, 60 seconds before the time T1 is set as the time T0 ′.

  Returning to FIG. 18, it is determined in step S55 whether or not a check item change operation has been performed, and in step S57, it is determined whether or not a second number change operation has been performed. If the decision result in the step S55 is YES, the check mark display target is changed between the item 1 and the item 2 in a step S59. If the decision result in the step S57 is YES, the changed number of seconds is displayed at a predetermined position of the item 2 in a step S61.

  When the process of step S59 or S61 is completed, the process proceeds to step S63, and the horizontal axis of the graph frame is adjusted according to the setting of the graph setting menu. Therefore, when item 2 of the graph setting menu is selected, the difference between the plain imaging time and the contrast medium injection start time is compensated by the process of step S63.

  In step S65, the graphs G01 and G1n are redrawn according to the frame having the adjusted horizontal axis. When item 1 is checked, a graph frame and graphs G01 to G1n are displayed in the upper part of the screen SCR in the manner shown in FIG. On the other hand, when item 2 is checked, a graph frame and graphs G01 to G1n are displayed in the upper part of the screen SCR as shown in FIG.

  In this embodiment, it is assumed that the contrast medium injection start time (= T0 ′) is delayed from the plane imaging time (= T0). Accordingly, in FIG. 15, the slope of the graph G01 decreases by the amount of error between the time T0 ′ and the time T0. On the other hand, in FIG. 16, since the injection start time (= T0 ′) of the contrast agent is the starting point of the horizontal axis, the slope of the graph G01 reflects the reality.

  If the process in step S65 is completed, or if the determination results in steps S55 and S57 are both NO, it is determined in step S67 whether or not an end operation has been performed with the keyboard 16 and / or the mouse 18. If a determination result is NO, it will return to Step S55, and if a determination result is YES, it will return to Step S39. Therefore, unless the end operation is performed, the graph frame and the display mode of the graphs G01 to G1n dynamically change every time the check item change operation or the seconds change operation is performed.

  According to this embodiment, by operating the graph setting menu, the graph frame and the graphs G01 to G1n are displayed on the screen SCR in a state where the difference between the plane imaging time and the contrast agent injection start time is compensated. . This enables interpretation along BI-RADS-MRI.

10 ... Diagnosis support device 14 ... CPU
DESCRIPTION OF SYMBOLS 20 ... Display apparatus 24 ... Main memory 30 ... MRI apparatus 40 ... Communication network

Claims (9)

Acquisition means for acquiring a tomographic image of an affected area captured by the tomographic imaging apparatus at each of a plurality of times belonging to a time zone from the start to the end of one examination;
Multiple each representing a planar color distribution vary depending on the corresponding and pixel values in each of a plurality of time phases Ru appear in the time zone from the start to the end of the defined and the one of the inspection based on the plurality of times Color map display means for displaying the color map of the image based on the tomographic image acquired by the acquisition means,
Pointer multiplexing means for respectively multiplexing a plurality of pointers commonly pointing to desired positions on the tomography according to the pointer movement operation on the plurality of color maps displayed by the color map display means, and corresponding to the plurality of time phases, respectively And a diagnostic support apparatus, comprising: a graph display unit configured to display a plurality of graphs each representing a temporal change in a pixel value at a position according to the pointer movement operation based on the tomographic image acquired by the acquisition unit. The horizontal and vertical axes of the graph are assigned time and the pixel value, respectively.
The diagnostic image processing apparatus according to claim 1, further comprising color bar display means for displaying a color bar indicating a different color according to the pixel value along a vertical axis of the graph. Representative image display means for displaying a plurality of representative images respectively representing the plurality of time phases based on the tomographic image acquired by the acquisition means;
3. The diagnosis support apparatus according to claim 1, wherein the color map display means includes color map multiplexing means for multiplexing the plurality of color maps on a plurality of representative images displayed by the representative image display means. The plurality of time phases includes an initial phase and a delay phase,
The plurality of graphs are a first graph corresponding to the initial phase and representing a change in the pixel value from an initial value, and a second graph corresponding to the delay phase and representing a change in the pixel value from the initial value. The diagnosis support apparatus according to any one of claims 1 to 3, comprising a graph. The tomographic imaging apparatus is an apparatus that assumes injection of a contrast medium into the affected area,
The plurality of times includes, as a reference time, a time before injecting the contrast medium into the affected area,
The graph display means includes compensation means for compensating for a difference between the reference time and the time at which the injection of the contrast medium is started, and first graph creation means for creating the first graph based on compensation by the compensation means. The diagnosis support apparatus according to claim 4, further comprising: The tomographic image acquired by the acquisition unit corresponding to each of the plurality of times represents each tomogram at a plurality of slice positions,
The diagnosis support apparatus according to claim 1, wherein the color map display unit and the graph display unit execute a process on a common slice position among the plurality of slice positions.   The diagnosis support apparatus according to claim 6, further comprising slice position changing means for changing a slice position targeted by the color map display means and the graph display means in accordance with a slice position change operation. A diagnosis support method executed by a diagnosis support apparatus including an acquisition unit that acquires a tomographic image of an affected area captured by a tomographic imaging apparatus at each of a plurality of times belonging to a time zone from the start to the end of one examination. ,
Multiple each representing a planar color distribution vary depending on the corresponding and pixel values in each of a plurality of time phases Ru appear in the time zone from the start to the end of the defined and the one of the inspection based on the plurality of times A color map display step for displaying the color map of the image based on the tomographic image acquired by the acquisition means;
A pointer multiplexing step that multiplexes a plurality of pointers commonly pointing to desired positions on the slice according to the pointer movement operation on the plurality of color maps displayed by the color map display step, and corresponds to the plurality of time phases, respectively. And a graph display step of displaying a plurality of graphs each representing a temporal change in pixel value at a position following the pointer movement operation based on the tomographic image acquired by the acquisition means. A processor of a diagnosis support apparatus including an acquisition unit that acquires a tomographic image of an affected area captured by a tomographic imaging apparatus at each of a plurality of times belonging to a time zone from the start to the end of one examination,
Multiple each representing a planar color distribution vary depending on the corresponding and pixel values in each of a plurality of time phases Ru appear in the time zone from the start to the end of the defined and the one of the inspection based on the plurality of times A color map display step for displaying the color map of the image based on the tomographic image acquired by the acquisition means;
A pointer multiplexing step that multiplexes a plurality of pointers commonly pointing to desired positions on the slice according to the pointer movement operation on the plurality of color maps displayed by the color map display step, and corresponds to the plurality of time phases, respectively. And a diagnostic support program for executing a graph display step of displaying a plurality of graphs each representing a temporal change of a pixel value at a position according to the pointer movement operation based on the tomographic image acquired by the acquisition means.

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