JP7134707B2 - Ultrasound diagnostic device and estimated fetal weight display program - Google Patents

Description

An embodiment of the present invention relates to an ultrasonic diagnostic apparatus and an estimated fetal weight display program.

2. Description of the Related Art In the medical field, an ultrasonic diagnostic apparatus is used that images the inside of a subject using ultrasonic waves generated using a plurality of transducers (piezoelectric transducers) of an ultrasonic probe. An ultrasonic diagnostic apparatus transmits ultrasonic waves into a subject from an ultrasonic probe connected to the ultrasonic diagnostic apparatus, generates echo signals based on reflected waves, and obtains a desired ultrasonic image by image processing.

Ultrasound diagnostic equipment that has a function to calculate estimated fetal weight based on clinical statistical data from fetal measurements based on ultrasound images, or plots current estimated fetal weight and past estimated fetal weight Some have a function of displaying on the display together with the fetal growth curve. Estimated fetal weight is based on the measured values of BPD (fetal head major transverse diameter), HC (fetal head circumference), AC (trunk circumference), FL (femoral length), etc. Calculated by applying the weight formula.

JP 2015-226836 A

The problem to be solved by the present invention is to present appropriate information to the operator and the pregnant woman when the fetus is in a specific state such as breech presentation during fetal examination.

An ultrasonic diagnostic apparatus according to an embodiment includes determination means, calculation means, and generation means. The determining means determines the state of the fetus. The calculating means calculates a plurality of estimated fetal weights by applying the measured values to a plurality of estimated weight formulas when the determining means determines that the state of the fetus is in the specific state. The generating means generates a superimposed image in which a plurality of estimated fetal weights are superimposed on the fetal growth curve, and causes the display unit to display the superimposed image.

1 is a schematic diagram showing the configuration of an ultrasonic diagnostic apparatus according to an embodiment; FIG. FIG. 2 is a diagram showing an example of a fetal growth curve in the ultrasonic diagnostic apparatus according to the embodiment; FIG. 3 is a block diagram showing functions of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 4 is a diagram showing, as a flowchart, a first operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 5 is a diagram showing, as a flowchart, a first operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 6 is a diagram showing a display example of a superimposed image when the fetus is in the breech presentation in the first operation example of the ultrasonic diagnostic apparatus according to the embodiment; 7 is a diagram showing a display example of a superimposed image when the fetus is in the head position in the first operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. FIG. 8 is a diagram showing, as a flowchart, a second operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 9 is a diagram showing an example of a screen for selecting an estimated weight formula when the fetus is in the breech position in the second operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 10 is a diagram showing, as a flowchart, a third operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 11 is a diagram showing, as a flowchart, a third operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 12 is a diagram showing, as a flowchart, a fourth operation example of the ultrasonic diagnostic apparatus according to the embodiment; FIG. 13 is a diagram showing an example of a screen for selecting an estimated weight formula when the fetus is in the breech position in the fourth operation example of the ultrasonic diagnostic apparatus according to the embodiment;

Hereinafter, embodiments of an ultrasonic diagnostic apparatus, a medical image processing apparatus, and an ultrasonic scan control program will be described in detail with reference to the drawings.

FIG. 1 is a schematic diagram showing the configuration of an ultrasonic diagnostic apparatus according to an embodiment.

FIG. 1 shows an ultrasonic diagnostic apparatus 10 according to an embodiment. FIG. 1 also shows an ultrasound probe 20 , an input interface 30 and a display 40 . An apparatus obtained by adding at least one of the ultrasonic probe 20, the input interface 30, and the display 40 to the ultrasonic diagnostic apparatus 10 may be called an ultrasonic diagnostic apparatus. In the following description, the case where the ultrasonic probe 20, the input interface 30, and the display 40 are all provided outside the ultrasonic diagnostic apparatus 10 will be described.

The ultrasonic diagnostic apparatus 10 includes a transmission/reception circuit 11, a B-mode processing circuit 12, a Doppler processing circuit 13, an image generation circuit 14, an image memory 15, a display control circuit 16, a network interface 17, a processing circuit 18, and a main memory 19. . The circuits 11 to 14 are configured by an application specific integrated circuit (ASIC) or the like. However, it is not limited to that case, and all or part of the functions of the circuits 11 to 14 may be implemented by the processing circuit 18 executing a program.

The transmission/reception circuit 11 has a transmission circuit and a reception circuit (not shown). The transmission/reception circuit 11 controls transmission directivity and reception directivity in transmission/reception of ultrasonic waves under the control of the processing circuit 18 . Although a case where the transmission/reception circuit 11 is provided in the ultrasonic diagnostic apparatus 10 will be described, the transmission/reception circuit 11 may be provided in the ultrasonic probe 20, or may be provided in both the ultrasonic diagnostic apparatus 10 and the ultrasonic probe 20. may be provided. The transmitting/receiving circuit 11 is an example of a transmitting/receiving section.

The transmission circuit has a pulse generator circuit, a transmission delay circuit, a pulsar circuit, and the like, and supplies drive signals to the ultrasonic transducers. A pulse generation circuit repeatedly generates rate pulses for forming a transmitted ultrasound wave at a predetermined rate frequency. The transmission delay circuit sets the delay time for each piezoelectric transducer necessary to focus the ultrasonic waves generated from the ultrasonic transducers of the ultrasonic probe 20 into a beam shape and determine the transmission directivity. given for each rate pulse that occurs. Also, the pulsar circuit applies a drive pulse to the ultrasonic transducer at a timing based on the rate pulse. The transmission delay circuit arbitrarily adjusts the transmission direction of the ultrasonic beam transmitted from the piezoelectric transducer surface by changing the delay time given to each rate pulse.

The receiving circuit has an amplifier circuit, an A/D (Analog to Digital) converter, an adder, etc., receives an echo signal received by the ultrasonic transducer, and performs various processing on this echo signal to obtain an echo signal. Generate data. The amplifier circuit amplifies the echo signal for each channel and performs gain correction processing. The A/D converter A/D-converts the gain-corrected echo signal and gives the digital data a delay time necessary to determine the reception directivity. The adder adds the echo signals processed by the A/D converter to generate echo data. The addition processing of the adder emphasizes the reflection component from the direction corresponding to the reception directivity of the echo signal.

Under the control of the processing circuit 18, the B-mode processing circuit 12 receives the echo data from the receiving circuit, performs logarithmic amplification, envelope detection processing, etc., and converts the signal intensity into data ( 2D or 3D data). This data is commonly referred to as B-mode data. Note that the B-mode processing circuit 12 is an example of a B-mode processing section.

Under the control of the processing circuit 18, the Doppler processing circuit 13 frequency-analyzes the velocity information from the echo data from the receiving circuit, extracts the blood flow and tissue by the Doppler effect, and obtains the moving state information such as the average velocity, variance, and power. is extracted for multiple points (two-dimensional or three-dimensional data). This data is commonly called Doppler data. Note that the Doppler processing circuit 13 is an example of a Doppler processing unit.

Under the control of the processing circuit 18, the image generation circuit 14 generates an ultrasound image expressed in a predetermined luminance range as image data based on the echo signal received by the ultrasound probe 20. FIG. For example, the image generation circuit 14 generates, as an ultrasound image, a B-mode image representing the intensity of the reflected wave by luminance from the two-dimensional B-mode data generated by the B-mode processing circuit 12 . In addition, the image generation circuit 14 converts the two-dimensional Doppler data generated by the Doppler processing circuit 13 into an ultrasound image to generate an average velocity image, a variance image, a power image, or a combination of these images. Generate color Doppler images. Note that the image generation circuit 14 is an example of an image generation unit.

The image memory 15 includes a two-dimensional memory, which is a memory having a plurality of memory cells in two axial directions per frame and having memory cells for a plurality of frames. A two-dimensional memory serving as the image memory 15 stores, as two-dimensional image data, one or more frames of ultrasound images generated by the image generating circuit 14 under the control of the processing circuit 18 . Note that the image memory 15 is an example of a storage unit.

Under the control of the processing circuit 18, the image generation circuit 14 performs three-dimensional reconstruction by performing interpolation processing as necessary on the ultrasonic images arranged in the two-dimensional memory as the image memory 15, thereby obtaining an image. An ultrasonic image is generated as volume data in a three-dimensional memory as the memory 15 . A known technique is used as the interpolation processing method.

The image memory 15 may also include a three-dimensional memory, which is a memory having a plurality of memory cells in three axial directions (X-axis, Y-axis, and Z-axis directions). The three-dimensional memory as the image memory 15 stores the ultrasound image generated by the image generation circuit 14 under the control of the processing circuit 18 as volume data.

The display control circuit 16 includes a GPU (Graphics Processing Unit), a VRAM (Video RAM), and the like. Under the control of the processing circuit 18 , the display control circuit 16 causes the display 40 to display an ultrasound image (for example, a live image) requested by the processing circuit 18 for display output. Note that the display control circuit 16 is an example of a display control unit.

The network interface 17 implements various information communication protocols according to the form of the network. The network interface 17 connects the ultrasonic diagnostic apparatus 10 with other devices such as the external medical image management apparatus 50 and the medical image processing apparatus 60 according to these various protocols. An electrical connection or the like via an electronic network can be applied to this connection. Here, the term "electronic network" refers to all information communication networks using telecommunication technology, including wireless/wired LANs (Local Area Networks) of hospital backbones, Internet networks, telephone communication networks, and optical fiber communication networks. , cable communication networks and satellite communication networks.

Network interface 17 may also implement various protocols for contactless wireless communication. In this case, the ultrasonic diagnostic apparatus 10 can directly transmit/receive data to/from the ultrasonic probe 20 without going through a network, for example. Note that the network interface 17 is an example of a network connection unit.

The processing circuit 18 means a dedicated or general-purpose CPU (central processing unit), MPU (micro processor unit), or GPU (Graphics Processing Unit), as well as an ASIC, a programmable logic device, or the like. Examples of programmable logic devices include simple programmable logic devices (SPLDs), complex programmable logic devices (CPLDs), and field programmable gate arrays (FPGAs). mentioned.

Also, the processing circuit 18 may be composed of a single circuit, or may be composed of a combination of a plurality of independent circuit elements. In the latter case, the main memory 19 may be provided separately for each circuit element, or a single main memory 19 may store programs corresponding to functions of a plurality of circuit elements. Note that the processing circuit 18 is an example of a processing unit.

The main memory 19 is composed of a semiconductor memory device such as a RAM (random access memory), a flash memory, a hard disk, an optical disk, or the like. The main memory 19 may be composed of portable media such as USB (universal serial bus) memory and DVD (digital video disk). The main memory 19 stores various processing programs (including application programs, an OS (operating system), etc.) used in the processing circuit 18, and data necessary for executing the programs. In addition, the OS can include a GUI (graphical user interface) that makes extensive use of graphics to display information on the display 40 for the operator and allows basic operations to be performed through the input interface 30 . Note that the main memory 19 is an example of a storage unit.

Further, the main memory 19 pre-stores fetal growth curves. The main memory 19 may store the data itself representing the fetal growth curve, or may store a data group for drawing the fetal growth curve.

FIG. 2 is a diagram showing an example of a fetal growth curve.

The fetal growth curve is, for example, the average fetal weight for each gestational week when multiple babies born with normal weight (between the 10th and 90th percentile of the standard value for newborns) were in the uterus. It is created by asking. Therefore, if the estimated fetal weight of the fetus to be estimated is within the reference value of the fetal growth curve, the fetus can be expected to be born with a normal weight.

Returning to the description of FIG. 1, the main memory 19 pre-stores a plurality of estimated weight formulas for obtaining the estimated fetal weight (EFW). Each estimated weight formula of the plurality of estimated weight formulas stored in the main memory 19 may be arbitrarily calculated for each country, each hospital, or each operator, or may be publicly known. good too. Known estimated weight formulas include, for example, the following formulas (1) to (3). Here, BPD represents the major lateral diameter of the fetal head (the diameter of the longest part of the left and right lateral width when the fetal head is viewed from directly above), and APTD represents the abdominal anteroposterior diameter (thickness of the fetal abdomen anteroposteriorly). TTD represents the abdominal transverse diameter (the length of the fetal abdominal width), FL represents the femur length (the length from the base of the fetal thigh to the knee), AC represents the trunk circumference (fetal belly circumference).

EFW(g)=1.07*BPD(cm) ³ +3.42*APTD(cm)*TTD(cm)*FL(cm) …(1)
EFW(g)=1.07*BPD(cm) ³ +0.30*AC(cm) ² *FL(cm) …(2)
Log ₁₀ (EFW)=1.304+(0.05281*AC(cm))+(0.1938*FL(cm))-(0.004*AC(cm)*FL(cm)) …(3)

In addition, the main memory 19 stores a measurement value associated with the number of weeks of pregnancy (examination date) for each pregnant woman. The measured value indicates fetal BPD or the like based on the ultrasound image. In any pregnant woman, by applying the measured value at each gestational week to a plurality of estimated weight formulas (e.g., the above formulas (1) to (3)), a plurality of estimated fetal weights for each gestational week ( EFW) can be calculated.

The ultrasonic probe 20 has a plurality of minute transducers (piezoelectric elements) on its front surface, and transmits and receives ultrasonic waves to and from a region including a scan target, for example, a region including a lumen. Each transducer is an electroacoustic transducer, and has a function of converting an electric pulse into an ultrasonic pulse during transmission and converting a reflected wave into an electric signal (receiving signal) during reception. The ultrasonic probe 20 is configured to be compact and lightweight, and is connected to the ultrasonic diagnostic apparatus 10 via a cable (or wireless communication).

The ultrasonic probe 20 is classified into a linear type, a convex type, a sector type, and the like depending on the scanning method. In addition, the ultrasonic probe 20 has a 1D array probe in which a plurality of transducers are arranged one-dimensionally (1D) in the azimuth direction, and a two-dimensional (2D) array probe in the azimuth and elevation directions. ) can be classified into a 2D array probe in which a plurality of transducers are arranged. Note that the 1D array probe includes a probe in which a small number of transducers are arranged in the elevation direction.

Here, when a 3D scan, that is, a volume scan is performed, a 2D array probe having scanning methods such as a linear type, a convex type, and a sector type is used as the ultrasonic probe 20 . Alternatively, when a volume scan is performed, a 1D probe having a scanning system such as a linear type, a convex type, a sector type, etc., and a mechanism for mechanically swinging in the elevation direction is used as the ultrasonic probe 20. be done. The latter probes are also called mecha 4D probes.

The input interface 30 includes an input device operable by an operator and an input circuit for inputting signals from the input device. Input devices include trackballs, switches, mice, keyboards, touchpads that perform input operations by touching the scanning surface, touch screens that integrate the display screen and touchpad, non-contact input devices using optical sensors, and a voice input device or the like. When the operator operates the input device, the input circuit generates a signal according to the operation and outputs it to the processing circuit 18 . Note that the input interface 30 is an example of an input unit.

The display 40 is configured by a general display output device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display. The display 40 displays various information under the control of the processing circuit 18 . The display 40 also includes a display for an operator of the ultrasound probe 20, a display for pregnant women, and the like. Note that the display 40 is an example of a display unit.

1 also shows a medical image management apparatus 50 and a medical image processing apparatus 60, which are external devices of the ultrasonic diagnostic apparatus 10. As shown in FIG. The medical image management apparatus 50 is, for example, a DICOM (Digital Imaging and Communications in Medicine) server, and is connected to equipment such as the ultrasonic diagnostic apparatus 10 via the network N so as to be able to transmit and receive data. The medical image management apparatus 50 manages medical images such as ultrasonic images generated by the ultrasonic diagnostic apparatus 10 as DICOM files.

The medical image processing apparatus 60 is connected to devices such as the ultrasonic diagnostic apparatus 10 and the medical image management apparatus 50 via the network N so as to be able to transmit and receive data. Examples of the medical image processing apparatus 60 include a workstation that performs various types of image processing on an ultrasonic image generated by the ultrasonic diagnostic apparatus 10, a portable information processing terminal such as a tablet terminal, and the like. The medical image processing apparatus 60 may be an off-line apparatus, and may be an apparatus capable of reading the ultrasonic image generated by the ultrasonic diagnostic apparatus 10 via a portable storage medium.

Next, functions of the ultrasonic diagnostic apparatus 10 will be described.

FIG. 3 is a block diagram showing functions of the ultrasonic diagnostic apparatus 10. As shown in FIG.

The processing circuit 18 reads out and executes a program stored in the main memory 19 or directly incorporated in the processing circuit 18 to perform a scan control function 21, a determination function 22, a calculation function 23, and a superimposed image generation function. 24, and a selection function 25. A case where the functions 21 to 25 function as software will be described below as an example. may

The scan control function 21 controls the transmission/reception circuit 11, the B-mode processing circuit 12, the Doppler processing circuit 13, the image generation circuit 14, and the like to execute a scan using the ultrasonic probe 20 to generate an ultrasonic image (for example, including the ability to generate live B-mode images). The scan control function 21 is an example of scan control means.

Determination function 22 includes a function to determine the state of the fetus based on the ultrasound images generated by scan control function 21 . The determination function 22 determines the operation of the input interface 30 (for example, a switch) by the operator, the orientation of the fetus in the body mark input by the operator, the orientation of the fetus with respect to the scanning direction of the ultrasonic probe 20 by the operator, and the orientation of the pregnant woman. The fetal condition of the pregnant woman is determined based on the patient information (for example, included in the examination order) and the like. For example, in a standardized ultrasound scanning technique, when scanning the ultrasound probe 20 parallel along the long axis of the uterus from the vagina to the fundus of the uterus, if the fetal head is recognized later than the fetal abdomen, determine Function 22 can determine that the fetus is in breech presentation. Note that the determination function 22 is an example of determination means.

When the determination function 22 determines that the fetus is in a specific state, the calculation function 23 calculates fetal BPD (fetal head diameter), HC (fetal head diameter) from the ultrasound image generated by the scan control function 21 . Head circumference), AC (trunk circumference), FL (femoral length), etc., and obtain the measured value, and measure the measured value with multiple estimated weight formulas (for example, the above formulas (1) to (3) ) to calculate multiple estimated fetal weights. The specific state is, for example, the breech presentation among the head and breech presentations of the fetus. Note that the calculation function 23 is an example of calculation means.

The superimposed image generating function 24 includes a function of generating a superimposed image in which a plurality of estimated fetal weights calculated by the calculating function 23 are superimposed on the fetal growth curve, and displaying the superimposed image on the display 40 . The fetal growth curve is stored in advance in a storage unit such as the main memory 19 or the like. Note that the superimposed image generation function 24 is an example of generation means.

The selection function 25 includes a function of selecting multiple estimated weight formulas to be used in the calculation function 23 according to an operation signal from the input interface 30 . The selection function 25 is an example of selection means.

Next, an operation example of the ultrasonic diagnostic apparatus 10 will be described with reference to FIGS. 4 to 13. FIG.

1. First Operation Example of Ultrasound Diagnostic Apparatus 10 FIGS. 4 and 5 are diagrams showing a first operation example of the ultrasound diagnostic apparatus 10 as a flow chart. In FIGS. 4 and 5, numerals attached to "ST" indicate respective steps of the flow chart.

The scan control function 21 controls the ultrasound probe 20 and the like via the transmission/reception circuit 11 to scan the abdomen (fetus) of a pregnant woman (step ST1). The scan control function 21 can display the ultrasound image generated by the scan executed in step ST1 on the display 40 as a live B-mode image, or store it in the image memory 15.

The calculation function 23 calculates fetal BPD (fetal head major lateral diameter), HC (fetal head circumference), AC (trunk circumference), FL (femur length), etc. from the ultrasound image generated by the scan in step ST1. is measured to obtain a measured value (step ST2). The determination function 22 determines the state of the fetus based on the ultrasound image generated by the scan in step ST1. That is, the determination function 22 determines whether or not the fetus is in the breech presentation based on the ultrasound image (step ST3).

If the determination in step ST3 is YES, that is, if it is determined that the fetus is in the breech position, the calculation function 23 applies the measured values obtained in step ST2 to a plurality of estimated weight formulas to obtain a plurality of estimated fetuses. A body weight is calculated (step ST4). Here, in the first operation example, the plurality of estimated weight formulas to be employed may be preset and unchanged. The superimposed image generation function 24 generates a superimposed image in which a plurality of estimated fetal weights calculated in step ST4 are superimposed on the fetal growth curve (shown in FIG. 2) (step ST5), and displays the superimposed image on the display 40. (step ST6).

Here, in step ST6, the superimposed image generation function 24 can display the ultrasound image and the superimposed image generated by the scan in step ST1 on the display for pregnant women as the display 40. FIG. In this case, the pregnant woman can be presented with a screen showing a plurality of estimated fetal weights calculated from a plurality of estimated fetal weights or a screen showing an estimated fetal weight designated by the operator. Also, in step ST6, the superimposed image generation function 24 can cause a printing machine (not shown) to print the ultrasonic image and the superimposed image generated by the scanning in step ST1. In this case, a form showing a plurality of estimated fetal weights calculated from a plurality of estimated fetal weights or a form showing estimated fetal weights specified by the operator can be handed over to the pregnant woman.

FIG. 6 is a diagram showing a display example of a superimposed image when the fetus is in the breech position.

FIG. 6 shows a graph plotting a plurality of estimated fetal weights, for example, two estimated fetal weights calculated in step ST4 for each gestational week (GA) of a certain pregnant woman on the fetal growth curve shown in FIG. Equivalent to the current number of weeks of pregnancy by applying the measured value measured at the current number of weeks of pregnancy of the pregnant woman (vertical thick line) to the first estimated weight formula "estimated weight formula A" on the fetal growth curve One plot (one mark “●” on the thick line shown in FIG. 6) is placed at the position where the On the other hand, by applying the measured value measured at the current gestational age (vertical thick line) of the pregnant woman to the fetal growth curve to the second estimated weight formula "estimated weight formula B", the current gestational age One plot (one mark “▪” on the thick line shown in FIG. 6) is placed at a position corresponding to .

In addition, the past measurement values associated with the number of weeks of pregnancy stored in the main memory 19 for the pregnant woman are used as the first estimated weight formula "estimated weight formula A" and the second estimated weight formula "estimated weight formula". Each application of Eq. B' places two plots at each gestational week in the past. Referring to the superimposed image shown in FIG. 6, the operator and the pregnant woman can visually recognize multiple transitions regarding the estimated fetal weight along with the fetal growth curve when the fetus is in the breech presentation.

Note that the main memory 19 may store past measured values and calculate an estimated fetal weight from the past measured values according to two estimated weight formulas when generating a superimposed image. The estimated fetal weight calculated according to two estimated weight formulas in the past may be stored.

As shown in FIG. 6, the plot of the estimated fetal weight obtained by applying the measured values of the fetus to the first estimated weight formula "estimated weight formula A" (marked "●" shown in FIG. 6) indicates that the fetal growth It deviates greatly from the 50th percentile curve (the solid line shown in FIG. 6) among the curves. Thus, when the estimated fetal weight is calculated by one estimated weight formula, the growth of the fetus is overestimated or underestimated, which makes the pregnant woman uneasy.

In particular, when the fetus is in the breech presentation, it usually has a long head, and the BPD measurement value is often smaller than usual. As a result, the estimated fetal weight calculated from the estimated weight formula including BPD is small, and the growth of the fetus is underestimated, which causes anxiety for the pregnant woman. For example, among the above formulas (1) to (3), formulas (1) and (2) are estimated weight formulas including BPD, while formula (3) is an estimated weight formula that does not include BPD. Thus, if the estimated body weight is underestimated, it is risky to use only the estimated body weight calculated from the estimated body weight formula including BPD as a selection criterion for vaginal delivery.

Therefore, the calculation function 23 calculates a plurality of estimated fetal weights by applying the measured values measured from the ultrasound images to a plurality of estimated weight formulas. That is, as shown in FIG. 6, the calculation function 23 adds the fetal measurement value to the estimated fetal weight obtained by applying the fetal measurement value to the first estimated weight formula "estimated weight formula A", The estimated fetal weight obtained by applying the estimated weight formula "estimated weight formula B" of 2 is calculated. This reduces the risk of fetal development being over- or underestimated.

Also, when the fetus is in the breech position, at least one of the multiple estimated weight formulas to be applied is preferably an estimated weight formula that does not include BPD (e.g., formula (3) above). . Alternatively, if the fetus is in the breech presentation, the estimated fetal weight calculated from the estimated weight formula including BPD to be applied is multiplied by a coefficient (e.g., 1.3 times, etc.) to determine the estimated fetal weight. good. This reduces the risk of fetal development being underestimated.

In the display example of the superimposed image shown in FIG. 6, plots of estimated fetal weights based on a plurality of estimated weight formulas are expressed by changing the display form, for example, the shape, for each estimated weight formula (or for each fetal position). The display form is not limited to the shape. For example, the plot of estimated fetal weight may be represented by different patterns and colors for each estimated weight formula. Further, when an arbitrary plot is selected by the operator on the display screen of the superimposed image shown in FIG. 6, the plot and other plots calculated from the same estimated weight formula as the plot are It can also be highlighted in display form. In that case, one fetal growth curve for the fetus is generated based on the plot selected by the operator and another plot calculated from the same estimated weight formula as the plot, and the superimposition shown in FIG. The single fetal growth curve can also be superimposed on the image.

Also, in the same pregnant woman, the fetal state may change to the head position or the breech position during the process of fetal growth. In that case, the display form of the plot may be changed between the position corresponding to the number of weeks of pregnancy in the head position and the position corresponding to the number of weeks of pregnancy in the case of the breech position.

Returning to the description of FIG. 4, if NO in step ST3, that is, if it is determined that the fetus is in the head position, the calculation function 23 proceeds to FIG. 5 to estimate the measured value obtained in step ST2. An estimated fetal weight is calculated by applying the weight formula (for example, one of the above formulas (1) to (3)) (step ST7). The superimposed image generation function 24 generates a superimposed image in which the estimated fetal weight calculated in step ST7 is superimposed on the fetal growth curve (shown in FIG. 2) (step ST8), and displays the superimposed image on the display 40 ( step ST9).

FIG. 7 is a diagram showing a display example of a superimposed image when the fetus is in the head position.

FIG. 7 shows a graph obtained by plotting the estimated fetal weight calculated in step ST7 for each gestational week (GA) of a certain pregnant woman, for example, the estimated fetal weight of one fetus on the fetal growth curve shown in FIG. By applying the measured value measured at the current gestational age (vertical thick line) of the pregnant woman to the fetal growth curve to the first estimated weight formula "estimated weight formula A", the position of the current gestational age , one plot (one mark “●” on the thick line shown in FIG. 7) is placed.

In addition, for the pregnant woman, by applying the past measurement value associated with the number of weeks of pregnancy stored in the main memory 19 to the first estimated weight formula "estimated weight formula A", each past pregnancy One plot is placed at the position of the week number. Referring to the superimposed image shown in FIG. 7, the operator and the pregnant woman can visually recognize one transition regarding the estimated fetal weight along with the fetal growth curve when the fetus is in the head position.

Note that the main memory 19 may store past measured values and calculate an estimated fetal weight from the past measured values according to one estimated weight formula when generating a superimposed image. Estimated fetal weight calculated according to one estimated weight formula in the past may be stored.

When the state of the fetus is the head position, the calculation function 23 calculates the estimated fetal weight obtained by applying the measured value of the fetus to the first estimated weight formula "estimated weight formula A" as shown in FIG. calculate. In the superimposed image in the case of the head position shown in FIG. 7, the case where one estimated fetal weight is calculated for each gestational week by one estimated weight formula is illustrated, but the case is limited to this case. is not. In the case of the head position, as in the case of the breech position, a plurality of estimated fetal weights may be calculated for each gestational age using a plurality of estimated weight formulas.

According to the first operation example of the ultrasonic diagnostic apparatus 10, when the fetus is in a specific state such as breech presentation during fetal examination, by presenting the pregnant woman with a plurality of estimated fetal weights obtained from a plurality of estimated weight formulas, Pregnant women can be presented with appropriate information. Further, according to the first operation example of the ultrasonic diagnostic apparatus 10, when the fetus is in a specific state such as breech presentation during fetal examination, at least the estimated fetal weight based on the estimated weight formula that does not include BPD is presented to the pregnant woman. Therefore, appropriate information can be presented to pregnant women.

2. Second Operation Example of Ultrasound Diagnostic Apparatus 10 In the above-described first operation example of the ultrasound diagnostic apparatus 10, the case where the plurality of estimated weight formulas to which the measured values are applied is preset and unchanged. Although described, it is not so limited. For example, the plurality of estimated weight formulas to which the measured values are applied may be arbitrarily selected by the operator, or may be arbitrarily changed by the operator while referring to the displayed superimposed image. can be anything. 8 and 9, a plurality of estimated weight formulas to which the measured values are applied are arbitrarily selected by the operator, and the operator refers to the displayed superimposed image. A case where it is arbitrarily changed by

FIG. 8 is a diagram showing a second operation example of the ultrasonic diagnostic apparatus 10 as a flowchart. In FIG. 8, numerals attached to "ST" indicate respective steps of the flow chart. In FIG. 8, steps that are the same as those shown in FIG. 4 are given the same reference numerals, and description thereof is omitted.

If the determination in step ST3 is YES, that is, if it is determined that the fetus is in breech presentation, the selection function 25 selects a plurality of estimated weight formulas to which the measured values are applied according to the operation signal from the input interface 30. (Step ST11). For example, in step ST11, the selection function 25 selects any two estimated weight formulas from the formulas (1) to (3) previously stored in the main memory 19 according to the operation signal from the input interface 30. select. The calculation function 23 calculates a plurality of estimated fetal weights by applying the measured values obtained in step ST2 to the plurality of estimated weight formulas selected in step ST11 (step ST4).

The selection function 25 determines whether or not to change the estimated weight formula on the display screen of the superimposed image displayed in step ST6 (step ST12). If the determination in step ST12 is YES, that is, if it is determined not to change the estimated weight formula, the ultrasonic diagnostic apparatus 10 ends the operation.

On the other hand, if the determination in step ST12 is NO, that is, if it is determined that the estimated weight formula should be changed, the selection function 25 selects a plurality of estimated weight formulas according to the operation signal from the input interface 30 (step ST11). ).

FIG. 9 is a diagram showing an example of a screen for selecting an estimated weight formula when the fetus is in the breech position.

FIG. 9 shows a screen including the superimposed image shown in FIG. 6 and a pull-down menu for selecting an estimated weight formula. The operator can arbitrarily select one of the first to third estimated weight formulas while referring to the superimposed image, thereby appropriately changing the plot position represented on the graph in the vertical direction. In the display screen shown in FIG. 9, "estimated weight formula A" is selected as the first estimated weight formula, and "estimated weight formula B" is selected as the second estimated weight formula.

Returning to the description of FIG. 8, if NO in step ST3, that is, if it is determined that the fetus is in the head position, the calculation function 23 proceeds to FIG. 5 to estimate the measured value obtained in step ST2. An estimated fetal weight is calculated by applying the weight formula (for example, one of the above formulas (1) to (3)) (step ST7).

According to the second operation example of the ultrasonic diagnostic apparatus 10, in addition to the above-described first operation example, when the fetus is in a specific state such as breech presentation during fetal examination, the operator uses a plurality of estimated weight formulas can be arbitrarily selected and changed.

3. Third Operation Example of Ultrasound Diagnostic Apparatus 10 The plurality of estimated weight formulas to which the measured values are applied may include estimated weight formulas for head position (normal use) and breech position. A case where a plurality of estimated body weight formulas to which the measured values are applied includes one for breech position and one for head position will be described with reference to FIGS. 10 and 11. FIG.

The main memory 19 stores in advance an estimated weight formula for the head position and an estimated weight formula for the breech position. For example, the main memory 19 stores an estimated weight formula including BPD (for example, the above formulas (1) and (2)) as an estimated weight formula for head position, and stores BPD as an estimated weight formula for breech position. Store the estimated weight formula that does not include (for example, formula (3) above). The reason why the estimated weight formula that does not include BPD is selected as the estimated weight formula for breech presentation is that, as described above, when the fetus is in breech presentation, the head tends to be long and the growth of the fetus is underestimated. This is to prevent

10 and 11 are flowcharts showing a third operation example of the ultrasonic diagnostic apparatus 10. FIG. In FIGS. 10 and 11, numerals attached to "ST" indicate respective steps of the flowchart. 10 and 11, the same steps as those shown in FIGS. 4 and 5 are assigned the same reference numerals, and the description thereof is omitted.

If the determination in step ST3 is YES, that is, if it is determined that the fetus is in the breech position, the calculation function 23 incorporates the measured values obtained in step ST2 into the estimated weight formulas for head position and breech position. A plurality of estimated fetal weights are calculated by applying a plurality of estimated weight formulas (step ST24). Here, in the third operation example, the plurality of estimated weight formulas to be employed may be preset and unchanged.

Here, in step ST6, the superimposed image generation function 24 can also cause the display 40 to display an image of the superimposed image (shown in FIG. 6) excluding the plot related to the estimated weight formula for head position. Also, in step ST6, the superimposed image generation function 24 can cause a printing machine (not shown) to print an image of the superimposed image (shown in FIG. 6) excluding plots related to the estimated weight formula for head position.

According to the third operation example of the ultrasonic diagnostic apparatus 10, when the fetus is in a specific state such as breech position during fetal examination, in addition to the estimated fetal weight based on the estimated weight formula for head position (normal use), Appropriate information can be presented to the pregnant woman by presenting the estimated fetal weight according to the estimated weight formula for the position to the pregnant woman. Further, according to the third operation example of the ultrasonic diagnostic apparatus 10, when the fetus is in a specific state such as breech presentation during fetal examination, at least the estimated fetal weight based on the estimated weight formula that does not include BPD is presented to the pregnant woman. Therefore, appropriate information can be presented to pregnant women.

4. Fourth Operation Example of Ultrasound Diagnostic Apparatus 10 In the above-described third operation example of the ultrasound diagnostic apparatus 10, the case where the plurality of estimated weight formulas to which the measured values are applied is preset and unchanged. Although described, it is not so limited. For example, the plurality of estimated weight formulas to which the measured values are applied may be arbitrarily selected by the operator, or may be arbitrarily changed by the operator while referring to the displayed superimposed image. can be anything. 12 and 13, a plurality of estimated weight formulas to which the measured values are applied are arbitrarily selected by the operator, and the operator refers to the displayed superimposed image. A case where it is arbitrarily changed by

FIG. 12 is a diagram showing a fourth operation example of the ultrasonic diagnostic apparatus 10 as a flowchart. In FIG. 12, numerals attached to "ST" indicate respective steps of the flow chart. 12, the same steps as those shown in FIG. 4 are denoted by the same reference numerals, and description thereof is omitted.

If the determination in step ST3 is YES, that is, if it is determined that the fetus is in the breech position, the selection function 25 selects, according to the operation signal from the input interface 30, the measurement values for head position and breech position. are selected (step ST31). For example, in step ST31, the selection function 25 selects any one head position from the formulas (1) to (3) previously stored in the main memory 19 in accordance with the operation signal from the input interface 30. Select the estimated weight formula and the estimated weight formula for any one breech presentation. The calculation function 23 calculates a plurality of estimated fetal weights by applying the measured values obtained in step ST2 to the plurality of estimated weight formulas selected in step ST31 (step ST24).

The selection function 25 determines whether or not to change the estimated weight formula on the display screen of the superimposed image displayed in step ST6 (step ST32). If the determination in step ST32 is YES, that is, if it is determined not to change the estimated weight formula, the ultrasonic diagnostic apparatus 10 ends the operation.

On the other hand, if the determination in step ST32 is NO, that is, if it is determined that the estimated weight formula should be changed, the selection function 25 selects a plurality of estimated weight formulas according to the operation signal from the input interface 30 (step ST31). ).

FIG. 13 is a diagram showing an example of a screen for selecting an estimated weight formula when the fetus is in the breech position.

FIG. 13 shows a screen including the superimposed image shown in FIG. 6 and a pull-down menu for selecting an estimated weight formula. The operator can arbitrarily select one of the first to third estimated weight formulas while referring to the superimposed image, thereby appropriately changing the plot position represented on the graph in the vertical direction. In the display screen shown in FIG. 13, the head posture estimated weight formula "estimated weight formula A" is selected as the first estimated weight formula, and the breech position estimated weight formula "estimated weight formula A" is selected as the second estimated weight formula. Weight formula B" is selected. Here, as shown in FIG. 13, the display form may be changed between the estimated weight formula for the head position and the estimated weight formula for the breech position (frame lines shown in FIG. 13).

According to the fourth operation example of the ultrasonic diagnostic apparatus 10, in addition to the above-described third operation example, when the fetus is in a specific state such as breech presentation during the fetal examination, the operator uses a plurality of estimated weight formulas can be arbitrarily selected and changed.

According to at least one embodiment described above, appropriate information can be presented to the operator and the pregnant woman when the fetus is in a specific state such as breech presentation during fetal examination.

The scan control function 21 is an example of scan control means. The determination function 22 is an example of determination means. The calculation function 23 is an example of calculation means. The superimposed image generation function 24 is an example of generation means. The selection function 25 is an example of selection means.

It should be noted that although several embodiments of the invention have been described, these embodiments are provided by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and modifications can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the scope of the invention described in the claims and equivalents thereof.

10 Ultrasonic Diagnostic Apparatus 18 Processing Circuit 21 Scan Control Function 22 Determination Function 23 Calculation Function 24 Superimposed Image Generation Function 25 Selection Function

Claims (12)

Determination means for determining whether the fetus is in breech or head position ;
When the determining means determines that the fetus is in the breech presentation , a plurality of estimated fetal weights are calculated by applying the measured values to a plurality of estimated weight formulas, while the determining means determines that the fetus is in the breech position. calculating means for calculating an estimated fetal weight by applying the measured value to one of the plurality of estimated weight formulas when the head position is determined ;
generating means for generating a superimposed image in which the plurality of estimated fetal weights or the estimated fetal weights calculated by the calculating means are superimposed on a fetal growth curve, and displaying the superimposed image on a display unit;
An ultrasound diagnostic device having The determination means determines whether the fetus is in the breech position based on the operation of the input unit by the operator, the orientation of the fetus with respect to the scanning direction of the ultrasound probe by the operator, or the patient information of the pregnant woman. determine whether it is the head position ,
The ultrasonic diagnostic apparatus according to claim 1. When the determining means determines that the fetus is in the breech presentation, the calculating means includes an estimated weight formula that does not include the fetal head major transverse diameter as at least one of the plurality of estimated weight formulas,
The ultrasonic diagnostic apparatus according to claim 1 or 2. When the determining means determines that the fetus is in the breech presentation, the calculating means includes an estimated weight formula including a fetal head major transverse diameter as at least one of the plurality of estimated weight formulas, and the measuring means Calculate the estimated fetal weight by multiplying the provisional estimated fetal weight calculated by applying the value to the estimated weight formula including the fetal head major transverse diameter, by a coefficient;
The ultrasonic diagnostic apparatus according to claim 1 or 2. further comprising a storage unit for storing an estimated weight formula for head position and an estimated weight formula for breech position;
When the determination means determines that the fetus is in the breech position, the calculation means calculates an estimated fetal weight by applying the measured value to the estimated weight formula for the head position, and calculates the estimated fetal weight. calculating the plurality of estimated fetal weights by applying the values to the estimated weight formula for breech presentation to calculate an estimated fetal weight;
The ultrasonic diagnostic apparatus according to claim 1 or 2 . further comprising selection means for selecting the plurality of estimated weight formulas according to an operation signal from an input unit when the determination means determines that the fetus is in the breech presentation ;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 5 . The generation means changes a display form of the plots of the plurality of estimated fetal weights arranged on the fetal growth curve according to whether the fetus is in the breech presentation or the head presentation. generate a superimposed image,
The ultrasonic diagnostic apparatus according to any one of claims 1 to 6 . When the determination means determines that the fetus is in the breech position, the calculation means calculates the measured value and the past measured value associated with the number of weeks of pregnancy using the plurality of estimated weight formulas. calculating the plurality of estimated fetal weights for each of the gestational weeks by applying to
The generating means generates the superimposed image in which plots of the plurality of estimated fetal weights are arranged on the fetal growth curve for each of the gestational weeks.
The ultrasonic diagnostic apparatus according to any one of claims 1 to 6 . the generation means, when the determination means determines that the fetus is in the breech presentation, while the superimposed image is being displayed on the display unit, a specific plot among the plurality of estimated fetal weight plots; generating a specific fetal growth curve based on the specific plot and other plots calculated from the same estimated weight formula, and further superimposing the specific fetal growth curve on the superimposed image;
The ultrasonic diagnostic apparatus according to claim 8 . When the determination means determines that the fetus is in the breech position, the generating means corresponds to the number of weeks of pregnancy when the fetus is in the breech position while the superimposed image is being displayed on the display unit. changing the display form of each plot of the plurality of estimated fetal weight plots at a position where the fetus is in the head position and a position corresponding to the number of weeks of pregnancy when the fetus is in the head position;
The ultrasonic diagnostic apparatus according to claim 8 . The generating means controls to display or print the superimposed image on a display unit for pregnant women as the display unit;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 10 . to the computer,
A determination function for determining whether the fetus is in breech or head position ;
When the determination function determines that the fetus is in the breech presentation , a plurality of estimated fetal weights are respectively calculated by applying the measured values to a plurality of estimated weight formulas, while the determination function determines that the fetus is in the breech position. a calculation function for calculating an estimated fetal weight by applying the measured value to one of the plurality of estimated weight formulas when the head position is determined ;
a function of generating a superimposed image in which the plurality of estimated fetal weights or the estimated fetal weights calculated by the calculating function are superimposed on a fetal growth curve, and displaying the superimposed image on a display unit;
An estimated fetal weight display program that realizes

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