JPH10137238A - Medical image processing equipment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To facilitate the simultaneous observation of an X-ray image and an IVUS image. SOLUTION: An X-ray image signal from a TV camera 33 and an image signal from an IVUS 40 are respectively sent through A/D converters 13 and 14 to image processing circuits 15 and 16. Afterwards, these signals are inputted to a mixer 21 and synthesized in real time while being synchronized with one video timing, and these output image data are returned to analog image signals by a D/A converter 22 and sent to an image monitoring device 25.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an apparatus for processing images for medical diagnosis, and more particularly to a medical image processing apparatus suitable for cardiovascular examination.

[0002]

2. Description of the Related Art A cardiovascular examination has hitherto been carried out by observing an X-ray image by an angiography performed by inserting a catheter. In recent years, the use of ultrasonic angioscopy (IVUS) in combination with this has also become widespread. That is, a treatment of identifying a stenosis portion of a blood vessel by using an X-ray image and an IVUS image by the angiography method, and expanding a stenosis portion by inserting a balloon catheter into that portion of the blood vessel has been performed.

[0003]

However, an X-ray TV apparatus for performing angiography and an IVUS are completely different apparatuses, and it is inconvenient and complicated to observe both images while contrasting them. There is a problem of sticking with. That is, the surgeon normally uses these images as needed, but the images are displayed on dedicated image monitor devices, which is complicated.
In addition, since both devices are separate devices, there is no association between the respective images, and there is no positional information on where the IVUS image was obtained on the X-ray image by angiography, so stenosis It is difficult to determine the exact location of the part.

[0004] In view of the above, the present invention provides an X-ray image and an IV
It is an object of the present invention to provide a medical image processing apparatus capable of facilitating simultaneous observation of a US image and facilitating understanding of a positional relationship therebetween.

[0005]

In order to achieve the above object, in a medical image processing apparatus according to the present invention, an input X-ray image signal and an IVUS image signal are synthesized while synchronizing with one synchronizing signal. Image synthesizing means for outputting an image signal as a single image signal, and means for detecting the position of the tip of the IVUS probe in the X-ray image from the X-ray image signal and storing the position information in association with the IVUS image. Has become.

[0006] Since the X-ray image signal and the IVUS image signal are synthesized and output as one image signal, by sending this to one image monitor device, both images are displayed on one screen of the image monitor device. It can be observed at the same time and is convenient. Further, since the probe inserted to obtain the IVUS image is shown in the X-ray image, the position of the probe tip can be detected in this X-ray image. That is, the position where the IVUS image was obtained can be detected, and the IVUS image is stored together with this position information.
IVUS obtained at the position by specifying the position in the line image
The image can be read and observed, and the positional relationship between the two can be easily grasped.

[0007]

Next, embodiments of the present invention will be described in detail with reference to the drawings. In FIG. 1, a medical image processing apparatus 10 according to the present invention
Input terminal 11 for inputting an X-ray image signal from V device 30
And an input terminal 1 for inputting an image signal from IVUS40
2 is provided. The X-ray TV device 30 includes an X-ray tube 31 for irradiating the subject 50 with X-rays, an image intensifier 32 disposed opposite to the X-ray tube 31, and a TV camera 33 coupled to the X-ray tube. This subject 50
Has a probe 41 inserted therein.
Image signal by reflected wave of ultrasonic wave emitted from
Obtained in S40.

The X-ray image signal input through the input terminal 11 is converted into digital data by the A / D converter 13 and then sent to the image processing circuit 15. The image processing circuit 15 uses the frame memory 17 to perform processing such as subtracting an image without a contrast agent from an image with a contrast agent and extracting a blood vessel image in real time. The image data after (or before) the processing is recorded in a recording device 19 such as a hard disk.

On the other hand, the IV input through the input terminal 12
The US image signal is converted to digital data by the A / D converter 14, sent to the image processing circuit 16 and subjected to various processes, and stored in the frame memory 18 or recorded in the recording device 20.

The image processing circuits 15 and 16 are connected to the CPU 2
3 is controlled. Image processing circuit 15,
16 is output from the CPU 2
In the mixer 21 controlled by the control unit 3, the images are synthesized in real time while being synchronized with one video timing. The output image data of the mixer 21 is converted back to an analog image signal by the D / A converter 22 and sent to the image monitor 25 via the output terminal 24. In the mixer 21, different matrices, frame rates, and the like of both images are integrated under one display timing, and, for example, one image is superimposed into the other image to be synthesized, or the screen is displayed. The image is divided so that each image is displayed, or both images are switched so that only one of them is displayed.

An X-ray image when the IVUS probe 41 is inserted is, for example, as shown in FIG. Here, the X-ray image 61 is obtained by inverting the blood vessel image obtained by angiography into black and white,
This is a map image in which an X-ray image currently obtained from the TV camera 33 in real time is superimposed on the map image.
2 appears white. Angiography is performed immediately before that, and an image obtained by the angiography is stored in the frame memory 17 or the like, read out, and superimposed on a real-time X-ray image. Since a real-time X-ray image is displayed in this manner, a probe image 63 traveling in the blood vessel image 62 is displayed.

Ultrasonic waves are emitted from the tip of the IVUS probe 41 and the reflected waves are captured, and an IVUS image is obtained. Only the IVUS image is displayed on the image monitor 25.
When this is displayed, the IVUS image 64 is displayed on the entire screen as shown in FIG. The IVUS images 64 are sequentially obtained in real time at fixed time intervals, and thus change like a moving image.

The display method is switched so that the I-
FIG. 2C shows a superimposed image 65 obtained by reducing the VUS image 64. The reduced IVUS image 65 is changing in real time, and as the probe 41 is inserted, it can be observed that the probe image 63 moves accordingly, and the reduced IVUS image 65
Sequentially displays images at the moved tip position in real time. In FIG. 2, since the tip of the probe 41 approaches the stenosis, the IVUS image 64 and the reduced I
The VUS image 65 shows the stenosis.

Then, the tip of the probe image 63 is designated by a marker (in this case, mark x) 66. Further, when the probe 41 is rotated in the blood vessel, a reduced IVUS image 65 is obtained.
Is rotated to find out which direction is the front direction (direction toward the X-ray tube 31) perpendicular to the display screen of the image monitor device 25, and indicates the direction with the arrow cursor 67. After performing such an operation and inputting the reference of the tip position and the rotation direction of the probe 41, the probe 41
The movement of the tip position of is the detection sending amount of the probe 41,
The rotation of the probe 41 can be automatically known by the detected rotation amount. Therefore, when the IVUS image 64 for each time is recorded on the recording device 20 or the like, the position information where the image 64 was obtained and the rotation information are recorded in association with each other. Thus, when the IVUS image 64 is read and used later, it is immediately known at what position what IVUS image 64 was obtained, and the image 64
It can also be understood which direction is the direction on the X-ray tube 31 side.

When performing a treatment for enlarging a stenosis by inserting a balloon catheter into a blood vessel, an image obtained by angiography and a real-time X-ray image are superimposed on the image as a reference image. Check that the catheter is correctly inserted into the blood vessel. This reference image is an X-ray image 61 shown in FIG.
It can be observed that the catheter image 71 progresses in the blood vessel image 62 of this image 61. At this time,
The distal end position of the catheter image 71 is detected by the image processing circuit 15, and the position information is transmitted to the image processing circuit 1 via the CPU 23.
6 to read an IVUS image near the position from the recording device 20 and superimpose a reduced IVUS image 65 as shown in FIG. It is desirable that the reduced IVUS image 65 is rotated and displayed so that, for example, the direction of the X-ray tube 31 is always on the upper side of the screen.

As a result, as shown in FIG.
From the catheter image 71, it can be seen that the catheter has approached the stenosis in the blood vessel, and at the same time, the reduction I
The VUS image 65 can also be confirmed by displaying the stenosis. Therefore, it is easy to find the optimum position for the treatment, and the treatment can be performed by placing the tip of the catheter at the optimum position.

As reference images for treatment with a balloon catheter, not only the above-mentioned X-ray image but also a superimposed reduced IVUS image 65, but also a 3D image 81 as shown in FIG. Can also be used. The 3D image 81 is obtained by binarizing the IVUS image read out from the recording device 20 using a predetermined threshold in the image processing circuit 16, extracting the edge, obtaining blood vessel contour data, and converting the IVUS image with the IVUS image. A three-dimensional image is formed by using the obtained position information and a shadow or the like is applied.
As described above, the 3D image 81 is a three-dimensional display of the blood vessel contour, and is displayed by being superimposed on an X-ray image obtained in real time, so that the three-dimensional positional relationship between the catheter image 71 traveling in the blood vessel and the stenosis part. Is easy to grasp.

Note that the above description relates to one example, and it is a matter of course that the present invention is not limited to the above. The IVUS image displayed together with the X-ray image obtained in real time is the same as the original IV
Not only US images and 3D images obtained from them,
Images processed in other ways can also be used. Also,
Regarding the rotation of the IVUS image (IVUS probe), the rotation is not detected, but the direction of the IVUS image is the front direction, and then the probe is inserted while keeping the probe from rotating. May not be changed. In addition, various specific configurations of the image processing circuits 15 and 16, the frame memories 17 and 18, the recording devices 19 and 20, the mixer 21, the CPU 23, and the like can be adopted.

[0019]

As described above, according to the medical image processing apparatus of the present invention, it is possible to easily observe an X-ray image and an IVUS image at the same time, thereby reducing the burden on the operator. You. Furthermore, a very appropriate image can be displayed as a reference image at the time of catheter operation, and the stenosis and the like can be easily specified, and the stenosis and the like can be three-dimensionally grasped.

[Brief description of the drawings]

FIG. 1 is a block diagram showing an embodiment of the present invention.

FIG. 2 is a diagram showing each image when an IVUS probe is inserted.

FIG. 3 is a diagram showing each image when a catheter is inserted.

[Explanation of symbols]

Reference Signs List 10 medical image processing device 11, 12 input terminal 13, 14 A / D converter 15, 16 image processing circuit 17, 18 frame memory 19, 20 recording device 21 mixer 22 D / A converter 23 CPU 24 output terminal 25 image monitoring device 30 X-ray TV device 31 X-ray tube 32 Image intensifier 33 TV camera 40 IVUS 41 Probe 61 X-ray image (map image) 62 Blood vessel image 63 Probe image 64 IVUS image 65 Reduced IVUS image 66 Marker 67 Direction arrow cursor 71 Catheter image 81 Vessel contour 3D image

Claims (1)

[Claims] 1. An image synthesizing means for synthesizing an input X-ray image signal and an IVUS image signal while synchronizing with one synchronizing signal and outputting as one image signal, and an X-ray image signal from the X-ray image signal. Means for detecting an IVUS probe tip position and storing the position information in association with the IVUS image.