JP5397938B2 - MEDICAL IMAGE CREATION DEVICE AND PROGRAM - Google Patents

Description

  The present invention relates to a medical image creation apparatus and a program such as an ultrasonic diagnostic apparatus, an X-ray CT (Computed Tomography) apparatus, and an MRI (Magnetic Resonance Imaging) apparatus.

  As a medical image creation apparatus, an ultrasonic diagnostic apparatus, an X-ray CT apparatus, an MRI apparatus, and the like are known. Among them, the ultrasonic diagnostic apparatus is a simple one that makes an ultrasonic probe contact the body surface of a subject. It is an apparatus that can obtain an ultrasonic image as a medical image in real time by operation.

  By the way, there is known a radiofrequency ablation treatment method in which a puncture needle is inserted into a subject and then a radio wave is irradiated from the puncture needle to cauterize a treatment target such as a tumor. In this radiofrequency ablation treatment method, a puncture needle is inserted while observing a medical image displayed in real time. As a medical image at this time, for example, an ultrasonic image is used.

  Here, after the treatment, in order to determine whether or not the appropriate range of cauterization has been performed on the treatment target, conventionally, as described in Patent Document 1, the ultrasound image before treatment and the after treatment These images are displayed side by side, and an operator such as a doctor compares the two images to make a determination. Specifically, the treatment mark appears black in the ultrasonic image after treatment. Therefore, the size of the treatment mark appearing in black in the ultrasonic image after treatment is compared with the size of the treatment target appearing in the ultrasonic image before treatment to determine whether or not an appropriate range has been cauterized. . When radiofrequency ablation treatment is performed, cauterization is performed so as to have a margin for the treatment target. Therefore, it is appropriate from the viewpoint of whether or not the treatment mark has a predetermined margin for the treatment target. Determine whether the range has been cauterized.

JP 2008-132109 A

  However, conventionally, the above-described determination has not been easy only by comparing the ultrasonic images before treatment and the ultrasonic images after treatment displayed side by side. Accordingly, it is desired that it is possible to easily recognize whether or not an appropriate range has been treated in a medical image after performing treatment such as radiofrequency ablation treatment.

  The problem to be solved by the present invention is to provide a medical image creation apparatus and program that can easily recognize whether or not an appropriate range has been treated.

  The present invention has been made to solve the above problems, and the invention of the first aspect includes a first medical image before starting treatment in a subject, a second medical image after starting treatment in the subject, A medical image creation unit for creating a treatment range, a treatment range determination unit for determining a treatment range so as to have a predetermined margin with respect to a treatment target in the first medical image, and a treatment mark in the second medical image, A medical image creation apparatus comprising: a determination unit that determines whether or not a range is completely included; and a notification unit that notifies a determination result of the determination unit.

  The invention of the second aspect is the invention of the first aspect, further comprising a treatment object display setting unit for displaying a treatment object display indicating a treatment object on the first medical image, wherein the treatment range determination unit is the treatment object A medical image creating apparatus characterized in that a treatment range is determined based on a display.

  The invention of the third aspect is the invention of the first or second aspect, further comprising: a treatment range display setting unit that displays a treatment range display indicating the treatment range on at least one of the first medical image and the second medical image. A medical image creation apparatus including the medical image creation apparatus.

  The invention of the fourth aspect is characterized in that in the invention of any one of the first to third aspects, there is provided a treatment mark display setting unit for displaying a treatment mark display indicating a range of treatment marks on the second medical image. A medical image creation apparatus.

  The invention of the fifth aspect is the invention of the fourth aspect, wherein the treatment object display is superimposed on the second medical image on which the treatment mark display is displayed or the treatment object display is displayed. And a superimposing unit that superimposes and displays the treatment mark display on the first medical image.

  The invention of the sixth aspect includes a medical image creation unit that creates a first medical image in a subject before the start of treatment and a second medical image in the subject after the start of treatment, and a treatment in the first medical image. A treatment range determining unit for determining a treatment range so as to have a predetermined margin for the subject, a treatment range display setting unit for displaying a treatment range display indicating the treatment range on the second medical image, and the second medical use A medical image creating apparatus comprising: a treatment mark display setting unit that displays a treatment mark display indicating a range of treatment marks in an image on the second medical image.

  The invention of the seventh aspect includes a medical image creation unit that creates a first medical image in a subject before the start of treatment and a second medical image in the subject after the start of treatment, and a treatment in the first medical image. A treatment range determination unit for determining a treatment range so as to have a predetermined margin for a subject, a treatment range display setting unit for displaying a treatment range display indicating the treatment range on the first medical image, and the second medical use An apparatus for creating a medical image, comprising: a superposition unit that superimposes and displays a treatment mark display indicating a treatment mark range on an image on the first medical image on which the treatment range display is displayed.

  The invention according to an eighth aspect is the invention according to any one of the third to seventh aspects, wherein the treatment range display setting unit includes the treatment range in at least one of the first medical image and the second medical image in real time. A medical image creation apparatus characterized by displaying a display.

  A ninth aspect of the invention provides a medical image creation apparatus that displays a medical image, and a medical image creation device that creates a first medical image before treatment in a subject and a second medical image during or after treatment in the subject. An image creation function, a treatment range determination function for determining a treatment range so as to have a predetermined margin with respect to a treatment target in the first medical image, and a treatment mark in the second medical image completely cover the treatment range. A program for executing a determination function for determining whether or not the information is included and a notification function for notifying a determination result of the determination unit.

  A tenth aspect of the invention is a medical image creating apparatus that displays a medical image, and a medical image for creating a first medical image before starting treatment in the subject and a second medical image after starting treatment in the subject. A creation function, a treatment range determination function for determining a treatment range so as to have a predetermined margin with respect to a treatment target in the first medical image, and a treatment range display indicating the treatment range are displayed on the second medical image. A program for executing a treatment range display setting function and a treatment mark display setting function for displaying a treatment mark display indicating a treatment mark range in the second medical image on the second medical image.

  According to an eleventh aspect of the present invention, a medical image creating apparatus for displaying a medical image creates a first medical image before starting treatment in a subject and a second medical image after starting treatment in the subject. A creation function, a treatment range determination function for determining a treatment range so as to have a predetermined margin with respect to a treatment target in the first medical image, and a treatment range display indicating the treatment range are displayed on the first medical image. A treatment range display setting function, and a superposition function for displaying a treatment mark display indicating a treatment mark range in the second medical image on the first medical image on which the treatment range display is displayed. It is a program characterized by this.

  According to the present invention, it is determined whether or not a treatment mark in the second image completely includes a treatment range determined to have a predetermined margin with respect to a treatment target in the first medical image. When the unit determines and the notification unit notifies the determination result, it can be easily recognized whether or not an appropriate range has been treated.

  The treatment range display setting unit displays the treatment range display on the second medical image, and the treatment mark display setting unit displays the treatment mark display on the second medical image. Since the treatment range display and the treatment mark display are superimposed and displayed on the medical image, the operator can easily recognize whether or not an appropriate range has been treated.

  The treatment range display setting unit causes the treatment range display to be displayed on the first medical image, and the superimposing unit superimposes the treatment mark display on the first medical image on which the treatment range display is displayed. Thus, the operator can easily recognize whether or not an appropriate range has been treated.

  In addition, by displaying the treatment range display on at least one of the first medical image and the second medical image in real time, the operator can use the treatment range display as a guide while viewing the first medical image or the second medical image. Can be treated.

1 is a block diagram showing a schematic configuration of an ultrasonic diagnostic apparatus which is an embodiment of a medical image creation apparatus according to the present invention. It is a block diagram which shows the structure of a part of ultrasonic diagnostic apparatus shown in FIG. It is a flowchart at the time of displaying an ultrasonic image on the ultrasonic diagnostic apparatus of 1st embodiment, and performing a treatment and a diagnosis. It is a figure which shows the 1st ultrasonic image by which the treatment target display was displayed in step S2 of the flowchart shown in FIG. It is a figure which shows the 2nd ultrasonic image by which the treatment trace display was displayed in step S4 of the flowchart shown in FIG. It is a figure which shows the 2nd ultrasonic image by which the treatment object display and the treatment trace display were superimposed and displayed in step S5 of the flowchart shown in FIG. It is a flowchart which shows an example of the detailed process in step S5 of the flowchart shown in FIG. It is a figure which shows the 1st ultrasonic image and 2nd ultrasonic image which were displayed side by side in step S501 of the flowchart shown in FIG. FIG. 9 is a diagram showing a state in which the first cursor is set to the branch point of the blood vessel in the first ultrasonic image from the state shown in FIG. 8 in step 502 of the flowchart shown in FIG. 7. FIG. 10 is a diagram showing a state in which the second cursor is set to the branch point of the blood vessel in the second ultrasonic image from the state shown in FIG. 9 in step S503 of the flowchart shown in FIG. FIG. 10 is a diagram illustrating a state in which a treatment target display is displayed on the second ultrasonic image from the state illustrated in FIG. 10 in step S504 of the flowchart illustrated in FIG. 7. It is a flowchart which shows the other example of the detailed process in step S5 of the flowchart shown in FIG. FIG. 13 is a diagram showing a state in which two first cursors are aligned with a first branch point and a second branch point of a blood vessel in the first ultrasonic image in step S512 of the flowchart shown in FIG. FIG. 13 is a diagram showing a state in which two second cursors are aligned with the first branch point and the second branch point of the blood vessel in the second ultrasonic image from the state shown in FIG. 13 in step S513 of the flowchart shown in FIG. It is a figure which shows the state by which the treatment target display was displayed on the 2nd ultrasonic image from the state shown in FIG. 14 in step S504 of the flowchart shown in FIG. It is a figure which shows the 2nd ultrasonic image by which the treatment range display was displayed in step S6 of the flowchart shown in FIG. It is a conceptual diagram for demonstrating the determination method in step S7 of the flowchart shown in FIG. FIG. 4 is a diagram showing a second ultrasonic image in a state where a region not included in the region surrounded by the treatment mark display is displayed in color in the region surrounded by the treatment range display in step S8 of the flowchart shown in FIG. 3. is there. It is a flowchart at the time of performing a treatment and a diagnosis by displaying an ultrasonic image on the ultrasonic diagnostic apparatus of the second embodiment. It is a figure which shows the 1st ultrasonic image by which the treatment object display was displayed in step S12 of the flowchart shown in FIG. It is a figure which shows the 1st ultrasonic image by which the treatment range display was displayed in step S13 of the flowchart shown in FIG. It is a figure which shows the 2nd ultrasonic image in which the treatment trace was displayed in step S15 of the flowchart shown in FIG. FIG. 20 is a diagram showing a second ultrasonic image in a state where a region not included in the region surrounded by the treatment mark display is displayed in color in the region surrounded by the treatment range display in step S <b> 17 of the flowchart shown in FIG. 19. is there.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. In the embodiments described below, an ultrasonic diagnostic apparatus will be described as a medical image creation apparatus according to the present invention. In this example, a case where radiofrequency ablation treatment is performed as treatment will be described.

(First embodiment)
First, a first embodiment will be described with reference to FIGS. As shown in FIG. 1, an ultrasonic diagnostic apparatus 1 of this example scans a scan surface by driving an ultrasonic probe 2 that transmits and receives ultrasonic waves, and the ultrasonic probe 2. The transmission / reception unit 3 that performs signal processing such as phasing and addition processing on the echo signal obtained in step 1 to obtain a sound ray signal, and the sound ray signal output from the transmission / reception unit 3 performs logarithmic compression processing and envelope detection processing A B-mode processing unit 4 that performs signal processing such as the above, and an ultrasonic image (B-mode image) to be displayed on a display unit 6 to be described later based on an output signal from the B-mode processing unit 4 are created and displayed The image display control part 5 which performs the control etc. which are displayed on the part 6 and the display part 6 on which an ultrasonic image is displayed are provided.

  The ultrasonic diagnostic apparatus 1 includes a control unit 7 that controls the entire apparatus, a storage unit 8 that stores data such as ultrasonic image data and programs, a keyboard, and a pointing device, and an operator inputs instructions. And an operation unit 9 for performing the operation. The control unit 7 is configured by a CPU (Central Processing Unit), and executes functions in each unit of the ultrasonic diagnostic apparatus 1 by executing a control program stored in the storage unit 8. . The function in each part will be described later.

  As shown in FIG. 2, the image display control unit 5 includes an image creation unit 51, a treatment target display setting unit 52, a treatment mark display setting unit 53, a superposition unit 54, a treatment range determination unit 55, and a treatment range display setting unit 56. And a determination unit 57 and a determination result display setting unit 58. Each configuration will be described below.

  The image creating unit 51 creates an ultrasonic image of the subject displayed on the display unit 6. The image creating unit 51 is an example of an embodiment of a medical image creating unit in the present invention. Here, an ultrasonic image before starting radiofrequency ablation treatment on the subject, that is, a state where no treatment is performed, is referred to as a first ultrasonic image G1, while an ultrasonic image after the start of treatment is referred to as a first ultrasonic image. It is assumed to be two ultrasonic images G2. The first ultrasonic image G1 is an example of the embodiment of the first medical image in the present invention, and the second ultrasonic image G2 is an example of the embodiment of the second medical image in the present invention.

  The treatment object display setting unit 52 displays a treatment object display indicating the treatment object A such as a tumor on the first ultrasonic image G1. In this example, the treatment target display is a treatment target instruction line T1 (see FIG. 4) indicating the outline of the treatment target A with a solid line. The treatment target instruction line T1 is set based on position information of the first cursor C1 (see FIG. 4) displayed in the first ultrasonic image G1. The position information of the first cursor C1 is input from the pointing device of the operation unit 9 to the image display control unit 5 via the control unit 7. The treatment object display setting unit 52 is an example of an embodiment of a treatment object display setting unit in the present invention.

  The treatment mark display setting unit 53 displays a treatment mark display indicating the range of the treatment mark B on the second ultrasonic image G2. In this example, the treatment mark display is a treatment mark instruction line T2 (see FIG. 5) indicating the outline of the treatment mark B with a solid line. The treatment mark instruction line T2 is set by inputting position information of the second cursor C2 (see FIG. 5) displayed on the second ultrasonic image G2 from the pointing device. The treatment mark display setting unit 53 is an example of an embodiment of a treatment object display setting unit in the present invention.

  The superimposing unit 54 displays the treatment target instruction line T1 displayed on the first ultrasonic image G1 on the second ultrasonic image G2. The superimposition unit 54 superimposes and displays the treatment target instruction line T1 and the treatment mark instruction line T2 in the second ultrasonic image G2. The superimposing unit 55 displays the treatment target instruction line T1 at the same position as the display position in the first ultrasonic image G1 with a magnification. The superimposing unit 54 is an example of an embodiment of the superimposing unit in the present invention.

  The treatment range determination unit 55 determines a treatment range, that is, a range to be cauterized in the radiofrequency ablation treatment. The treatment range determination unit 55 determines a treatment range so as to be larger than the treatment target A, that is, to have a predetermined margin with respect to the treatment target A, and the treatment target instruction line T1 The treatment range is determined based on the above. The treatment range determination unit 55 is an example of an embodiment of a treatment range determination unit in the present invention.

  The treatment range display setting unit 56 displays a treatment range display U indicating the treatment range determined by the treatment range determination unit 55 on the second ultrasonic image G2. In this example, the treatment range display U is indicated by a broken line (see FIG. 16). The treatment range display U is a display showing the outline of the treatment range. The treatment range display setting unit 56 is an example of an embodiment of a treatment range display setting unit in the present invention.

  The determination unit 57 determines whether or not the treatment mark B completely includes the treatment range. Specifically, the determination unit 57 determines whether or not the treatment mark instruction line T2 completely includes the treatment range display U. Details will be described later. The determination unit 57 is an example of an embodiment of a determination unit in the present invention.

  When it is determined by the determination unit 57 that the treatment mark instruction line T2 does not completely include the treatment range display U, the determination result display setting unit 58 displays the determination result as the second ultrasonic image. Display on G2. Specific display will be described later. The determination result display setting unit 58 is an example of an embodiment of a notification unit in the present invention.

  Now, a flow for performing treatment and diagnosis by displaying an ultrasound image in the ultrasound diagnostic apparatus 1 of the first embodiment will be described. In FIG. 3, first, in step S <b> 1, a real-time first ultrasonic image G <b> 1 before treatment is displayed on the display unit 6. More specifically, ultrasound is transmitted / received to / from a subject before treatment using the ultrasound probe 2, and the image creation unit 51 is based on the obtained echo signal, and the image creating unit 51 A sound wave image G1 is created and displayed on the display unit 6.

  Next, in step S2, the operator traces the contour of the treatment object A that appears in the first ultrasonic image G1, so that the treatment object display setting unit 52 is configured as shown in FIG. A treatment target instruction line T1 is displayed on the first ultrasonic image G1. Specifically, first, the operator operates the operation unit 9 to freeze the real-time first ultrasonic image G1 displayed on the display unit 6. When the treatment target A is a tumor, the tumor has a lower luminance than the normal tissue and appears black in the first ultrasonic image G1, which is a B-mode image. Therefore, the operator operates the operation unit 9 to display the first cursor C1 on the first ultrasonic image G1, and then uses the pointing device of the operation unit 9 to display the first cursor C1. And move along the contour of the treatment object A that appears black. Thereby, the locus of the first cursor C1 is displayed as the treatment target instruction line T1. The first ultrasonic image G1 on which the treatment target instruction line T1 is displayed is stored in the storage unit 8 via the control unit 7.

  Next, in step S3, ablation treatment of the treatment target A is performed. Specifically, first, the freeze of the first ultrasonic image G1 is canceled. When the freeze of the first ultrasonic image G1 is released, the treatment object display setting unit 52 does not display the treatment object instruction line T1. Then, the operator inserts a puncture needle (not shown) from the body surface of the subject while observing the first ultrasonic image G1 displayed on the display unit 6, and radiates a radio wave from the puncture needle. Start cauterization treatment. Incidentally, the ultrasonic image after the start of the cauterization treatment is the second ultrasonic image G2.

  Note that the timing for not displaying the treatment target instruction line T1 may be performed by an instruction from the operation unit 9, even after the freeze of the first ultrasonic image G1 is released, For example, the treatment target instruction line T1 may be displayed until the puncture needle is inserted. Further, the treatment target instruction line T1 may be kept displayed during the cauterization treatment. However, in this case, even if the imaging position of the first ultrasound image G1 or the second ultrasound image G2 displayed in real time is shifted, the treatment object display setting unit 52 does not change the first ultrasound image. The treatment target instruction line T1 is continuously displayed at a fixed position in the image G1 or the second ultrasonic image G2.

  Even after the ablation treatment is completed in step S3, the second ultrasonic image G2 is displayed on the display unit 6 in the same manner as before the ablation treatment. In step S4, the operator traces the contour of the treatment mark B appearing in the second ultrasonic image G2, so that the treatment mark display setting unit 53, as shown in FIG. A treatment mark instruction line T2 is displayed on the sound wave image G2. Specifically, first, the operator operates the operation unit 9 to freeze the real-time second ultrasonic image G2 displayed on the display unit 6. In the second ultrasonic image G2, the treatment mark B has a lower luminance than the surrounding tissue and appears black. Therefore, the operator operates the operation unit 9 to display the second cursor C2 on the second ultrasonic image G2, and then uses the pointing device of the operation unit 9 to display the second cursor C2. And move along the contour of the treatment mark B appearing black. Thereby, the locus of the second cursor C2 is displayed as the treatment mark instruction line T2.

  Next, in step S5, as shown in FIG. 6, the superimposing unit 54 adds the treatment target instruction line T1 to the second ultrasonic image G2 as a still image on which the treatment mark instruction line T2 is displayed. Display. The superimposing unit 54 causes the treatment target instruction line T1 to be displayed at the same position as the display position of the first ultrasonic image G1 with a magnification. Here, the imaging positions of the first ultrasonic image G1 and the second ultrasonic image G2 in the subject may be misaligned. Accordingly, after the first ultrasonic image G1 and the second ultrasonic image G2 are aligned, the treatment target instruction line T1 is displayed on the second ultrasonic image G2. This will be specifically described below.

  First, details of the processing in step S5 when the first ultrasonic image G1 and the second ultrasonic image G2 are displaced in parallel without rotation will be described based on the flow of FIG. . In FIG. 7, in step S501, the control unit 7 reads the first ultrasonic image G1 stored in the storage unit 8, and outputs the first ultrasonic image G1 to the image creation unit 51. The image creation unit 51 As shown in FIG. 8, the display unit 6 displays the first ultrasonic image G1 and the second ultrasonic image G2 side by side.

  Next, in step S502, in the first ultrasonic image G1, as shown in FIG. 9, a characteristic portion such as a branch point BL1 of the blood vessel BL (not shown in FIGS. 4 to 6) is displayed by the operator. When the position of the first cursor C1 is determined and the position is fixed, the superimposing unit 54 stores the positional relationship information between the first cursor C1 and the sampling point on the treatment target instruction line T1. Next, in step S503, as shown in FIG. 10, in the second ultrasonic image G2, the operator aligns the second cursor C2 with the branch point BL1 of the blood vessel BL and determines its position. Position information of the second cursor C2 is input to the superimposing unit 54.

  Next, in step S504, the superimposing unit 54, based on the positional relationship information stored in step S502 with respect to the position of the cursor C2, in the second ultrasonic image G2, as shown in FIG. The treatment target instruction line T1 is displayed at the position specified in the above. Incidentally, the first ultrasonic image G1 and the second ultrasonic image G2 are displayed at the same magnification, and the treatment target instruction line T1 is the same size as the size displayed on the first ultrasonic image G1. Now, it is displayed on the second ultrasonic image G2. If the display magnifications of the first ultrasonic image G1 and the second ultrasonic image G2 are different, the superimposing unit 54 displays the treatment target display instruction line T1 on the first ultrasonic image G1. The second ultrasonic image G2 is displayed by being enlarged or reduced so as to have a size corresponding to the size.

  Next, detailed processing in step S5 when the first ultrasonic image G1 and the second ultrasonic image G2 are displaced with rotation will be described based on the flow of FIG. First, in step S511, as in step S501 of the flow shown in FIG. 7, the image creating unit 51 displays the first ultrasonic image G1 and the second ultrasonic image G2 side by side on the display unit 6. Let Next, in step S512, as shown in FIG. 13, the operator moves the first cursors C11 and C12 to, for example, the first branch point BL1 and the second branch point BL2 of the blood vessel BL in the first ultrasonic image G1. When the position is fixed together, the superimposing unit 54 determines the positional relationship information between the first cursor C11 and the first cursor C12, the distance D1 from the first branch point BL1 to the point P, and the second branch. The distance information about the distance D2 from the point BL2 to the point P is stored. Incidentally, the point P is an arbitrary point in the region surrounded by the treatment target instruction line T1, and is designated in advance by the operator, for example. When a point P is designated, information on the positional relationship between the point P and the sampling point on the treatment target instruction line T1 is stored.

  Next, in step S513, as shown in FIG. 14, the operator moves the second cursors C21 and C22 to the first branch point BL1 and the second branch point BL2 of the blood vessel BL in the second ultrasonic image G2. At the same time, confirm the position. Position information of the cursors C21 and C22 is input to the superimposing unit 54. Next, in step S514, the superimposing unit 54 displays the treatment target instruction line T1 on the second ultrasonic image G2, as shown in FIG. More specifically, the superimposing portion 54 is located at a position at a distance D1 from the second cursor C21 and at a position at a distance D2 from the second cursor C22 (the second cursor indicated by a one-dot chain line). A point P ′ at the same position as the point P in the first ultrasonic image G1 is an intersection of a circle having a radius D1 centered on C21 and a circle having a radius D2 centered on the second cursor C22. As specified. When the position of the point P ′ is specified in this way, the superimposing unit 54 is based on positional relationship information between the point P in the first ultrasonic image G1 and the sample point of the treatment target instruction line T1. The treatment target instruction line T1 is displayed on the second ultrasonic image G2. At this time, similarly to the case described in the flow of FIG. 7, the superimposing unit 54 sets the size of T1 in consideration of the display magnification of the ultrasonic image G1 and the ultrasonic image G2.

  Incidentally, in specifying the point P ′, there are two intersections of a circle having a radius D1 centered on the cursor C21 and a circle having a radius D2 centered on the cursor C22, which is indicated by a one-dot chain line. (Only one is shown in FIG. 15). Which point of intersection is the point P ′ is determined based on the positional relationship between the first branch point BL1 and the second branch point BL2, that is, the stored positional relationship between the cursor C11 and the cursor C12. Note that the circle with the radius D1 centered on the cursor C21 and the circle with the radius D2 centered on the cursor C22 shown in FIG. 15 are not actually displayed on the display unit 6.

  When the imaging positions of the first ultrasonic image G1 and the second ultrasonic image G2 in the subject are not shifted, the superimposing unit 54 does not perform the alignment as described above, The display position of the treatment target instruction line T1 in the two ultrasonic images G2 may be the same coordinates as the coordinates in the first ultrasonic image G1.

  When the treatment target instruction line T1 is displayed on the second ultrasonic image G2 as described above, only the second ultrasonic image G2 is displayed on the display unit 6 without displaying the first ultrasonic image G1. The operator inputs an instruction in the operation unit 9 so as to be displayed. Accordingly, the second ultrasonic image G2 is displayed on the display unit 6 as shown in FIG.

  In this way, when the treatment target instruction line T1 is displayed on the second ultrasonic image G2 in step S5, the treatment range display setting unit 56, as shown in FIG. The treatment range display U is displayed on the sound wave image G2. The treatment range display setting unit 56 displays the treatment range display U similar to the treatment range trace T1 so as to have a predetermined margin with respect to the treatment range trace T1. The predetermined margin may be stored in advance, or may be input from the operation unit 9 by an operator.

  Next, in step S7, the determination unit 57 determines whether or not the treatment mark instruction line T2 completely includes the treatment range display U. An example of a specific determination method will be described with reference to FIG. 17. The determination unit 57 assumes a plurality of straight lines L1, L2, and L3 parallel to each other in the second ultrasonic image G2, and these straight lines L1. , L2 and L3, and the above-described determination based on the positional relationship of the intersections of the treatment range display U and the treatment mark instruction line T2. More specifically, the determination unit 57 determines that the intersections QA and QB of the straight lines L1, L2, and L3 and the treatment range display U are the straight lines L1, L2, and L3. It is determined whether or not it is included between the intersections RA and RB between L3 and the treatment mark instruction line T2. If any one of the intersection points QA and QB is not included between the intersection points RA and RB, the straight line is regarded as an error. For example, in the straight line L1, the intersection point QB is included between the intersection points RA and RB, but the intersection point QA is not included between the intersection points RA and RB. Therefore, the determination unit 57 sets the straight line L1 as an error. In addition, since the straight line L2 includes both the intersection points QA and QB between the intersection points RA and RB, the determination unit 57 does not make the straight line L2 an error. In addition, since the intersection points RA and RB do not exist in the straight line L3, and the intersection points QA and QB are not included between the intersection points RA and RB, the determination unit 57 makes the straight line L3 an error. To do. The straight lines L1 to L3 are examples, and the determination unit 57 determines a predetermined number of straight lines parallel to each other in the second ultrasonic image G2, and determines whether each of the straight lines has the error described above. If there is also an error straight line in this book, it is determined that the treatment mark instruction line T2 does not completely include the treatment range display U.

  If it is determined in step S7 that the treatment mark instruction line T2 completely includes the treatment range display U (YES in FIG. 3), an appropriate range has been ablated, and treatment and diagnosis are performed. Ends. In this case, the determination result display setting unit 56 may display that the appropriate range has been cauterized on the display unit 6 although not particularly illustrated.

  On the other hand, when it is determined in step S7 that the treatment mark instruction line T2 does not completely include the treatment range display U (NO in FIG. 3), the process proceeds to step S8. In step S8, the determination result display setting unit 56 displays the determination result in step S7. Specifically, the determination result display setting unit 56 is not included in the region surrounded by the treatment mark instruction line T2 in the region surrounded by the treatment range display U as shown in FIG. Regions Z1 and Z2 are shown in color. The determination result display setting unit 56 performs color display by specifying the regions Z1 and Z2 based on the information used in the determination by the determination unit 57 in step S7.

  In step S8, when color display of the areas Z1 and Z2 is performed, the process returns to step S3, and the operator performs cauterization treatment again. Thereafter, the same processing as described above is performed.

  According to the first embodiment described above, in the region surrounded by the treatment range display U, the region that is not included in the region surrounded by the treatment mark instruction line T2 is displayed in color. It is possible to easily recognize whether or not an appropriate range has been ablated.

  Next, a modification of the first embodiment will be described. In this modification, after the treatment range display U is displayed in step S6, the determination unit 57 determines whether or not the treatment mark instruction line T2 completely includes the treatment range display U in step S7. Instead, the operator may make a visual decision. If the treatment mark instruction line T2 completely includes the treatment range display U, the process ends. If not completely, the process proceeds to step S3 without performing step S8. Returning, the processing after step S3 is performed again.

(Second embodiment)
Next, a second embodiment will be described based on FIGS. The configuration of the ultrasonic diagnostic apparatus of this example is the same as that of the first embodiment, and a description thereof is omitted.

  In the second embodiment, unlike the first embodiment, treatment is performed while viewing the real-time second ultrasonic image G2 on which the treatment range display U is displayed. A flow when displaying an ultrasonic image in the ultrasonic diagnostic apparatus 1 of the second embodiment will be described based on FIG.

  In FIG. 19, first, in step S11, a real-time first ultrasonic image G1 before treatment is displayed on the display unit 6 as in the first embodiment. Next, in step S12, as in the first embodiment, as shown in FIG. 20, the operator freezes the first ultrasonic image G1 and displays the treatment target instruction line T1.

  Next, in step S13, as shown in FIG. 21, the treatment range display setting unit 56 displays the treatment range display U on the first ultrasonic image G1 in the same manner as in step S5 of the first embodiment. Let In step S14, after releasing the freeze of the first ultrasonic image G1, the ablation treatment of the treatment target A is started. In this example, even if the freeze of the first ultrasonic image G1 is released, the treatment target display setting unit 52 and the treatment range display setting unit 56 display the treatment target instruction line T1 and the treatment range display U, respectively. The first ultrasonic image G1 in real time is displayed. Even after the start of the cauterization treatment, the treatment target display setting unit 52 and the treatment range display setting unit 56 display the treatment target instruction line T1 and the treatment range display U on the second ultrasonic image G2 in real time. Continue to display. Thereby, the operator can perform cauterization treatment using the treatment range display U as a guide.

  Here, although the first ultrasonic image G1 and the second ultrasonic image G2 are real-time images, the treatment object display setting unit 52 and the treatment range display setting unit 56 are configured to display the treatment object instruction line T1 and the treatment object instruction line T1. The treatment range display U is displayed at a fixed position in the first ultrasonic image G1 and the second ultrasonic image G2. Therefore, it is desirable that the position of the ultrasonic image G1 and the position of the ultrasonic image G2 in the subject are not shifted as much as possible with the passage of time. For this reason, it is desirable for the operator to transmit and receive ultrasonic waves so that the position and angle of the ultrasonic probe 2 are not changed as much as possible.

  Next, in step S15, the treatment mark display setting unit 53 displays the treatment mark instruction line T2 on the second ultrasonic image G2, as shown in FIG. As in the first embodiment, the treatment mark display setting unit 53 causes the operator to move the cursor (not shown in this example) along the treatment mark B to display the treatment mark instruction line T2. Alternatively, the treatment mark B may be automatically detected and the treatment mark instruction line T2 may be displayed. Specifically, since the treatment mark B has a lower brightness than the surroundings, the treatment mark display setting unit 53 uses a predetermined brightness value that is set in advance in the second ultrasonic image G2. A portion having a low luminance value is detected, and the treatment mark instruction line T2 is displayed on the contour portion. The treatment mark display setting unit 53 detects the luminance value every frame or every several frames and displays the treatment mark instruction line T2. Thereby, the treatment mark instruction line T2 is displayed in real time during cauterization. Therefore, it can be observed that the treatment mark indicating line T2 becomes larger as the treatment mark becomes larger as the ablation progresses.

  Incidentally, the range in which the treatment mark B is automatically detected may be limited to a part of the second ultrasonic image G2. In this case, for example, when the operator uses the pointing device or the like to designate a point in the region that is considered to be the treatment mark B, the treatment mark display setting unit 53 sets an area in a predetermined range centered on this point. The treatment mark B may be automatically detected within the detection range specified as the detection range.

  Next, in step S16, it is determined whether or not the treatment mark instruction line T2 completely includes the treatment range display U. This determination is performed by the determination unit 57 as in step S7 of the first embodiment.

  If it is determined in step S16 that the treatment mark instruction line T2 completely includes the treatment range display U (YES in FIG. 19), an appropriate range has been ablated, and treatment and diagnosis are performed. Ends.

  On the other hand, when it is determined in step S16 that the treatment mark instruction line T2 does not completely include the treatment range display U (NO in FIG. 19), the process proceeds to step S17. In step S17, as shown in FIG. 23, as in step S8 of the first embodiment, in a region surrounded by the treatment range display U, a region Z3 not included in the treatment mark instruction line T2 is colored. Is displayed. Then, when the process of step S17 ends, the process returns to step S14.

  Incidentally, as in the modification of the first embodiment, instead of the determination unit 57 performing the determination in step S16, whether or not the treatment mark instruction line T2 completely includes the treatment range display U is determined. The operator may make a judgment visually. If the treatment mark instruction line T2 completely includes the treatment range display U, the process is terminated. If not completely included, the process proceeds to step S14 without performing step S17. Return.

  Also in the second embodiment described above, it is possible to easily recognize whether or not an appropriate range has been cauterized as in the first embodiment. In addition, ablation treatment can be performed using the treatment range display U displayed in the second ultrasonic image G2 as a guide.

  Incidentally, in the second embodiment, when the operator makes a visual determination in step S16 and does not perform the process of step S17, the determination unit 57 and the determination result display setting unit 58 are not provided. May be.

  As mentioned above, although this invention was demonstrated by each said embodiment, of course, this invention can be variously implemented in the range which does not change the main point. For example, after the treatment range is determined by the treatment range determination unit 55, whether or not a treatment mark completely includes the treatment range without displaying the treatment range display U on the display unit 6 is determined. The determination result may be displayed on the display unit 6 by, for example, characters such as “error present” and “no error”.

  In the first embodiment, the treatment range display U is displayed on the first ultrasonic image G1 on which the treatment target instruction line T1 is displayed, and the treatment range display U is also displayed on the second ultrasonic image G2. May be displayed at the same position as the first ultrasonic image G1.

  Also in the first embodiment, as described in the second embodiment, the treatment mark B may be automatically detected and the treatment mark instruction line T2 may be displayed. Furthermore, when the treatment target A is a tumor, the brightness of the tumor is lower than that of the surrounding tissue. Therefore, in the first embodiment and the second embodiment, the tumor is automatically detected in the same manner as the treatment mark B. The treatment target instruction line T1 may be displayed.

  When the treatment object A and the treatment mark B are automatically detected, the treatment object instruction line T1 and the treatment mark display instruction line T2 may not be displayed. In this case, the treatment range determination unit 55 determines a treatment range based on the detected range of the treatment target A, and the determination unit 57 determines whether or not the treatment mark B completely includes the treatment range. Then, the determination result may be displayed in characters or the like.

  In the first embodiment, instead of displaying the treatment target instruction line T1 on the second ultrasonic image G2 on which the treatment mark instruction line T2 is displayed, the treatment target instruction line T1 is stored in the storage unit 8 and the treatment target Even if the treatment range display setting unit 56 displays the treatment range display U and the superposition unit 54 displays the treatment mark instruction line T2 on the first ultrasonic image G1 on which the instruction line T1 is displayed. Good.

  In addition, when the treatment target instruction line T1 and the treatment mark instruction line T2 are superimposed and displayed in the first ultrasonic image G1 or the second ultrasonic image G2, the first ultrasonic image G1 and the second ultrasonic image G1 are displayed. The treatment target instruction line T1 and the treatment mark instruction line T2 may not be displayed at positions corresponding to each other in the two ultrasonic images G2. That is, when the treatment target instruction line T1 is displayed on the second ultrasonic image G2 on which the treatment mark instruction line T2 is displayed, it may not be displayed at the same position as the first ultrasonic image G1. . Further, when the treatment mark instruction line T2 is displayed on the first ultrasonic image G1, it may not be displayed at the same position as the second ultrasonic image G2. In this case, the first ultrasonic image G1 and the second ultrasonic image G2 are not aligned, and the treatment target instruction line T1 and the treatment mark instruction line T2 are displaced from the positions in the original image. Although displayed in a superimposed manner, the operator visually observes the treatment with reference to the size and shape of the treatment range display U and the treatment mark instruction line T2 displayed based on the treatment object instruction line T1. It is determined whether or not the mark instruction line T2 completely includes the treatment range display U.

  The present invention is not limited to an ultrasonic diagnostic apparatus, and can be applied to, for example, an X-ray CT apparatus and an MRI apparatus, and can also be applied to medical images such as an X-ray CT image and an MRI image. it can. Further, the medical image is not limited to the 2D image, and can be similarly applied to the 3D image.

1 Ultrasonic diagnostic equipment 51 Image creation unit (medical image creation unit)
52 treatment object display setting unit 53 treatment mark display setting unit 54 superposition unit 55 treatment range determination unit 56 treatment range display setting unit 57 determination unit 58 determination result display setting unit (notification unit)
G1 First ultrasound image (first medical image)
G2 Second ultrasound image (second medical image)
T1 treatment target indication line (treatment target display)
T2 treatment mark indication line (treatment mark display)
U treatment range display

Claims (11)

A medical image creation unit for creating a first medical image before the start of treatment in the subject and a second medical image after the start of treatment in the subject;
A treatment range determining unit for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A determination unit that determines whether a treatment mark in the second medical image completely includes the treatment range; and
A notification unit for reporting the determination result of the determination unit;
A medical image creating apparatus comprising: A treatment object display setting unit for displaying a treatment object display indicating a treatment object on the first medical image;
The medical image creation apparatus according to claim 1, wherein the treatment range determination unit determines a treatment range based on the treatment target display.   The medical image creation apparatus according to claim 1, further comprising a treatment range display setting unit configured to display a treatment range display indicating the treatment range on at least one of the first medical image and the second medical image. .   The medical image creation apparatus according to claim 1, further comprising a treatment mark display setting unit that displays a treatment mark display indicating a range of treatment marks on the second medical image.   The treatment target display is superimposed on the second medical image on which the treatment mark display is displayed, or the treatment mark display is superimposed on the first medical image on which the treatment target display is displayed. The medical image creation apparatus according to claim 4, further comprising: a superimposing unit that causes the image to overlap. A medical image creation unit for creating a first medical image before the start of treatment in the subject and a second medical image after the start of treatment in the subject;
A treatment range determining unit for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A treatment range display setting unit for displaying a treatment range display indicating the treatment range on the second medical image;
A treatment mark display setting unit for displaying a treatment mark display indicating a range of treatment marks in the second medical image on the second medical image;
A medical image creating apparatus comprising: A medical image creation unit for creating a first medical image before the start of treatment in the subject and a second medical image after the start of treatment in the subject;
A treatment range determining unit for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A treatment range display setting unit for displaying a treatment range display indicating the treatment range on the first medical image;
A superimposing unit for displaying a treatment mark display indicating a range of treatment marks in the second medical image superimposed on the first medical image on which the treatment range display is displayed;
A medical image creating apparatus comprising:   The said treatment range display setting part displays the said treatment range display on at least one of the said 1st medical image and said 2nd medical image in real time, The Claim 1 characterized by the above-mentioned. Medical image creation device. In the medical image creation device that displays medical images,
A medical image creation function for creating a first medical image before treatment in a subject and a second medical image during or after treatment in the subject;
A treatment range determination function for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A determination function for determining whether a treatment mark in the second medical image completely includes the treatment range; and
A notification function for notifying the determination result of the determination unit;
A program characterized by having executed. In the medical image creation device that displays medical images,
A medical image creation function for creating a first medical image in a subject before starting treatment and a second medical image in the subject after starting treatment;
A treatment range determination function for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A treatment range display setting function for displaying a treatment range display indicating the treatment range on the second medical image;
A treatment mark display setting function for displaying a treatment mark display indicating a range of treatment marks in the second medical image on the second medical image;
A program characterized by having executed. In the medical image creation device that displays medical images,
A medical image creation function for creating a first medical image in a subject before starting treatment and a second medical image in the subject after starting treatment;
A treatment range determination function for determining a treatment range so as to have a predetermined margin for a treatment target in the first medical image;
A treatment range display setting function for displaying a treatment range display indicating the treatment range on the first medical image;
A superimposition function for superimposing and displaying a treatment mark display indicating a treatment mark range in the second medical image on the first medical image on which the treatment range display is displayed;
A program characterized by having executed.

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