JP5875826B2 - X-ray diagnostic equipment - Google Patents

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus capable of capturing a parallax image.

  By performing X-ray imaging from two directions, X-ray images corresponding to the two directions (hereinafter referred to as parallax images) can be generated. By using a monitor that alternately displays parallax images and polarizing glasses that switch the angle of polarization in synchronization with the switching timing of the parallax images (hereinafter referred to as a polarization shutter method), the display is stereoscopically visible to the operator. There is technology to do.

  Stereoscopic display of devices (catheters, cauterizers, stents, balloons, guidewires, etc.) percutaneously inserted into blood vessels during interventional radiotherapy (Interventional radiology: IVR). When an operator operates and treats under the following conditions, there are the following problems. First, in order to display stereoscopically, it is necessary to generate a perspective image in two directions. For this reason, the X-ray diagnostic apparatus needs to be equipped with a complicated system such as a bifocal tube, which increases the cost of the X-ray diagnostic apparatus. Second, there is a problem that the exposure dose to the subject by fluoroscopy from two directions is twice as much as the exposure dose to the subject by fluoroscopy from one normal direction.

  In order to solve the above problems, there are the following techniques. First, a parallax image used for stereoscopic vision is generated by previously capturing blood vessel images in two directions in advance. Next, there is a technique in which a perspective image seen from one of the two directions is superimposed on the generated parallax image and displayed in a stereoscopic manner.

  Specifically, if one of the two directions is the left eye direction of the operator (hereinafter referred to as the left eye direction) and the other is the right eye direction of the operator (hereinafter referred to as the right eye direction), first, the left eye direction , A digital subtraction angiography (hereinafter referred to as DSA) image is generated (hereinafter referred to as a left-eye DSA image). Next, a DSA image is generated in the right eye direction (hereinafter referred to as a right eye DSA image). Subsequently, for example, in the left eye direction, an image obtained by subtracting an X-ray image generated by X-ray imaging before insertion of the device into the subject from a fluoroscopic image generated by X-ray fluoroscopy after the device is inserted into the subject. (Hereinafter referred to as a fluoroscopic image for the left eye) is generated. A superimposed image obtained by superimposing the left-eye perspective image on the left-eye DSA image (hereinafter referred to as a left-eye superimposed image) is generated. Finally, the left-eye superimposed image and the right-eye DSA image are displayed on the monitor in a stereoscopic manner.

  According to the above technique, in the IVR, blood vessels can be displayed in a stereoscopic manner. In addition, since the X-ray fluoroscopy when the operator operates the device is in one direction, the X-ray exposure dose to the subject by X-ray fluoroscopy from two directions can be halved.

  However, in the above technique, the left-eye perspective image is superimposed on the left-eye DSA image, but since the perspective image is not superimposed on the right-eye DSA image, information on the perspective image is input to the right eye of the operator. Not. Therefore, for example, when an operator observes a monitor by a polarization shutter method or the like, there is a problem that a portion related to a fluoroscopic image in an image displayed so as to be stereoscopically viewed is perceived by the operator to blink. In addition, the part relating to the fluoroscopic image is darker than the background DSA image, and has an unnatural appearance.

  In addition, the DSA image is input to both eyes of the operator and is perceived so as to be stereoscopically viewed. However, since the fluoroscopic image is input only to the left eye, both binocular vision of the DSA image and monocular vision of the fluoroscopic image are mixed. It will be. This mixture of binocular vision and monocular vision places a heavy burden on the operator's visual processing system. Thereby, in the said technique, there exists a problem which an operator becomes easy to get tired. In particular, in the IVR procedure (treatment, catheter insertion, etc.) performed while observing the display image for several hours, the operator has a heavy burden on the visual processing system. There is a problem that can not be tolerated.

Japanese Patent Laid-Open No. 4-166135

  An object of the present invention is to provide an X-ray diagnostic apparatus that does not require a complicated system such as a bifocal tube, can generate a stereoscopically visible image with less burden on the visual processing system. .

The X-ray diagnostic apparatus according to the present embodiment includes an X-ray generator that generates X-rays, and an X-ray that is generated from the X-ray generator and detects X-rays that have passed through a subject placed on a top plate. A detection unit; a support mechanism that movably supports the X-ray generation unit and the X-ray detector; a support mechanism drive unit that moves the support mechanism; a first imaging position with respect to the subject; Movement control for controlling the support mechanism driving unit to move the X-ray detection unit to a second imaging position different from one imaging position and one fluoroscopic position different from the first and second imaging positions. And first and second images respectively corresponding to X-ray imaging at the first and second imaging positions, and generating a first fluoroscopic image by X-ray fluoroscopy at the fluoroscopic position, An image that generates first and second superimposed images in which the fluoroscopic images are superimposed on each of the second images Raw portion, the first, characterized by comprising a display unit for displaying the second superimposed image.

FIG. 1 is a diagram illustrating a configuration of an X-ray diagnostic apparatus according to the present embodiment. FIG. 2 is a diagram illustrating an example of the outline of the moving direction of the C-arm together with the three orthogonal axes and the subject P according to the present embodiment. FIG. 3 relates to the present embodiment, and shows CRA and CAU related to the subject P viewed from the X direction and LAO and RAO related to the subject P viewed from the Y direction together with the first and second imaging positions and fluoroscopic positions. FIG. FIG. 4 relates to the present embodiment, and a procedure for generating first and second superimposed images in which a fluoroscopic image of the device is superimposed on each of the first and second angiographic images corresponding to the first and second imaging positions, respectively. It is a flowchart which shows an example. FIG. 5 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position according to the present embodiment. FIG. 6 is a schematic diagram illustrating an outline of generating the first superimposed image at the first imaging position and the second superimposed image at the second imaging position according to the present embodiment. FIG. 7 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position according to the first modification of the present embodiment. FIG. 8 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position by tilting the top plate according to the second modification of the present embodiment. FIG. 9 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position obtained by translating the top plate according to the third modification of the present embodiment. FIG. 10 relates to a fourth modification of the present embodiment, and the first and second fluoroscopic images are superimposed on the first and second digital subtraction angiographic images corresponding to the first and second imaging positions, respectively. It is a flowchart which shows an example of the procedure which produces | generates a superimposed image. FIG. 11 is a schematic diagram illustrating an outline of generating the first superimposed image at the first imaging position and the second superimposed image at the second imaging position according to the fourth modification of the present embodiment. FIG. 12 relates to a fifth modification of the present embodiment. First, first and second digital subtraction angiographic images respectively corresponding to the first and second imaging positions are superimposed on the first and second fluoroscopic images. It is a flowchart which shows an example of the procedure which produces | generates a 2nd superimposed image. FIG. 13 is a schematic diagram illustrating an outline of generating a first superimposed image at the first imaging position and a second superimposed image at the second imaging position according to the fifth modification of the present embodiment.

  Hereinafter, an X-ray diagnostic apparatus according to an embodiment of the present invention will be described with reference to the drawings. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

  FIG. 1 shows a configuration of an X-ray diagnostic apparatus 1 according to the present embodiment. The X-ray diagnostic apparatus 1 includes an X-ray generation unit 3, an X-ray detection unit 5, a support mechanism 7, a support mechanism drive unit 9, a top plate 11, a top plate drive unit 13, and a position determination unit 15. , A movement control unit 17, an image generation unit 19, an image storage unit 21, a display unit 23, an input unit 25, and a system control unit 27.

  The X-ray generator 3 includes an X-ray tube and a high voltage generator not shown. The high voltage generator generates a tube current supplied to the X-ray tube and a tube voltage applied to the X-ray tube. The high voltage generator supplies a tube current suitable for X-ray imaging and X-ray fluoroscopy to the X-ray tube, and applies a tube voltage suitable for X-ray imaging and X-ray fluoroscopy to the X-ray tube, respectively. The X-ray tube generates X-rays from the X-ray focal point (hereinafter referred to as the tube focal point) based on the tube current supplied from the high voltage generator and the tube voltage applied by the high voltage generator. .

  The X-ray detection unit 5 detects X-rays generated from the X-ray generation unit 3 and transmitted through the subject P. For example, the X-ray detection unit 5 includes a flat panel detector (hereinafter referred to as FPD). The FPD has a plurality of semiconductor detection elements. The semiconductor detection element includes a direct conversion type and an indirect conversion type. The direct conversion type is a type in which incident X-rays are directly converted into electrical signals. The indirect conversion form is a form in which incident X-rays are converted into light by a phosphor and the light is converted into an electrical signal. Electrical signals generated by a plurality of semiconductor detection elements with the incidence of X-rays are output to an analog-to-digital converter (hereinafter referred to as an A / D converter) (not shown). The A / D converter converts an electrical signal into digital data. The A / D converter outputs the digital data to a preprocessing unit (not shown). Note that an image intensifier may be used as the X-ray detection unit 5.

  The preprocessing unit performs preprocessing on the digital data output from the X-ray detection unit 5. Pre-processing includes correction of non-uniform sensitivity between channels in the X-ray detection unit 5, correction of extreme signal degradation or data loss due to an X-ray strong absorber such as metal. The preprocessed digital data is output to an image generator 19 described later.

  The support mechanism 7 supports the X-ray generation unit 3 and the X-ray detection unit 5 so as to be movable. Specifically, the support mechanism 7 includes, for example, a C arm and a C arm support unit (not shown). The C-arm mounts the X-ray generator 3 and the X-ray detector 5 so as to face each other. An Ω arm may be used instead of the C arm. The C arm support part supports the C arm so as to be slidable in a direction along the C shape (hereinafter referred to as a first direction). The C-arm support unit supports the C-arm so as to be rotatable in a direction orthogonal to the first direction (hereinafter referred to as the second direction) around the connection portion between the C-arm and the C-arm support. Note that the C-arm support portion can also support the C-arm so as to be able to translate in the lateral direction (hereinafter referred to as the X direction) and the longitudinal direction (hereinafter referred to as the Y direction) of the top plate described later. .

  FIG. 2 is a diagram showing an example of the outline of the moving direction of the C arm together with three orthogonal axes (X axis, Y axis, Z axis) and the subject P. In FIG. 2, the first direction is indicated by a first oblique position (hereinafter referred to as “RAO”) and a second oblique position (hereinafter referred to as “LAO”). The second direction is indicated by a head direction (CRAnal: hereinafter referred to as CRA) and a tail direction (CAUdal: hereinafter referred to as CAU). RAO, LAO, CRA, and CAU are represented by angles. The X axis in FIG. 2 is the transverse direction (X direction) of the top board. The Y axis in FIG. 2 is the longitudinal direction (Y direction) of the top plate.

  The support mechanism drive unit 9 drives the support mechanism 7 under the control of a movement control unit 17 described later. Specifically, the support mechanism drive unit 9 supplies a drive signal corresponding to the control signal from the movement control unit 17 to the C arm support unit, slides the C arm in the first direction (LAO or RAO), Rotate in two directions (CRA or CAU).

  During X-ray fluoroscopy and X-ray imaging, a subject P placed on the top 11 is placed between the X-ray generator 3 and the X-ray detector 5.

  The top plate drive unit 13 moves the top plate 11 by driving the top plate 11 under the control of a movement control unit 17 described later. Specifically, the top plate driving unit 13 is based on a control signal from the movement control unit 17 in the transverse direction of the top plate 11 (X direction in FIG. 2) or the longitudinal direction of the top plate 11 (Y direction in FIG. 2). ) Slide the top plate 11. Moreover, the top-plate drive part 13 raises / lowers the top-plate 11 regarding a perpendicular direction (Z direction of FIG. 2). In addition, the top plate drive unit 13 rotates the top plate 11 to tilt the top plate 11 with at least one of the longitudinal direction and the lateral direction as a rotation axis (X axis, Y axis in FIG. 2). .

  The position determination unit 15 determines the first and second imaging positions based on the fluoroscopic position of the subject P, the reference position, and a predetermined parallax angle set in advance by the input unit 25 described later. The reference position is, for example, the origin of three orthogonal axes in FIG. The parallax angle is an angle range smaller than the stereoscopic view possible range. Specifically, the parallax angle is an angle between the first shooting position and the second shooting position with respect to the reference position. The predetermined parallax angle is stored in advance in a storage unit (not shown). The predetermined parallax angle can be input via the input unit 25 described later. In addition, the predetermined parallax angle can be changed as appropriate in a stereoscopic image generation function described later. In addition, instead of the predetermined parallax angle, the distance between the first photographing position and the fluoroscopic position (hereinafter referred to as the first distance) and the distance between the second photographing position and the fluoroscopic position (hereinafter referred to as the second distance). And may be used.

  The stereoscopic viewable range is a range of parallax angles that can be stereoscopically viewed. That is, two X-ray images generated by X-ray imaging at two different imaging positions are an angle range that is recognized by the operator as stereoscopic vision. Note that the distance between two different shooting positions may be used instead of the angle range. This angle range is, for example, an angle between a straight line connecting the tube focus and the center of the FPD at the first shooting position and a straight line connecting the tube focus and the center of the FPD at the second shooting position is 0. An angle range of 2 ° to 20 °.

  Specifically, the position determination unit 15 includes the fluoroscopic position within a predetermined parallax angle, and the first and first parallax angles so that the angle between the first and second shooting positions with respect to the reference position becomes the predetermined parallax angle. 2 Determine the shooting position. Hereinafter, to simplify the description, it is assumed that the X-ray detector 5 is moved to the fluoroscopic position and the first and second imaging positions. More specifically, it is assumed that the center of the FPD (hereinafter referred to as the FPD center) in the X-ray detection unit 5 is moved. Specifically, the stereoscopic view possible range is, for example, the maximum value and the minimum value of the angle in the first direction (RAO and LAO) with the starting point of the arrow (RAO, LAO, CRA, CAU) in FIG. Given in. Note that the stereoscopic view possible range may be given by the maximum value and the minimum value of the angle in the second direction (CRA and CAU) starting from the perspective position. In the example of the angle range, the minimum value is 0.2 ° and the maximum value is 20 °. Hereinafter, in order to simplify the description, it is assumed that the fluoroscopic position is at the starting point of an arrow (RAO, LAO, CRA, CAU) in FIG. Also, the RAO direction angle and the LAO angle, or the CRA angle and the CAU angle are the same for the sake of simplicity. That is, the perspective position is assumed to be located at the center of the parallax angle. Note that the fluoroscopic position may be located anywhere within the parallax angle.

  FIG. 3A is a diagram showing the CRA and CAU related to the subject P viewed from the X direction, together with the first and second imaging positions and the fluoroscopic position. FIG. 3B is a diagram illustrating RAO and LAO related to the subject P viewed from the Y direction, together with the first and second imaging positions and the fluoroscopic position. Hereinafter, in order to simplify the description, it is assumed that the first shooting position is a position defined by an angle in the LAO direction, and the second shooting position is a position defined by an angle in the RAO direction. Note that CRA may be used instead of LAO, and CAU may be used instead of RAO. For example, when 4 ° is input as the stereoscopic angle range via the input unit 25 described later, the angle in the LAO direction and the angle in the RAO direction are both 2 °. The position determination unit 15 outputs the determined first and second imaging positions and the position information of the fluoroscopic position to the image generation unit 19 described later. When the parallax angle is 4 ° and the angle in the LAO direction and the angle in the RAO direction are 2 °, the operator can naturally observe stereoscopically.

  The movement control unit 17 controls the support mechanism driving unit 9 to position the FPD center at the first and second imaging positions and the fluoroscopic position by the rotation of the support mechanism 7. Specifically, the movement control unit 17 outputs a control signal for positioning the FPD center at the first photographing position determined by the position determination unit 15 to the support mechanism driving unit 9. The movement control unit 17 uses a system that will be described later as a signal indicating that X-ray imaging of the subject P is possible when the center of the FPD has reached the first imaging position (hereinafter referred to as an imaging enabled signal). Output to the control unit 27.

  The movement control unit 17 sends a control signal for positioning the FPD center at the second imaging position determined by the position determination unit 15 to the support mechanism driving unit 9 when the X-ray imaging at the first imaging position ends. Output. The movement control unit 17 outputs a shootable signal to the system control unit 27 to be described later when the FPD center has reached the second shooting position.

  The movement control unit 17 outputs a control signal for positioning the FPD center at the fluoroscopic position to the support mechanism driving unit 9 when the X-ray imaging at the second imaging position ends. The movement control unit 17 outputs a shootable signal to the system control unit 27 (described later) when the FPD center has reached the fluoroscopic position. The movement control unit 17 receives a signal indicating that X-ray fluoroscopy is possible for the subject P (hereinafter referred to as fluoroscopy) when the center of the FPD reaches the fluoroscopy position or when the execution of X-ray imaging at the fluoroscopy position ends. May be output to the system control unit 27 described later.

  The image generator 19 generates a first image based on digital data preprocessed after X-ray imaging at the first imaging position. The image generator 19 generates a second image based on digital data preprocessed after X-ray imaging at the second imaging position. The image generator 19 generates a third image based on digital data preprocessed after X-ray imaging at the fluoroscopic position.

  The image generator 19 generates a fluoroscopic image based on digital data that has been pre-processed after X-ray fluoroscopy at the fluoroscopic position. The image generation unit 19 may generate a fluoroscopic image at a predetermined time interval or substantially continuously until an operation regarding the end of X-ray fluoroscopy is input via the input unit 25 described later. The image generation unit 19 generates a difference image obtained by subtracting the third image from the perspective image every time the perspective image is generated. The difference image is, for example, a device image (hereinafter referred to as a device image).

  The image generator 19 generates a first multiplied image obtained by multiplying the first image by a first coefficient R1 in order to adjust the luminance (transparency) in display on the display unit 23 described later. The image generation unit 19 generates a second multiplied image obtained by multiplying the second image by the second coefficient R2 in order to adjust the luminance (transparency) in display on the display unit 23 described later. The image generation unit 19 generates a first superimposed image in which the difference image is superimposed on the first multiplied image. The image generator 19 generates a second superimposed image in which the difference image is superimposed on the second multiplied image.

  The image generator 19 uses the ECG (ElectroCardGram) signal output from an electrocardiograph connected via an interface (not shown) to match the cardiac phases of the first and second images and the difference image. Thus, it is possible to generate the first and second superimposed images. At this time, an ECG gate method (ElectroCardio Gram trigger method) may be used.

  The image generator 19 generates a plurality of images based on a pre-processed digital data set after X-ray imaging at predetermined intervals or continuously from the first imaging position to the second imaging position. May be. The image generation unit 19 generates a plurality of images based on a digital data set that has been preprocessed after X-ray imaging is performed at predetermined intervals or continuously over a stereoscopic view range centered on the fluoroscopic position. It may occur. The digital data set is a set of a series of digital data preprocessed after X-ray imaging at predetermined intervals or continuously from the first imaging position to the second imaging position. The image generation unit 19 generates two superimposed images in which a difference image is superimposed on each of two images selected via the input unit 25 described below from among the plurality of generated images. The parallax angles regarding the two selected images are, for example, 2 °, 4 °, and 6 °. At this time, the image generation unit 19 may multiply each of the two selected images by different coefficients (for example, the first coefficient R1, the second coefficient R2, etc.) before superimposition.

  The image generation unit 19 can also add color information corresponding to the living tissue in the subject P to the generated first or second superimposed image or two superimposed images. For example, the image generation unit 19 adds color information for displaying in red on the display unit 25 described later to the pixels corresponding to the blood vessels in the superimposed image. Further, for example, the image generation unit 19 adds color information for displaying in white on the display unit 25 described later to the pixels corresponding to the bones in the superimposed image.

  The image storage unit 21 stores various images generated by the image generation unit 19. Specifically, the image storage unit 21 corresponds to the first image and the first multiplied image corresponding to the first shooting position, the second image and the second multiplied image corresponding to the second shooting position, and the fluoroscopic position. The third image, the fluoroscopic image, and the difference image are stored. The image storage unit 21 can also store the first and second superimposed images. Further, the image storage unit 21 may store a plurality of images generated between the first shooting position and the second shooting position.

  The display unit 23 displays the fluoroscopic image generated by the image generation unit 19. The display unit 23 displays the first and second superimposed images so as to be stereoscopically viewable. The display capable of stereoscopic viewing is a display using, for example, a polarization shutter system, a lenticular lens, or the like. The display unit 23 may include a glassless three-dimensional monitor. The display unit 23 can also switchably display the fluoroscopic image and the first and second superimposed images according to an instruction from the operator via the input unit 25 described later. Note that the complementary color method may be used as a stereoscopically visible display. Each of the first and second superimposed images used in the complementary color method is given color information having a complementary color relationship by the image generation unit 19.

  The input unit 25 includes an X-ray imaging condition and an X-ray fluoroscopic condition desired by the operator, a fluoroscopic position, a parallax angle, the start and end of X-ray fluoroscopy, two images used for stereoscopic display, and a fluoroscopic image. And switching between display of the first and second superimposed images. Specifically, the input unit 25 captures various instructions / commands / information / selections / settings from the operator into the X-ray diagnostic apparatus 1. The fluoroscopic position is defined by an angle with respect to the reference position, for example. For example, if the starting point of the arrows (RAO, LAO, CRA, CAU) in FIG. 2 is the perspective position and the reference position is the origin of the three orthogonal axes in FIG. 2, the angle of the perspective position is 0 °. Although not shown, the input unit 25 includes a trackball, a switch button, a mouse, a keyboard, and the like for setting a region of interest. The input unit 25 detects the coordinates of the cursor displayed on the display screen, and outputs the detected coordinates to the system control unit 27 described later. Note that the input unit 25 may be a touch panel provided so as to cover the display screen. In this case, the input unit 25 detects coordinates instructed by a touch reading principle such as an electromagnetic induction type, an electromagnetic distortion type, and a pressure sensitive type, and outputs the detected coordinates to the system control unit 27.

  Note that the input unit 25 may include a button (hereinafter referred to as a blood vessel stereoscopic button) for switching between the display of the fluoroscopic image and the display capable of being stereoscopically viewed by the first and second superimposed images. At this time, the input unit 25 outputs a signal for switching the fluoroscopic image displayed on the display unit 23 to the first and second superimposed images to the display unit 23 in response to the operation of the blood vessel stereoscopic button. Note that the input unit 25 may output a signal for executing X-ray imaging at the first and second imaging positions to the system control unit 27, which will be described later, triggered by the operation of the blood vessel stereoscopic button.

  The input unit 25 may have an imaging switch for starting X-ray imaging. At this time, the input unit 25 outputs a trigger signal for performing X-ray imaging to the system control unit 27 described later, triggered by the operation of the imaging switch. At this time, the input unit 23 outputs a signal for injecting the contrast medium into the subject P to an injector (not shown) connected via an interface (not shown) triggered by the operation of the imaging switch. Also good.

  Note that the input unit 25 may include a device stereoscopic button for generating an image related to the stereoscopic vision of the device inserted into the subject P. The input unit 25 outputs a signal for executing X-ray imaging at the first and second imaging positions to the system control unit 27 described later, triggered by operation of the device stereoscopic button.

  The input unit 25 may include a display image replacement switch. For example, when the first superimposed image as the left-eye image and the second superimposed image as the right-eye image are alternately displayed on the display unit 23, the display image replacement switch is the operator. Is operated, the second superimposed image is alternately displayed on the display unit 23 as the image for the left eye, and the first superimposed image is alternately displayed as the image for the right eye.

  The system control unit 27 includes a CPU (Central Processing Unit) and a memory (not shown). The system control unit 27 temporarily stores information such as operator instructions, imaging conditions, and fluoroscopic conditions sent from the input unit 25 in a memory (not shown). The system control unit 27 controls the X-ray generation unit 3, the movement control unit 17, and the like in order to execute X-ray imaging in accordance with an operator instruction, imaging conditions, and the like stored in the memory. Specifically, the system control unit 27 uses the X-ray to perform X-ray imaging at the first and second imaging positions and the fluoroscopic position in response to arrival of the imaging enable signal output from the movement control unit 17. The generator 3 is controlled. The system control unit 27 controls the X-ray generation unit 3 in order to execute X-ray fluoroscopy at the fluoroscopic position in response to the arrival of the fluoroscopic signal output from the movement control unit 17.

  The system control unit 27 may control the movement control unit 17 in order to place the FPD center at the first and second imaging positions in response to arrival of a signal related to the operation of the blood vessel stereoscopic button. In addition, the system control unit 27 may control the X-ray generation unit 3 in order to execute X-ray imaging in response to arrival of a signal related to the operation of the imaging button.

  In addition, the system control unit 27 is triggered by the arrival of a signal related to the operation of the device stereoscopic button, and the movement of the FPD center to the first and second imaging positions and the X-ray imaging at the first and second imaging positions are performed. In order to execute the above, the movement control unit 17 and the X-ray generation unit 3 may be controlled.

(Stereoscopic image generation function)
The stereoscopic image generation function is a first image obtained by superimposing a difference image obtained by subtracting a third image from a fluoroscopic image at a fluoroscopic position on each of the first and second images corresponding to the first and second imaging positions, respectively. This is a function for generating a second superimposed image. Hereinafter, processing related to the stereoscopic image generation function (hereinafter referred to as stereoscopic image generation processing) will be described. Note that the stereoscopic image generation process can be executed only when the operator desires stereoscopic viewing.

  FIG. 4 relates to the present embodiment, and a procedure for generating first and second superimposed images in which a fluoroscopic image of the device is superimposed on each of the first and second angiographic images corresponding to the first and second imaging positions, respectively. It is a flowchart which shows an example.

  Prior to performing IVR on the subject placed on the top 11, the fluoroscopic position is input via the input unit 25. Next, the FPD center is moved to the fluoroscopic position. X-ray imaging is executed at the fluoroscopic position triggered by the arrival of the radiographable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button. By this X-ray imaging, an X-ray image (third image) is generated (step Sa1). The third image is stored in the image storage unit 21.

  IVR is performed on the subject placed on the top 11. First, a device is inserted into the subject P. Next, when the device reaches a blood vessel branching portion or the like in complicated blood vessel traveling, a stereoscopic imaging program is activated to confirm the direction in which the device should be advanced (step Sa2). At this time, the IVR is stopped. The stereoscopic shooting program is a program related to a stereoscopic image generation process and a process of displaying the generated first and second superimposed images on the display unit 23 so as to be stereoscopically viewable. Note that the stereoscopic imaging program may be started when the blood vessel stereoscopic button or the device stereoscopic button in the input unit 25 is operated by the operator. Hereinafter, a case where the blood vessel stereoscopic button is operated will be described. The case where the device stereoscopic button is operated will be described later.

  The parallax angle is input via the input unit 25 in accordance with the activation of the stereoscopic imaging program. Based on the fluoroscopic position and the parallax angle, the first and second imaging positions are determined (step Sa3). The parallax angle may be a predetermined angle (for example, 4 °) stored in a storage unit (not shown).

  FIG. 5 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position according to the present embodiment. C in FIG. 5 indicates the FPD at the fluoroscopic position. L in FIG. 5 indicates the FPD rotated by (θ−δ) ° from C in the LAO direction (counterclockwise). The FPD center in L in FIG. 5 is the first photographing position. R in FIG. 5 indicates the FPD rotated by (δ) ° from C in the RAO direction (clockwise). The FPD center in R of FIG. 5 is the second imaging position. The parallax angle between the first shooting position and the second shooting position is θ. The parallax angle between the second photographing position and the fluoroscopic position is δ (0 <δ <θ). Hereinafter, it is assumed that the position of the tube focus when the stereoscopic photographing program is activated is C in FIG.

  When the first and second imaging positions are determined, a contrast agent is injected into the subject P (step Sa4). The injection of the contrast agent into the subject P may be interlocked with the operation of the imaging button. After the injection of the contrast agent, the FPD center is moved to the first imaging position. Specifically, the center of the FPD is moved from the fluoroscopic position (C in FIG. 5) to the first photographing position (L in FIG. 5) by the rotation of the support mechanism 7 by the support mechanism drive unit 9. The rotation angle of the support mechanism 7 is (θ−δ) ° counterclockwise.

  X-ray imaging is executed at the first imaging position after an appropriate delay time, triggered by the arrival of the radiographable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button after an appropriate time has elapsed after injection of a contrast medium. By this X-ray imaging, a first angiographic image (first image) is generated (step Sa5). The first angiographic image is an image obtained by photographing a background such as a bone and blood vessels. The first angiographic image is an image used for the left eye in stereoscopic display. A first multiplied image is generated by multiplying the first angiographic image by a first coefficient. The first multiplied image is stored in the image storage unit 21.

  After the X-ray imaging at the first imaging position, the FPD center is moved to the second imaging position. Specifically, the center of the FPD is moved from the first shooting position (L in FIG. 5) to the second shooting position (R in FIG. 5) by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° clockwise.

  X-ray imaging is executed at the second imaging position in response to the arrival of the imaging enable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button after an appropriate time has elapsed after injection of a contrast medium. A second angiographic image (second image) is generated by this X-ray imaging (step Sa6). The second angiographic image is stored in the image storage unit 21. The second angiographic image is an image in which a background such as a bone and blood vessels are photographed. The second angiographic image is an image used for the right eye in stereoscopic display. A second multiplied image is generated by multiplying the second angiographic image by the second coefficient. The second multiplied image is stored in the image storage unit 21. After the X-ray imaging at the second imaging position is executed, the injection of the contrast agent into the subject P is terminated (Step Sa7).

  After the X-ray imaging at the second imaging position, the FPD center is moved to the fluoroscopic position. Specifically, the center of the FPD is moved from the second imaging position (R in FIG. 5) to the fluoroscopic position (C in FIG. 5) by the rotation of the support mechanism 7 by the support mechanism drive unit 9. The rotation angle of the support mechanism 7 is δ ° counterclockwise.

  When the FPD center is moved to the fluoroscopic position, IVR is resumed and X-ray fluoroscopy is performed. At this time, specifically, X-ray fluoroscopy is executed at the fluoroscopic position in response to arrival of the fluoroscopic signal output from the movement control unit 17. A fluoroscopic image is generated by this X-ray fluoroscopy. Next, a difference image is generated by subtracting the third image from the fluoroscopic image (step Sa9). The difference image is an image related to the device inserted into the subject. A first and second superimposed images are generated by superimposing the difference image on each of the first and second multiplied images (step Sa10).

  The generated first and second superimposed images are displayed on the display unit 23 so as to be stereoscopically viewable (step Sa11). For example, in the case of the polarization shutter method, the display unit 23 displays the first and second superimposed images so that the first superimposed image is input to the left eye of the operator and the second superimposed image is input to the right eye of the operator. . At this time, depending on the individual difference near the operator, there is an operator in which the stereoscopic effect in the depth direction is the same as in reality, and there is an operator in which the stereoscopic effect is reversed. When the stereoscopic effect is reversed, when the display image replacement switch provided in the input unit 25 is operated by the operator, the display unit 23 inputs the first superimposed image to the right eye and the second superimposed image to the left eye. In this way, the display pattern of the first and second superimposed images is changed. By replacing the images input to the left eye and the right eye of the operator, it is possible to make the perception of a stereoscopic effect with individual differences the same as in reality.

  According to the first and second superimposed images displayed in step Sa11, the operator can perceive bones and blood vessels in three dimensions and can perceive the device in a plane. Until the stereoscopic photographing program is terminated by the operator via the input unit 23, the processing from step Sa9 to step Sa11 is repeated (step Sa12).

  Hereinafter, a case where the device stereoscopic button is operated will be described.

  First, the IVR is stopped. Next, when the device stereoscopic button of the input unit 25 is operated by the operator, the FPD center is moved to the first photographing position. X-ray imaging is executed at the first imaging position, and an X-ray image at the first imaging position is generated. Subsequently, the FPD center is moved to the second imaging position. X-ray imaging is executed at the second imaging position, and an X-ray image at the second imaging position is generated. The X-ray image at the first imaging position and the X-ray image at the second imaging position are displayed on the display unit 23 so as to be stereoscopically viewed. With this display, the operator can perceive bones, devices, and the like in three dimensions.

  FIG. 6 is a schematic diagram illustrating an outline of generating the first superimposed image at the first imaging position and the second superimposed image at the second imaging position. L, C, and R in FIG. 6 respectively correspond to L, C, and R in FIG. 6 are L, C, and R in FIG. 7 to be described later, L, C, and R in FIG. 8 to be described later, and L, C, and R in FIG. 9 to be described later. You may respectively correspond to L, C, and R of any one figure.

  FIG. 6A shows a first angiographic image. FIG. 6B shows a second angiographic image. FIG. 6C shows the third image. FIG. 6D shows a fluoroscopic image. FIG. 6E shows a difference image (device image) obtained by subtracting the third image (c) from the perspective image (d). R1 in FIG. 6 is a first coefficient to be multiplied with the first angiographic image (a). R2 in FIG. 6 is a second coefficient to be multiplied with the second angiographic image (b). FIG. 6F shows a first superimposed image in which the difference image (e) is superimposed on the first multiplied image. (G) of FIG. 6 has shown the 2nd superimposed image which superimposed the difference image (e) on the 2nd multiplication image.

(First modification)
The difference from the above embodiment is that the movement of the center of the FPD to the first and second imaging positions and the fluoroscopic position is executed by the parallel movement of the support mechanism 7.

  The position determining unit 15 determines the first and second imaging positions based on the fluoroscopic position, the first distance, and the second distance of the subject P input by the input unit 23. The first and second distances can be appropriately input by the input unit 25 described later. Hereinafter, in order to simplify the description, it is assumed that the second distance is equal to the first distance. The sum of the first distance and the second distance (hereinafter referred to as parallax distance) corresponds to the stereoscopic view possible range, and is set to a range of 1 cm to 10 cm, for example. The first and second distances or parallax distances are stored in advance in a storage unit (not shown). Note that the parallax distance may be input by the input unit 25. Further, the first and second distances or the parallax distance can be appropriately changed via the input unit 25. Note that a parallax angle may be used instead of the first and second distances.

  The movement control unit 17 controls the support mechanism driving unit 9 in order to position the FPD center at the first and second imaging positions and the fluoroscopic position by the parallel movement of the support mechanism 7. Specifically, the movement control unit 17 outputs a control signal for translating the tube focus to the first photographing position to the support mechanism driving unit 9. The movement control unit 17 outputs a control signal for translating the center of the FPD to the second imaging position to the support mechanism driving unit 9 when the X-ray imaging is completed at the first imaging position. The movement control unit 17 outputs a control signal for translating the FPD center to the fluoroscopic position to the support mechanism driving unit 9 when the X-ray imaging at the second imaging position ends.

  FIG. 7 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position. C in FIG. 7 corresponds to C in FIG. 5 and indicates the FPD at the fluoroscopic position. L in FIG. 7 is a position for obtaining the same image as L in FIG. Specifically, L in FIG. 7 is a position (first photographing position) obtained by translating the center of the FPD with respect to the first distance in the lateral direction from C. R in FIG. 7 is a position for obtaining the same image as R in FIG. Specifically, R in FIG. 7 is a position (second photographing position) obtained by translating the center of the FPD with respect to the second distance from C in the lateral direction. The parallax angle between the first shooting position and the second shooting position is θ, which corresponds to the parallax distance. The parallax angle between the second imaging position and the fluoroscopic position is δ (0 <δ <θ), which corresponds to the second distance. The parallax angle between the first photographing position and the fluoroscopic position is (θ−δ) and corresponds to the first distance.

(Second modification)
The difference from the first modification is that the tube focus is fixed and the top 11 is moved to the first and second imaging positions and the fluoroscopic position. The first and second imaging positions and the fluoroscopic position are relative positions with respect to the tube focus. Hereinafter, in order to simplify the description, the fluoroscopic position is a position facing the tube focus. The first imaging position is a position obtained by translating the top plate 11 about the first distance from the fluoroscopic position along the X direction. The second imaging position is a position obtained by translating the top plate 11 about the second distance from the fluoroscopic position along the X direction. The moving direction of the top plate 11 may be the longitudinal direction (Y direction).

  The position determining unit 15 determines the first and second imaging positions based on the fluoroscopic position, the first distance, and the second distance of the subject P input by the input unit 25. Instead of the first distance, a first parallax angle (θ−δ) between the fluoroscopic position and the first photographing position may be used. Further, instead of the second distance, a second parallax angle δ between the fluoroscopic position and the second imaging position may be used. Hereinafter, in order to simplify the description, it is assumed that the second distance is equal to the first distance. At this time, the second parallax angle δ is equal to the first parallax angle (θ−δ).

  The movement control unit 17 controls the top plate driving unit 13 in order to move the top plate 11 to the first and second imaging positions and the fluoroscopic position by sliding the top plate 11. Specifically, the movement control unit 17 outputs a control signal for sliding the top plate 11 to the first photographing position to the top plate drive unit 13. The movement control unit 17 outputs a control signal for sliding the top board 11 to the second imaging position to the top board driving unit 13 when the X-ray imaging is completed at the first imaging position. The movement control unit 17 outputs a control signal for sliding the top board 11 to the fluoroscopic position to the top board driving unit 13 when the X-ray imaging at the second imaging position ends.

  The top plate drive unit 13 drives the top plate 11 under the control of the movement control unit 17 to move the top plate 11 to the first and second imaging positions and the fluoroscopic position. Specifically, the top board drive unit 13 slides the top board 11 in the transverse direction of the top board 11 (X direction in FIG. 2) based on a control signal from the movement control unit 17.

  FIG. 8 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position. FIG. 8A corresponds to C in FIGS. 5 and 7 and shows the FPD at the fluoroscopic position. FIG. 8B is a position for obtaining the same image as L in FIGS. 5 and 7. Specifically, it is a position (first photographing position) in which the top 11 is translated from C to the lateral direction by a first distance. FIG. 8C is a position for obtaining the same image as R in FIGS. Specifically, it is a position (second photographing position) where the top plate 11 is translated from C to the lateral direction by a second distance. The first parallax angle between the first photographing position and the fluoroscopic position is (θ−δ) and corresponds to the first distance. The parallax angle between the second imaging position and the fluoroscopic position is δ (0 <δ <θ), which corresponds to the second distance. The parallax angle between the first shooting position and the second shooting position is θ, which corresponds to the parallax distance.

(Third Modification)
The difference from the second modification is that the parallax is generated by tilting the top plate 11. In the third modification, the rotation axis when the top plate 11 is tilted is the longitudinal direction (Y direction). The rotation axis of the top plate 11 may be in the transverse direction (X direction). Hereinafter, in order to simplify the description, the perspective position is a horizontal plane. The first photographing position is a position obtained by rotating the angle (θ−δ) counterclockwise from the horizontal plane. The second imaging position is a position obtained by rotating the angle δ clockwise from the horizontal plane.

  The position determination unit 15 determines the first and second imaging positions in the stereoscopic view possible range based on the fluoroscopic position of the subject P input by the input unit 25 and a predetermined parallax angle set in advance.

  The movement control unit 17 controls the top plate driving unit 13 in order to tilt the top plate 11 to the first and second imaging positions by rotating the top plate 11. Specifically, the movement control unit 17 outputs a control signal for rotating the top plate 11 to the first imaging position to the top plate drive unit 13. The movement control unit 17 outputs a control signal for rotating the top board 11 to the second imaging position to the top board driving unit 13 when the X-ray imaging at the first imaging position ends. The movement control unit 17 outputs a control signal for rotating the top board 11 to the fluoroscopic position to the top board driving unit 13 when the X-ray imaging at the second imaging position ends.

  The top board drive unit 13 rotates the top board 11 to the first and second imaging positions and the fluoroscopic position by driving the top board 11 under the control of the movement control unit 17. Specifically, the top plate driving unit 13 rotates the top plate 11 based on the control signal from the movement control unit 17 with the longitudinal direction of the top plate 11 (Y direction in FIG. 2) as the rotation axis.

  FIG. 9 is a diagram illustrating an example of the relationship between the first and second imaging positions and the fluoroscopic position. FIG. 9A corresponds to C in FIGS. 5, 7, and 8, and shows the FPD that faces the tube focal point at the fluoroscopic position. FIG. 9B is a position for obtaining the same image as L in FIGS. 5, 7, and 8. Specifically, FIG. 9B shows the top plate 11 rotated from C by (θ−δ) ° in the RAO direction (clockwise). The position of the tilted top plate 11 in FIG. 9B is the first photographing position. FIG. 9C shows the top plate 11 rotated from C by (δ) ° in the LAO direction (counterclockwise). The position of the tilted top plate 11 in FIG. 9C is the second photographing position. The parallax angle between the first shooting position and the second shooting position is θ. The parallax angle between the second photographing position and the fluoroscopic position is δ (0 <δ <θ).

(Fourth modification)
The difference from the above embodiment is that a first digital subtraction angiography image is generated as the first image, a second digital subtraction angiography image is generated as the second image, and the first digital subtraction angiography image is used as the first superimposed image. And generating an image in which the fluoroscopic image is superimposed on the second digital subtraction angiographic image as a second superimposed image.

  Based on digital data pre-processed after X-ray imaging at the first imaging position before injection of the contrast agent into the subject, the image generator 19 (hereinafter, referred to as first X-ray image at the first imaging position). Called a mask image). Based on digital data pre-processed after X-ray imaging at the second imaging position before injection of the contrast agent into the subject, the image generator 19 (hereinafter referred to as the second X-ray image at the second imaging position). Called a mask image).

  The image generation unit 19 generates a first digital subtraction angiographic image (hereinafter referred to as a first DSA image) as a first image by subtracting the first mask image from the first angiographic image. The image generation unit 19 generates a second digital subtraction angiographic image (hereinafter referred to as a second DSA image) as the first image by subtracting the second mask image from the second angiographic image. The image generator 19 generates a first multiplied image obtained by multiplying the first DSA image by the first coefficient R1. The image generator 19 generates a second multiplied image obtained by multiplying the second DSA image by the second coefficient R2.

  The image generator 19 generates an image in which a fluoroscopic image is superimposed on the first multiplied image as the first superimposed image. The image generator 19 generates an image obtained by superimposing a fluoroscopic image on the second multiplied image as the second superimposed image. The image storage unit 19 stores the first and second mask images, the first and second DSA images, and the first and second multiplied images.

(Stereoscopic image generation function)
The stereoscopic image generation function in the fourth modification is the first and second superimpositions in which the fluoroscopic images at the fluoroscopic positions are superimposed on the first and second DSA images corresponding to the first and second imaging positions, respectively. This function generates images. Hereinafter, processing related to the stereoscopic image generation function (hereinafter referred to as stereoscopic image generation processing) will be described. Note that the stereoscopic image generation process can be executed only when the operator desires stereoscopic viewing.

  FIG. 10 is a flowchart illustrating an example of a procedure for generating the first and second superimposed images in which the fluoroscopic images are superimposed on the first and second DSA images corresponding to the first and second imaging positions, respectively.

  IVR is performed on the subject placed on the top 11. It is assumed that the position of the tube focus when the IVR is being executed is a fluoroscopic position. First, a device is inserted into the subject P. Next, when the device reaches a blood vessel branching portion or the like in complicated blood vessel running, a stereoscopic imaging program is started to confirm the direction in which the device should be advanced. At this time, the IVR is stopped. The stereoscopic shooting program is a program related to a stereoscopic image generation process and a process of displaying the generated first and second superimposed images on the display unit 23 so as to be stereoscopically viewable. With the start of the stereoscopic imaging program, the fluoroscopic position and the parallax angle are input via the input unit 25. Based on the fluoroscopic position and the parallax angle, the first and second imaging positions are determined.

  When the first and second shooting positions are determined, the FPD center is moved to the first shooting position. Specifically, the center of the FPD is moved from the fluoroscopic position to the first photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is (θ−δ) ° counterclockwise. A first mask image is generated by X-raying the subject P at the first imaging position. Next, the FPD center is moved to the second imaging position. Specifically, the FPD center is moved from the first photographing position to the second photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° clockwise. A second mask image is generated by X-ray imaging of the subject P at the second imaging position (step Sb1). The generated first and second mask images are stored in the image storage unit 21.

  After the X-ray imaging at the second imaging position, a contrast medium is injected into the subject P (step Sb2). After the injection of the contrast agent, the FPD center is moved to the first imaging position. Specifically, the FPD center is moved from the second imaging position to the first imaging position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° counterclockwise. X-ray imaging is executed at the first imaging position after an appropriate delay time, triggered by the arrival of the radiographable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button after an appropriate time has elapsed after injection of a contrast medium. By this X-ray imaging, a first angiographic image is generated (step Sb3). The first angiographic image is stored in the image storage unit 21.

  After the X-ray imaging at the first imaging position, the FPD center is moved to the second imaging position. Specifically, the FPD center is moved from the first photographing position to the second photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° clockwise. X-ray imaging is executed at the second imaging position after an appropriate delay time, triggered by the arrival of the radiographable signal output from the movement control unit 17. A second angiographic image is generated by this X-ray imaging (step Sb4). The second angiographic image is stored in the image storage unit 21.

  After the X-ray imaging at the second imaging position is executed, the injection of the contrast agent into the subject P is terminated (Step Sb5). A first DSA image is generated by subtracting the first mask image from the first angiographic image (step Sb6). The first DSA image is an image obtained by photographing blood vessels. The first DSA image is an image used for the left eye in stereoscopic display, for example. A first multiplied image is generated by multiplying the first DSA image by a first coefficient. The first multiplied image is stored in the image storage unit 21.

  A second DSA image is generated by subtracting the second mask image from the second angiographic image (step Sb7). The second DSA image is an image obtained by photographing blood vessels. The second DSA image is, for example, an image used for the right eye in stereoscopic display. A second multiplied image is generated by multiplying the second DSA image by the second coefficient. The second multiplied image is stored in the image storage unit 21.

  After X-ray imaging at the second imaging position, the FPD center is moved to the fluoroscopic position (step Sb8). Specifically, the center of the FPD is moved from the second imaging position to the fluoroscopic position by the rotation of the support mechanism 7 by the support mechanism drive unit 9. The rotation angle of the support mechanism 7 is δ ° counterclockwise.

  X-ray fluoroscopy is executed at the fluoroscopic position triggered by the arrival of the fluoroscopic signal output from the movement control unit 17. At this time, IVR is resumed. A fluoroscopic image is generated by X-ray fluoroscopy (step Sb9). The fluoroscopic image is an image obtained by photographing a background such as a bone and a device. A first and second superimposed images are generated by superimposing the perspective image on each of the first and second multiplied images (step Sb10).

  The generated first and second superimposed images are displayed on the display unit 23 so as to be stereoscopically viewed (step Sb11). According to the first and second superimposed images displayed in step Sa10, the operator can perceive the blood vessel in three dimensions and can perceive the background such as bone and the device in a plane. Until the stereoscopic photographing program is terminated by the operator via the input unit 23, the processing from step Sb9 to step Sb11 is repeated (step Sb12).

  FIG. 11 is a schematic diagram illustrating an outline of generating a first superimposed image at the first shooting position and a second superimposed image at the second shooting position. L, C, and R in FIG. 11 respectively correspond to L, C, and R in FIG. Note that L, C, and R in FIG. 11 are those in any one of L, C, and R in FIG. 7, L, C, and R in FIG. 8, and L, C, and R in FIG. You may correspond to L, C, and R, respectively.

  FIG. 11A shows the first mask image. FIG. 11B shows the second mask image. FIG. 11C shows a first angiographic image. FIG. 11D shows a second angiographic image. FIG. 11E shows a first DSA image obtained by subtracting the first mask image (a) from the first angiographic image (c). FIG. 11 (f) shows a second DSA image obtained by subtracting the second mask image (b) from the second angiographic image (d). R1 in FIG. 11 is a first coefficient to be multiplied by the first DSA image (e). R2 in FIG. 11 is a second coefficient to be multiplied by the second DSA image (f). FIG. 11G shows a fluoroscopic image. FIG. 11H shows a first superimposed image obtained by superimposing the perspective image (g) on the first multiplied image. FIG. 11 (i) shows a second superimposed image obtained by superimposing the fluoroscopic image (g) on the second multiplied image.

(Fifth modification)
In the fifth modification, the first and second superimposed images are generated by superimposing the difference image generated in the embodiment on each of the first and second DSA images generated in the fourth modification. It is in.

  The processing in each component is omitted because the processing in the fourth modification is added to the processing in the present embodiment. A functional difference between this embodiment and the fourth modification will be described below.

(Stereoscopic image generation function)
The stereoscopic image generation function in the fifth modified example is a difference image obtained by subtracting the third image from the fluoroscopic image at the fluoroscopic position in each of the first and second DSA images corresponding to the first and second imaging positions, respectively. This is a function for generating the first and second superimposed images respectively superimposed. Hereinafter, processing related to the stereoscopic image generation function (hereinafter referred to as stereoscopic image generation processing) will be described.

  FIG. 12 shows an example of a procedure for generating first and second superimposed images in which a device perspective image (difference image) is superimposed on each of the first and second DSA images corresponding to the first and second imaging positions, respectively. It is a flowchart.

  Prior to performing IVR on the subject placed on the top 11, the fluoroscopic position is input via the input unit 25. Next, the FPD center is moved to the fluoroscopic position. X-ray imaging is executed at the fluoroscopic position triggered by the arrival of the radiographable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button. By this X-ray imaging, an X-ray image (third image) is generated (step Sc1). The third image is stored in the image storage unit 21.

  IVR is performed on the subject placed on the top 11. It is assumed that the position of the FPD center when the IVR is being executed is a fluoroscopic position. First, a device is inserted into the subject P. Next, when the device reaches a blood vessel branching portion or the like in complicated blood vessel running, a stereoscopic imaging program is started to confirm the direction in which the device should be advanced. At this time, the IVR is stopped. The stereoscopic shooting program is a program related to a stereoscopic image generation process and a process of displaying the generated first and second superimposed images on the display unit 23 so as to be stereoscopically viewable. With the start of the stereoscopic imaging program, the fluoroscopic position and the parallax angle are input via the input unit 25. Based on the fluoroscopic position and the parallax angle, the first and second imaging positions are determined.

  When the first and second shooting positions are determined, the FPD center is moved to the first shooting position. Specifically, the center of the FPD is moved from the fluoroscopic position to the first photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is (θ−δ) ° counterclockwise. A first mask image is generated by X-raying the subject P at the first imaging position. Next, the FPD center is moved to the second imaging position. Specifically, the FPD center is moved from the first photographing position to the second photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° clockwise. A second mask image is generated by X-ray imaging of the subject P at the second imaging position (step Sc2). The generated first and second mask images are stored in the image storage unit 21.

  After the X-ray imaging at the second imaging position, a contrast medium is injected into the subject P (step Sc3). After the injection of the contrast agent, the FPD center is moved to the first imaging position. Specifically, the FPD center is moved from the second imaging position to the first imaging position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° counterclockwise. X-ray imaging is executed at the first imaging position after an appropriate delay time, triggered by the arrival of the radiographable signal output from the movement control unit 17. Note that X-ray imaging may be performed by operating an imaging button after an appropriate time has elapsed after injection of a contrast medium. A first angiographic image is generated by this X-ray imaging (step Sc4). The first angiographic image is stored in the image storage unit 21.

  After the X-ray imaging at the first imaging position, the FPD center is moved to the second imaging position. Specifically, the FPD center is moved from the first photographing position to the second photographing position by the rotation of the support mechanism 7 by the support mechanism driving unit 9. The rotation angle of the support mechanism 7 is θ ° clockwise. X-ray imaging is executed at the second imaging position after an appropriate delay time, triggered by the arrival of the radiographable signal output from the movement control unit 17. A second angiographic image is generated by this X-ray imaging (step Sc5). The second angiographic image is stored in the image storage unit 21.

  After the X-ray imaging at the second imaging position is executed, the injection of the contrast agent into the subject P is terminated (Step Sc6). A first DSA image is generated by subtracting the first mask image from the first angiographic image (step Sc7). The first DSA image is an image obtained by photographing blood vessels. The first DSA image is an image used for the left eye in stereoscopic display, for example. A first multiplied image is generated by multiplying the first DSA image by a first coefficient. The first multiplied image is stored in the image storage unit 21.

  A second DSA image is generated by subtracting the second mask image from the second angiographic image (step Sc8). The second DSA image is an image obtained by photographing blood vessels. The second DSA image is, for example, an image used for the right eye in stereoscopic display. A second multiplied image is generated by multiplying the second DSA image by the second coefficient. The second multiplied image is stored in the image storage unit 21.

  After the X-ray imaging at the second imaging position, the FPD center is moved to the fluoroscopic position (step Sc9). Specifically, the center of the FPD is moved from the second imaging position to the fluoroscopic position by the rotation of the support mechanism 7 by the support mechanism drive unit 9. The rotation angle of the support mechanism 7 is δ ° counterclockwise.

  X-ray fluoroscopy is executed at the fluoroscopic position triggered by the arrival of the fluoroscopic signal output from the movement control unit 17. At this time, IVR is resumed. A fluoroscopic image is generated by X-ray fluoroscopy. Next, a difference image obtained by subtracting the third image from the fluoroscopic image is generated (step Sc10). The difference image is an image related to the device inserted into the subject. First and second superimposed images are generated by superimposing the difference image on each of the first and second multiplied images (step Sc11).

  The generated first and second superimposed images are displayed on the display unit 23 so as to be stereoscopically viewed (step Sc12). According to the first and second superimposed images displayed in step Sc12, the operator can perceive the blood vessel three-dimensionally and can perceive the device planarly. Until the stereoscopic photographing program is terminated by the operator via the input unit 25, the processes of Step Sc10 to Step Sc12 are repeated (Step Sc13).

  FIG. 13 is a schematic diagram illustrating an outline of generating the first superimposed image at the first imaging position and the second superimposed image at the second imaging position. L, C, and R in FIG. 13 correspond to L, C, and R in FIG. Note that L, C, and R in FIG. 13 are the same as L, C, and R in FIG. 7, L, C, and R in FIG. 8, and L, C, and R in FIG. You may correspond to L, C, and R, respectively.

  FIG. 13A shows the first mask image. FIG. 13B shows a second mask image. FIG. 13C shows a first angiographic image. FIG. 13D shows a second angiographic image. FIG. 13E shows a first DSA image obtained by subtracting the first mask image (a) from the first angiographic image (c). FIG. 13F shows a second DSA image obtained by subtracting the second mask image (b) from the second angiographic image (d). R1 in FIG. 13 is a first coefficient to be multiplied by the first DSA image (e). R2 in FIG. 13 is a second coefficient to be multiplied by the second DSA image (f). FIG. 13G shows the third image. FIG. 13H shows a perspective image. FIG. 13I shows a difference image obtained by subtracting the third image (g) from the perspective image (h). (J) of FIG. 13 shows a first superimposed image in which the difference image (i) is superimposed on the first multiplied image. FIG. 13K shows a second superimposed image in which the difference image (i) is superimposed on the second multiplied image.

According to the configuration described above, the following effects can be obtained.
According to the present X-ray diagnostic apparatus 1, by performing X-ray imaging from two different directions, a complex system such as a bifocal tube is not required, and a tissue that is necessary for the operation of a device inserted into a subject. Stereoscopic viewing is possible. In addition, a fluoroscopic image can be generated by performing X-ray fluoroscopy for a device inserted into the subject at a fluoroscopic position between these two directions. By superimposing the generated fluoroscopic image on the first image and the second image, first and second superimposed images are generated. By displaying the first and second superimposed images on the display unit 23 so as to enable stereoscopic viewing, the fluoroscopic images are input to both eyes of the operator. Thereby, the burden on the visual processing system such as blinking of the fluoroscopic image is reduced, and a stereoscopic image that can be easily observed by the operator can be provided.

  Further, according to the X-ray diagnostic apparatus 1, it is possible to generate first and second superimposed images in which a difference image (device image) is superimposed on each of the first and second angiographic images. Thereby, in the 1st, 2nd superimposed image displayed on the display part 23 so that stereoscopic vision was possible, the operator can observe a bone and a blood vessel three-dimensionally and a device planarly. Therefore, the operator can appropriately determine the direction in which the device inserted into the subject should be advanced.

  In addition, according to the X-ray diagnostic apparatus 1, it is possible to generate first and second superimposed images in which a fluoroscopic image is superimposed on each of the first and second DSA images. Thereby, in the 1st, 2nd superimposed image displayed on the display part 23 so that stereoscopic vision was possible, the operator can observe a blood vessel in three dimensions and a bone | frame and a device planarly. Therefore, the operator can appropriately determine the direction in which the device inserted into the subject should be advanced.

  Furthermore, according to the X-ray diagnostic apparatus 1, it is possible to generate first and second superimposed images in which device images are superimposed on the first and second DSA images, respectively. Thereby, in the 1st, 2nd superimposed image displayed on the display part 23 so that stereoscopic vision was possible, the operator can observe the blood vessel three-dimensionally and a device planarly. Therefore, the operator can appropriately determine the direction in which the device inserted into the subject is to be advanced when a background such as a bone obstructs observation.

  Further, according to the present X-ray diagnostic apparatus 1, X-ray imaging is performed at a predetermined interval in accordance with the movement of the FPD center from the first imaging position to the second imaging position, and a plurality of second images used for stereoscopic vision are used. 1. A second image can be generated. Thereby, two images having appropriate parallax angles can be selected so that the device does not come off the blood vessel. In addition, according to the present X-ray diagnostic apparatus 1, it is possible to generate first and second images that enable stereoscopic viewing of devices, bones, and the like. As a result, the background of the device and the bone can be stereoscopically displayed.

  According to the X-ray diagnostic apparatus 1, the first and second images used for the first and second superimposed images and the difference image (or fluoroscopic image) are generated by matching the cardiac phase by the ECG gate. be able to. This improves the recognition of the positional relationship between the blood vessel and the device in an organ such as a moving heart. Further, according to the present X-ray diagnostic apparatus 1, it is possible to give a hue to an organ such as a blood vessel in the first and second DSA images. Thereby, the recognizability of the organ to which the hue is given is improved.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

  DESCRIPTION OF SYMBOLS 1 ... X-ray diagnostic apparatus, 3 ... X-ray generation part, 5 ... X-ray detection part, 7 ... Support mechanism, 9 ... Support mechanism drive part, 11 ... Top plate, 13 ... Top plate drive part, 15 ... Position determination part , 17 ... Movement control unit, 19 ... Image generation unit, 21 ... Image storage unit, 23 ... Display unit, 25 ... Input unit, 27 ... System control unit

Claims (14)

An X-ray generator for generating X-rays;
An X-ray detection unit that detects X-rays generated from the X-ray generation unit and transmitted through the subject placed on the top;
A support mechanism for supporting the X-ray generation unit and the X-ray detection unit;
A support mechanism drive for moving the support mechanism;
To move the X-ray detection unit to a first imaging position with respect to the subject, a second imaging position different from the first imaging position, and one fluoroscopic position different from the first and second imaging positions. And a movement control unit for controlling the support mechanism driving unit,
First and second images corresponding to X-ray imaging at the first and second imaging positions are generated, respectively, and a fluoroscopic image is generated by X-ray fluoroscopy at the fluoroscopic position, and each of the first and second images is generated. An image generating unit for generating first and second superimposed images in which the fluoroscopic image is superimposed on;
A display unit for displaying the first and second superimposed images;
An X-ray diagnostic apparatus comprising: The support mechanism drive unit is
Rotating the support mechanism to position the X-ray detection unit at the first and second imaging positions and the fluoroscopic position;
The X-ray diagnostic apparatus according to claim 1. The support mechanism drive unit is
Locating the X-ray detection unit at the first and second imaging positions and the fluoroscopic position by translating the support mechanism;
The X-ray diagnostic apparatus according to claim 1. An input unit for inputting the fluoroscopic position as an angle with respect to a reference position;
Based on the fluoroscopic position, the reference position, and a predetermined parallax angle, an angle that includes the fluoroscopic position within the predetermined parallax angle and is sandwiched by the first and second shooting positions with respect to the reference position is A position determining unit that determines the first and second imaging positions to match a predetermined parallax angle;
The X-ray diagnostic apparatus according to any one of claims 1 to 3, wherein The position determination unit
Determining the first and second imaging positions with the midpoint of the predetermined parallax angle as the perspective position;
The X-ray diagnostic apparatus according to claim 4. The image generator is
Along with the movement of the X-ray detection unit from the first imaging position to the second imaging position, a plurality of images are generated by X-ray imaging at a predetermined interval,
Generating two superimposed images in which the fluoroscopic image is superimposed on each of the two images selected by the operator among the plurality of images;
The display unit
Displaying the two superimposed images in a stereoscopic manner;
X-ray diagnostic apparatus according to any one of claims 1 to 5, characterized in. The image generator is
Generating a first angiographic image as the first image;
Generating a second angiographic image as the second image;
Generating a third image relating to X-ray imaging at the fluoroscopic position;
Generating the fluoroscopic image by X-ray fluoroscopy at the fluoroscopic position after the generation of the third image;
Generating a difference image obtained by subtracting the third image from the perspective image;
As the first superimposed image, an image in which the difference image is superimposed on the first angiographic image is generated,
Generating an image in which the difference image is superimposed on the second angiographic image as the second superimposed image;
The X-ray diagnostic apparatus according to any one of claims 1 to 6, wherein: The image generator is
Generating a first digital subtraction angiographic image as the first image;
Generating a second digital subtraction angiographic image as the second image;
Generating an image in which the fluoroscopic image is superimposed on the first digital subtraction angiographic image as the first superimposed image;
Generating an image in which the fluoroscopic image is superimposed on the second digital subtraction angiographic image as the second superimposed image;
The X-ray diagnostic apparatus according to any one of claims 1 to 6, wherein: The image generator is
Generating a first digital subtraction angiographic image as the first image;
Generating a second digital subtraction angiographic image as the second image;
Generating a third image relating to X-ray imaging at the fluoroscopic position;
Generating the fluoroscopic image by X-ray fluoroscopy at the fluoroscopic position after the generation of the third image;
Generating a difference image obtained by subtracting the third image from the perspective image;
Generating an image in which the difference image is superimposed on the first digital subtraction angiographic image as the first superimposed image;
Generating an image in which the difference image is superimposed on the second digital subtraction angiographic image as the second superimposed image;
The X-ray diagnostic apparatus according to any one of claims 1 to 6, wherein: The display unit displays the first and second superimposed images in a stereoscopic manner;
X-ray diagnostic apparatus according to any one of claims 1 to 9, wherein. An X-ray generator for generating X-rays;
An X-ray detection unit that detects X-rays generated from the X-ray generation unit and transmitted through the subject placed on the top;
A top plate driving unit for driving the top plate;
In order to move the top to a first imaging position with respect to the subject, a second imaging position different from the first imaging position, and one fluoroscopic position different from the first and second imaging positions, A movement control unit for controlling the top plate driving unit;
First and second images corresponding to X-ray imaging at the first and second imaging positions are generated, respectively, and a fluoroscopic image is generated by X-ray fluoroscopy at the fluoroscopic position, and each of the first and second images is generated. An image generating unit for generating first and second superimposed images in which the fluoroscopic image is superimposed on;
A display unit for displaying the first and second superimposed images;
An X-ray diagnostic apparatus comprising: The top plate drive unit is
Locating the top plate at the first and second imaging positions and the fluoroscopic position by translating a support mechanism that supports the X-ray generation unit and the X-ray detection unit ;
The X-ray diagnostic apparatus according to claim 11. The top plate drive unit is
Tilting the top plate to position the top plate at the first and second photographing positions and the fluoroscopic position;
The X-ray diagnostic apparatus according to claim 11 or 12 , wherein: The display unit displays the first and second superimposed images in a stereoscopic manner;
X-ray diagnostic apparatus according to any one of claims 11 to 13, characterized in.

Images