JP6479346B2 - Medical image processing device - Google Patents

Description

  Embodiments described herein relate generally to a medical image processing apparatus.

  In general, aortic stenosis is a disease in which the aortic valve is stenotic due to calcification of the aortic valve. When the aortic valve is narrowed, it becomes difficult to supply blood to the whole body.

  As a conventional method for treating aortic valve stenosis, an artificial valve is generally set by surgery. As a treatment method for this aortic valve stenosis, in recent years, a treatment method called TAVR (Transatheter Aortic Valve Replacement) in which an artificial valve is installed with a transcatheter under fluoroscopy has become widespread. TAVR is also called TAVI (Transcatheter Aortic Valve Implantation). In this treatment method, for example, a medical image captured by a CT (Computed Tomography) apparatus is used to perform a surgical plan, C-arm angle setting of an X-ray diagnostic apparatus, or the like.

  By the way, when the TAVR / TAVI is used to evaluate the pressure difference before and after treatment, the tip of two pressure wires is placed above and below the aortic valve under fluoroscopy, and the blood pressure difference at each position is set. Observe. Therefore, the burden on the patient is large and invasive.

  Also, the ultrasonic diagnostic apparatus takes an ultrasonic Doppler image of the left ventricle / aorta and measures the velocity distribution of the aortic valve to calculate the pressure difference between the left ventricle / aorta. However, in the pressure difference analysis using the ultrasonic Doppler image captured by the ultrasonic diagnostic apparatus, the analysis result depends on the skill of the operator and results in an angle-dependent analysis. The reproducibility of the analysis result is relatively low. It is difficult to evaluate together with structural analysis such as morphological abnormalities and calcification, and the analysis range is narrow, so if there is a sudden pressure drop, the evaluation result may be incorrect, the imaging range is narrow, so the imaging range There is a problem that, when moving, the analysis result includes a time difference.

  An object of the embodiment is to provide a medical image processing apparatus that can simultaneously perform non-invasively functional analysis such as morphological analysis and pressure difference in an aortic valve.

  The medical image processing apparatus according to this embodiment uses a volume data obtained by imaging an area including at least the aorta, the aortic valve, and the left ventricle, and calculates a pressure difference of the aortic valve; And a display unit that displays the pressure difference and the aortic valve on the predetermined morphological image in a spatial correspondence with each other.

1 is a block diagram showing a medical image analysis apparatus according to a first embodiment. 1 is a block diagram showing a medical image processing apparatus according to a first embodiment. FIG. 2 is a block diagram showing a functional configuration of a processor of the medical image processing apparatus according to the first embodiment. 5 is a flowchart showing a flow of image analysis processing in the medical image analysis apparatus according to the first embodiment. The figure which shows the timing which images a projection image. The perspective view which shows the aortic valve detected by the aortic valve surface detection part shown in FIG. The figure which shows an example of the table for evaluating the seriousness of the disease in an aortic valve. The figure which shows the example of a display of the result by the image analysis process shown in FIG. The block diagram which shows the function structure of the processor of the medical image processing apparatus which concerns on 2nd Embodiment. 9 is a flowchart showing a flow of image analysis processing in the medical image analysis apparatus according to the second embodiment. The figure which shows the example of a display of the result by the image analysis process shown in FIG. The block diagram which shows the function structure of the processor of the medical image processing apparatus which concerns on 3rd Embodiment. 10 is a flowchart showing a flow of image analysis processing in the medical image analysis apparatus according to the third embodiment. The figure which shows the example of a display of the result by the image analysis process shown in FIG.

  The medical image processing apparatus according to this embodiment will be described below with reference to the drawings.

(First embodiment)
FIG. 1 is a block diagram showing a medical image analysis apparatus according to the first embodiment. FIG. 1 shows the configuration of an X-ray CT apparatus as an example of a medical image diagnostic apparatus provided in a medical image analysis apparatus.

  The medical image analysis apparatus shown in FIG. 1 includes a gantry 100, a preprocessing apparatus 106, a high voltage generator 107, a reconstruction apparatus 109, a system controller 110, and an X-ray data collection condition setting apparatus 112. An apparatus 1000 and a medical image processing apparatus 200 are provided.

  The gantry 100 includes an X-ray tube 101, an annular frame 102, a multi-row or two-dimensional array type X-ray detector 103, a data acquisition system (DAS) 104, a non-contact data transmitter 105, and a slip ring. (Slip ring) 108 and a rotation unit 111.

  The X-ray tube 101 and the X-ray detector 103 are mounted on an annular frame 102 that is provided to be rotatable around a rotation axis RA.

  The X-ray detector 103 is disposed to face the X-ray tube 101.

  The DAS 104 converts the signal output from the X-ray detector 103 of each channel into a voltage signal, amplifies the voltage signal, and further converts it into a digital signal. The raw data output from the DAS 104 is sent to the preprocessing device 106 via the non-contact data transmitter 105.

  The pre-processing device 106 corrects the sensitivity uniformity between channels with respect to the raw data output from the DAS 104, and corrects an extreme decrease in signal intensity or signal dropout due to an X-ray strong absorber (mainly a metal part). . The projection data that is corrected and output from the preprocessing device 106 is output to the storage device 6 of the medical image processing device 200 described later.

  In order to generate X-rays from the X-ray tube 101, the high voltage generator 107 applies a tube voltage to the X-ray tube 101 via the slip ring 108 and supplies a filament current.

  The reconstruction device 109 receives the projection data preprocessed by the preprocessing device 106, and reconstructs the volume data based on the projection data. The reconstruction device 109 performs fast Fourier transform (FFT) for transforming the projection data into the frequency domain, and performs three-dimensional backprojection processing on the projection data on which the reconstruction function is superimposed. And obtain a tomographic image for each body axis direction of a normal subject.

  Also, the reconstruction device 109 reconstructs a two-dimensional distribution tomogram of X-ray tube voltage-dependent information related to the distribution of atoms, so-called dual energy imaging tomogram, from both high-voltage and low-voltage projection images. Includes a dual energy image reconstruction unit.

  The system controller 110 controls the high voltage generator 107 so as to periodically change the tube voltage of the X-ray tube 101 between a high voltage (for example, 140 kV) and a low voltage (for example, 80 kV). The high voltage and the low voltage may be referred to as a high energy level and a low energy level.

  Further, the system controller 110 controls the rotation unit 111 to rotate the annular frame 102 at a high speed such as 0.4 seconds / rotation. The system controller 110 moves a top plate (not shown) by controlling a moving unit (not shown). The subject placed on the top plate is moved along the rotation axis RA by the movement of the top plate.

  In addition, the system controller 110 receives an input from the reconstruction device 109 and causes the X-ray data collection condition setting device 112 to set a collection condition. Based on this collection condition, the system controller 110 controls the high voltage generator 107 to periodically change the tube voltage for each view, and collects data in synchronization with the change. To control. Here, the system controller 110 is connected to the reconstruction apparatus 109 and the medical image processing apparatus 200 via a data / control bus.

  The X-ray data collection condition setting device 112 sets the tube voltage and the tube current so that when the tube voltage of the X-ray tube 101 is different, the noise of the data of different tube voltages becomes equal or a constant ratio, Corresponding to each tube voltage, conditions (collection conditions) such as integration time of X-ray collection of DAS 104 or the number of views are set.

  FIG. 2 is a block diagram showing the medical image processing apparatus 200 according to the first embodiment.

  A medical image processing apparatus 200 illustrated in FIG. 2 includes a processor 1, a memory 2, a communication device 3, an input device 4, a display device 5, a storage device 6, and a bus line 7. The bus line 7 includes an address bus and a data bus that connect the processor 1, the memory 2, the communication device 3, the input device 4, the display device 5, and the storage device 6 so that they can communicate with each other.

  The processor 1 is, for example, a CPU (Central Processing Unit), and implements various processes by executing computer programs.

  The memory 2 is a main memory including a ROM (Read Only Memory) and a RAM (Random Access Memory). The memory 2 stores a medical image processing program 30 and volume data for causing the processor 1 to implement main processing in the present embodiment. The memory 2 forms a working storage area for temporarily storing various information.

  The communication device 3 communicates with an external device by wire or wireless. The external device is, for example, a modality such as an X-ray diagnostic apparatus, a server included in a system such as PACS (Picture Archiving and Communication System), or another workstation.

  The input device 4 is an interface for inputting commands and the like according to user operations, and includes, for example, a keyboard, a mouse, a touch panel, a trackball, and various buttons.

  The display device 5 is a display such as an LCD (Liquid Crystal Display) or an OELD (Organic ElectroLuminescence Display).

  The storage device 6 is an HDD (Hard Disk Drive), an SSD (Solid State Drive), or the like that can store a relatively large amount of data. The storage device 6 stores a plurality of time-series volume data, analysis results, and the like in the course of processing realized by the processor 1 executing the medical image processing program 30.

  FIG. 3 is a block diagram illustrating functions realized by the processor 1 executing the medical image processing program 30. As shown in FIG. 3, the processor 1 includes a data input unit 11, a core line extraction unit 12, an aorta region extraction unit 13, a left ventricular region extraction unit 14, an aortic valve surface detection unit 15, an analysis region setting unit 16, and a severity level. Functions as the determination unit 17, the image generation unit 18, and the image output unit 19 are realized. The processor 1 operates as these units.

  Next, image analysis processing in the medical image analysis apparatus having the above-described configuration will be described in detail.

  FIG. 4 is a flowchart showing a flow of image analysis processing in the medical image analysis apparatus according to the first embodiment.

  The medical image diagnostic apparatus 1000 captures a plurality of time-series projected images by using Real-Prep for observing a change in CT value due to contrast medium injection, aiming at a time phase when the aorta and the left ventricle start to be imaged. (Acquisition of projection data) (step ST11). FIG. 5 is a diagram illustrating the imaging timing of the projection image. As shown in FIG. 5, the medical image diagnostic apparatus 1000 captures a projection image at a timing at which the aortic valve blood flow velocity V becomes maximum. The timing at which the aortic valve blood flow velocity V becomes maximum is, for example, the state of the heart (FIG. 5A), the pressure around the left ventricle and the aorta (FIG. 5B), and the volume of the left ventricle (FIG. 5). (C)), determination is made with reference to an electrocardiogram (FIG. 5 (d)) and the like.

  The medical image diagnostic apparatus performs reconstruction of the plurality of time-series projection images by setting a plurality of small reconstruction windows based on the exposure time in the reconstruction apparatus 109 (step ST12). Thereby, a plurality of time-series volume data are generated. This volume data corresponds to a specific cardiac phase obtained by scanning the heart region of the subject with an X-ray CT apparatus in advance. Further, the medical image diagnostic apparatus executes an inter-image registration process in order to correct a positional shift or deformation between a plurality of time-series volume data (step ST13).

  In the medical image diagnostic apparatus according to the present embodiment, after detecting the anatomical region / Landmark, the information on the anatomical region and Landmark may be used as an input for alignment. In this case, the feedback result is reflected on the anatomical position / shape.

  A plurality of time-series volume data for which the inter-image registration processing is executed is input to the data input unit 11 of the processor 1.

  For example, the data input unit 11 communicates with the medical image diagnostic apparatus 1000 via the communication device 3 to input a plurality of time-series volume data to be subjected to the inter-image registration processing from the medical image diagnostic apparatus 1000. A plurality of input time-series volume data is stored in the storage device 6.

  The core line extraction unit 12 performs an extraction process of the aorta and the left ventricle core lines and the like on the time-series volume data. For example, the core wire extraction unit 12 extracts the core wire of the aorta included in a plurality of time-series volume data stored in the storage device 6 (step ST14). For example, the core line extraction unit 12 calculates a long region estimated from the volume data as the lumen of the aorta based on a change in the voxel value included in the volume data and a predetermined feature value related to the general aorta. Identify. The core line extraction unit 12 extracts the center line along the longitudinal direction in the specified region as the core line of the aorta.

  The aorta region extraction unit 13 extracts the aorta region from the volume data based on the aorta core line extracted by the core line extraction unit 12 (step ST15).

  The core line extraction unit 12 extracts a left ventricular core line included in a plurality of time-series volume data stored in the storage device 6 (step ST16). The core line extraction unit 12 specifies a region estimated as the lumen of the left ventricle from the volume data based on the change in the voxel value included in the volume data and a predetermined characteristic value related to the general left ventricle. The core line extraction unit 12 extracts the center line along the longitudinal direction in the identified region as the core line of the left ventricle.

  The left ventricular region extracting unit 14 extracts a left ventricular region from the volume data based on the left ventricular core extracted by the core extracting unit 12 (step ST17).

  The aortic valve surface detection unit 15 detects the valve surface of the aortic valve included in the aortic region extracted by the aortic region extraction unit 13 from the boundary surface position between the aortic region and the left ventricular region and the surrounding CT values (step ST18). ). The valve surface is defined as a central plane in a plane group that intersects perpendicularly with the core line of the aorta and includes the aortic leaflets, for example. Therefore, for example, the aortic valve surface detection unit 15 extracts and extracts a plane group including the aortic valve leaflet by scanning a plane perpendicular to the core line along the core line in the aorta region extracted by the aorta region extraction unit 13. The central plane of the plane group is taken as the valve face. The aortic valve surface detection unit 15 displays the aortic region extracted by the aortic region extraction unit 13 on the display device 5 and detects a plane set on the image by the user via the input device 4 as the aortic valve surface. May be.

  FIG. 6 is a perspective view showing the aortic valve detected by the aortic valve surface detection unit 15.

  FIG. 6 shows a slab having a thickness t centered on the aortic valve surface as a display surface. On this display surface, a sketch of the outline of the aortic sinus is shown, and its cloverleaf shape is markedly represented. A display axis is shown, which is perpendicular to the display surface and intersects the display surface at the center of the cross section of the aortic sinus on this display surface. In addition, the display direction is aligned with the illustrated axis on the display surface.

  The analysis region setting unit 16 sets a blood flow velocity analysis region for calculating a blood flow velocity based on at least one of the left ventricle, the aortic valve, and the aorta (step ST17). For example, the analysis region setting unit 16 may automatically set the blood flow velocity analysis region using a preset position stored in advance. The analysis region setting unit 16 sets a blood flow velocity analysis region based on a range manually input via a morphological image showing the anatomical shape of the left ventricle or aorta displayed on the display device 5. May be.

  The severity determination unit 17 observes the blood flow velocity analysis region between a plurality of time-series volume data and analyzes a change in signal value between the plurality of time-series volume data (step ST18). . The severity determination unit 17 calculates the blood flow velocity from the increasing rate of the signal value obtained from the analysis result (step ST19). For example, when imaging is performed in the time phase at the moment when the maximum blood flow velocity is reached, the severity determination unit 17 can calculate the blood flow velocity by dividing the moving distance of the contrast medium head in the blood vessel by the time.

The severity determination unit 17 calculates the pressure difference of the aortic valve from the calculated blood flow velocity using the simple Bernoulli method (step ST112). The severity determination unit 17 measures the blood flow velocity Vmax (m / sec) of the aortic valve, and calculates the pressure difference from the simple Bernoulli equation shown in Equation (1).

Further, the average pressure difference is obtained by the equation (2) and correlates well with the pressure difference measured invasively.

  When measuring the pressure difference, if the LVOT (Left Ventricular Outflow Tract) blood flow velocity> 1.5 m / s (such as advanced AR (Aortic Regurgitation) or high cardiac output), the aortic valve pressure difference is overestimated. If there is a possibility, and if the left ventricular drive output is reduced, it is necessary to be careful because there is a possibility of severe stenosis even if the pressure difference is low.

  The severity determination unit 17 determines the severity of the disease in the aortic valve from the calculated pressure range (step ST113). Severity refers to the degree of disease severity determined from the calculated pressure difference.

  FIG. 7 is a diagram illustrating an example of a table for evaluating the severity of a disease in the aortic valve.

  The severity determination unit 17 refers to the table shown in FIG. 7 to determine the severity of the disease in the aortic valve. For example, if the average pressure range is greater than 40 mmHg, it is determined that the condition is severe. Note that the table shown in FIG. 7 may be stored in the storage device 6.

  After the above image analysis processing is completed, the image generation unit 18 generates a morphological image indicating the anatomical shape of the aorta, and the image output unit 19 outputs the generated morphological image to the display device 5. The display device 5 displays the calculated pressure difference value as a function analysis result on the screen together with the aorta morphological analysis result (step ST114).

  FIG. 8 is a diagram illustrating a display example of a result of the image analysis processing illustrated in FIG.

  The medical image processing apparatus sets the blood flow velocity analysis region as shown in FIG. Further, as shown in FIG. 8B, the display device 5 displays the calculated pressure difference value as an analysis result on the screen together with the aortic morphological analysis result.

  For example, the display device 5 may display a cylinder that can define an upper surface and a lower surface that are perpendicular to the core line, and display graphics that can be translated, expanded, and reduced in the core line direction on the display image. Good.

  The display device 5 may display a graphic reflecting the shape of an anatomical region such as the aorta instead of the cylinder. Further, the blood flow velocity analysis region may be displayed independently for the aorta and the left ventricle, or may be covered by a single display.

  According to the above configuration, the medical image processing apparatus 200 according to the first embodiment can perform aorta morphological analysis using medical image data captured by the medical image diagnostic apparatus 1000. Further, the medical image processing apparatus 200 can perform a function analysis for obtaining a pressure difference in the aortic valve.

  Therefore, the medical image processing apparatus 200 can simultaneously perform non-invasively the functional analysis such as the morphological analysis and pressure difference in the aortic valve.

  In the medical image processing apparatus of the above-described embodiment, an example in which an X-ray CT apparatus is used as an example of the apparatus has been shown. However, a medical image captured by MRI (Magnetic Resonance Imaging) may be used.

  The medical image analysis apparatus includes the preprocessing apparatus 106 and the reconstruction apparatus 109 in the medical image diagnostic apparatus 1000, but is not limited thereto. The medical image analysis apparatus may include the preprocessing device 106 and the reconstruction device 109 in the medical image processing device 200.

(Second Embodiment)
FIG. 9 is a block diagram showing a functional configuration of the processor 1 of the medical image processing apparatus according to the second embodiment. The configuration of the medical image analysis apparatus according to the second embodiment is the same as that of the medical image analysis apparatus shown in FIG.

  As shown in FIG. 9, the processor 1 includes a data input unit 11, a core line extraction unit 12, an aorta region extraction unit 13, a left ventricular region extraction unit 14, an aortic valve surface detection unit 15, a severity determination unit 91, and an image generation Functions as the unit 18 and the image output unit 19 are realized. The processor 1 operates as these units.

  FIG. 10 is a flowchart showing the flow of image analysis processing in the medical image analysis apparatus according to the second embodiment.

  The medical image diagnostic apparatus 1000 captures a projection image at a predetermined time by using Real-Prep for observing a change in CT value due to contrast medium injection, aiming at a time phase when the aorta and the left ventricle start to be imaged ( Step ST21).

  The medical image diagnostic apparatus 1000 reconstructs a projection image at a predetermined time based on the exposure time (step ST22). Thereby, volume data at a predetermined time is generated.

  Volume data at a predetermined time at which the inter-image registration processing is performed is input to the data input unit 11 of the processor 1.

  For example, the data input unit 11 communicates with the above-described medical image diagnostic apparatus 1000 via the communication device 3 to input volume data at a predetermined time when the inter-image registration processing is performed from the medical image diagnostic apparatus 1000. The input volume data at a predetermined time is stored in the storage device 6.

  The core line extraction unit 12 executes an extraction process of the aorta and the left ventricle core lines on the volume data at the predetermined time. For example, the core line extraction unit 12 extracts the core line of the aorta stored in the storage device 6 and included in the volume data at a predetermined time (step ST23).

  The aorta region extraction unit 13 extracts the aorta region from the volume data based on the aorta core line extracted by the core line extraction unit 12 (step ST24).

  Moreover, the core wire extraction unit 12 extracts the left ventricular core wire included in the volume data at a predetermined time stored in the storage device 6 (step ST25).

  The left ventricular region extracting unit 14 extracts a left ventricular region from the volume data based on the left ventricular core line extracted by the core line extracting unit 12 (step ST26).

  The aortic valve surface detecting unit 15 detects the valve surface of the aortic valve included in the aortic region extracted by the aortic region extracting unit 13 from the boundary surface position between the aortic region and the left ventricular region and the surrounding CT values (step ST27). ).

  The seriousness determination unit 91 analyzes a change in the signal value of the aortic core wire. Further, the medical image processing apparatus creates a graph by plotting the CT value of the analyzed core wire, draws a straight line based on the CT value distribution of the created graph, and acquires the gradient of the straight line (step ST28). Specifically, the severity determination unit 91 develops an image with reference to the core line like a Stretched MPR image. The severity determination unit 91 graphs the change in the CT value of the core wire on the Crosscut image orthogonal to the core wire. The horizontal axis of the graph is the distance from the origin, and the vertical axis of the graph is the CT value of the core wire. The medical image processing apparatus can draw a straight line of the CT value of the core line by graphing the change in the CT value of the core line.

  The severity determination unit 91 calculates the spatial change rate of the voxel value of the voxel selected with reference to the core line of the aorta using the volume data at a predetermined time. Severity determination unit 91 calculates a pressure difference based on the spatial change rate of the voxel value (step ST29).

  Severity determination unit 91 determines the severity of the disease in the aortic valve from the calculated pressure difference (step ST210).

  After the above image analysis processing is completed, the image generation unit 18 generates a morphological image indicating the anatomical shape of the aorta, and the image output unit 19 outputs the generated morphological image to the display device 5. Further, the display device 5 displays the calculated pressure difference value as a function analysis result on the screen of the display device 5 together with the aortic morphological analysis result (step ST211).

  FIG. 11 is a diagram illustrating a display example of a result of the image analysis process illustrated in FIG.

  As shown in FIG. 10A, the display device 5 displays the morphological analysis result of the aorta. Further, as shown in FIG. 10B, the medical image processing apparatus 200 displays the CT value graph as an analysis result on the screen together with the aorta morphological analysis result. Here, as shown in FIG. 10C, when the slope of the straight line is large, the pressure difference is large. That is, it can be determined that the blood flow is not sent to the aorta, and it can be determined that there is an abnormality. Moreover, when the inclination of the straight line is small, the pressure difference is small. That is, it can be determined that blood flow is sent to the aorta, and it can be determined that the blood flow is normal.

  As in the first embodiment, a severity may be determined by providing a table.

According to the above configuration, the medical image processing apparatus 200 according to the second embodiment can perform aortic morphological analysis using medical image data captured by the medical image diagnostic apparatus 1000. Further, the medical image processing apparatus 200 can perform a function analysis for obtaining a pressure difference in the aortic valve. Therefore, the medical image processing apparatus 200 performs a function analysis such as a morphological analysis and a pressure difference in the aortic valve non-invasively. Can be realized simultaneously.

  In the medical image processing apparatus 200 according to the above-described embodiment, an example in which an X-ray CT apparatus is used as an example of the apparatus is shown. However, a medical image captured by MRI (Magnetic Resonance Imaging) may be used.

  The medical image analysis apparatus includes the preprocessing apparatus 106 and the reconstruction apparatus 109 in the medical image diagnostic apparatus 1000, but is not limited thereto. The medical image analysis apparatus may include the preprocessing device 106 and the reconstruction device 109 in the medical image processing device 200.

(Third embodiment)
FIG. 12 is a block diagram illustrating a functional configuration of the processor 1 of the medical image processing apparatus 200 according to the third embodiment. The configuration of the medical image analysis apparatus according to the third embodiment is the same as that of the medical image analysis apparatus shown in FIG.

  As shown in FIG. 12, the processor 1 includes a data input unit 11, a core line extraction unit 12, an aorta region extraction unit 13, a left ventricular region extraction unit 14, an aortic valve surface detection unit 15, a model generation unit 121, and a severity determination. Functions as the unit 122, the image generation unit 18, and the image output unit 19 are realized. The processor 1 operates as these units.

  FIG. 13 is a flowchart showing a flow of image analysis processing in the medical image analysis apparatus according to the third embodiment.

  The medical image diagnostic apparatus 1000 captures a projection image at a predetermined time by using Real-Prep for observing a change in CT value due to contrast medium injection, aiming at a time phase when the aorta and the left ventricle start to be imaged ( Step ST31).

  The medical image processing apparatus reconstructs a projection image at a predetermined time based on the exposure time (step ST32). Thereby, volume data at a predetermined time is generated.

  Volume data at a predetermined time when the inter-image registration processing is executed is input to the data input unit 11 of the processor 1.

  For example, the data input unit 11 communicates with the above-described medical image diagnostic apparatus 1000 via the communication device 3 to input volume data at a predetermined time when the inter-image registration processing is performed from the medical image diagnostic apparatus 1000. The input volume data at a predetermined time is stored in the storage device 6.

  For example, the data input unit 11 communicates with the medical image diagnostic apparatus 1000 via the communication device 3 to input volume data at a predetermined time when the inter-image registration processing is performed from the medical image diagnostic apparatus 1000. The input volume data at a predetermined time is stored in the storage device 6.

  The core line extraction unit 12 executes an extraction process of the aorta and the left ventricle core lines on the volume data at the predetermined time. For example, the core line extraction unit 12 extracts the core line of the aorta stored in the storage device 6 and included in the volume data at a predetermined time (step ST33).

  The aorta region extraction unit 13 extracts the aorta region from the volume data based on the aorta core line extracted by the core line extraction unit 12 (step ST34).

  Moreover, the core wire extraction part 12 extracts the core wire of the left ventricle contained in the volume data at the predetermined time memorize | stored in the memory | storage device 6 (step ST35).

  The left ventricular region extracting unit 14 extracts a left ventricular region from the volume data based on the left ventricular core line extracted by the core line extracting unit 12 (step ST36).

  The aortic valve surface detecting unit 15 detects the valve surface of the aortic valve included in the aortic region extracted by the aortic region extracting unit 13 from the boundary surface position between the aortic region and the left ventricular region and the surrounding CT values (step ST37). ).

  The model generation unit 121 generates a three-dimensional model of the aortic valve and the left ventricle (step ST38).

  The seriousness determination unit 122 calculates the pressure distribution of the aortic valve and the left ventricle by CFA (Confirmatory Factor Analysis) (step ST39).

  Severity determination unit 122 calculates the pressure difference of the aortic valve from the pressure distribution (step ST310). Instead of the CFA, FSI (Fluid Structure Interaction) analysis for calculating the velocity distribution of fluid, that is, blood flow may be performed.

  Severity determination unit 122 determines the severity of the disease in the aortic valve from the calculated pressure difference (step ST210).

  Similar to the first and second embodiments, a table may be provided to determine the severity.

  After the above image analysis processing is completed, the image generation unit 18 generates a morphological image indicating the anatomical shape of the aorta, and the image output unit 19 outputs the generated morphological image to the display device 5. The display device 5 displays the pressure difference on the screen together with the morphological analysis results of the left ventricle and the aorta (step ST311).

  FIG. 14 is a diagram illustrating a display example of a result obtained by the image analysis processing illustrated in FIG.

  As shown in FIG. 14A, the display device 5 may display the calculated pressure difference on the screen together with the fluid analysis result of the aortic valve. Further, as shown in FIG. 14B, the display device 5 may display the calculated pressure difference on the screen together with the blood flow velocity distribution and pressure distribution of the left ventricle and the aorta.

  In the third embodiment, volume data at a predetermined time is used, but a plurality of time-series volume data may be used.

According to the above configuration, the medical image processing apparatus 200 according to the third embodiment can perform aortic morphological analysis using the medical image data captured by the medical image diagnostic apparatus 1000. Further, the medical image processing apparatus 200 can perform a function analysis for obtaining a pressure difference in the aortic valve. Therefore, the medical image processing apparatus 200 performs a function analysis such as a morphological analysis and a pressure difference in the aortic valve non-invasively. Can be realized simultaneously.

  In the medical image processing apparatus of the above-described embodiment, an example in which an X-ray CT apparatus is used as an example of the apparatus has been shown. However, a medical image captured by MRI (Magnetic Resonance Imaging) may be used.

  As mentioned above, although embodiment of this invention was described, this embodiment is shown as an example and is not intending limiting the range of invention. The novel embodiment can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. This embodiment and its modifications are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

  DESCRIPTION OF SYMBOLS 1000 ... Medical diagnostic imaging apparatus, 100 ... Gantry, 101 ... X-ray tube, 102 ... Annular frame, 103 ... X-ray detector, 104 ... DAS (data acquisition system), 105 ... Non-contact data transmitter, 106 ... Pre-processing DESCRIPTION OF SYMBOLS 107 ... High voltage generator 108 ... Slip ring 109 ... Reconstruction device 110 ... System controller 111 ... Rotation unit 112 ... X-ray data acquisition condition setting device 200-203 ... Medical image processing device DESCRIPTION OF SYMBOLS 1 ... Processor, 2 ... Memory, 3 ... Communication apparatus, 4 ... Input device, 5 ... Display apparatus, 6 ... Memory | storage device, 7 ... Bus line, 11 ... Data input part, 12 ... Core wire extraction part, 13 ... Aorta area | region Extraction unit, 14 ... Left ventricular region extraction unit, 15 ... Aortic valve surface detection unit, 16 ... Analysis region setting unit, 17, 91, 121 ... Severity determination unit, 18 ... Image Generating unit, 19 ... image output unit, 122 ... model generating unit.

Claims (11)

A calculation unit that calculates a pressure difference of the aortic valve using a voxel value of volume data obtained by imaging an area including at least the aorta, the aortic valve, and the left ventricle;
A medical image processing apparatus comprising: a display unit configured to spatially display the pressure difference and the aortic valve on a predetermined morphological image. An acquisition unit for acquiring volume data obtained by imaging the subject;
Of the volume data, an area that is at least part of the aorta and connected to the aortic valve, an area corresponding to the aortic valve, and an area that is at least part of the left ventricle and connected to the aortic valve are specified. Specific part to do,
A calculation unit that calculates a pressure difference of the aortic valve using a voxel value of volume data of each region specified by the specifying unit;
A display unit for displaying the calculated pressure difference;
A medical image processing apparatus comprising:   The medical image processing apparatus according to claim 2, wherein the morphological image related to the aortic valve and the pressure difference calculated by the calculation unit are displayed on the same screen.   The medical image processing apparatus according to claim 3, wherein a region corresponding to the aortic valve in the morphological image is further displayed on the morphological image.   5. The calculation unit calculates a blood flow velocity in an analysis region based on an aortic valve using a plurality of time-series volume data, and calculates the pressure range based on the blood flow velocity. The medical image processing apparatus as described in any one of these.   The medical image processing apparatus according to claim 5, further comprising a setting unit that sets the analysis region based on at least one of the left ventricle, the aortic valve, and the aorta.   The medical image processing apparatus according to claim 6, wherein the setting unit automatically sets the analysis region using a preset position stored in advance.   The medical image processing apparatus according to claim 6, wherein the setting unit sets the analysis region based on a range manually input via the morphological image.   The calculation unit calculates a spatial change rate of a voxel value of a voxel selected with reference to the core line of the aorta using volume data at a predetermined time, and based on the spatial change rate of the voxel value The medical image processing apparatus according to any one of claims 1 to 8, wherein the pressure difference is calculated.   The calculation unit uses a plurality of time-series volume data or volume data at a predetermined time to perform blood pressure analysis by CFA (Confirmatory Factor Analysis) or pressure distribution of the aorta or FSI (Fluid Structure Interaction) analysis. 10. The medical image processing apparatus according to claim 1, wherein a flow velocity distribution is calculated, and the pressure difference is calculated from the pressure distribution or the blood flow velocity distribution.   The medical image processing apparatus according to claim 1, wherein the volume data is data captured by an X-ray computed tomography apparatus or a magnetic resonance imaging apparatus.