JP6521587B2 - Medical image interpretation apparatus, medical image presentation method, computer program and kit - Google Patents

Description

  The present invention relates to a medical image interpretation apparatus capable of reducing the occurrence of oversights such as lesions in image diagnosis and contributing to more reliable image diagnosis, an image diagnosis system including the same, and the like.

  At present, a CT (Computed Tomography) scanner, an MRI (Magnetic Resonance Imaging) apparatus, a PET (Positron Emission Tomography) apparatus, an ultrasonic diagnostic apparatus, an angiography imaging apparatus etc. are known as medical diagnostic imaging apparatuses. ing.

  With the recent advances in performance of imaging devices, medical images and the like obtained in a single examination have become larger in volume, and it has become possible to find minute lesions and the like that could not be found conventionally. Also, various softwares have been proposed for interpreting such a large amount of medical images and the like on a viewer.

Japanese Patent Application Publication No. 2007-114433

  An object of the present invention is to provide a medical image interpretation apparatus and the like which can reduce the occurrence of oversight such as a lesion in image diagnosis and can contribute to more highly reliable image diagnosis.

The medical image interpretation apparatus according to one aspect of the present invention for solving the above-mentioned problems is as follows:
A medical image interpretation apparatus for interpreting a medical image imaged by a medical imaging apparatus for imaging a patient's medical image (including not only an image but also a moving image),
A display device for displaying the medical image;
An imaging device for imaging an operator who performs work while looking at the display device, or an eye potential sensing device;
And a control unit,
The control unit
a: Determine the open / close state of the surgeon's eyes,
b: It is judged whether the open / closed state of the eye is within the normal range,
c: perform a predetermined action associated with a warning operation and / or an interpretation operation for the operator
A medical image interpretation device that is configured as follows.

  According to the present invention, it is possible to provide a medical image interpretation apparatus and the like that can reduce the occurrence of oversight such as a lesion in image diagnosis and can contribute to more highly reliable image diagnosis.

It is a block diagram showing composition of an image diagnostic system of one embodiment typically. It is a figure showing an example of physical composition of an image interpretation device. It is a flowchart which shows an example of operation | movement of the image interpretation apparatus based on blink detection and the detection result. It is a figure which shows an example of the display mode of the scroll gauge on an interpretation screen. It is a figure which shows an example of the display mode of an interpretation screen and a scroll gauge. It is a figure showing an example of glasses and an imaging device attached to it. It is a block diagram which shows the structure of the system which concerns on another form typically, and becomes the structure similar to FIG. 1 except the point by which the imaging device is substituted to the electro-oculogram sensing device.

  Embodiments of the present invention will be described below with reference to the drawings.

First Embodiment
As shown in FIG. 1, the image diagnostic system 100 of the present embodiment includes a medical imaging device 300 for capturing a medical image of a patient, and a medical image interpretation device 500 that is a viewer for performing image diagnosis. There is.

  In the present invention, of course, in addition to these components, for example, a drug solution injector for injecting a drug solution such as a contrast agent into a patient, RIS (Radiology Information System) which is a radiology information system, image storage communication A system, such as PACS (Picture Archiving and Communication Systems), may be provided.

[About the imaging device]
The imaging device 300 may be, for example, an X-ray CT scanner or an MRI device. In this example, as schematically shown in FIG. 1, the imaging apparatus 300 includes an imaging unit 303 b that captures a medical image of a patient, a bed 304 on which the patient is placed, and a control unit 303 a that controls the operation of the bed. doing. Further, although detailed description will be omitted, the imaging apparatus 300 has a function of transmitting the medical image of the imaged patient to an external system or device. Here, the imaging device 300 may have a function of capturing a moving image as well as the function of capturing a fluoroscopic image. The “medical image” in the present specification may include not only medical images but also moving images.

  The method of communication with the outside is not particularly limited, and conventionally known communication methods and communication protocols can be appropriately used.

[About image reading device]
The image interpretation device 500 is used to interpret a medical image of a patient acquired by the imaging device 300. The image interpretation apparatus 500 may have, for example, the same configuration as a general computer. Specifically, for example, as shown in FIG. 1 and FIG. 2, the control unit 501a disposed in the computer case 503, the storage device 501b, the display device 502, the input devices 505, 506, etc. It may be.

  The control unit 501a is hardware including a processor, a memory, and the like, and implements various functions in accordance with a computer program. The computer program may be stored in, for example, the storage unit 501b or a memory in the control unit 501a.

  The display device 502 may be, for example, a liquid crystal display (LCD) or the like, and displays various information including a medical image of a patient. The number of display devices 502 is not particularly limited, and may be one or more.

  Examples of the input device include arbitrary devices such as a keyboard 505, a mouse 506, a trackball (not shown), and a joystick (not shown). In addition, you may use not only the input means for general computers, such as a mouse | mouth and a track ball, but the medical input device which switches an image by operating a lever.

  The storage unit 501b may be a hard disk drive or the like that stores various data. The above-described control unit 501a can also be referred to as a control unit, a processor unit, a controller, a controller unit, a microcomputer, or the like.

The computer program may, for example, implement the following function for image reading:
A function of acquiring data of a medical image of a patient imaged by an imaging device,
-A function to display an interpretation screen for interpreting a plurality of medical images on a display device,
-The function of switching the displayed medical image in accordance with the operation of the input means by the operator,
-A function of automatically paging an image at a predetermined switching speed in a predetermined imaging range (for example, a predetermined range along the body axis direction).

  Further, in the present embodiment, as shown in FIG. 1 and FIG. 2, the image interpretation apparatus 500 is provided with an imaging device 560 for imaging an operator who is performing an operation of interpreting a medical image. The imaging device 560 may be, for example, a camera unit that performs imaging using a digital method, and a CCD camera or the like may be used as a specific example. The imaging device 560 may be small enough to be attached to a portion of the display device 502 as in FIG. Specifically, it may be an upper portion of the display device 502.

  As another example, the imaging device 560 may be held by a dedicated holding member (not shown) instead of being attached to the display device 502. Alternatively, the camera unit itself may be simply disposed on a table on which an interpretation operation is performed. Signal exchange between the imaging device 560 and the control unit 501a may be performed via a wired connection or may be performed via a wireless connection.

In the present embodiment, a computer program (software) for realizing the blink detection function described below is also implemented in the control unit 501a. This computer program is for realizing at least the following functions.
a: Determine the open / close state of the operator's eyes imaged by the imaging device,
b: It is judged whether the open / closed state of the eye is within the normal range,
c: Perform a predetermined action associated with a warning action for the operator and / or a reading action. Note that this operation is an example, and may be performed when it is determined that the open / close state of the eye is out of the normal range as a result of the determination of b.

  More specifically, in the above a, the control unit 501a determines the open / closed state of one or both eyes of the operator. That is, one or more of whether the eye is open or closed, the number of blinks per unit time, the degree of opening of the eye, and the like are determined.

In the above b, for example, one or both of the following determinations are made.
b1: Whether the eyes of the caster are closed for a certain period of time or not,
b2: Whether the operator's eye open / close interval is less than a predetermined threshold value.

  When the operator's eyes are closed for a certain period of time, it is estimated that the operator is in the sleeping state, and in this state, the accuracy of the image diagnosis may be reduced. Here, the length of the “fixed time” as a reference is not particularly limited, but may be, for example, about several seconds. The same reference time may be uniformly used for any operator, or the reference time may be changed for each operator performing an interpretation.

  Next, “when the opening / closing interval of the operator's eyes is equal to or less than a predetermined threshold value” is, for example, a case where it is estimated that sleepiness occurs in the operator. Specifically, a threshold based on the opening / closing interval (the number of blinks) of the normal operator registered in advance is prepared, and the threshold and the opening / closing interval of the detected operator's eyes (the number of blinks) are prepared. This determination may be made by comparing with. As a reference threshold, a general value of the eye open / close interval (the number of blinks) may be set, not unique to the operator.

  Finally, in the above c, an alarm that is one or more of, for example, a sound, an image, text information, and a vibration may be issued as a warning to the operator. The means for emitting the alarm may be a device provided in the image reading apparatus 500 or a device provided in another device or facility.

The “predetermined operation associated with the image interpretation operation” in c above may be one or more of the following in one example:
c1: reduce the paging speed in the paging operation or stop the paging operation
c2: When a paging operation is performed, an image display unit for recognizing a medical image corresponding to the portion advanced by the paging is displayed, etc.

  As described in c1 above, by slowing down or stopping the paging operation, the medical image is automatically paged in a state where the operator can not scrutinize the image, and a lesion or the like is overlooked. Is reduced or prevented.

  If the operator is configured to know where up to which medical image has been paged in a state where the operator can not scrutinize an image as in c2 above, the operator can perform all of the medical images This is preferable in terms of work efficiency, because it is not necessary to review again, but to interpret only the target image that is suspected of being overlooked.

(Movement control of mouse)
In addition, as an imaging device, an imaging device 560 'of the type attached to spectacles (an example) as shown in FIG. 6 etc. can also be utilized. As a function of the control unit 510a (in other words, as a function of a computer program), such an imaging device 560 'may be used to determine the open / close state of the eye of the operator. In addition, based on the result, for example, an operation may be performed to restrict an input operation of a mouse or the like.

  More specifically, when the operator has his eyes closed for a certain period of time, or the number of blinks is greater than a predetermined reference value (for example, the number of blinks of the person's normal time), the mouse May be restricted (eg, click and / or mouse wheel rotation, etc.). One method is that such input is made from the mouse, but the computer side is made to stop without performing processing (for example, paging operation on the viewer) that should be originally performed when such input is made, or However, the processing may be performed such that the paging movement amount is smaller than that in the normal state. Instead of making the paging rate suddenly zero, a correction process may be implemented such as gradually reducing or temporarily reducing. According to such a configuration, when the open / close state of the eye is not normal, the input operation with the mouse or the like is restricted (prohibited). For example, a predetermined input (not limited to any given software of the computer) However, for example, the selection of the send / receive button in the electronic mail software may be invalidated, and as a result, it is possible to prevent an erroneous operation or the like.

  How much a given object on the software is moved (or scrolled) when the mouse wheel is rotated may depend on the setting of the mouse set on the computer. In one aspect of the present invention, when detecting the abnormality in the open / close state of the eye of the operator as described above, how much the predetermined object on the software is moved when the mouse wheel is temporarily rotated. May be configured to be low.

(About blink detection)
Next, blink detection will be described along the flowchart of FIG.

  First, in step S1, imaging by the imaging device 560 is started, and the blink detection function of the image interpretation apparatus 500 is turned on. Thereby, the determination of the open / close state of the eye of the operator is started.

  Next, in step S2, it is determined whether the open / closed state of the eye is within the normal range. The details of this determination are as described above, and thus the redundant description will be omitted. For example, it is determined whether the eye of the operator is closed for a predetermined time or more.

  If it is determined in step S2 that "normal" (for example, the operator's eyes have not closed for a predetermined time or more), steps S1 and S2 are continuously performed.

  On the other hand, if it is determined in step S2 that the condition is "non-normal" (e.g., the surgeon's eyes are closed for a predetermined time or more), the following steps are taken. Although steps S3a to S3d are illustrated in parallel in the flowchart of FIG. 3 for convenience of explanation, it is of course not necessary to carry out all of them, and the order of carrying out can be changed as appropriate. is there.

  In step S3a, an alarm is emitted to the operator, which is one or more of a sound, an image, text information, and a vibration.

  In step S3b, the image interpretation operation performed by the image interpretation apparatus 500, in particular, the paging speed in the automatic paging operation in which the image is switched automatically is reduced or the paging operation is stopped. When such an operation is performed, the history may be stored as log data in a predetermined storage area.

  In step S3c, on the interpretation screen, the operator can find out where and from which medical image has been paged (in the case of moving images from where) in a state where the operator can not inspect the image. A predetermined highlight is displayed at the scroll gauge 533. A specific example will be described with reference to FIGS. 4 and 5.

  FIG. 5 exemplifies a screen 531 for image interpretation, in which a medical image 531a in the axial direction is displayed in one window in the screen, and a medical image 531b is displayed in another window. There is. Further, in this example, a scroll gauge 533 extending in the vertical direction is displayed. As another form, FIG. 4 shows a display in which the scroll gauge 533 is displayed in the lateral direction, with the display mode being changed a little.

  Here, the display of “1”, “300” to “400”, “1000”, etc. on the scroll gauge 533 in FIG. 4 is added to indicate the position of the imaging range in order to make the description easy to understand. is there. Among the gauges of 1 to 1000, in this example, the portions "300" to "400" are highlighted. This highlighted display area 535 is an area that may be overlooked by the operator's interpretation. Of course, the display method of the display unit 535 can be variously changed, and is not necessarily limited to the mode of highlighting the inside of the gauge.

  Returning to the description of the flowchart again, in step S3d, a part of the medical image of the subject is specified so that the operator can know from where the medical image up to which the medical image has been paged in a state where the image can not be inspected. The identification mark of is displayed. Although detailed illustration is omitted, for example, a configuration may be adopted in which a predetermined identification mark is attached to a part of medical images from the Ath to Bth sheets. Alternatively, these medical images may be displayed at a lower resolution than other medical images. By doing this, it is possible to recognize that these captured images need to be read again.

  According to the medical image interpretation apparatus of the present embodiment as described above, while imaging the face of the operator with the imaging device 560, the open / close state of the eye of the operator is determined by the "blink detection function" When it is determined that the open / close state (interpretation state) of the person's eyes is not normal, an alarm is issued or the speed of the automatic paging operation is reduced, so The occurrence of an oversight can be reduced, and the reliability in image diagnosis can be further improved.

Second Embodiment
Although the aspect which uses an imaging device in order to determine the eye open / close state was shown above, it changes to an imaging device and you may utilize an electro-oculogram sensing device.

  The electro-oculogram sensing device detects the potential difference associated with eye movement to detect the eye open / closed state and the like. For example, a three-point ocular potential sensing technique may be used, and in one form the ocular potential sensing device comprises three electrode members that abut the face.

  Specifically, such an electrode member may have any form, but as an example, one is disposed in the intercostal portion of the glasses and two are disposed in the nose pad portion, and these are disposed as an ocular potential sensor It may be designed to function. The electro-oculogram sensing device 580 schematically shown in FIG. 7 includes a first electro-oculogram sensor 581 disposed in the intercostal region of the glasses and two electro-oculogram sensors 582 disposed in the nose pad portion. There is.

  The computer may determine the open / close state of the eye on software based on the signal of the electro-oculogram detected by the electro-oculography sensing device. The computer in this case is not limited to a general desktop PC, and may be a notebook PC, a tablet PC, or a portable terminal such as a smartphone. The software may, for example, determine the sleepiness and / or fatigue level of the operator.

  Although the above description has basically been described focusing on the configuration and operation of the image interpretation apparatus, the present application also discloses an interpretation method corresponding to the above series of operations, a computer program for realizing the same, and the like. Further, the present invention is not limited to the embodiment described above, and can be appropriately modified without departing from the scope of the invention.

The present application discloses the following inventions:
1. On the computer
a: A process of analyzing the image captured by the imaging device (560) or determining the open / closed state of the eye of the operator performing an interpretation operation based on data detected by the electro-oculogram sensing device ,
b: a process of determining whether the eye open / close state is within the normal range;
c: a process of performing a predetermined action associated with a warning action for the operator and / or a reading action;
A computer program that runs

2. If the eye open / close status is out of the normal range,
Have the computer execute processing to reduce the paging speed of medical images or processing to stop the paging operation
A computer program as described above.

3. The computer program described above,
An imaging device or an electro-oculogram sensing device for imaging an operator;
Kit.

4. The kit as described above, wherein the imaging device or the electro-oculogram sensing device is provided as part of glasses.

5. On the computer
a: A process of analyzing the image captured by the imaging device (560) or determining the open / closed state of the operator's eyes based on data detected by the electro-oculogram sensing device;
b: a process of determining whether the eye open / close state is within the normal range;
c: A computer program that executes, when outside the normal range, a process of restricting input via an input device of a computer.

6. The kit as described above, wherein the imaging device or the electro-oculogram sensing device is provided as part of glasses.

7. A medical image interpretation apparatus (500) for interpreting a medical image captured by a medical imaging apparatus for capturing a medical image of a patient, comprising:
A display device (502) for displaying the medical image;
An imaging device (560) for imaging an operator performing work while looking at the display device, or an electro-oculogram sensing device;
A control unit (501a) having at least an image interpretation function;
The control unit (501a)
a: Determine the open / close state of the surgeon's eyes,
b: It is judged whether the open / closed state of the eye is within the normal range,
c: perform a predetermined action associated with a warning operation and / or an interpretation operation for the operator
A medical image interpretation apparatus (500) configured as follows.

8. The control unit determines that the eye open / closed state is within the normal range as the determination as described above.
b1: Determine whether the operator's eyes are closed for a predetermined time or more
Apparatus as described above.

9. The control unit determines that the eye open / closed state is within the normal range as the determination as described above.
b2: It is determined whether the blinker's time interval is less than or equal to a predetermined threshold.
Apparatus as described above.

10. The image interpretation function has a paging function of sequentially displaying a plurality of medical images at a predetermined speed,
The apparatus as described above, which is configured to reduce the paging speed or to stop the paging as a predetermined operation associated with the interpretation operation when the open / close state of the operator's eyes is outside the normal range. .

11. The image interpretation function has a paging function of sequentially displaying a plurality of medical images at a predetermined speed,
An image for recognizing a medical image of a portion advanced during the paging operation as a predetermined operation associated with the interpretation operation when the paging is performed when the open / close state of the eye of the operator is out of the normal range A device as described above, wherein a display (535 or the like) is displayed.

12. The apparatus as described above, wherein the image display unit is displayed on a part (535) of a scroll gauge displayed on an image interpretation screen.

The present invention can be applied not only to medical devices but also to general image and / or video monitoring devices (viewing devices). It should be noted that the technical ideas of the other aspects of the present invention expressed as follows as an example can be appropriately combined with the various inventions of one aspect of the present invention described above.
A1. An apparatus for viewing an image and / or a moving image captured by an imaging device (for example, an imaging means such as a security camera).
A display device for displaying images and / or videos,
An imaging device for imaging an operator who works while viewing the display device, or an electro-oculogram sensing device;
At least a control unit (which may be a computer);
The control unit
a: Determine the open / close state of the worker's eyes,
b: It is judged whether the open / closed state of the eye is within the normal range,
c: perform a predetermined action associated with the warning action and / or the reading action
The device that is configured to: In addition, a computer program for causing a computer to perform operations a to c, and the like.

100 image diagnostic system 300 medical imaging device 303a control unit 300b imaging unit 304 bed 500 medical image interpretation device 500
501a Control unit (control unit, processor unit, controller unit)
501 b storage unit 502 display unit 503 case (computer main body)
505, 506 Input device 531 Screens 531a, 531b Medical images (not only images but also moving images in a broad sense)
533 scroll gauge 535 recognition image display unit 560, 560 'imaging device (camera)
580 Electropotential sensing devices 581 and 582 Electropotential sensors

Claims (12)

On the computer
a: a process of analyzing an image captured by the imaging device or determining the open / closed state of the eye of the operator performing an interpretation operation based on data detected by the electro-oculogram sensing device;
b: a process of determining whether the eye open / close state is within the normal range;
c: a process of performing a predetermined operation associated with the read shadow operation,
A computer program that executes
The predetermined operation associated with the image interpretation operation is
In the use of the paging function of sequentially displaying a plurality of medical images at a predetermined speed, when paging is performed when the open / close state of the eye of the operator is out of the normal range, the medical image for the portion advanced during the paging To display an image display unit for recognizing
Computer program. If the eye open / close status is out of the normal range,
The computer, to execute the processing of reducing the rate of the medical image paging,
The computer program according to claim 1. A computer program according to claim 1 or 2;
An imaging device or an electro-oculogram sensing device for imaging an operator;
Kit.   The kit according to claim 3, wherein the imaging device or the electro-oculogram sensing device is provided as part of glasses. The image display unit is displayed on a part of a scroll gauge displayed on an image interpretation screen.
A computer program according to claim 1 or 2. A medical image interpretation apparatus for interpreting a medical image captured by a medical imaging apparatus for capturing a medical image of a patient, comprising:
A display device for displaying the medical image;
An imaging device for imaging an operator who performs work while looking at the display device, or an eye potential sensing device;
A control unit having at least an image interpretation function;
The image interpretation function has a paging function of sequentially displaying a plurality of medical images at a predetermined speed,
The control unit
a: Determine the open / close state of the surgeon's eyes,
b: It is judged whether the open / closed state of the eye is within the normal range,
c: performing a predetermined operation associated with the read shadow operation,
Was configured as
When the paging is performed when the open / close state of the eye of the operator is out of the normal range, as the predetermined operation associated with the image interpretation operation, the medical image for recognizing the advanced medical image during the paging is A medical image interpretation apparatus displayed by an image display unit. The control unit determines that the eye open / closed state is within the normal range as the determination as described above.
b1: Determine whether the operator's eyes are closed for a predetermined time or more
The medical image interpretation apparatus according to claim 6. The control unit determines that the eye open / closed state is within the normal range as the determination as described above.
b2: It is determined whether the blinker's time interval is less than or equal to a predetermined threshold.
The medical image interpretation apparatus according to claim 6. The control unit
If the caster's eyes open and closed states is out of the normal range, by Ru reduce paging rate is urchin configuration,
The medical image interpretation apparatus according to any one of claims 6 to 8. The image display unit is displayed on a part of a scroll gauge displayed on an image interpretation screen.
The medical image interpretation apparatus according to any one of claims 6 to 9. a: analyzing an image captured by the imaging device or, based on data detected by the electro-oculogram sensing device, determining the open / closed state of the eye of the operator performing an interpretation operation;
b: determining whether the open / close state of the eye is within the normal range;
c: a step of performing a predetermined operation associated with the read shadow operation,
A method of presenting a medical image, wherein the steps a to c are performed by a computer,
The predetermined operation associated with the image interpretation operation is
In the use of the paging function of sequentially displaying a plurality of medical images at a predetermined speed, when paging is performed when the open / close state of the eye of the operator is out of the normal range, the medical image for the portion advanced during the paging To display an image display unit for recognizing
How to present medical images. The image display unit is displayed on a part of a scroll gauge displayed on an image interpretation screen.
A method of presenting a medical image according to claim 11.

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