JP7758486B2 - Ultrasound diagnostic equipment - Google Patents

Description

The embodiments disclosed in this specification and drawings relate to an ultrasound diagnostic device, an output method, and an output program.

An ultrasound diagnostic device is a device that irradiates ultrasound waves generated from a piezoelectric transducer into a living body and receives the ultrasound waves reflected from the body to create images (photographs) of the condition inside the body. Because imaging using ultrasound diagnostic devices is real-time and non-invasive, they are widely used in the examination of a variety of diseases.

Ultrasound diagnostic devices use multiple imaging modes (also called "scan modes," "photography modes," etc.) that use different imaging methods. There are a variety of imaging modes, including B-mode, which captures B-mode image data; M-mode, which captures M-mode image data; color Doppler mode, which captures color Doppler image data; PW Doppler mode, which captures Doppler waveform data using the pulse wave (PW) Doppler method; CW Doppler mode, which captures Doppler waveform data using the continuous wave (CW) Doppler method; and elastography, which captures stiffness images that represent the stiffness of biological tissue using elastography. These imaging modes are used according to the purpose of the examination.

JP 2013-000517 A Japanese Patent Application Laid-Open No. 2001-061836 JP 2015-116331 A

One of the problems that the embodiments disclosed in this specification and drawings attempt to solve is to reduce the risk of overlooking a disease. However, the problems that the embodiments disclosed in this specification and drawings attempt to solve are not limited to the above problem. Problems that correspond to the effects of each configuration shown in the embodiments described below can also be positioned as other problems.

An ultrasound diagnostic device according to an embodiment includes an estimation unit, a determination unit, and an output control unit. The estimation unit estimates a health condition based on measurements obtained using ultrasound image data. The determination unit determines additional tests to be used in diagnosing the health condition based on the estimated health condition. The output control unit outputs information representing the health condition and the additional tests.

FIG. 1 is a diagram showing an example of the configuration of an ultrasound diagnostic apparatus according to an embodiment. FIG. 2 is a flowchart showing a processing procedure in the ultrasound diagnostic apparatus according to the embodiment. FIG. 3 is a diagram illustrating an example of display of ultrasound image data according to the embodiment. FIG. 4 is a diagram for explaining the processing of the estimation function according to the embodiment. FIG. 5 is a diagram for explaining the process of the determination function according to the embodiment. FIG. 6 is a diagram illustrating an example of a display screen according to the embodiment. FIG. 7 is a diagram illustrating an example of a display screen after an additional examination according to the embodiment. FIG. 8 is a flowchart showing a processing procedure in an ultrasound diagnostic apparatus according to an application example of the embodiment. FIG. 9 is a flowchart showing a processing procedure in an ultrasound diagnostic apparatus according to an application example of the embodiment. FIG. 10 is a flowchart showing a processing procedure in an ultrasound diagnostic apparatus according to an application example of the embodiment. FIG. 11 is a diagram illustrating an example of an input screen according to an application example of the embodiment. FIG. 12 is a diagram illustrating an example of an input screen according to an application example of the embodiment.

The ultrasound diagnostic device, output method, and output program according to the embodiments will be described below with reference to the drawings. Note that the embodiments are not limited to the following embodiments. Furthermore, the content described in one embodiment can, in principle, be applied to other embodiments as well.

(Embodiment)
An example of the configuration of an ultrasound diagnostic apparatus 1 according to an embodiment will be described using Fig. 1. Fig. 1 is a diagram showing an example of the configuration of the ultrasound diagnostic apparatus 1 according to an embodiment. As shown in Fig. 1, the ultrasound diagnostic apparatus 1 according to an embodiment includes a device main body 100, an ultrasound probe 101, an input interface 102, and a display 103. The ultrasound probe 101, the input interface 102, and the display 103 are connected to the device main body 100. Note that a subject P is not included in the configuration of the ultrasound diagnostic apparatus 1.

The ultrasonic probe 101 has multiple transducers (e.g., piezoelectric transducers), which generate ultrasonic waves based on drive signals supplied from a transmission/reception circuit 110 included in the device main body 100 (described below). The multiple transducers included in the ultrasonic probe 101 also receive reflected waves from the subject P and convert them into electrical signals. The ultrasonic probe 101 also has a matching layer provided on the transducers, a backing material that prevents ultrasonic waves from propagating backward from the transducers, and other components.

When ultrasound waves are transmitted from the ultrasound probe 101 to the subject P, the transmitted ultrasound waves are reflected successively by discontinuous surfaces of acoustic impedance in the tissues of the subject P and are received as reflected wave signals (echo signals) by the multiple transducers of the ultrasound probe 101. The amplitude of the received reflected wave signals depends on the difference in acoustic impedance at the discontinuous surfaces from which the ultrasound waves are reflected. When the transmitted ultrasound pulse is reflected by the surface of a moving blood flow, heart wall, etc., the reflected wave signal undergoes a frequency shift due to the Doppler effect, depending on the velocity component of the moving object in the direction of ultrasound transmission.

The embodiment is applicable to any of the following cases: when the ultrasonic probe 101 shown in FIG. 1 is a one-dimensional ultrasonic probe in which multiple piezoelectric vibrators are arranged in a row; when it is a one-dimensional ultrasonic probe in which multiple piezoelectric vibrators arranged in a row are mechanically oscillated; and when it is a two-dimensional ultrasonic probe in which multiple piezoelectric vibrators are arranged in a two-dimensional grid pattern.

The input interface 102 includes a mouse, keyboard, buttons, panel switches, a touch command screen, a foot switch, a trackball, a joystick, etc., and accepts various setting requests from the operator of the ultrasound diagnostic device 1 and transfers the accepted setting requests to the device main body 100.

The display 103 displays a GUI (Graphical User Interface) that allows the operator of the ultrasound diagnostic device 1 to input various setting requests using the input interface 102, and also displays ultrasound image data generated by the device main body 100.

The device main body 100 is a device that generates ultrasound image data based on reflected wave signals received by the ultrasound probe 101, and as shown in FIG. 1, has a transmission/reception circuit 110, a signal processing circuit 120, an image generation circuit 130, an image memory 140, a storage circuit 150, and a processing circuit 160. The transmission/reception circuit 110, the signal processing circuit 120, the image generation circuit 130, the image memory 140, the storage circuit 150, and the processing circuit 160 are connected to each other so that they can communicate with each other.

The transmission/reception circuit 110 controls the ultrasonic probe 101 to perform ultrasonic scanning. The transmission/reception circuit 110 includes a pulse generator, a transmission delay unit, a pulser, etc., and supplies a drive signal to the ultrasonic probe 101. The pulse generator repeatedly generates rate pulses at a predetermined rate frequency to form transmitted ultrasonic waves. The transmission delay unit focuses the ultrasonic waves generated from the ultrasonic probe 101 into a beam and provides a delay time for each piezoelectric transducer required to determine the transmission directivity to each rate pulse generated by the pulse generator. The pulser applies a drive signal (drive pulse) to the ultrasonic probe 101 at a timing based on the rate pulse. In other words, the transmission delay unit changes the delay time provided for each rate pulse to arbitrarily adjust the transmission direction of the ultrasonic waves transmitted from the piezoelectric transducer surface.

The transmitter/receiver circuit 110 has the ability to instantly change the transmission frequency, transmission drive voltage, etc., in order to execute a specified scan sequence based on instructions from the processing circuit 160, which will be described later. In particular, changes to the transmission drive voltage are achieved by a linear amplifier-type oscillator circuit that can instantly switch its value, or by a mechanism that electrically switches between multiple power supply units.

The transmission/reception circuit 110 also has a preamplifier, A/D (Analog/Digital) converter, reception delay unit, adder, etc., and performs various processes on the reflected wave signals received by the ultrasound probe 101 to generate reflected wave data. The preamplifier amplifies the reflected wave signals for each channel. The A/D converter A/D converts the amplified reflected wave signals. The reception delay unit provides the delay time required to determine the reception directivity. The adder performs addition processing on the reflected wave signals processed by the reception delay unit to generate reflected wave data. The addition processing by the adder emphasizes the reflected components from a direction corresponding to the reception directivity of the reflected wave signal, and an overall beam for ultrasound transmission and reception is formed based on the reception directivity and transmission directivity.

When scanning a two-dimensional region of the subject P, the transmission/reception circuit 110 causes the ultrasound probe 101 to transmit ultrasound beams in two-dimensional directions. The transmission/reception circuit 110 then generates two-dimensional reflected wave data from the reflected wave signals received by the ultrasound probe 101. When scanning a three-dimensional region of the subject P, the transmission/reception circuit 110 causes the ultrasound probe 101 to transmit ultrasound beams in three-dimensional directions. The transmission/reception circuit 110 then generates three-dimensional reflected wave data from the reflected wave signals received by the ultrasound probe 101.

The signal processing circuit 120 performs, for example, logarithmic amplification and envelope detection processing on the reflected wave data received from the transmission/reception circuit 110 to generate data (B-mode data) in which the signal strength at each sample point is expressed as luminance brightness. The B-mode data generated by the signal processing circuit 120 is output to the image generation circuit 130. Note that B-mode data is an example of scan data.

The signal processing circuit 120 also generates data (Doppler data) that extracts motion information based on the Doppler effect of a moving object at each sample point within the scanning region from, for example, the reflected wave data received from the transmission/reception circuit 110. Specifically, the signal processing circuit 120 frequency-analyzes the velocity information from the reflected wave data, extracts blood flow, tissue, and contrast agent echo components due to the Doppler effect, and generates data (Doppler data) that extracts moving object information such as average velocity, variance, and power for multiple points. Here, moving objects refer to, for example, blood flow, tissue such as the heart wall, and contrast agent. The motion information (blood flow information) obtained by the signal processing circuit 120 is sent to the image generation circuit 130 and displayed in color on the display 103 as an average velocity image, variance image, power image, or a combination of these. Note that Doppler data is an example of scan data.

The image generation circuit 130 generates ultrasound image data from the data generated by the signal processing circuit 120. The image generation circuit 130 generates B-mode image data, which represents the intensity of the reflected wave as brightness, from the B-mode data generated by the signal processing circuit 120. The image generation circuit 130 also generates Doppler image data, which represents moving object information, from the Doppler data generated by the signal processing circuit 120. The Doppler image data is velocity image data, variance image data, power image data, or image data that combines these.

Here, the image generation circuit 130 generally converts (scan converts) the scan line signal sequence of the ultrasound scan into a scan line signal sequence in a video format, such as that used in televisions, to generate ultrasound image data for display. Specifically, the image generation circuit 130 generates ultrasound image data for display by performing coordinate conversion according to the ultrasound scanning format used by the ultrasound probe 101. In addition to scan conversion, the image generation circuit 130 also performs various other image processing, such as image processing (smoothing processing) that regenerates an average brightness image using multiple image frames after scan conversion, and image processing (edge enhancement processing) that uses a differential filter within the image. The image generation circuit 130 also combines supplementary information (text information of various parameters, scales, body marks, etc.) with the ultrasound image data.

In other words, the B-mode data and Doppler data are ultrasound image data before scan conversion processing, and the data generated by the image generation circuit 130 is ultrasound image data for display after scan conversion processing. When the signal processing circuit 120 generates three-dimensional scan data (three-dimensional B-mode data and three-dimensional Doppler data), the image generation circuit 130 generates volume data by performing coordinate conversion according to the ultrasound scanning form of the ultrasound probe 101. The image generation circuit 130 then performs various rendering processes on the volume data to generate two-dimensional image data for display.

The image memory 140 is a memory that stores image data for display (display images) generated by the image generation circuit 130. The image memory 140 can also store data generated by the signal processing circuit 120. The B-mode data and Doppler data stored in the image memory 140 can be called up by the operator after diagnosis, for example, and becomes ultrasound image data for display via the image generation circuit 130.

The memory circuitry 150 stores control programs for transmitting and receiving ultrasound, image processing, and display processing, as well as various data such as diagnostic information (e.g., patient ID, doctor's findings, etc.), diagnostic protocols, and various body marks. The memory circuitry 150 is also used, as needed, to store image data stored in the image memory 140. Furthermore, the data stored in the memory circuitry 150 can be transferred to an external device via an interface (not shown).

The processing circuitry 160 controls the overall processing of the ultrasound diagnostic device 1. Specifically, the processing circuitry 160 controls the processing of the transmission/reception circuitry 110, signal processing circuitry 120, and image generation circuitry 130 based on various setting requests input by the operator via the input interface 102 and various control programs and data read from the memory circuitry 150. The processing circuitry 160 also controls the display 103 to display ultrasound image data for display stored in the image memory 140.

Furthermore, as shown in FIG. 1, the processing circuit 160 executes a measurement function 161, an estimation function 162, a determination function 163, an output control function 164, and a switching function 165. The measurement function 161 is an example of a measurement unit. The estimation function 162 is an example of an estimation unit. The determination function 163 is an example of a determination unit. The output control function 164 is an example of an output control unit. The switching function 165 is an example of a switching unit.

Here, for example, the processing functions executed by the measurement function 161, estimation function 162, determination function 163, output control function 164, and switching function 165, which are components of the processing circuitry 160 shown in FIG. 1, are recorded in the form of computer-executable programs in a storage device (e.g., storage circuitry 150) of the ultrasound diagnostic device 1. The processing circuitry 160 is a processor that reads each program from the storage device and executes it to realize the function corresponding to each program. In other words, the processing circuitry 160 in a state in which each program has been read will have each function shown in the processing circuitry 160 in FIG. 1. The processing functions executed by the measurement function 161, estimation function 162, determination function 163, output control function 164, and switching function 165 will be described below.

The term "processor (circuit)" used in the above description refers to circuits such as a CPU (Central Processing Unit), GPU (Graphics Processing Unit), or an Application Specific Integrated Circuit (ASIC), programmable logic device (e.g., Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)). The processor realizes its functions by reading and executing a program stored in the memory circuit 150. Note that instead of storing the program in the memory circuit 150, the program may be directly embedded in the processor circuit. In this case, the processor realizes its functions by reading and executing the program embedded in the circuit. Note that each processor in this embodiment is not limited to being configured as a single circuit; it may also be configured as a single processor by combining multiple independent circuits to realize its functions. Furthermore, multiple components in each diagram may be integrated into a single processor to realize its functions.

However, doctors sometimes make diagnoses based on guidelines. For example, if a doctor suspects a circulatory system disorder based on a patient's symptoms and medical history, they will first evaluate left ventricular diastolic function in accordance with specified guidelines. As an example, the left ventricular volume, mitral valve orifice blood flow velocity, mitral valve annular motion velocity, etc. are measured in accordance with the guidelines, and the doctor then makes a diagnosis.

However, doctors must make their own judgment as to whether a measurement value is defined as abnormal in the guidelines. As a result, doctors with little experience or knowledge may not be able to recognize whether a measurement value is abnormal, and may overlook a disease.

The ultrasound diagnostic device 1 according to this embodiment therefore performs the following processing to reduce the risk of overlooking a disease. The following description will be given of the ultrasound diagnostic device 1 being used to diagnose a disease of the circulatory system, but the present invention is not limited to this. The ultrasound diagnostic device 1 according to this embodiment can be applied to the diagnosis of any disease. Furthermore, the test items described below are merely examples, and any test item can be applied.

The processing procedure in the ultrasound diagnostic device 1 according to the embodiment will be described using Figure 2. Figure 2 is a flowchart showing the processing procedure in the ultrasound diagnostic device 1 according to the embodiment. Figure 2 will be described with reference to Figures 3 to 7.

The processing procedure shown in Figure 2 is initiated, for example, when an operator inputs an instruction to start imaging (ultrasound scanning). Note that the processing procedure shown in Figure 2 is not limited to the order shown in Figure 2, and can be changed as desired within the scope of the processing content.

As shown in FIG. 2, when an instruction to start imaging is input by the operator (Yes in step S101), ultrasound diagnostic device 1 starts processing from step S102 onwards. Note that until an instruction to start imaging is input (No in step S101), processing from step S102 onwards is not started, and the processing in FIG. 2 is in a standby state.

When an instruction to start imaging is input (Yes in step S101), the transmission/reception circuitry 110 performs an ultrasound scan (step S102). For example, the transmission/reception circuitry 110 controls the ultrasound probe 101 to transmit ultrasound waves into the body of the subject P. The transmission/reception circuitry 110 also performs various processes on the reflected wave signals received by the ultrasound probe 101 to generate reflected wave data. The signal processing circuitry 120 then generates scan data from the reflected wave data generated by the transmission/reception circuitry 110.

Next, the image generation circuitry 130 generates and displays ultrasound image data (step S103). For example, the image generation circuitry 130 generates ultrasound image data from the scan data generated by the signal processing circuitry 120. Then, the processing circuitry 160 (output control function 164) displays the generated ultrasound image data on the display 103.

An example of the display of ultrasound image data according to the embodiment will be described using Figure 3. Figure 3 is a diagram showing an example of the display of ultrasound image data according to the embodiment. The upper part of Figure 3 illustrates an example of B-mode image data. The lower part of Figure 3 illustrates an example of velocity image data.

As shown in FIG. 3, for example, the output control function 164 causes the display 103 to display B-mode image data and velocity image data. The B-mode image data depicts measurement calipers indicating the measurement positions of blood flow velocity. The velocity image data shows the time series changes in blood flow velocity measured in CW Doppler mode at the measurement positions indicated by the measurement calipers.

Then, the measurement function 161 performs measurements using the ultrasound image data (step S104). For example, the measurement function 161 performs measurements for each of multiple measurement items based on the ultrasound image data to obtain measurement values.

As an example, the measurement function 161 measures three measurement items: "EF," "MV E/e'," and "MV e' Vel sep." Here, "EF" represents the ejection fraction (EF) of the left ventricle. Furthermore, "MV E/e'" represents the ratio of the early diastolic wave (E) of the mitral valve orifice blood flow velocity waveform to the early diastolic wave (e') of the mitral valve annulus motion velocity waveform. Furthermore, "MV e' Vel sep" represents the motion velocity on the septal side (Sep) of the mitral valve annulus.

The types of measurement items are not limited to "EF," "MV E/e'," and "MV e' Vel sep," and any measurement item can be set. Furthermore, any known technology can be applied as the measurement method for each measurement item.

The estimation function 162 then estimates the disease based on the measurement value (step S105). For example, the estimation function 162 estimates the disease from the measurement value measured by the measurement function 161 by referencing information (disease estimation table) that associates diseases with measurement value conditions.

The processing of the estimation function 162 according to the embodiment will be described using Figure 4. Figure 4 is a diagram for explaining the processing of the estimation function 162 according to the embodiment. Figure 4 illustrates an example of a disease estimation table referenced by the estimation function 162. Note that the disease estimation table is stored in advance in, for example, the memory circuitry 150.

As shown in Figure 4, the disease estimation table associates the suspected disease "left ventricular diastolic dysfunction" with the measurement condition "two or more of EF, MV E/e', and MV e' Vel sep deviate from normal values." This indicates that left ventricular diastolic dysfunction is suspected when two or more of "EF," "MV E/e'," and "MV e' Vel sep" deviate from normal values. Note that Figure 4 shows an example of left ventricular diastolic dysfunction, but other diseases are also stored in a similar manner.

For example, the estimation function 162 compares the measurement value measured by the measurement function 161 with the "measurement value conditions" in the disease estimation table. Specifically, each measurement value is determined to be normal or abnormal using a threshold value. For example, for "EF," a value of 50% or more is normal, and a value below 50% is abnormal. For "MV E/e'," a value below 14 is normal, and a value above 14 is abnormal. For "MV e' Vel sep," a value of 7 cm/s or more is normal, and a value below 7 cm/s is abnormal.

Here, for example, if "EF" is a normal value and "MV E/e'" and "MV e' Vel sep" are abnormal values, this corresponds to "two or more of EF, MV E/e', and MV e' Vel sep deviate from the normal value." In this case, the estimation function 162 estimates that subject P has "left ventricular diastolic dysfunction."

Note that the processing of the estimation function 162 described above is merely an example, and embodiments are not limited to this. For example, the processing of the estimation function 162 can be set arbitrarily in accordance with guidelines. Furthermore, the processing for estimating diseases is not limited to processing using thresholds, and it is also possible to apply, for example, a trained model constructed for disease estimation.

Furthermore, the disease (disease name) estimated by the estimation function 162 is estimated to assist the doctor in making a diagnosis, and is not intended to confirm the diagnosis. The final diagnosis is made by the doctor.

Then, the determination function 163 determines the additional examination based on the estimated disease (step S106). For example, the determination function 163 determines the additional examination corresponding to the disease estimated by the estimation function 162 by referring to information (additional examination table) that associates diseases with additional examinations.

The processing of the determination function 163 according to the embodiment will be described using Figure 5. Figure 5 is a diagram for explaining the processing of the determination function 163 according to the embodiment. Figure 5 illustrates an example of an additional inspection table referenced by the determination function 163. Note that the additional inspection table is stored in advance in the memory circuitry 150, for example.

As shown in Figure 5, the additional examination table associates the suspected disease "left ventricular diastolic dysfunction" with the additional examinations "TR Velocity, LA Volume." This indicates that if left ventricular diastolic dysfunction is suspected, the two examination items "TR Velocity" and "LA Volume" will be determined as additional examinations. Note that Figure 5 shows an example of left ventricular diastolic dysfunction, but other diseases can also be stored in a similar manner.

For example, the determination function 163 refers to the additional examination table and determines the additional examination corresponding to the disease estimated by the estimation function 162. In the example of Figure 5, the determination function 163 determines that the two examination items "TR Velocity" and "LA Volume" are additional examinations for "left ventricular diastolic dysfunction."

Here, the determination function 163 determines whether to perform an additional examination based on the current imaging mode in which the ultrasound image data was captured. For example, if there are multiple candidates for additional examination, the determination function 163 determines the priority of each of the multiple candidates for additional examination.

As an example, the determination function 163 determines the priority of each of multiple candidate additional examinations based on whether the additional examination will be performed in the same imaging mode as the current imaging mode. Note that the additional examination "TR Velocity" determined in Figure 5 is measured in CW Doppler mode, and "LA Volume" is measured in B-mode.

Here, if the current imaging mode is CW Doppler mode, the determination function 163 determines that "TR Velocity" measured in the same imaging mode has a higher priority, and that "LA Volume" measured in a different imaging mode has a lower priority. As a result, the priority of "TR Velocity" becomes "1" and the priority of "LA Volume" becomes "2." Note that the lower the priority number, the higher the priority.

Note that the processing of the determination function 163 described above is merely an example, and embodiments are not limited to this. For example, in the above explanation, priority is indicated by a priority order, but this is not limited to this. For example, priority may be defined such that the higher the numerical value, the higher the value.

Then, the output control function 164 displays information representing the disease and additional tests (step S107). For example, the output control function 164 causes the display 103 to display information representing the priority of each of the multiple additional test candidates and the multiple additional tests.

An example of a display screen according to the embodiment will be described using Figure 6. Figure 6 is a diagram showing an example of a display screen according to the embodiment. Figure 6 illustrates an example of a window including "Measurement Results," "Suspected Diseases," and "Additional Tests."

As shown in FIG. 6, the output control function 164 displays a window containing "Measurement Results," "Suspected Disease," and "Additional Tests" on the display 103. Here, the "Measurement Results" include the measurement items measured by the processing up to this point, their measurement values, and information indicating that each measurement value is abnormal.

For example, the output control function 164 displays three measurement items measured by the measurement function 161 as "measurement results": "EF," "MV E/e'," and "MV e' Vel sep." In the example of Figure 6, "EF" is 50.8%; "MV E/e'" is 12.8; and "MV e' Vel sep" is 6.4 cm/s. The output control function 164 also displays an asterisk (*) to indicate that each measurement value is abnormal. In the example of Figure 6, the output control function 164 displays an asterisk (*) to the right of "MV E/e'" and "MV e' Vel sep." This indicates that "MV E/e'" and "MV e' Vel sep" were abnormal values.

For convenience of illustration, an example has been described in which an abnormal measurement value is displayed with an "*", but the embodiment is not limited to this. For example, the measurement value may be displayed in a color different from the other text (e.g., red), or may be displayed using an underline or a border.

In addition, the output control function 164 displays "left ventricular diastolic dysfunction" estimated by the estimation function 162 as the "suspected disease." Note that if the estimation function 162 estimates that multiple diseases are suspected, multiple diseases may be displayed.

In addition, the output control function 164 displays the additional tests determined by the determination function 163 as "additional tests" along with their priorities. As an example, the output control function 164 displays "1. TR Velocity" and "2. LA Volume" in order of priority.

Note that the processing of the output control function 164 described above is merely an example, and embodiments are not limited to this. For example, the output form by the output control function 164 is not limited to display, and may be output by means of sound, vibration patterns, or other means. Furthermore, the output control function 164 may transmit the information to be output to an external device (any device different from the ultrasound diagnostic device 1) and output it in any output form at the destination external device.

Then, the switching function 165 determines whether the imaging mode for the additional examination differs from the current imaging mode (step S108). At this time, if there are multiple additional examinations, the switching function 165 determines whether the imaging mode for the additional examination with the highest priority differs from the current imaging mode.

Here, if it is determined that the imaging mode for the additional examination and the current imaging mode are different (Yes in step S108), the switching function 165 switches the imaging mode (step S109). For example, if the imaging mode for the additional examination is "B mode" and the current imaging mode is "CW Doppler mode," the switching function 165 switches the imaging mode from "CW Doppler mode" to "B mode." On the other hand, if it is not determined that the imaging mode for the additional examination and the current imaging mode are different (No in step S108), the switching function 165 proceeds to the processing of step S110 without executing the processing of step S109.

Then, the transmission/reception circuitry 110 performs an ultrasound scan for the additional examination (step S110). The image generation circuitry 130 then generates and displays ultrasound image data for the additional examination. The measurement function 161 also performs measurements using the ultrasound image data for the additional examination. Once measurements for the additional examination have been performed, the output control function 164 updates the display screen.

An example of a display screen after an additional examination according to an embodiment will be described using Figure 7. Figure 7 is a diagram showing an example of a display screen after an additional examination according to an embodiment. The display screen shown in Figure 7 is the display screen shown in Figure 6 that has been updated by performing the additional examination "TR Velocity."

As shown in FIG. 7, the output control function 164 adds the measurement value from the additional test "TR Velocity" to the "Measurement Results" column. In the example shown in FIG. 7, the measurement value for "TR Velocity" is 3.0 [m/s]. The output control function 164 also displays "*" as information indicating that each measurement value is abnormal. Note that a "TR Velocity" of 2.8 [m/s] or higher is determined to be abnormal.

Furthermore, upon execution of the additional test "TR Velocity," the output control function 164 deletes "TR Velocity" from the "Additional Test" items and raises the priority of the remaining additional tests by one. As a result, the output control function 164 displays "1. LA Volume" as the "Additional Test" in Figure 7.

Then, the processing circuitry 160 determines whether all additional tests have been completed (step S111). If additional tests remain (step S111: No), the processing circuitry 160 proceeds to step S108. If all additional tests have been completed (step S111: Yes), the processing circuitry 160 ends the processing of FIG. 2.

As described above, in the ultrasound diagnostic device 1 according to the embodiment, the estimation function 162 estimates a disease based on measurements taken using ultrasound image data. The determination function 163 determines additional tests to be used in diagnosing the disease based on the estimated disease. The output control function 164 outputs information indicating the disease and additional tests. This allows the ultrasound diagnostic device 1 to reduce the number of diseases that are overlooked. For example, even a doctor with little experience or knowledge can reduce the number of diseases that are overlooked by referring to the diseases and additional tests presented by the ultrasound diagnostic device 1.

Furthermore, for example, the ultrasound diagnostic device 1 determines the additional examination based on the current imaging mode. For example, when there are multiple candidates for additional examinations, the ultrasound diagnostic device 1 preferentially presents the same imaging mode as the current imaging mode. This allows the ultrasound diagnostic device 1 to minimize the number of times the imaging mode needs to be switched even when there are multiple additional examinations, allowing the series of examinations to be carried out smoothly.

Furthermore, for example, if the imaging mode for the additional examination differs from the current imaging mode, the ultrasound diagnostic device 1 automatically switches the imaging mode. This allows the ultrasound diagnostic device 1 to reduce the effort required for the operator (doctor) to switch modes.

Conventionally, ultrasound diagnostic devices have used a variety of imaging modes depending on the purpose of the examination. However, the greater the variety of imaging modes, the greater the operator's experience and knowledge required to use them effectively. The ultrasound diagnostic device 1 according to this embodiment allows for smooth operation while presenting necessary additional examinations as needed, thereby enabling the advantage of having a variety of imaging modes to be utilized regardless of the operator's experience or knowledge.

(Application example)
An application example of the above-described embodiment will be described below, in which the ultrasound diagnostic device 1 according to the above-described embodiment is applied to the diagnosis of heart failure.

Figures 8, 9, and 10 are flowcharts showing the processing steps in an ultrasound diagnostic device according to an application example of the embodiment. Note that Figure 9 is a flowchart showing detailed processing steps in the processing of step S207 in Figure 8. Also, Figure 10 is a flowchart showing detailed processing steps in the processing of step S212 in Figure 8. Also, Figures 8 to 10 will be explained with reference to Figures 11 and 12. Figures 11 and 12 are diagrams showing examples of input screens according to an application example of the embodiment.

The processing procedure shown in Figure 8 begins, for example, when an operator inputs an instruction to start imaging (ultrasound scanning).

As shown in FIG. 8, when an instruction to start imaging is input by the operator (Yes in step S201), ultrasound diagnostic device 1 starts processing from step S202 onwards. Note that until an instruction to start imaging is input (No in step S201), processing from step S202 onwards does not start, and the processing in FIG. 8 is in a standby state.

When an instruction to start imaging is input (Yes in step S201), the transmission/reception circuitry 110 executes a B-mode scan (step S202). The image generation circuitry 130 then generates and displays B-mode image data. Note that the processing in step S202 corresponds to the processing in steps S102 and S103 in Figure 2.

Next, the measurement function 161 measures EF using the B-mode image data (step S203). Here, "EF" represents the ejection fraction of the left ventricle, as described above, and is measured based on the change in volume of the left ventricle calculated from the B-mode image data. Note that the processing of step S203 corresponds to the processing of step S104 in Figure 2.

The estimation function 162 then determines whether EF is less than 50 (step S204). If EF is less than 50 (Yes in step S204), the estimation function 162 estimates that the condition is heart failure with reduced contractility (step S205) and proceeds to processing in step S213. On the other hand, if EF is 50 or greater (No in step S204), the estimation function 162 estimates that the condition is likely heart failure with preserved left ventricular contractility (step S206) and proceeds to processing in step S207.

The disease estimated by the estimation function 162 does not necessarily have to be a specific "disease name." For example, as shown in FIG. 8, the estimation function 162 can also estimate "health conditions" such as "heart failure with reduced contractility" or "possible heart failure with preserved left ventricular contractility." These estimation processes are realized, for example, by using a preset table, a specified function, threshold processing, etc.

Then, the estimation function 162 executes a process (process A) to check for the possibility of other cardiac diseases (step S207). The processing procedure of process A will be explained using Figure 9. Note that "A" in Figure 9 is linked to "A" in Figure 8, and indicates that the process will proceed to step S213.

As shown in FIG. 9, the estimation function 162 accepts previously set finding information (step S301). For example, the estimation function 162 displays the input screen shown in FIG. 11 on the display 103 and accepts previously set finding information using this input screen. Note that the finding information is an example of "non-image information" that is different from ultrasound image data.

In the example shown in FIG. 11, the input screen displays various findings associated with radio buttons for inputting the presence or absence of the findings. Specifically, the input screen displays radio buttons for inputting the presence or absence of findings for congenital heart disease, valvular disease, left ventricular enlargement, pericardial disease, and pulmonary arterial hypertension. For example, the operator (doctor) refers to the input screen shown in FIG. 11, and if subject P has a finding that corresponds to the findings, selects the radio button indicating the presence of the finding and presses the OK button. As a result, the estimation function 162 accepts finding information indicating whether subject P has various findings. Note that the finding of pulmonary arterial hypertension is determined based on pulmonary hypertension, significant right ventricular enlargement, and the absence of left atrial enlargement.

Next, the estimation function 162 determines whether or not there are findings of congenital heart disease (step S302). If there are findings of congenital heart disease (Yes in step S302), the estimation function 162 estimates that there is congenital heart disease (step S303) and proceeds to step S213.

On the other hand, if there are no findings of congenital heart disease (No in step S302), the estimation function 162 determines whether there are findings of valvular disease (step S304). Here, if there are findings of valvular disease (Yes in step S304), the estimation function 162 estimates valvular disease (step S305) and proceeds to step S213.

On the other hand, if there are no findings of valvular disease (No in step S304), the estimation function 162 determines whether there are findings of left ventricular enlargement (step S306). Here, if there are findings of left ventricular enlargement (Yes in step S306), the estimation function 162 estimates a high cardiac output state (step S307) and proceeds to step S213.

On the other hand, if there are no findings of left ventricular enlargement (No in step S306), the estimation function 162 determines whether there are findings of pericardial disease (step S308). Here, if there are findings of pericardial disease (Yes in step S308), the estimation function 162 estimates pericardial disease (step S309) and proceeds to step S213.

On the other hand, if there are no findings of pericardial disease (No in step S308), the estimation function 162 determines whether there are findings of pulmonary arterial hypertension (step S310). Here, if there are findings of pulmonary arterial hypertension (Yes in step S310), the estimation function 162 estimates pulmonary arterial hypertension (step S311) and proceeds to step S213.

On the other hand, if there are no findings of pulmonary arterial hypertension (No in step S310), the estimation function 162 terminates process A shown in FIG. 9 and proceeds to step S208 in FIG. 8. Note that the processes in steps S204 to S207 correspond to the process in step S105 in FIG. 2.

In other words, as shown in Figure 9, the estimation function 162 estimates health status based on non-image information.

Returning to the explanation of Figure 8, the determination function 163 then determines E/e' and RAd-Ad as additional tests (step S208). For example, since the determination function 163 considers that there is a possibility of heart failure with preserved left ventricular contractility and that the possibility of other cardiac diseases is low, it determines E/e' and RAd-Ad as additional tests.

Here, "E/e'" is the same as "MV E/e'" described above. Furthermore, "RAd-Ad" represents the difference between the width of the atrial systolic wave of the pulmonary vein blood flow velocity waveform (RAd) and the width of the atrial systolic wave of the left ventricular inflow blood flow velocity waveform (Ad). Both E/e' and RAd-Ad can be measured based on velocity image data (data collected in CW Doppler mode). The processing in step S208 corresponds to the processing in step S106 in Figure 2.

Then, the switching function 165 switches the imaging mode to CW Doppler mode (step S209). For example, the imaging mode capable of measuring E/e' and RAd-Ad is "CW Doppler mode," which differs from the imaging mode (current imaging mode) executed in step S202, "B mode," so the switching function 165 switches the imaging mode to CW Doppler mode. Note that the processing in step S209 corresponds to the processing in steps S108 to S109 in FIG. 2.

Then, the transmission/reception circuitry 110 performs a CW Doppler mode scan (step S210). The image generation circuitry 130 then generates and displays velocity image data based on the data collected by the CW Doppler mode scan. Note that the processing in step S210 corresponds to the processing in step S111 in Figure 2.

Then, the measurement function 161 measures E/e' and RAd-Ad using the velocity image data (step S211). Any known technique can be applied to measure E/e' and RAd-Ad.

Then, the estimation function 162 executes a process (process B) to confirm the possibility of heart failure with preserved left ventricular contractility (step S212). The processing procedure of process B will be explained using Figure 10.

As shown in FIG. 10, the estimation function 162 determines whether E/e' is 15 or greater (step S401). If E/e' is 15 or greater (Yes in step S401), the estimation function 162 estimates heart failure with preserved left ventricular contractility (step S407) and terminates process B.

On the other hand, if E/e' is less than 15 (No in step S401), the estimation function 162 accepts input of BNP (step S402). Here, "BNP" represents the amount of brain (B-type) natriuretic peptide in the blood, and is measured by a blood test (or BNP test). For example, the estimation function 162 displays the input screen shown in FIG. 12 on the display 103 and accepts input of BNP using this input screen.

In the example shown in FIG. 12, the input screen displays an input field for accepting input of a BNP value. For example, an operator (doctor) enters the BNP value of subject P measured in a blood test conducted in advance into the input field shown in FIG. 12 and presses the OK button. As a result, the estimation function 162 accepts the input of the BNP value of subject P. Note that BNP is an example of "non-image information."

The estimation function 162 then determines whether E/e' is greater than or equal to 8 and less than 15, and BNP is greater than or equal to 200 pg/mL (step S403). If E/e' is greater than or equal to 8 and less than 15, and BNP is greater than or equal to 200 pg/mL (Yes in step S403), the estimation function 162 estimates heart failure with preserved left ventricular contractility (step S407), and terminates process B.

On the other hand, if E/e' is 8 or more and less than 15 and BNP is not 200 pg/mL or more (No in step S403), the estimation function 162 determines whether E/e' is 8 or more and less than 15 and RAd-Ad is 30 msec or more (Step S404). If E/e' is 8 or more and less than 15 and RAd-Ad is 30 msec or more (Yes in step S404), the estimation function 162 estimates heart failure with preserved left ventricular contractility (Step S407) and terminates process B.

On the other hand, if E/e' is greater than or equal to 8 and less than 15, and RAd-Ad is not greater than or equal to 30 msec (No in step S404), the estimation function 162 determines whether BNP is greater than or equal to 200 pg/mL, and RAd-Ad is greater than or equal to 30 msec (Step S405). If BNP is greater than or equal to 200 pg/mL, and RAd-Ad is greater than or equal to 30 msec (Yes in step S405), the estimation function 162 estimates heart failure with preserved left ventricular contractility (Step S407), and ends Process B.

On the other hand, if BNP is 200 pg/mL or higher and RAd-Ad is not 30 msec or higher (No in step S405), the estimation function 162 estimates that the possibility of heart failure is low (step S406) and terminates process B.

In other words, as shown in Figure 10, the estimation function 162 estimates health status based on non-image information.

Returning to the explanation of Figure 8, the output control function 164 outputs the cardiac disease estimation result (step S213). For example, the output control function 164 causes the estimation result estimated by the estimation function 162 to be displayed on the display 103. The ultrasound diagnostic device 1 then ends the processing procedure of Figure 8.

Note that the processing procedures shown in Figures 8 to 10 are merely examples, and embodiments are not limited to these. For example, the order of the processes shown in Figures 8 to 10 can be changed as appropriate as long as no inconsistencies occur in the processing content. For example, the process of accepting input of finding information (step S301) and the process of accepting input of BNP (step S402) may be performed at an earlier stage.

Furthermore, while Figures 8 to 10 illustrate a case where the process for accepting input of finding information (step S301) and the process for accepting input of BNP (step S402) are performed manually by an operator, embodiments are not limited to this. For example, if the finding information or BNP has already been tested, it may be automatically acquired from the test results. For example, when reservation information for an ultrasound test for cardiac disease for a certain subject P is sent from the test reservation system to the ultrasound diagnostic device 1, if the finding information or BNP has already been tested, the finding information and BNP value may also be sent from the test reservation system to the ultrasound diagnostic device 1.

In the above example, "BNP" was used, but "NT-proBNP" may also be used. "NT-proBNP" is a hormone produced by the breakdown of its precursor hormone, proBNP, and is released into the bloodstream together with BNP in a 1:1 ratio. Like BNP, it is an indicator value used to aid in the diagnosis of heart failure.

In the above example, "RAd-Ad" was used, but at least one of "left atrial volume index," "left atrial diameter," "left ventricular weight index," and "atrial fibrillation findings" may also be used. "Left atrial volume index," "left atrial diameter," and "left ventricular weight index" can be measured based on B-mode image data of the left ventricle. "Atrial fibrillation findings" are information determined by electrocardiogram testing, and can be obtained manually by the operator or automatically from a test reservation system, etc.

(Modification)
In the above embodiment, the priority of the additional examination is determined based on whether the imaging mode is the same as the current imaging mode, but the embodiment is not limited to this. For example, the priority may be determined based on whether the additional examination is performed in B mode.

B-mode image data creates cross-sectional images of the inside of a living body, making it the optimal imaging mode for the operator to understand the state of the inside of the subject P's body. B-mode image data is also used as a background image for other imaging modes to specify the positions of regions of interest, measurement calipers, annotations, etc. For these reasons, B-mode can be said to be one of the main imaging modes in ultrasound diagnostic equipment.

Therefore, the determination function 163 may determine the priority of each of multiple candidate additional examinations based on whether or not the additional examination is to be performed in "B mode." For example, if multiple candidate additional examinations include an additional examination to be performed in "B mode" and an additional examination to be performed in another imaging mode, the determination function 163 determines that the additional examination to be performed in "B mode" has a higher priority than the additional examination to be performed in the other imaging mode.

Note that when multiple candidate additional examinations exist that are performed in both the "same imaging mode as the current imaging mode" and "B-mode," it is preferable to prioritize the "same imaging mode as the current imaging mode." In other words, when there is no additional examination performed in the same imaging mode as the current imaging mode among the multiple candidate additional examinations, the determination function 163 determines that the priority of the additional examination performed in "B-mode" is higher. However, in cases where B-mode is not performed as the initial imaging mode, the determination function 163 may determine that the priority of the additional examination performed in "B-mode" is higher than that of the "same imaging mode as the current imaging mode."

(Other embodiments)
In addition to the above-described embodiments, the present invention may be implemented in various different forms.

Furthermore, the components of each device shown in the figure are conceptual functional components and do not necessarily have to be physically configured as shown. In other words, the specific form of distribution and integration of each device is not limited to that shown, and all or part of it can be functionally or physically distributed and integrated in any unit depending on various loads, usage conditions, etc. Furthermore, all or any part of the processing functions performed by each device can be realized by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware using wired logic.

Furthermore, among the processes described in the above embodiments, all or part of the processes described as being performed automatically can be performed manually, or all or part of the processes described as being performed manually can be performed automatically using known methods. In addition, the information, including the processing procedures, control procedures, specific names, various data, and parameters shown in the above documents and drawings, can be changed as desired unless otherwise specified.

The output method (ultrasound imaging method) described in the above-described embodiment can be realized by executing a prepared output program (ultrasound imaging program) on a computer such as a personal computer or workstation. This ultrasound imaging method can be distributed via a network such as the Internet. This ultrasound imaging method can also be recorded on a non-transitory computer-readable recording medium such as a hard disk, flexible disk (FD), CD-ROM, MO, or DVD, and executed by being read from the recording medium by a computer.

In addition, in the above embodiments and variations, "real time" means that each process is performed immediately as each piece of data to be processed is generated. For example, the process of displaying an image in real time is not limited to cases where the time the subject is imaged and the time the image is displayed exactly match, but also includes cases where the image is displayed with a slight delay due to the time required for each process, such as image processing.

At least one of the embodiments described above can reduce the risk of overlooking a disease.

While several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments may be embodied in a variety of other forms, and various omissions, substitutions, modifications, and combinations of embodiments may be made without departing from the spirit of the invention. These embodiments and their variations are included within the scope and spirit of the invention, as well as within the scope of the invention and its equivalents as set forth in the claims.

1 Ultrasound diagnostic device 160 Processing circuit 161 Measurement function 162 Estimation function 163 Determination function 164 Output control function 165 Switching function

Claims (2)

an estimation unit that estimates a health state based on a measurement value measured using ultrasound image data;
a determination unit that determines an additional test to be used for diagnosing the health condition based on the estimated health condition;
an output control unit that outputs information representing the health condition and the additional examination;
Equipped with
When there are a plurality of candidates for the additional examination, the determination unit determines the priority of each of the plurality of candidates for the additional examination;
the output control unit outputs information indicating the priority of each of the plurality of additional examination candidates and the plurality of additional examinations;
the determining unit determines the priority of each of the plurality of additional examination candidates based on whether the additional examination is to be performed in the same imaging mode as the current imaging mode.
Ultrasound diagnostic equipment. an estimation unit that estimates a health state based on a measurement value measured using ultrasound image data;
a determination unit that determines an additional test to be used for diagnosing the health condition based on the estimated health condition;
an output control unit that outputs information representing the health condition and the additional examination;
Equipped with
When there are a plurality of candidates for the additional examination, the determination unit determines the priority of each of the plurality of candidates for the additional examination;
the output control unit outputs information indicating the priority of each of the plurality of additional examination candidates and the plurality of additional examinations;
the determining unit determines the priority of each of the plurality of candidates for additional examination based on whether the additional examination is to be performed in B-mode.
Ultrasound diagnostic equipment.