JP6510200B2 - Ultrasonic diagnostic apparatus and control program - Google Patents

Description

  An embodiment of the present invention is an ultrasonic diagnostic apparatus that generates and displays treatment support data effective for ablation treatment based on reference image data such as CT image data obtained at the same site of a patient and ultrasonic image data. And the control program.

  The ultrasonic diagnostic apparatus emits ultrasonic pulses generated from a vibrating element incorporated in an ultrasonic probe into the body of a patient, and receives ultrasonic reflected waves generated by differences in acoustic impedance of living tissue by the vibrating element. Various biological information is collected. A recent ultrasonic diagnostic apparatus capable of electronically controlling transmission / reception directions and focusing points of ultrasonic waves by controlling a delay time of a drive signal supplied to a plurality of transducer elements and a reception signal obtained from the transducer elements In the above, real-time image data can be easily observed by a simple operation of bringing the tip of the ultrasonic probe into contact with the body surface, and therefore, it is widely used for morphological diagnosis and functional diagnosis of living organs.

  In addition, a minimally invasive inspection method and treatment method using a catheter or a puncture needle, etc. has been developed under observation of ultrasonic image data displayed in real time, for example, administration of a drug to a site to be inspected / treated or cells / By performing puncture for the purpose of tissue extraction under observation of two-dimensional ultrasound image data or three-dimensional ultrasound image data, the safety and efficiency in examination and treatment can be dramatically improved.

  Furthermore, in recent years, a puncture needle has been inserted into a site to be treated, such as a tumor, and a method of performing ablation treatment with microwaves or radio waves emitted from the tip of the puncture needle has been carried out. So-called radio frequency ablation (RFA), which coagulates the target site, can be used as a therapeutic method for liver tumors etc. because it can control local ablation area easily and reliably. It is getting worse.

  When an examination or treatment using such a puncture needle is performed under observation of ultrasonic image data, the puncture needle is attached to a puncture adapter provided integrally with the ultrasonic probe, and the puncture displayed together with the treatment target site Insertion is performed while confirming the tip position by ultrasonic image data of the needle. In addition, based on the position information obtained by the position detector provided in the puncture needle or the ultrasonic probe, a puncture marker indicating the insertion direction of the puncture needle is generated and superimposed on the ultrasonic image data of the region to be treated and displayed As a result, it became possible to insert a more accurate puncture needle.

  On the other hand, treatment using a puncture needle such as radiofrequency ablation is usually performed under guidance of ultrasound image data for easy real-time display, but spatial resolution and contrast resolution of ultrasound image data are X-ray CT Since it is inferior to image data and MRI image data, it is often difficult to grasp the existence of the tumor and the shape thereof, and it takes much time to determine the insertion direction and insertion distance of the puncture needle.

  In order to complement the resolution of such ultrasound image data, three-dimensional reference image information (volume data) in the patient's body is collected in advance by an X-ray CT apparatus or MRI apparatus, and the placement position, placement direction, etc. of the ultrasound probe X-ray CT image data or MRI image data of a cross section corresponding to the above-mentioned scan cross-section generated based on the ultrasonic image data collected on the scan cross-section in the patient's body uniquely determined by Hereinafter, a method of comparing and displaying reference image data) is proposed.

Unexamined-Japanese-Patent No. 2002-112998

  According to the method described in the above-mentioned Patent Document 1 etc., the position and shape of the tumor area before treatment can be accurately captured by observing the reference image data excellent in resolution together with the ultrasonic image data.

  However, since the reference image data obtained at this time is generated based on the three-dimensional reference image information collected in advance before ablation treatment, the region in which the state of the tissue has been changed by radiofrequency ablation treatment etc. And the causation region) can not be obtained from the above-mentioned reference image data.

  The present invention has been made in view of the above-described problems, and its object is to provide a medical treatment area using ultrasound image data collected in parallel with ablation treatment using a puncture needle (cauterization Section), and the information of the obtained cauterization area is a cross section corresponding to the scan cross section of the ultrasonic image data collected using another medical image diagnostic apparatus (hereinafter referred to as a medical image information collecting apparatus) The present invention is to provide an ultrasonic diagnostic apparatus and a control program capable of accurately determining whether or not the cautery treatment is appropriate by superimposing on the reference image data.

In order to solve the above problems, an ultrasonic diagnostic apparatus according to an embodiment of the present disclosure is an ultrasonic diagnostic apparatus that displays treatment support data for supporting ablation treatment using a puncture needle, and transmits and receives an ultrasonic wave to a patient Using the reference image information of the patient collected in advance by image data generation means for generating ultrasonic image data based on the received signal obtained by the above, and a medical image information collection device separately installed and different from the ultrasonic diagnostic device Reference image data generating means for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data; first ultrasonic image data before ablation treatment generated by the image data generation means; and ablation treatment Ablation region detection means for detecting the ablation region indicated in the second ultrasound image data based on later second ultrasound image data, and the reference image And support data generating means for generating the therapeutic assistance data by superimposing the contour data of the ablation area over data, is characterized by comprising display means for displaying the therapeutic assistance data.

FIG. 1 is a block diagram showing an entire configuration of an ultrasonic diagnostic apparatus in the present embodiment. FIG. 2 is a block diagram showing a specific configuration of a transmission / reception unit and a reception signal processing unit included in the ultrasonic diagnostic apparatus of the present embodiment. FIG. 2 is a block diagram showing a specific configuration of an ablation region detection unit provided in the ultrasonic diagnostic apparatus of the present embodiment. The figure which shows the specific example of the 1st treatment assistance data for the purpose of exact penetration of the RFA puncture needle produced | generated in the assistance data generation part of this embodiment. FIG. 8 is a view showing a specific example of second treatment support data for the purpose of accurate determination as to whether the ablation treatment is correct or not using the RFA puncture needle generated in the support data generation unit of the present embodiment. The figure for demonstrating the specific example of the RFA puncture needle used for the cauterization treatment of this embodiment. The flowchart which shows the production | generation / display procedure of the treatment assistance data in this embodiment. The figure which shows the modification of the 1st treatment support data aiming at accurate insertion of the RFA puncture needle produced | generated in the assistance data generation part of this embodiment. The figure which shows the modification of the 2nd treatment support data for the purpose of exact determination of the quality of ablation treatment using the RFA puncture needle produced | generated in the assistance data generation part of this embodiment.

  Hereinafter, embodiments of the present disclosure will be described with reference to the drawings.

(Embodiment)
The ultrasonic diagnostic apparatus of the present embodiment described below is a three-dimensional reference image collected in advance by a medical image information collecting apparatus such as an X-ray CT apparatus prior to ablation treatment for a tumor area in a patient's body using an RFA puncture needle. Two-dimensional reference image data is generated by extracting reference image information of a cross section (hereinafter referred to as an MPR cross section) corresponding to a scan cross section of ultrasound image data from information (volume data), and this reference image The first for aiming at accurate insertion of RFA puncture needle by superimposing tumor area information detected using data on the first ultrasound image data before ablation treatment collected in the above-mentioned scanning section Generate treatment support data.

  Then, subtraction processing between the second ultrasound image data and the first ultrasound image data collected during or after completion of the ablation treatment performed under observation of the above-mentioned first treatment support data By superimposing the information on the ablation region detected by the above into the above-mentioned reference image data, second treatment support data is generated for the purpose of accurate determination of whether the ablation treatment is good or bad using the RFA puncture needle.

(Device configuration and function)
The configuration and function of the ultrasonic diagnostic apparatus according to the present embodiment will be described with reference to FIGS. FIG. 1 is a block diagram showing the entire configuration of the ultrasonic diagnostic apparatus, and FIG. 2 is a block diagram showing a specific configuration of a transmission / reception unit and a reception signal processing unit included in the ultrasonic diagnostic apparatus. Moreover, FIG. 3 is a block diagram which shows the concrete structure of the cauterization area | region detection part with which the above-mentioned ultrasound diagnosing device is equipped.

  The ultrasonic diagnostic apparatus 100 of the present embodiment shown in FIG. 1 transmits ultrasonic waves (ultrasonic pulses) to a desired scanning cross section in a patient's body before or after ablation treatment using the RFA puncture needle 150 or during ablation treatment. An ultrasonic probe 2 comprising a plurality of vibration elements for emitting a received ultrasonic wave (ultrasound reflected wave) obtained from the scanning section by the transmitted ultrasonic wave into an electric received signal; A transmission / reception unit 3 which supplies drive signals for radiating transmission ultrasonic waves in a predetermined direction of the cross section to the above-mentioned vibration elements, and performs phase addition of received signals of a plurality of channels obtained from these vibration elements; The reception signal processing unit 4 generates signal B-mode data as ultrasound data by performing signal processing on the received signal after phase addition, and two-dimensional superimposing based on the above-mentioned B-mode data obtained in ultrasound transmission / reception direction units. sound Image data generation unit 5 for generating image data, ultrasound image data before ablation treatment (first ultrasound image data), and ultrasound image data during ablation treatment or after ablation treatment (second ultrasound image data B) an ablation area detection unit 6 for detecting an ablation area with respect to a tumor area shown in these ultrasound image data, a position signal of the ultrasound probe 2 supplied from the probe position sensor 21, and an ultrasound probe Position information detecting unit 7 for detecting position information of the ultrasonic probe 2 and the RFA puncture needle 150 based on the position signal of the RFA puncture needle 150 supplied from the puncture needle position sensor 22 attached to the puncture adapter (not shown) 2; On the basis of the position information (the center position / inclination angle of the ultrasonic probe 2, the arrangement direction of the vibration elements, etc.) of the ultrasonic probe 2 supplied from the position information detection unit 7. Information on the position of the RFA puncture needle 150 (the position of the RFA puncture needle 150 supplied from the position information detection unit 7) and the MPR cross-section setting unit 8 that sets the MPR (multi-planar-reconstruction) cross section And the insertion direction estimation unit 9 that estimates the insertion direction of the RFA puncture needle 150 in the patient's body based on the inclination angle or the like.

  In addition, the ultrasound diagnostic apparatus 100 includes a tumor region of the patient collected in advance using a medical image information collecting apparatus excellent in spatial resolution and contrast resolution such as an X-ray CT apparatus and an MRI apparatus installed separately. Reference image information storage unit 10 in which dimensional reference image information (volume data) is stored, and a reference image corresponding to the above-mentioned MPR cross section among three-dimensional reference image information stored in reference image information storage unit 10 Reference image data generation unit 11 that generates two-dimensional reference image data corresponding to a scanning cross section of ultrasound transmission and reception by extracting information, and tumor area detection that detects a tumor area of the patient indicated in the reference image data First treatment support data in which a puncture marker indicating the insertion direction of the RFA puncture needle 150, area information of a tumor, and the like are superimposed on the first ultrasonic image data; Support data generation unit 13 that generates second treatment support data in which information on ablation area and the like is superimposed on reference image data, and a display unit that displays the obtained first treatment support data and second treatment support data 14, an input unit 15 for inputting patient information, setting ultrasonic transmission / reception conditions and treatment support data generation conditions, selecting an examination mode, inputting various instruction signals, etc., and transmitting delay time for the transmitting / receiving unit 3 The system includes a scan control unit 16 that controls an ultrasonic wave transmission / reception direction by setting a reception delay time, and a system control unit 17 that controls the above-described units in an integrated manner.

  The ultrasonic probe 2 has N vibrating elements (not shown) at its tip in contact with the patient's body surface, and these vibrating elements are input / output of the transmitting / receiving unit 3 through N-channel multicore cables (not shown) It is connected to the terminal. The above-mentioned vibration element included in the ultrasonic probe 2 is an electroacoustic transducer, which converts a drive signal (electric pulse) into a transmission ultrasonic wave (ultrasonic pulse) at the time of transmission, and a reception ultrasonic wave (ultrasound reflection wave) at the time of reception. Has a function of converting the signal into an electrical reception signal.

  Then, on the wall surface of the ultrasound probe 2, a puncture adapter (not shown) for setting the insertion direction of the RFA puncture needle 150 used for cautery treatment and holding the RFA puncture needle 150 slidably in the insertion direction, A puncture needle position sensor 22 for generating a position signal of the RFA puncture needle 150 and a probe position sensor 21 for generating a position signal of the ultrasonic probe 2 are provided.

  The ultrasound probe is compatible with sector scanning, linear scanning, and convex scanning, and medical workers (hereinafter referred to as operators) who operate the ultrasound diagnostic apparatus 100 are of various types of ultrasound probes. Although it is possible to arbitrarily select an ultrasonic probe suitable for the cautery treatment from among the above, in the present embodiment, the ultrasonic probe 2 for sector scanning in which N vibration elements are provided at the tip thereof is used. The case of use is described.

  Next, the transmission / reception unit 3 shown in FIG. 2 is a drive for emitting, for example, a transmission ultrasonic wave corresponding to a B-mode test to the ultrasonic transmission / reception direction Θp (Θp = θ1 to θP) set in the patient's body. The transmission unit 31 that supplies a signal to the vibration element of the ultrasonic probe 2 and the reception unit 32 that performs phase addition of received signals of a plurality of channels obtained from these vibration elements, and the transmission unit 31 is a rate pulse generator A transmission delay circuit 312 and a drive circuit 313 are provided.

  The rate pulse generator 311 generates a rate pulse that determines the repetition period of the transmission ultrasonic wave emitted into the body by dividing the reference signal supplied from the system control unit 17 and transmits the obtained rate pulse. The signal is supplied to the delay circuit 312. The transmission delay circuit 312 is composed of an independent delay circuit having the same number as Nt transmission vibration elements selected in advance from N vibration elements contained in the ultrasonic probe 2, and is supplied from the scan control unit 16. Emitting the transmitting ultrasonic wave to a focusing delay time for focusing the transmitting ultrasonic wave to a predetermined depth to obtain a narrow beam width in transmission according to the delay time control signal, and to the above ultrasonic transmitting / receiving direction 送 受 信 p The delay time for deflection is given to the above-mentioned rate pulse supplied from the rate pulse generator 311. The drive circuit 313 has a function of driving the Nt transmission vibration elements incorporated in the ultrasonic probe 2, and based on the rate pulse supplied from the transmission delay circuit 312, for the above-mentioned focusing delay time and deflection. A drive signal of a predetermined shape having a delay time is generated.

  On the other hand, the receiving unit 32 includes Nr channel preamplifiers 321, A / D converters 322, and reception delays corresponding to Nr receiving vibrating elements selected from N vibrating elements contained in the ultrasonic probe 2. A / D converter 322 is provided with a circuit 323 and an adder 324, and when the “B mode” is selected as the inspection mode, the received signal of the Nr channel supplied from the receiving vibration element via the preamplifier 321 is a digital signal And sent to the reception delay circuit 323.

  The reception delay circuit 323 has a focusing delay time and an ultrasound transmission / reception direction Θ p (Θ p = θ 1 to focus received ultrasound waves reflected from a predetermined depth in the patient's body according to a delay time control signal supplied from the scan control unit 16. The deflection delay time for setting strong reception directivity with respect to θP) is given to each of the Nr channel received signals output from the A / D converter 322, and the adder 324 The output signals of the Nr channel are added and synthesized. That is, the reception delay circuit 323 and the adder 324 perform phasing addition on the reception signal corresponding to the reception ultrasonic wave in the ultrasonic transmission / reception direction 整 p.

  On the other hand, the reception signal processing unit 4 performs envelope conversion on the reception signal after envelope detection, and an envelope detector 411 which performs envelope detection on the reception signal after phasing addition output from the addition unit 324 of the reception unit 32. A logarithmic converter 412 is provided to generate B mode data in which a smaller signal amplitude is relatively emphasized.

  Returning to FIG. 1, the image data generation unit 5 has a function of generating ultrasound image data based on the B mode data generated in the reception signal processing unit 4. For example, an ultrasound data storage unit (not shown) It has an arithmetic processing unit configured by a DSC (digital scan converter), a DSP (digital signal processor), and the like.

  That is, when the “B mode” is selected as the inspection mode, the image data generation unit 5 performs ultrasonic wave on B mode data supplied from the logarithmic converter 412 of the reception signal processing unit 4 in time series in transmission and reception direction units. The arithmetic processing unit sequentially stores data in the data storage unit, and the arithmetic processing unit generates B mode image data by performing data processing such as filtering on the above-described B mode data stored in the ultrasonic data storage unit.

  Next, when performing ablation treatment on the tumor region of the patient using the PFA puncture needle 150, the ablation region detection unit 6 collects the first ultrasonic image data collected on the tumor region before ablation treatment. The area where the ablation treatment was performed by the PFA puncture needle 150 based on the pixel value of and the pixel value of the second ultrasonic image data collected for the tumor area during or after the ablation treatment , And includes an image data storage unit 61, a subtraction processing unit 62, and an outline extraction unit 63, as shown in FIG.

  One of the first ultrasonic image data generated by the image data generation unit 5 is stored in the image data storage unit 61 of the ablation region detection unit 6 based on the reception signal obtained by ultrasonic transmission and reception with respect to the tumor region before ablation treatment. Department is saved. On the other hand, the subtraction processing unit 62 directly receives the second ultrasound image data generated by the image data generation unit 5 based on the reception signal obtained by ultrasonic transmission / reception to the tumor area during or during the cautery treatment. A subtraction process is performed on the pixel value of the second ultrasound image data and the pixel value of the first ultrasound image data read from the image data storage unit 61.

  Then, the contour extraction unit 63 detects the ablation region by comparing the difference value of the pixel values obtained in the subtraction processing unit 62 with the predetermined threshold value β1, and further extracts the contour to thereby detect the ablation region. Generate contour data. That is, by comparing the first ultrasound image data collected before cautery treatment with the second ultrasound image data collected during cautery treatment or immediately after cautery treatment, the acoustic characteristics of the tissue are cauterized by cautery It is possible to detect a site that has significantly changed as an ablation area.

  Referring back to FIG. 1 again, the position information detection unit 7 includes a probe position detection unit and a puncture needle position detection unit (not shown), and the probe position detection unit includes a plurality provided inside or around the ultrasonic probe 2. Based on the position signal supplied from the probe position sensor 21, the position information (the center position / tilt angle of the ultrasonic probe 2, the arrangement direction of the vibrating elements, etc.) of the ultrasonic probe 2 disposed on the patient body surface is detected.

  Similarly, the puncture needle position detection unit is a position signal supplied from the puncture adapter (not shown) of the ultrasonic probe 2 or the puncture needle position sensor 22 of the RFA puncture needle 150 slidably attached to the puncture adapter. The position information (the position, the inclination angle, etc. of the RFA puncture needle 150) of the RFA puncture needle 150 to be inserted into the patient's body is detected based on the above.

  Various methods have already been proposed as position information detection methods for ultrasonic probes and RFA puncture needles, but in consideration of detection accuracy, cost, size, etc., a method using ultrasonic sensors or magnetic sensors as position sensors is preferable. It is. The probe position detection unit of the position information detection unit 7 using a magnetic sensor, for example, detects a transmitter (magnetism generation unit) that generates magnetism as described in JP-A-2000-5168, etc. A position information calculation unit (not shown) for calculating position information of the ultrasonic probe 2 by processing position signals supplied from the plurality of magnetic sensors (probe position sensor 21) is provided.

  The magnetic sensor as the probe position sensor 21 is usually mounted on the surface of the ultrasonic probe 2, and the transmitter of the probe position detection unit is on the surface of the case of the ultrasonic diagnostic apparatus 100 close to the ultrasonic probe 2. Be placed. Then, the above-mentioned position information calculation unit calculates the position information of the ultrasound probe 2 based on the distance between each of the plurality of magnetic sensors measured by magnetism and the transmitter.

  The MPR cross section setting unit 8 is a position and direction of a scan cross section where ultrasonic transmission / reception is performed based on position information of the ultrasonic probe 2 supplied from the probe position detection unit of the position information detection unit 7 via the system control unit 17 Are detected, and an MPR cross section corresponding to this scanning cross section is set. That is, the cross-section setting for three-dimensional reference image information when generating the reference image data in the same cross-section as the ultrasound image data of the desired scan cross-section collected by ultrasonic transmission / reception using the three-dimensional reference image information collected in advance Is performed based on the above-mentioned MPR cross section.

  Meanwhile, the insertion direction estimation unit 9 is an RFA puncture needle in the patient's body based on the position information of the RFA puncture needle 150 supplied from the puncture needle position detection unit of the position information detection unit 7 through the system control unit 17. Estimate 150 insertion directions.

  Next, the reference image information storage unit 10 includes an image information storage unit and a coordinate conversion unit (not shown), and the image information storage unit includes spatial resolution and contrast resolution of separately installed X-ray CT apparatus, MRI apparatus and the like. Positional information at the time of collection of three-dimensional reference image information including the tumor area of the patient, collected in advance by a superior medical image information collecting apparatus and supplied via a network or a large capacity storage medium etc. It is kept as. On the other hand, the coordinate conversion unit described above receives the position information of the ultrasound probe 2 supplied from the position information detection unit 7 via the system control unit 17 and this position information and the three-dimensional reference from the image information storage unit described above Coordinate conversion is performed on the three-dimensional reference image information so as to correspond to the read out position information together with the image information. Then, the three-dimensional reference image information associated with the ultrasound probe 2 by this coordinate conversion processing and the position information thereof are stored again in the above-mentioned image information storage unit.

  The reference image data generation unit 11 generates a two-dimensional reference image data based on the reference image information of the desired cross section extracted from the three-dimensional reference image information stored in the reference image information storage unit 10 described above. have. That is, first, the reference image data generation unit 11 receives the position information of the MPR cross section set by the MPR cross section setting unit 8 based on the position information of the ultrasonic probe 2. Next, ultrasound image data collection is performed by extracting reference image information having the same position information as the position information of the MPR cross section from among the three-dimensional reference image information stored in advance in the reference image information storage unit 10. Two-dimensional reference image data in a cross section corresponding to the scanning cross section at the time is generated, and the obtained reference image data is stored in its own image data storage unit.

  The tumor area detection unit 12 uses the two-dimensional reference image data generated by the reference image data generation unit 11 described above based on the three-dimensional reference image information collected by the medical image information collection apparatus, and uses the tumor area of the patient. It has a function of detecting, and for example, a pixel value comparison unit and a contour extraction unit (not shown) are provided.

  The pixel value comparison unit of the tumor area detection unit 12 compares the pixel value of the reference image data supplied from the reference image data generation unit 11 with the threshold value β2 set in advance, for example, the pixel value of a normal tissue The pixel having a significantly large pixel value or a small pixel value is extracted. By comparing the pixel value of the reference image data superior in spatial resolution and contrast resolution to such ultrasonic image data and the threshold value β2, it becomes possible to extract the pixels of the tumor area with high accuracy.

  Then, the contour extraction unit of the tumor region detection unit 12 generates contour data of a tumor region by performing connection processing on a plurality of adjacent pixels extracted by the above-described pixel value comparison unit.

  Next, the support data generation unit 13 uses the reference image data generated by the reference image data generation unit 11 and the region information of the tumor detected by the tumor region detection unit 12 and the RFA puncture needle estimated by the insertion direction estimation unit 9 The purpose is to accurately insert the RFA puncture needle 150 by superimposing the puncture marker indicating the insertion direction of 150 on the first ultrasonic image data before ablation treatment generated by the image data generation unit 5 in time series. Generating first treatment support data.

  Furthermore, the assistance data generation unit 13 detects an ablation region based on the first ultrasonic image data before cautery treatment generated by the image data generation unit 5 and the second ultrasonic image data during or after cautery treatment. The second for the purpose of accurate determination of the quality of ablation treatment using the RFA puncture needle 150 by superimposing the information on the ablation region detected by the unit 6 on the above-mentioned reference image data generated by the reference image data generation unit 11 Generate treatment support data.

  That is, prior to the insertion of the RFA puncture needle 150 into the tumor area of the patient, the tumor area detection unit 12 extracts the three-dimensional reference image information including the tumor area stored in advance in the reference image information storage unit 10. The above-mentioned tumor area is detected using the reference image data generated by the reference image data generation unit 11 based on the reference image information of the cross section corresponding to the scan cross section of the ultrasound image data, and contour data of this tumor area is generated. . Then, the support data generation unit 13 performs the outline data of the tumor area and the RFA puncture described above in each of the first ultrasonic image data generated by the image data generation unit 5 in time series in ultrasonic transmission and reception in the above-described scanning cross section. By superimposing the puncture marker of the needle 150, first treatment support data is generated.

  FIG. 4 shows a specific example of the first treatment support data generated by the support data generation unit 13. For example, the left region (a) of the first treatment support data includes the tumor At. The reference image data Ira generated by the reference image data generation unit 11 using the reference image information of the cross section is shown, and in the right area (b), the tumor detected by the tumor area detection unit 12 using this reference image data Ira The first ultrasound image data Iua on which the contour data (area information) Ct of At is superimposed is shown. Further, puncture markers Br and Bu indicating the insertion method of the RFA puncture needle 150 estimated by the insertion direction estimation unit 9 are added to the respective image data.

  On the other hand, when ablation treatment is performed using the RFA puncture needle 150 inserted into the tumor region, or when ablation treatment for the tumor region is completed, the ablation region detection unit 6 stores its own image data storage unit. The ablation region is detected based on the first ultrasonic image data before cauterization treatment read out from 61 and the second ultrasonic image data during or after cauterization treatment, and contour data of the cauterization region is generated. Then, the support data generation unit 13 generates second treatment support data by superimposing the outline data of the ablation region on the above-described reference image data generated by the reference image data generation unit 11.

  FIG. 5 shows a specific example of the second treatment support data generated by the support data generation unit 13. For example, in the left region (a) of the second treatment support data, the ablation region detection unit The outline data (area information) Da of the ablation area detected by subtraction processing of the first ultrasonic image data and the second ultrasonic image data 6 and the reference image data Irb on which the above-described puncture marker Br is superimposed are shown. In the right area (b), contour data Ct of the tumor At and second ultrasound image data Iub in which the puncture marker Bu is superimposed are shown.

  Although FIG. 4 describes the case where the contour data Ct of the tumor At is superimposed on the first ultrasonic image data Iua that constitutes the first treatment support data, the same applies to the reference image data Ira. Contour data Ct may be added. Similarly, FIG. 5 describes the case where the contour data Ca of the ablation region Aa is superimposed on the reference image data Irb constituting the second treatment support data, but the second ultrasonic image data Iub is described. Similar contour data Ca may be added.

  Next, the display unit 14 of FIG. 1 includes a display data generation unit, a data conversion unit, and a monitor (not shown), and the display data generation unit is a first treatment support data generated by the support data generation unit 13 before ablation treatment. The display data is generated by converting the second treatment support data generated during or after the acupuncture and moxibustion treatment into a predetermined display format, and the data conversion unit performs D / A conversion or television on the obtained display data. Perform conversion processing such as format conversion and display on the monitor.

  On the other hand, the input unit 15 includes input devices such as a display panel, a keyboard, a trackball, a mouse, a selection button, and an input button on the operation panel, and inputs patient information, sets ultrasound transmission / reception conditions, and image data generation conditions. Setting of treatment support data generation conditions, selection of examination mode, setting of threshold value β1 and threshold value β2, input of various instruction signals, and the like are performed.

  Next, the scan control unit 16 includes a delay time control unit (not shown). The delay time control unit performs an operation on the scan section including the tumor area of the patient in accordance with the scan instruction signal supplied from the system A delay time control signal for performing sound wave transmission and reception is supplied to the transmission delay circuit 312 of the transmission unit 31 and the reception delay circuit 323 of the reception unit 32.

  The system control unit 17 includes a CPU (not shown) and an input information storage unit, and the above-described various information input / selected / set in the input unit 15 is stored in the input information storage unit. On the other hand, the CPU executes ultrasonic transmission / reception with respect to the patient by totally controlling each unit provided in the ultrasonic diagnostic apparatus 100 using the various information described above, and generates ultrasonic image data in a desired scanning cross section. Using the RFA puncture needle 150 based on the reference image data of the cross section corresponding to the scanning cross section generated using the three-dimensional reference image information collected in advance by the medical image information collecting apparatus and the ultrasonic image data described above Execute generation and display of various treatment support data effective for ablation treatment.

  Next, a specific configuration of the deployable RFA puncture needle 150 attached to the puncture adapter of the ultrasonic probe 2 will be described with reference to FIG. 6A shows the RFA puncture needle 150 before the deployment needle 152 described later is deployed, and FIG. 6B shows the RFA puncture needle 150 in which the deployment needle 152 is deployed.

  That is, the RFA puncture needle 150 shown in FIG. 6 includes a needle-like hand piece 151 having a hollow structure which is percutaneously inserted toward a tumor area which is a treatment target site of the patient, and the hand piece 151. Is inserted into the tumor area in a state housed in the center of the body, and is connected to each of a plurality of deployment needles 152 deployed from the tip to surround the tumor area, and each of the deployment needles 152, RFA treatment not shown A lead 153 is provided to supply an alternating current of a predetermined frequency (for example, 500 KHz) from the drive circuit of the device. And the deployment needle 152 driven by the above-mentioned alternating current irradiates the radio wave of the same frequency from the front-end | tip part, and performs cauterization treatment with respect to a tumor area.

  For example, when the tip of the handpiece 151 inserted into the patient's body reaches the back of the tumor area, the deployment needle 152 is pushed out of the tip and placed (deployed) around the tumor area. In this case, as shown in FIG. 6B, the deployment needle 152 is deployed along a spherical surface 110 whose diameter is, for example, 2 cm to 3 cm, and in ablation treatment using an RFA puncture needle, Among various RFA puncture needles having different spread diameters, an RFA puncture needle having a spread diameter suitable for the tumor area is selected. Although FIG. 6 shows the RFA puncture needle 150 having four deployment needles 152, the RFA puncture needle 150 having eight to ten deployment needles is used in ordinary cautery treatment.

(Procedure for generating / displaying treatment support data)
Next, the procedure for generating / displaying the treatment support data in the present embodiment will be described with reference to the flowchart of FIG.

  Prior to ultrasound transmission / reception to / from the patient, the reference image information storage unit 10 of the ultrasound diagnostic apparatus 100 is collected beforehand by a medical image information acquisition apparatus such as an X-ray CT apparatus or an MRI apparatus installed separately. The three-dimensional reference image information (volume data) of the patient and the position information supplied via the storage medium are stored in the image information storage unit of the user (step S1 in FIG. 7).

  On the other hand, the coordinate conversion unit of the reference image information storage unit 10 receives the position information of the ultrasonic probe 2 at the predetermined position supplied from the position information detection unit 7 via the system control unit 17 and this position information and the above-mentioned Coordinate conversion is performed on the three-dimensional reference image information so that the three-dimensional reference image information and the position information read out from the image information storage unit correspond to each other. Then, the three-dimensional reference image information associated with the ultrasound probe 2 by this coordinate conversion processing and the position information thereof are stored again in the above-mentioned image information storage unit (step S2 in FIG. 7).

  When the association between the three-dimensional reference image information and the ultrasound probe 2 is completed, the operator of the ultrasound diagnostic apparatus 100 inputs patient information, ultrasound transmission / reception conditions, and treatment support data generation conditions at the input unit 15. Setting the examination mode (B mode examination), setting the threshold β1 and the threshold β2, etc., move the ultrasonic probe 2 that can transmit and receive ultrasonic waves along the patient's body surface. At this time, under observation of ultrasonic image data displayed on the display unit 14, the ultrasonic probe 2 is disposed at a position suitable for depiction of a tumor area (step S3 in FIG. 7).

  Then, while the ultrasound probe 2 is fixed at the above-mentioned position, ultrasound transmission / reception with respect to the tumor area of the patient is continuously performed, and the image data generation unit 5 cauterizes based on the received signal obtained from the patient body at this time. Ultrasonic image data (first ultrasonic image data) before treatment is generated in time series (step S4 in FIG. 7). Then, the first ultrasound image data in a desired time phase extracted from among the plurality of obtained first ultrasound image data is stored in the image data storage unit 61 of the ablation region detection unit 6 ( Step S5 of FIG. 7).

  On the other hand, the puncture needle position detection unit of the position information detection unit 7 is the position information of the RFA puncture needle 150 attached to the puncture adapter of the ultrasonic probe 2 disposed at a suitable position on the patient body surface in step S3 described above. The insertion direction estimation unit 9 detects the position of the tip of the puncture needle position detection unit 9 based on the position information of the RFA puncture needle 150 supplied from the puncture needle position detection unit via the system control unit 17. The insertion direction of the RFA puncture needle 150 in the body is estimated (step S6 in FIG. 7).

  Further, the MPR cross section setting unit 8 is a position of the scanning cross section where ultrasonic transmission / reception is performed based on the position information of the ultrasonic probe 2 supplied from the probe position detection unit of the position information detection unit 7 via the system control unit 17 And the direction is detected, and the MPR cross section corresponding to this scanning cross section is set.

  Next, the reference image data generation unit 11 refers to reference image information having the same position information as the position information of the MPR cross section set by the MPR cross section setting unit 8 based on the position information of the ultrasonic probe 2 10. Extract from the three-dimensional reference image information stored in 10 and generate two-dimensional reference image data, and store the obtained reference image data in its own image data storage unit (step S7 in FIG. 7) .

  Next, the pixel value comparison unit of the tumor area detection unit 12 compares the pixel value of the reference image data read out from the image data storage unit of the reference image data generation unit 11 with the threshold value β2 set in advance. The tumor area in the reference image data is detected by extracting pixels having pixel values significantly different from the average pixel value threshold value β2 (step S8 in FIG. 7). Then, the contour extraction unit of the tumor region detection unit 12 generates contour data of a tumor region by performing connection processing on a plurality of adjacent pixels extracted by the above-described pixel value comparison unit.

  On the other hand, the support data generation unit 13 receives ultrasound image data (first ultrasound image data) before ablation treatment that the image data generation unit 5 generates in time series, and the image of the reference image data generation unit 11 Region information (for example, contour data of a tumor region) of a tumor detected by the tumor region detection unit 12 using the reference image data read out from the data storage unit and insertion of the RFA puncture needle 150 estimated by the insertion direction estimation unit 9 By superimposing a puncture marker indicating the direction on the first ultrasound image data, first treatment support data aimed at accurate insertion of the RFA puncture needle 150 into the tumor area is generated. Then, the first treatment support data in which the tumor region information and the puncture marker of the RFA puncture needle 150 are displayed is displayed on the monitor of the display unit 14 (step S9 in FIG. 7).

  On the other hand, the operator of the ultrasonic diagnostic apparatus 100 who has observed the first treatment support data displayed on the display unit 14 determines the desired part of the tumor area and the RFA puncture needle 150 indicated in the first treatment support data. After confirming that the puncture marker crosses the puncture marker, the RFA puncture needle 150 is inserted into the patient's body along the puncture adapter of the ultrasound probe 2 (step S10 in FIG. 7), and its tip is the tumor area After reaching the predetermined site, the ablation treatment for the tumor area is started by switching the separately installed RFA treatment apparatus to the operation state (step S11 in FIG. 7).

  Then, if ablation treatment for the tumor area has been performed for a predetermined time, the ablation treatment is temporarily interrupted by switching the above-mentioned RFA treatment apparatus to the non-operating state, and then the tumor is ablated according to the same procedure as Step 4 above. Ultrasonic transmission / reception is performed with respect to a scanning cross section in a patient's body including a region, and ultrasonic image data (second ultrasonic image data) after ablation treatment is generated in time series (step S12 in FIG. 7).

  Next, the ablation region detection unit 6 receives the above-mentioned second ultrasonic image data generated by the image data generation unit 5, and the pixel value of the second ultrasonic image data and its own image data storage unit 61. The subtraction process with the pixel value of ultrasound image data (first ultrasound image data) before cautery treatment read out from the above is performed. Then, the ablation region is detected by comparing the obtained difference value of the pixel values with the predetermined threshold value β1 (step S13 in FIG. 7), and the contour data of these regions is extracted to extract the contour data of the ablation region. Generate

  On the other hand, the support data generation unit 13 reads the reference image data stored in the image data storage unit of the reference image data generation unit 11 in step S7 described above, and the ablation region detection unit 6 detects the first ultrasound image data and the first ultrasound image data. Information of ablation area detected by subtraction processing with 2 ultrasonic image data (for example, contour data of ablation area) and a puncture marker indicating the insertion direction of the RFA puncture needle 150 estimated by the insertion direction estimation unit 9 By superimposing on the above-described reference image data, second treatment support data for the purpose of accurate determination as to whether the ablation treatment is performed by the RFA puncture needle 150 is generated. Then, the second treatment support data in which the information on the ablation region and the puncture marker of the RFA puncture needle 150 are displayed is displayed on the monitor of the display unit 14 (step S14 in FIG. 7).

  At this time, the operator of the ultrasonic diagnostic apparatus 100 who has observed the second treatment support data displayed on the display unit 14 determines whether or not sufficient ablation treatment has been performed on all of the planned tumor regions. If the cautery treatment is insufficient, the procedure of steps S10 to S15 is repeated. On the other hand, if it is confirmed in the above-mentioned step S15 that sufficient ablation treatment has been performed on the tumor area, the RFA puncture needle 150 is removed, and the ablation treatment for the patient is ended.

  According to this embodiment described above, the tumor area of the patient is detected based on reference image information obtained in advance by a medical image information collecting apparatus such as an X-ray CT apparatus or an MRI apparatus excellent in spatial resolution and contrast resolution. By inserting an RFA puncture needle into the tumor area under observation of the first treatment support data generated by superimposing the area information on the first ultrasound image data before cauterizing treatment. It is possible to accurately insert the desired position.

  In addition, the above-mentioned reference image information in a cross section corresponding to the transmission / reception cross section in which the first ultrasound image data is collected is extracted from among the three-dimensional reference image information (volume data) collected by the medical image information collecting apparatus. Thus, ultrasound image data and reference image data in the desired cross section of the patient can be obtained easily and accurately.

  On the other hand, cauterization based on the first ultrasonic image data collected before cauterization treatment using the RFA puncture needle and the second ultrasonic image data collected during cauterization treatment or at the end of cauterization treatment. By detecting the region and observing the second treatment support data generated by superimposing the region information on the reference image data excellent in resolution, whether or not sufficient ablation treatment has been performed on the tumor region It can be determined accurately.

  In particular, by subtracting the pixel value of the first ultrasound image data and the pixel value of the second ultrasound image data, it becomes possible to detect with high accuracy the region whose characteristic has changed due to ablation treatment.

  Although the embodiments of the present disclosure have been described above, the present disclosure is not limited to the above-described embodiments, and can be modified and implemented. For example, in the above-mentioned embodiment, although the case (refer FIG. 5) of superposing the area | region information (outline data) of a tumor with respect to the 1st ultrasound image data which comprises 1st treatment assistance data was described, Similar area information may be added to image data. Similarly, although the case (refer to FIG. 6) of superposing the information (outline data) of the ablation region on the reference image data constituting the second treatment support data has been described, the second ultrasonic image data is described. Even the same area information may be added. The area information in this case is not limited to the contour data.

  Although the tumor area detection unit 12 in the above embodiment has described the case of detecting the tumor area by comparing all the pixel values of the reference image data with the threshold value β2, the present invention is not limited to this. For example, as shown in FIG. 8, reference image data existing inside a concentric circle of radius Rr (for example, Rr <1.5 cm) centered on the tip portion Pr of the RFA puncture needle 150 shown on the puncture marker Br The area of the tumor At may be detected by comparison of the pixel value of and the threshold value β2.

  Similarly, the case where the ablation region detection unit 6 detects the ablation region by subtracting all pixel values of the first ultrasonic image data and all pixel values of the second ultrasonic image data As described above, for example, as shown in FIG. 9, the pixel value of the first ultrasonic image data existing inside the concentric circle of radius Ru centered on the tip Pu of the RFA puncture needle 150 shown on the puncture marker Bu And the pixel value of the second ultrasound image data may be subtracted to detect the ablation region Aa. Further, the above-described calculation may be performed centering on a rough central portion of the tumor At instead of the distal end portion Pr or the distal end portion Pu of the RFA puncture needle 150 described above.

  As described above, by limiting the processing range of the pixel value to the periphery of the tip of the RFA puncture needle, it is possible to shorten the time required for comparison processing of the pixel value and the threshold value β2 or subtraction processing between pixel values. In addition, the influence of noise and the like generated outside the tumor area is reduced, so that the tumor area and the cautery area can be accurately detected.

  The above-described RFA puncture needle tip may be automatically detected by a position signal of a tip position sensor provided separately, or it may be detected as reference image data or ultrasound image data in which the RFA puncture needle 150 is shown. Alternatively, the operator may designate using the input device of the input unit 15.

  Further, in the above-described embodiment, the case of performing ablation treatment on a tumor area using a so-called RFA puncture needle corresponding to radio wave ablation treatment has been described, in which radiological waves are irradiated to coagulate a treatment target. However, the present invention is not limited to the above, and may be cautery treatment using a puncture needle of another type.

  On the other hand, the ultrasound data generated in the reception signal processing unit 4 of the above-described embodiment is not limited to the B mode data, and may be other ultrasound data such as color Doppler data. In this case, the image data generation unit 5 generates the first ultrasonic image data and the second ultrasonic image data in time series based on each ultrasonic data or a plurality of ultrasonic data different in inspection mode. .

  Each unit included in the ultrasonic diagnostic apparatus 100 according to the present embodiment may be realized by using a computer including, for example, a CPU, a RAM, a magnetic storage device, an input device, a display device, etc. as hardware. it can. For example, the system control unit 17 that controls each unit of the ultrasonic diagnostic apparatus 100 can realize various functions by causing a processor such as a CPU mounted on the above computer to execute a predetermined control program. In this case, the control program described above may be installed in a computer in advance, or may be stored in a computer-readable storage medium or installed in a computer on a control program distributed via a network. .

  While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, substitutions, and modifications can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and the gist of the invention, and are included in the invention described in the claims and the equivalent scope thereof.

DESCRIPTION OF SYMBOLS 2 ... Ultrasonic probe 21 ... Probe position sensor 22 ... Puncture needle position sensor 3 ... Transmission and reception part 31 ... Transmission part 32 ... Reception part 4 ... Reception signal processing part 5 ... Image data generation part 6 ... Ablation area detection part 7 ... Position information Detection unit 8 MPR cross section setting unit 9 Insertion direction estimation unit 10 Reference image information storage unit 11 Reference image data generation unit 12 Tumor area detection unit 13 Support data generation unit 14 Display unit 15 Input unit 16 ... scan control unit 17 ... system control unit 150 ... RFA puncture needle 100 ... ultrasonic diagnostic apparatus

Claims (11)

An ultrasonic diagnostic apparatus that displays treatment support data for supporting ablation treatment using a puncture needle,
Image data generation means for generating ultrasound image data based on a received signal obtained by ultrasound transmission / reception to a patient;
Reference image for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using reference image information of the patient collected separately by a medical image information acquisition apparatus different from the ultrasonic diagnostic apparatus installed separately Data generation means,
The ablation region indicated in the second ultrasound image data based on the first ultrasound image data before ablation treatment and the second ultrasound image data after ablation treatment generated by the image data generation means An ablation region detecting means for detecting;
Support data generation means for generating the treatment support data by superimposing contour data of the ablation region on the reference image data;
An ultrasonic diagnostic apparatus comprising: display means for displaying the treatment support data.   The ultrasonic diagnostic apparatus according to claim 1, wherein the ablation area detection unit detects the ablation area by subtraction processing of the first ultrasonic image data and the second ultrasonic image data.   The ablation region detection means is based on the first ultrasonic image data and the second ultrasonic image data within a predetermined range centered on the tip of the puncture needle inserted into the patient's body. The ultrasonic diagnostic apparatus according to claim 1, wherein the ablation region is detected.   Contour extraction means for extracting the contour of the ablation region as the contour data based on a difference value between the first ultrasonic image data and the second ultrasonic image data obtained by the subtraction processing; 3. The ultrasonic wave according to claim 2, wherein the support data generation unit generates the treatment support data by superimposing the contour data of the ablation area obtained by the contour extraction unit on the reference image data. Diagnostic device.   The reference image data generation unit copes with the ultrasound image data by extracting reference image information of a cross section corresponding to the scanning cross section from among three-dimensional reference image information collected in advance by the medical image information collecting apparatus. The ultrasound diagnostic apparatus according to claim 1, wherein the reference image data is generated. An ultrasonic diagnostic apparatus that displays treatment support data for supporting ablation treatment using a puncture needle,
Image data generation means for generating ultrasound image data before ablation treatment based on a received signal obtained by ultrasound transmission / reception to a patient;
Reference image data generating means for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using reference image information of the patient collected in advance by a medical image information collecting device installed separately;
A tumor area detection means for detecting a tumor area of the patient in reference image data of the cross section within a range based on the position of the tip of the puncture needle inserted into the patient;
Support data generation means for generating treatment support data by superimposing outline data of the tumor area on the ultrasound image data;
An ultrasonic diagnostic apparatus comprising: display means for displaying the treatment support data.   7. The ultrasonic diagnostic apparatus according to claim 6, wherein the tumor area detection unit detects the tumor area by comparing a pixel value of the reference image data with a predetermined threshold value.   The ultrasonic diagnostic apparatus according to claim 6, wherein the tumor area detection means detects the tumor area based on the reference image data within a predetermined range centered on the position of the tip of the puncture needle. .   The method may further include: insertion direction estimation means for estimating the insertion direction of the puncture needle, wherein the support data generation means superimposes contour data of the tumor area and a puncture marker indicating the insertion direction on the ultrasonic image data. The ultrasound diagnostic apparatus according to claim 6, wherein the treatment support data is generated by In contrast to an ultrasonic diagnostic apparatus that displays treatment support data that supports ablation treatment using a puncture needle,
An image data generation function of generating ultrasound image data based on a received signal obtained by ultrasound transmission / reception to a patient;
Reference image for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using reference image information of the patient collected separately by a medical image information acquisition apparatus different from the ultrasonic diagnostic apparatus installed separately Data generation function,
The ablation region indicated in the second ultrasound image data based on the first ultrasound image data before ablation treatment and the second ultrasound image data after ablation treatment generated by the image data generation function With ablation area detection function to detect,
A support data generation function of generating the treatment support data by superimposing outline data of the ablation region on the reference image data;
A control program characterized by executing a display function for displaying the treatment support data. In contrast to an ultrasonic diagnostic apparatus that displays treatment support data that supports ablation treatment using a puncture needle,
An image data generation function of generating ultrasound image data before ablation treatment based on a received signal obtained by ultrasound transmission and reception to a patient;
A reference image data generation function of generating reference image data of a cross section corresponding to a scan cross section of the ultrasound image data using reference image information of the patient collected in advance by a medical image information collection device installed separately;
A tumor area detection function of detecting a tumor area of the patient in reference image data of the cross section within a range based on the position of the tip of the puncture needle inserted into the patient;
A support data generation function of generating the treatment support data by superimposing outline data of the tumor area on the ultrasound image data;
A control program characterized by executing a display function for displaying the treatment support data.

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