JP2008054763A - Medical image diagnostic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image diagnostic apparatus for creating fusion images by which abnormal sites such as polyps and calcified regions are easily found by superimposing a virtual endoscopic image on an abnormal site discriminating image. <P>SOLUTION: The medical image diagnostic apparatus creates the fusion image by superimposing the virtual endoscopic image on a summation image which is the abnormal site discriminating image as viewed from a virtual endoscopic image display position to create the virtual endoscopic image and displays to discriminate the abnormal site from a normal site, and displays the fusion image on a monitor. The abnormal sites such as polyps are easily found by creating the summation image, and the anatomic location of the abnormal position is easily understood by superposing the virtual endoscopic image viewed from the same observing point on the summation image. Consequently, the abnormal site is easily found. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a medical image diagnostic apparatus, and more particularly to a medical image diagnostic apparatus that creates a virtual endoscopic image of a luminal organ.

  One of the image processing techniques of the X-ray CT apparatus is a virtual endoscopic image display method. An image processing technology called cruising eye view, virtual endoscopy, etc., which makes it possible to view images that look inside various luminal organs such as the large intestine, small intestine, and blood vessels using an endoscope. It is created from a line CT image, MR image or the like. According to the virtual endoscopic image display method, the inside of the luminal organ can be observed at a desired position as in a normal endoscope.

  A known technique related to a virtual endoscope display method is described in detail in Patent Document 1.

  FIG. 8 is an example of virtual endoscopic image display of a bronchial bifurcation, 8-1 shows an axial image at the observation start position of the virtual endoscopic image, and 8-2 starts observation of the virtual endoscopic image. A sagittal image of the position is shown, 8-3 is a coronal image of the observation start position of the virtual endoscopic image, and 8-4 is a virtual endoscopic image.

  By indicating information on the viewpoint position x of the virtual endoscopic image in an axial image, a sagittal image, and a coronal image, from which position (see FIG. 8x) and which direction (see FIG. 8 arrow) of the subject is observed Is represented. From the coronal image 8-3, it can be clearly seen that there is a bronchial branch from the virtual endoscope observation position x to the viewpoint direction of the arrow.

  The virtual endoscopic image can be observed inside the hollow organ by moving the viewpoint. When the viewpoint position of the virtual endoscopic image is changed, the axial image, the sagittal image, and the coronal image are also updated accordingly.

  Thus, the virtual endoscope is a technique that can clearly image the inside of a hollow organ.

  One of the merits of the virtual endoscope is that the physical burden on the patient is small because the endoscope is not actually inserted into the patient.

  Another advantage is that the luminal organ internal image is created from an X-ray CT image, an MR image, etc., so that it can be observed from various angles. For example, in an actual endoscope, it is not always possible to observe a colon polyp from a desired angle. However, if a virtual endoscopic image is used, it is possible to observe a colonic polyp from a desired angle, and observing a virtual endoscopic image of a colonic polyp is very useful for planning a surgical plan for polypectomy. It can be said that it contributes.

Further, in blood vessels, it is possible to detect a calcified region by observing the inside of the blood vessel by removing blood by threshold processing, and its application range is very wide.
Japanese Patent Application Laid-Open No. 08-016813

  However, the virtual endoscope image display technology as shown in Patent Document 1 has the following drawbacks. In the virtual endoscopic image display technology as shown in Patent Document 1, if the bulge is a small polyp and the bulge is small compared to the surrounding tissue, the operator is likely to overlook the polyp. There is. Similarly, in the calcified region inside the blood vessel, if the calcified region is small and the bulge is small compared to the surrounding tissue or there is no bulge, the operator can overlook the calcified region. There is a problem of high nature.

  That is, there is a problem that the possibility of overlooking the abnormal part is high when the abnormal part is not conspicuous, for example, the bulge is small compared to the normal part.

  The present invention has been made in view of the above circumstances, and by superimposing a virtual endoscopic image and an abnormal part identification image, a fusion image in which an abnormal part such as a polyp or a calcified region can be easily found. It is an object of the present invention to provide a medical image diagnostic apparatus for creating a camera.

  In order to solve the above-mentioned problem, the medical image diagnostic apparatus according to claim 1 acquires a plurality of tomographic images of a subject, and uses the acquired tomographic images of the subject inside the subject. In a medical image diagnostic apparatus that creates a virtual endoscopic image viewed from a set viewpoint, an abnormal part identification image viewed from a virtual endoscopic image display position for creating the virtual endoscopic image, An image creation means for creating an abnormal part identification image for displaying a part distinguishably from a normal part, and a fusion image in which the virtual endoscopic image and the abnormal part identification image created by the image creation means are superimposed And a display means for displaying the fused image created by the fused image creating means.

  According to the medical image diagnostic apparatus according to claim 1, the abnormal part viewed from the virtual endoscopic image and the virtual endoscopic image display position for creating the virtual endoscopic image can be distinguished from the normal part. A fused image is created by superimposing the abnormal part identification image to be displayed on the screen and displayed. In other words, by creating an abnormal part identification image that displays the abnormal part in a distinguishable manner from the normal part, the abnormal part can be easily found and superimposed with the virtual endoscopic image viewed from the same viewpoint, The anatomical position of the abnormal part can be easily grasped. Thereby, discovery of abnormal parts, such as a polyp and a calcification area, becomes easy.

  The medical image diagnostic apparatus according to claim 2 is the medical image diagnostic apparatus according to claim 1, wherein the abnormal site identification image is obtained from a virtual endoscopic image display position for creating the virtual endoscopic image. It is an addition image obtained by adding pixel values for a certain thickness.

  According to the medical image diagnostic apparatus of claim 2, the addition of adding a pixel value for a certain thickness from the virtual endoscopic image and the virtual endoscopic image display position for creating the virtual endoscopic image Create and display a fused image that overlays the image. By creating an addition image with pixel values for a certain thickness added, abnormal parts, especially polyps, can be easily found, and this addition image is superimposed on a virtual endoscopic image viewed from the same viewpoint. Thus, it becomes easy to grasp the anatomical position of the abnormal part. This facilitates the discovery of abnormal sites such as tumors and polyps.

  The medical image diagnostic apparatus according to claim 3 is the medical image diagnostic apparatus according to claim 1, wherein the abnormal part identification image is obtained from a virtual endoscopic image display position for creating the virtual endoscopic image. It is a MIP image created in a certain thickness range.

  According to the medical image diagnostic apparatus of claim 3, a virtual endoscopic image and an MIP image created within a certain thickness range from a virtual endoscopic image display position for creating the virtual endoscopic image Create and display a fused image with By creating a MIP image created within a certain thickness range, abnormal sites, especially calcified regions, can be easily found, and this added image is superimposed on a virtual endoscopic image viewed from the same viewpoint. This makes it easy to grasp the anatomical position of the abnormal part. This facilitates the discovery of abnormal sites such as calcification regions.

  According to the present invention, there is provided a medical image diagnostic apparatus that creates a fusion image in which an abnormal site such as a polyp or a calcified region can be easily found by superimposing a virtual endoscopic image and an abnormal site identification image. be able to.

  The best mode for carrying out the present invention will be described below with reference to the accompanying drawings.

<First Embodiment>
This embodiment is for clearly imaging a tumor, a polyp, or the like that is inconspicuous even when compared with other tissues because the lesion is small. If the tumor or polyp that is an abnormal lesion is relatively large, it will be imaged like a “projection” on the virtual endoscopic image, so it should be clearly imaged only by the virtual endoscopy display method. Is possible. However, if this lesion is small and does not stand out even when compared with other tissues, the image of the lesion may not be clearly expressed even on the virtual endoscopic image. In the present embodiment, in order to solve such a problem, a fusion image is created by superimposing a virtual endoscopic image and an addition image.

  FIG. 1 is a hardware configuration diagram showing the overall configuration of the medical image diagnostic apparatus according to the first embodiment of the present invention.

  The medical image diagnostic apparatus 10 is connected to a medical image capturing apparatus 2 that captures an image of a subject through a network such as a LAN 3. Although the X-ray CT apparatus is described as an example of the medical image photographing apparatus, the medical image photographing apparatus is configured by an apparatus capable of photographing an object image (preferably a three-dimensional image) such as an MR apparatus.

  The medical image diagnostic apparatus 10 mainly includes a central processing unit (CPU) 11 as a control device that controls the operation of each component, and a main memory 12 that stores a control program for the device and serves as a work area when the program is executed. A magnetic disk 13 on which an operating system (OS), peripheral device drives, various application software including a program for creating a fusion image, and the like, and a display for temporarily storing display data A memory 14, a monitor 15 such as a CRT monitor or a liquid crystal monitor that displays an image based on data from the display memory 14, a mouse 17 as a position input device, and a mouse on the monitor 15 by detecting the state of the mouse 17 A controller 16 that outputs signals such as the position of the pointer and the state of the mouse 17 to the CPU 11. , A keyboard 18 for the operator to enter the support, and a bus 19 which connects the above components.

  The CPU 11 reads the program from the magnetic disk 13, loads it into the main memory 12, and executes it.

  In this embodiment, the magnetic disk 13 is connected as a storage device other than the main memory 12, but a hard disk drive or the like may be connected in addition thereto.

  Next, a processing flow of the medical image diagnostic apparatus 10 will be described.

  FIG. 2 is a flowchart showing a processing flow of the medical image diagnostic apparatus 10. The CPU 11 operates according to this flowchart.

  First, a tomographic image of the subject is taken (step S10). In the present embodiment, a tomographic image is taken by the X-ray CT apparatus 2.

  In the case of observing the large intestine, preparation work for imaging a subject as described below is performed prior to virtual endoscopy.

  First, feces etc. inside the large intestine are excreted outside the body. It is generally done by laxatives and large amounts of water. This is done so that tumors and polyps hidden in the stool are not overlooked.

  Thereafter, air is injected into the large intestine to inflate the large intestine. This is a measure for preventing oversight of an abnormal site, such as when a polyp is buried in a state where the large intestine is deflated.

  This completes the preparation for imaging the subject. The above preparation work is generally performed not only in a virtual endoscopy but also in an inspection using a normal endoscope.

  Thereby, since there is no residue and the large intestine which is stretched with air can be X-ray CT-imaged, a high-speed and high-definition tomographic image can be obtained. The captured tomographic image is input to the magnetic disk 13 via the LAN 3.

  A virtual endoscopic image is created based on the tomographic image input to the magnetic disk 13 (step S12). Then, the optimum place for observing the abnormal part (tumor, polyp, etc.) is automatically determined as the virtual endoscopic image display position (step S14).

  In this embodiment, the virtual endoscopic image display position that is optimal for observing a tumor, a polyp, or the like is automatically determined. However, the operator can determine the virtual endoscopic image display position. Good. In that case, after creating a virtual endoscopic image (step S12), the operator looks at the image displayed on the monitor 15 via the display memory 14 and uses the mouse 17 or the like to view the virtual endoscope image. The virtual endoscope image display position is determined by moving the image.

  When the virtual endoscopic image display position is determined, an added image is created by adding pixel values of a certain thickness from the virtual endoscopic image display position (steps S16 to S26). In the present embodiment, since the X-ray CT apparatus 2 is used, the pixel value means a CT value.

  First, n = 1 is set (step S16).

  Next, a path qn (n = 1 to N, where N is an integer of 2 or more) for adding CT values for a predetermined thickness along the line of sight from the virtual endoscopic image display position is created (step) 18). The path qn is a straight line having a predetermined length L (see FIG. 3) starting from a pixel position pn on the straight line ln along the line of sight from the virtual endoscopic image display position m.

  Here, a method for setting the path qn will be described.

  As shown in FIGS. 3A and 3B, a pixel position p1 in the field of view is connected by a straight line l1 from the virtual endoscopic image display position m. The straight line l1 matches the line of sight when the pixel position p1 is viewed from the virtual endoscope image display position m. A straight line having a length L (including the pixel position p1) extending from the pixel position p1 toward the intestinal wall side on the straight line l1 is a path q1.

  When there is an abnormal part such as a tumor or a polyp, as shown in FIG. 3B, on the line of sight l3 and l4 when the pixel positions p3 and p4 on the polyp are viewed from the virtual endoscopic image display position m. In addition, straight lines having a length L passing through the polyp and the intestinal wall starting from the pixel positions p3 and p4 on the polyp are paths q3 and q4.

  Note that the length L indicates a range in which CT values are added. In this embodiment, since the large intestine is observed, the length L is a length obtained by adding several mm to the thickness t of the intestinal wall, and is in a range of about 1 to 3 times the thickness t of the intestinal wall. is there.

  The length L may be automatically determined as an optimum value for creating the added image, or may be determined by the operator. When the operator decides, the basic value L is displayed on the monitor 15 via the display memory 14 and is selected by the operator using the mouse 17 or the like.

  When the path qn is created, the CT value included in the path qn is added (step S20).

  When the addition of the CT value is completed, n = n + 1 is set (step S22).

  Then, it is determined whether n = N, that is, whether the CT value has been added to the path qn passing through all the pixels included in the visual field from the virtual endoscopic image display position m (step S24). ).

  In the case of NO, the process returns to the path qn creation (step S18) and the above process is performed again.

  In the case of YES, the CT values of the pixel positions p1 to pN in the virtual endoscopic image are replaced with the added CT values in the paths q1 to qN passing through the pixel positions p1 to pN added in step S20 (step S26).

  As a result, an added image in which CT values for a certain thickness are added from the virtual endoscope image display position m is created.

  When there is no abnormal site such as a tumor or polyp (see FIG. 3A), the values obtained by adding the CT values on the paths q1 to qN are equal in the paths q1 to qN. Therefore, the added image is a flat image.

  On the other hand, when there is an abnormal part such as a tumor or polyp (see FIG. 3B), the value obtained by adding the CT values on the path qn (abnormal part and intestinal wall) passing through the abnormal part is the path passing through the normal part. It becomes higher than the value obtained by adding the CT values on qn (only the intestinal wall). When the CT value is imaged, a portion with a high CT value is generally dark and a portion with a low CT value is displayed lightly. Therefore, in the added image, the abnormal portion is displayed darker than the normal portion. .

  In FIG. 3, the outline has been described using a plane including the virtual endoscope image display position m and the intestinal wall, but in reality, a three-dimensional space within the field of view of the virtual endoscope image display position m. The above processing is performed on

  When the added image is created, the virtual endoscopic image stored in the magnetic disk 13 (see FIG. 4A) and the added image created in step S26 (see FIG. 4B) are superimposed. The fused image (see FIG. 4C) is created (step S28) and displayed on the monitor 15 via the display memory 14 (step S30). The image fusion technique is also called image fusion, and there are many known techniques such as PET image and CT image fusion processing and PET / MR image fusion processing, which can be executed by using them.

  Since the addition image is an image having an addition CT value of a certain thickness from the virtual endoscope image display position, as shown in FIG. 4B, the abnormal part 4-1 such as a tumor or a polyp is darkened, Other normal parts can be thinly imaged, but unlike a normal virtual endoscopic image, the image is “blurred”. Therefore, it becomes difficult to grasp the anatomical position of the abnormal part, which hinders clinical diagnosis.

  Therefore, by superimposing the virtual endoscopic image as shown in FIG. 4 (a) and the addition image as shown in FIG. 4 (b) into a fusion image as shown in FIG. 4 (c), Accurate position information of the abnormal part can be obtained from the virtual endoscopic image, and clinically effective information can be provided to the operator. Thereby, the anatomical position of the abnormal part obtained by the addition image can be grasped more efficiently.

  According to the present embodiment, by creating an addition image that is an abnormal part identification image that displays an abnormal part in a distinguishable manner from a normal part, an abnormal part that is likely to be overlooked only by a virtual endoscopic image, particularly a tumor And image information such as polyps can be accurately conveyed to the operator.

  Further, according to the present embodiment, by superimposing the addition image and the virtual endoscopic image viewed from the same viewpoint, it becomes easy to grasp the anatomical position of the abnormal part.

  As a result, the operator can easily discriminate between the abnormal part and the normal part, and can easily find an abnormal part such as a tumor or a polyp.

<Second Embodiment>
In the medical image diagnostic apparatus according to the first embodiment, an abnormal region that is small and inconspicuous even when compared with other tissues is created by superimposing a virtual endoscopic image and an addition image to create a fusion image. The method for enabling identification of an abnormal site that is small and is not noticeable even when compared with other tissues is not limited to this.

  When there is a high X-ray absorber such as calcification, a MIP image (Maximum Intensity Prediction image) is effective. For example, when observing calcification inside the coronary artery, it is possible to provide the operator with information on the degree of calcification inside the coronary artery by observing an image obtained by superimposing the virtual endoscopic image and this MIP image. It becomes possible. This information is clinically effective information for preventing ischemic heart disease or the like, which is said to be correlated with calcification inside the coronary artery.

  The medical image diagnostic apparatus of the present embodiment can identify a small abnormal part that is small and inconspicuous even when compared with other tissues by creating a fused image by superimposing a virtual endoscopic image and a MIP image To do.

  FIG. 5 is a flowchart showing a processing flow of the medical image diagnostic apparatus 10 according to the second embodiment of the present invention. In the figure, the same portions as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

  First, a tomographic image is taken by the X-ray CT apparatus 2 (step S32).

  The captured tomographic image is input to the magnetic disk 13 via the LAN 3, and a virtual endoscopic image is created based on the tomographic image input to the magnetic disk 13 (step S34). Then, the optimum place for observing the abnormal part (calcified region) is automatically determined as the virtual endoscopic image display position (step S36).

  In the present embodiment, the virtual endoscopic image display position that is optimal for observing the calcified region or the like is automatically determined. However, the operator can determine the virtual endoscopic image display position. Good. In that case, after creating a virtual endoscopic image (step S34), the operator looks at the image displayed on the monitor 15 via the display memory 14 and uses the mouse 17 or the like to view the virtual endoscope image. The virtual endoscope image display position is determined by moving the image.

  When the virtual endoscopic image display position is determined, an MIP image is created within a certain thickness from the virtual endoscopic image display position (steps S38 to S48). In the present embodiment, since the X-ray CT apparatus 2 is used, the pixel value means a CT value. This operation is a process of extracting the maximum CT value within a certain thickness range and creating an image based on the CT value.

    First, n = 1 is set (step S38).

  Next, a path qn ′ (n = 1 to N, N is an integer of 2 or more) for extracting the highest CT value within a predetermined thickness range is created (step 40). As shown in FIG. 6, this path qn ′ is located on a straight line ln ′ along the line of sight from the virtual endoscopic image display position m ′ and starts at a pixel position pn ′ on the straight line ln ′. A straight line having a length L ′ passing through the coronary artery wall (see FIG. 6A) or the coronary artery wall including the calcified region (see FIG. 6B).

  The length L ′ indicates a range in which the highest CT value is extracted. Since the coronary artery is observed in this embodiment, the length L ′ is a length obtained by adding several millimeters to the thickness t ′ of the coronary artery wall, which is about 1 to 3 times the thickness t ′ of the coronary artery wall. It is a range.

  The length L ′ may be automatically determined as an optimal value for MIP image creation, or may be determined by an operator. When the operator decides, the basic value L ′ is displayed on the monitor 15 via the display memory 14 and selected by the operator using the mouse 17 or the like.

  When the pass qn 'is created, the highest CT value among the pixels included in the pass qn' is extracted (step S42).

  When the extraction of the highest CT value is completed, n = n + 1 is set (step S44).

  Then, it is determined whether n = N, that is, whether the highest CT value is extracted for the path qn ′ that passes through all the pixels included in the visual field from the virtual endoscope image display position m. (Step S46).

  In the case of NO, the process returns to the path qn creation (step S40) and the above process is performed again.

  In the case of YES, the CT values of the pixel positions p1 ′ to pN ′ in the virtual endoscopic image become the highest CT values in the paths q1 ′ to qN ′ passing through the pixel positions p1 ′ to pN ′ extracted in step S42. It is replaced (step S48).

  Thereby, the MIP image based on the maximum CT value extracted in the range of a fixed thickness from the virtual endoscope image display position m is created.

  When there is no abnormal part (calcified region) (see FIG. 6A), the highest CT values on the paths q1 'to qN' are equal in the paths q1 'to qN'. Therefore, the MIP image is a flat image.

  On the other hand, when there is an abnormal site (calcified region) (see FIG. 6B), since the calcified region is a high X-ray absorber, the path qn ′ (abnormal site and intestinal wall) passing through the abnormal site. The highest CT value on the upper side is higher than the highest CT value on the path qn ′ (only the intestinal wall) passing through the normal site. Further, the highest CT value on the path qn ′ (abnormal part and intestinal wall) passing through the abnormal part varies depending on the degree of calcification of the abnormal part.

  When the CT value is imaged, a portion with a high CT value is generally dark and a portion with a low CT value is displayed lightly. Therefore, in an MIP image, an abnormal region is displayed darker than a normal region. .

  In FIG. 6, the outline has been described using a plane including the virtual endoscopic image display position m ′ and the coronary artery wall. However, in actuality, 3 in the visual field of the virtual endoscopic image display position m ′. The above processing is performed on the dimension space.

  When the MIP image is created, the virtual endoscopic image stored in the magnetic disk 13 (see FIG. 7A) and the MIP image created in step S26 (see FIG. 7B) are superimposed. The fused image (see FIG. 7C) is created (step S50) and displayed on the monitor 15 via the display memory 14 (step S52).

  The MIP image is an image in which the abnormal part is displayed in light and shade, and as shown in FIG. 7B, the abnormal part (calcified region) 7-2 can be displayed darkly, but the virtual endoscopic image Unlike this, it becomes difficult to grasp the anatomical position of the abnormal part, which hinders clinical diagnosis.

  Therefore, the virtual endoscopic image (see FIG. 7 (a)) and the MIP image (see FIG. 7 (b)) are overlapped to form a fused image (see FIG. 7 (c)). Position information can be obtained from the virtual endoscopic image, and clinically effective information can be provided to the operator. Thereby, the anatomical position of the abnormal part obtained by the MIP image can be grasped more efficiently.

  Here, although the abnormal part (calcification area | region) 7-1 currently displayed on the virtual endoscopic image is an ellipse, two abnormal part (calcification area | region) 7-2 currently displayed on the MIP image are two pieces. The shape is different between the abnormal part (calcified region) 7-1 and the abnormal part (calcified region) 7-2. This is because the threshold value set when creating the MIP image is set to a value that can emphasize a region having a particularly high calcification strength. Note that the calcification region displayed in the MIP image can be made the same as the calcification region displayed in the virtual endoscopic image by setting the threshold value lower than in the present embodiment.

  According to the present embodiment, by creating an MIP image that is an abnormal part identification image that displays a normal part in a distinguishable manner from a normal part, an abnormal part that is likely to be overlooked only by a virtual endoscopic image, particularly lime The image information of the conversion area can be accurately conveyed to the operator.

  Further, according to the present embodiment, by superimposing the virtual endoscopic image and the MIP image viewed from the same viewpoint, it becomes easy to grasp the anatomical position of the abnormal part.

  Thereby, the operator can easily discriminate between the abnormal part and the normal part, and can easily find the abnormal part such as the calcified region.

  In the present embodiment, the case where the coronary artery has a calcified region having a small bulge has been described, but the present invention can also be applied to the case where the coronary artery has a calcified region having no bulge.

1 is a schematic diagram illustrating an overall configuration of a first embodiment of a medical imaging apparatus to which the present invention is applied. It is a flowchart which shows the flow of a process of 1st Embodiment of the said medical imaging device. It is explanatory drawing explaining the method of producing the addition image of 1st Embodiment of the said medical imaging device, (a) shows the case of only a normal site | part, (b) is a case containing an abnormal site | part (polyp) Indicates. It is an image display example of 1st Embodiment of the said medical imaging device, (a) shows the case of only a virtual endoscopic image, (b) shows the case of only an addition image, (c) is virtual The case where an endoscopic image and an addition image are superimposed (a fused image) is shown. It is a flowchart which shows the flow of a process of 2nd Embodiment of the medical imaging device to which this invention was applied. It is explanatory drawing explaining the method of producing the addition image of 2nd Embodiment of the said medical imaging device, (a) shows the case of only a normal site | part, (b) shows an abnormal site | part (calcification area | region). Indicates the case of inclusion. It is an image display example of 2nd Embodiment of the said medical imaging device, (a) shows the case where only a virtual endoscopic image is shown, (b) shows the case where only a MIP image is shown, (c) is virtual The case where the endoscopic image and the MIP image are superimposed (a fused image) is shown. It is a display example of the screen of the conventional embodiment.

Explanation of symbols

2: X-ray CT apparatus, 10: medical imaging apparatus, 15: monitor

Claims (3)

In a medical image diagnostic apparatus that acquires a plurality of tomographic images of a subject and creates a virtual endoscopic image viewed from a viewpoint set inside the subject using the plurality of tomographic images of the acquired subject.
Image creating means for creating an abnormal site identification image as viewed from a virtual endoscopic image display position for creating the virtual endoscopic image, wherein the abnormal site identification image is displayed so as to be distinguishable from the normal site When,
Fusion image creation means for creating a fusion image obtained by superimposing the virtual endoscopic image and the abnormal part identification image created by the image creation means;
Display means for displaying the fused image created by the fused image creating means;
A medical image diagnostic apparatus comprising:   The said abnormal site | part identification image is an addition image which added the pixel value for fixed thickness from the virtual endoscopic image display position for creating the said virtual endoscopic image. Medical image diagnostic equipment.   The said abnormal site | part identification image is a MIP image produced in the range of fixed thickness from the virtual endoscopic image display position for producing the said virtual endoscopic image, It is characterized by the above-mentioned. Medical diagnostic imaging device.

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