JP2011101679A - Ultrasonic diagnostic system - Google Patents

Abstract

In the examination of metabolic syndrome, the abdominal circumference has been conventionally measured, but it does not necessarily have a good correlation with the visceral fat mass.
Three contact positions are defined on the surface of the abdomen, and three predetermined distances in the living body are measured by contacting the probe at these positions. Specifically, three measurement paths 36B, 36A, and 36C starting from the center point O of the lower aorta are set, and the distance from the center point O to the fat layer surface (inner surface) on the body surface side on each measurement path. a, b, and c are observed. An approximate area of the visceral fat area 20 can be obtained from the distances a, b, c and angles θb, θc, and an index value is calculated based on the area.
[Selection] Figure 3

Description

  The present invention relates to an ultrasonic diagnostic system, and more particularly to an ultrasonic diagnostic system for measuring visceral fat.

  Ultrasound diagnostic systems are used in the medical field. An ultrasonic diagnostic system is generally configured by an ultrasonic diagnostic apparatus or a combination of an ultrasonic diagnostic apparatus and a computer. The ultrasonic diagnostic apparatus includes an ultrasonic probe that transmits ultrasonic waves to a living body and receives reflected waves from the living body, and image formation and various types of signals based on reception signals from the ultrasonic probe. And an apparatus main body that performs measurement. According to the ultrasonic diagnosis, the problem of exposure that occurs in the X-ray diagnosis can be avoided, and a large-scale mechanism like the X-ray diagnosis is unnecessary. From such convenience, it is desired to use ultrasonic diagnosis for medical examination of metabolic syndrome (visceral fat type obesity).

  Currently, in the metabolic syndrome medical examination, the abdominal circumference is generally measured. This is because a certain correlation is observed between the abdominal circumference and visceral fat mass. However, the abdominal circumference is only length information including subcutaneous fat (including muscle), and does not represent the amount of visceral fat in the abdominal cavity or the size of the range where it can exist. A method has also been proposed in which a weak current is passed through the abdomen and the visceral fat mass is estimated from the electrical resistance. However, a large-scale device is required to realize such a method, and the structure in the abdomen can be fully considered. Since it is not a thing, the reliability of a measured value cannot be improved in that sense. According to the technique for measuring visceral fat mass using an X-ray CT apparatus, it is possible to achieve high-precision measurement. However, in order to do so, it is necessary to construct a very large-scale system. There is a problem, especially in terms of exposure. Therefore, it has been studied to apply an ultrasonic diagnosis that can observe the internal structure in a non-invasive manner to a medical checkup of metabolic syndrome, that is, a visceral fat measurement.

  Non-Patent Document 1 is a paper describing the relationship between visceral fat and cardiovascular risk factors. Although the visceral fat mass is unknown, it is presumed that the visceral fat mass has been measured and calculated using an ultrasonic image. Specifically, on the abdominal cross section (cross section perpendicular to the lumbar vertebra) shown in FIG. 1 of the same document, three paths that spread radially from the lumbar vertebra to the front side of the abdomen are set. It seems that distances a, b, and c to fat are obtained, and the average value ((a + b + c) / 3) is calculated as information VFD (Visceral fat distance) corresponding to visceral fat mass . Although three distances are measured on three different paths, they are eventually subjected to an average value calculation. That is, the angle between them is not taken into consideration. In this method, only one-dimensional distance information is used, and it is understood that two-dimensional information or structural information is not used. This paper does not disclose a mechanism for setting the three paths with good reproducibility.

  Patent Document 1 discloses a built-in fat obesity inspection apparatus that calculates the ratio of the cross-sectional area of subcutaneous fat and the cross-sectional area of preperitoneal fat by image processing on an ultrasonic image. However, this apparatus does not measure a wide range in the abdomen, nor does it include a measurement condition for improving reproducibility or a jig for supporting measurement.

  In Patent Document 2, a pre-peritoneal fat thickness in the vicinity of the liver and a pre-peritoneal fat thickness in the vicinity of the umbilicus are specified on an ultrasound image, and the visceral fat coefficient depending on the visceral fat amount based on the information A visceral fat measuring device for obtaining the above is disclosed. This is for observing visceral fat at two points separated in the direction of extension of the spine, and does not consider the shape or structure in the cross section perpendicular to the spine.

  Patent Document 3 discloses an ultrasonic probe attachment. This prevents the fat thickness from changing when the ultrasonic probe abuts. However, only one probe holding part is provided. Patent Document 4 discloses a near-infrared light type body fat measuring device having a band-like string. An umbilical alignment portion is provided on the string.

JP 2007-135980 A JP 2008-194240 A JP 2008-284136 A JP 2006-296770 A

Yu CHIBA et al., "Relationship between Visceral Fat and Cardiovascular Disease Risk Factors: The Tanno and Sobetsu Study", Hypertens Res Vol. 30, No. 3, 2007, pp. 229-236.

  In the examination of metabolic syndrome, especially in the mass examination, it is required to measure information corresponding to the visceral fat amount easily and quickly and with high reliability. The request cannot be satisfied sufficiently.

  An object of the present invention is to enable accurate measurement of information corresponding to visceral fat mass using ultrasonic waves.

  An object of the present invention is to enable a plurality of visceral fat measurement paths to be set with good reproducibility on a cross section of a living body.

  An object of the present invention is to provide an ultrasonic diagnostic system capable of obtaining a simple and reliable measurement result as a medical means suitable for mass screening of metabolic syndrome.

  An ultrasonic diagnostic system according to the present invention includes a transmission / reception unit that is in contact with a living body, transmits / receives an ultrasonic wave and outputs a reception signal, and an image formation unit that forms an ultrasonic image based on the reception signal. , Using a plurality of ultrasonic images including a plurality of measurement paths set radially on the cross section of the living body, a predetermined part located in a shallow part and a reference part located in a deep part on each measurement path Correlation with visceral fat mass based on the distance measurement means for measuring the distance to the boundary surface and the geometric relationship between the plurality of measurement paths and the plurality of distances measured on the plurality of measurement paths Index value calculating means for calculating an index value in which the value is recognized, and output means for outputting the index value.

  According to the above configuration, a range in which visceral fat may exist on a plurality of measurement paths in a living body is specified as a plurality of distances, and a geometric relationship (preferably an intersection angle) of the plurality of measurement paths, Based on the plurality of distances, an index value that correlates with the visceral fat mass is calculated. In the measurement of the abdominal circumference, the measurement target is included up to the subcutaneous fat and muscle thickness, but according to the above configuration, the range in which visceral fat may exist while excluding the subcutaneous fat layer and the like is specified, It can be used as the basis for index value calculation. In that case, since a plurality of distances are measured on a plurality of measurement paths, the two-dimensional size can be considered, that is, a two-dimensional shape in a range where visceral fat may exist can be considered. The reliability of the index value can be increased. When an X-ray CT apparatus is used, there is a problem of exposure, and a large-scale mechanism is required. However, according to the above configuration, since index values can be measured quickly and non-invasively, the medical utility is high. Is recognized. The predetermined boundary surface is a boundary surface that surrounds an area where visceral fat is present, and is generally the inner surface of the subcutaneous layer where visceral fat is not present, and specifically, the inner surface of the muscle layer or the subcutaneous fat layer. It is the inside.

  The number of measurement paths is two or more, preferably three. If three measurement paths are set, it is possible to consider not only the expansion of the range in which visceral fat may exist, but also the approximate shape (or the left and right morphological differences). Four or more measurement paths may be set. When distance measurement is performed manually or semi-automatically, it is desirable to use three measurement paths if the burden is taken into consideration. Of course, the distance measurement can be automated. It is desirable that a plurality of measurement paths intersect in the deep part of the body. Since the range in which visceral fat may be present or the shape of the body cavity is generally elliptical, it is desirable to set a reference region near the center and set a plurality of measurement paths that radiate from there. In order to realize distance measurement on a plurality of measurement paths, the probe is contacted stepwise or simultaneously with a plurality of contact positions on the surface of the living body.

  Preferably, the reference site is a blood vessel, and each ultrasound image corresponding to each measurement path is displayed as a tomographic image, and a distance between the blood vessel and the predetermined boundary surface is measured on each tomographic image. Is done. If a tomographic image is displayed, it is easy to visually identify a predetermined boundary surface. In addition, the blood vessel can be easily identified. The identification of blood vessels may be performed automatically using an ultrasonic Doppler method. Preferably, the blood vessel is a pulsating lower aorta. Such a pulsating blood vessel is extremely easy to recognize on a tomographic image, and if each measurement path is set based on it, the reliability of manual measurement can be improved.

  Preferably, the plurality of tomographic images correspond to a plurality of scanning planes that are orthogonal to a cross section of the living body and cross each other on the lower aorta. Preferably, among the plurality of scanning planes, the central scanning plane is formed at a position avoiding the navel.

  Preferably, the plurality of scan planes include a central scan plane, a right scan plane, and a left scan plane, and the right scan plane and the left scan plane are set with substantially the same inclination angle on the left and right with respect to the central scan plane. Is done. Preferably, the plurality of measurement paths include a central path, a right path, and a left path, and the index value calculation means includes the distance on the central path, the distance on the right path, the central path, and the right path. A right side area between the central path and the right path based on the right angle, a means for determining a right side area of the right part sandwiched between the central path and the right path, a distance on the central path, a distance on the left path, Means for determining a left side area of a left side portion sandwiched between the central path and the left side path based on a left side angle between the central path and the left side path, the right side area and the left side area Means for calculating the index value using at least.

  The calculated area value may be output as an index value as it is, or the volume value may be calculated by calculating such an area value at each position of the living body and output as an index value. . Various methods are conceivable as the method of area calculation and volume calculation. In any case, it is desirable that a plurality of distances are obtained on a plurality of radial measurement paths, and the index value is calculated on the basis of two-dimensional shape information.

  According to the present invention, information corresponding to the visceral fat mass can be accurately measured using ultrasonic waves. Alternatively, a plurality of visceral fat measurement paths can be set with high reproducibility on the cross section of the living body. Alternatively, it is possible to provide an ultrasonic diagnostic system that can provide a simple and reliable measurement result as a medical means suitable for mass screening of metabolic syndrome.

It is a figure for demonstrating three measurement paths | routes for calculating an index value. It is a figure for demonstrating distance measurement on three tomographic images corresponding to three measurement paths. It is a figure for demonstrating the area calculation based on three distances. It is a conceptual diagram which shows the specific example of calculation in area calculation. It is a figure for demonstrating the example of a calculation of the partial area on the right side, and the partial area on the left side. It is a figure for demonstrating the area calculation method using a table. It is a figure for demonstrating the automatic distance calculation on a measurement path | route. It is a figure which shows the ultrasonic diagnosing system provided with the function which calculates the index value which has a correlation with visceral fat mass. It is a flowchart which shows the operation example of the apparatus shown in FIG. It is a perspective view for demonstrating the instrument used when fixing a probe to the several position on a body surface. It is sectional drawing of the instrument shown in FIG. It is a figure for demonstrating the whole structure of the instrument shown in FIG.

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments of the invention will be described with reference to the drawings.

  FIG. 1 schematically shows a cross section of the abdomen in a living body. FIG. 1 particularly shows a situation when measuring and calculating an index value having a correlation with visceral fat mass. Incidentally, the X direction is the backbone direction, the Z direction is the thickness direction of the living body, and the Y direction is the left-right direction. FIG. 1 shows a cross section when viewed from the foot side to the head side.

  In FIG. 1, the living body 10 is the abdomen, the lower side is the back, and the upper side is the abdominal surface 12. For example, a living body is placed on its back on a bed. A subcutaneous fat layer 14 exists inside the living body 10. The subcutaneous fat layer 14 is a layer including skin and muscle. The muscle 16 exists inside thereof, and the visceral fat area 20 exists further inside thereof. The visceral fat area 20 is a gap region extending in the YZ plane in FIG. 1 and exists around the organ. Of course, the existence ratio varies depending on the person, but according to the present method described below, it is possible to calculate an index value that is significantly correlated with the visceral fat mass.

  In FIG. 1, reference numeral 18 represents a lumbar spine, and reference numeral 24 represents another tissue such as an organ. The tissue to be noted here is the inferior aorta 22, which is a thick artery, and the pulsation can be easily visually recognized on the ultrasonic image. The inferior aorta 22 is located substantially at the center of the abdomen and is used as a reference tissue or reference part.

  When measuring the index value, in the present embodiment, three measurement paths 36A, 36B, and 36C are set. In FIG. 1, they are represented as three lines, which cross at the center of the inferior aorta 22. Incidentally, the other two measurement paths 36B and 36C are inclined by the same angle with respect to the central measurement path 36A. The angle is, for example, 40 degrees, but of course, it may be set within a range of 30 to 50 degrees or other values. In order to set the three measurement paths 36A, 36B, and 36C radially, three contact positions A, B, and C are determined.

  Specifically, a holding device 26 is provided on the abdominal surface 12, and the probes 32 are sequentially held at the three contact positions A, B, and C by the holding device 26. The holding device 26 has three holding portions 30A, 30B, and 30C, and the probe 32 can be selectively inserted into any of the holding portions 30A, 30B, and 30C to hold it. For example, in FIG. 1, a probe 32 is provided at the contact position A, and specifically, the probe 32 is inserted into the holding portion 30A. The transmission / reception surface is in close contact with the abdominal surface 12, and in this state, ultrasonic transmission / reception, specifically, electronic scanning of the ultrasonic beam is executed. When the measurement at that position is completed, the probe 32 is then moved to the contact position B, where the same ultrasonic measurement is performed. Thereafter, the ultrasonic measurement similar to the above is further performed at the contact position C. Incidentally, the code | symbol 28 represents the base part of the holding fixture 26, the code | symbol 32-2 and the code | symbol 32-3 have each shown the probe after replacement | exchange. Note that the electronic scanning direction of the probe 32 is the X direction, that is, electronic scanning is performed in a direction orthogonal to the cross section shown in FIG. 1, and a scanning plane is formed in that direction. The central contact position A is set at a position slightly avoiding the navel position, and thus, good acoustic propagation is always ensured. Such a position is located immediately above the lower aorta 22.

  In the present embodiment, in order to measure a value corresponding to the area of the visceral fat area 20 shown in FIG. 1, the three measurement paths 36A, 36B, 36C are set as described above, and the measurement paths 36A, 36B are set. , 36C, the distance from the center of the lower aorta to the boundary surface 16A existing on the front side of the living body is measured manually or automatically. An example in which manual measurement is performed is shown in FIG. The boundary surface 16A is the inner surface of the muscle layer. The inner surface of the subcutaneous fat layer 14 can also be used.

  In FIG. 2, three tomographic images Fa, Fb, and Fc are shown corresponding to the above-described three contact positions A, B, and C. These tomographic images Fa, Fb, and Fc are formed based on the echo data on the three scanning planes. Here, each scanning surface is formed by electronic scanning of an ultrasonic beam. In FIG. 2, the probes 32 installed at the respective contact positions are conceptually shown.

  Here, for example, when attention is paid to the central tomographic image Fa, the measurement path is indicated by a symbol La therein. When distance measurement is performed, the center O of the lower aorta is designated by the user, and the point 40A corresponding to the depth position of the boundary surface Ra is designated by the user. These two points O and 40A are designated on the measurement path La corresponding to the center line. Of course, such a path may be inclined and deflected. The boundary surface Ra is generally easily visually identifiable, and the inferior aorta is extremely easily identified on the image. Therefore, the distance can be specified with high accuracy. Similarly, at the contact position B, the center O of the lower aorta and the point 40B on the boundary surface Rb are designated by the user on the measurement path Lb, and as a result, the distance b is automatically specified. Similarly, at the contact position C, the center point O and the point 40C on the boundary surface Rc are specified by the user on the measurement path Lc, and the distance c is automatically calculated thereby. Through the above process, the three distances a, b, and c are recognized.

  FIG. 3 shows a cross section of the living body again. On the measurement paths 36A, 36B, and 36C, reference numerals 38A, 38B, and 38C represent center points on the transmission / reception surface, and O represents the center point of the lower aorta as described above. Reference numerals 40A, 40B, and 40C are points on the boundary surface designated by the above-described process. Here, the central measurement path 36A is set vertically in the present embodiment, and the inclination angles θb and θc of the other two measurement paths 36B and 36C with respect to the center measurement path 36A are known, for example, both are 40 degrees. As a result, four points specifying two triangles are determined. That is, it is possible to specify a two-dimensional shape of a quadrangle or two triangles surrounded by the four points of the center point O, the boundary point 40B, the boundary point 40A, and the boundary point 40C. It has been empirically found that such a two-dimensional shape is strongly correlated with the visceral fat mass in the abdominal cavity, and using such information, an index value indicating the magnitude of the visceral fat mass can be calculated. Is possible.

  As a method for obtaining such an index value, there are a function calculation method and a table method. In the following, the function calculation method will be described first. It seeks the area from a geometric point of view.

  More specifically, first, the areas Sb and Sc of the two triangles are easily obtained from the distances a, b, and c already obtained and the two angles θb and θc. In this embodiment, the area of four triangles is further calculated by extending such a method. That is, the partial areas Sb1, Sb2, Sc1, and Sc2 are calculated.

  More specifically, the area Sb1 is a triangular area surrounded by the points O, 40B, and R1, which can be calculated from the angle θb1 and the lengths b and b1 of the two sides. The angle θb1 is a known value, and the side length b1 is defined as the same as the length of the side b in the present embodiment or multiplied by a predetermined coefficient. The area Sb2 is a triangular area surrounded by three points O, R1, and R2, which is obtained from the side lengths b1 and b2 and the angle θb2. θb2 is a known value, and the length b2 can be obtained by using a predetermined coefficient from b and c, for example. The partial area Sc1 and the partial area Sc2 are obtained by the same method. The former is calculated from c, c1, and θc1, and the latter is obtained from c1, c2, and θc2. Since θc1 and θc2 are also known, c1 and c2 may be estimated from c or c and b. Eventually, an area S obtained by combining these partial areas Sb, Sc, Sb1, Sb2, Sc1, and Sc2 is obtained and output as it is as an index value representing visceral fat mass, or the area value is converted or corrected. The index value is obtained by In any case, by measuring the size of the visceral fat area 20 from a two-dimensional viewpoint, it is possible to obtain a more reliable index value than the measurement of the abdominal circumference.

  FIG. 4 shows the concept described above as a conceptual diagram. Reference numeral 52 represents an arithmetic module. The calculation there is realized by a function of software, for example. Numerical values a, b, c, θb, and θc indicated by reference numerals 42 to 50 are input to the module 52. Further, θb1, θb2, θc1, and θc2 indicated by reference numerals 54 to 60 are given as necessary. Based on such values, as shown by reference numerals 62 to 72, the six partial areas Sb to Sc are calculated with functions as shown. Of course, the illustrated example is an example, and in any case, it is desirable to use the three measured distances a, b, and c and the two angles θb and θc. Reference numeral 74 represents the addition of six partial areas. The area value S as a result of the addition may be output as an index value as it is, or may be output as a volume value. Moreover, you may make it perform the calculation which considers a body type, age, or sex. This is indicated by reference numeral 76. In other words, the final index value S ′ may be obtained by correcting the addition result S according to various conditions. It may be a volume value V ′. When obtaining the volume value, it is desirable to obtain the area value at a plurality of positions in the living body and obtain the volume value based on them. Of course, as a rule of thumb, if the volume value can be converted from the area value, such a conversion operation may be executed.

  FIG. 5 illustrates two basic partial area arithmetic expressions. In (A), the calculation method of the partial area Sb is indicated by reference numeral 78. Here, ½ · absin θb is calculated. Similarly, in (B), an example of an arithmetic expression for the partial area Sc is indicated by reference numeral 80. It is determined by 1/2 · acsin θc.

  In addition, as shown in FIG. 6, a table 82 may be provided in which a, b, c, θb, and θc are given as input values and S is obtained as an output value. For example, such a table can be constructed by acquiring data from a large number of subjects and accumulating the data.

  FIG. 7 shows an automatic distance calculation method. On the frame F, a measurement line L as a center line is set. W represents a search range. For example, it is possible to specify the edge point 40 on the boundary surface R by performing edge detection processing from the origin of the search range W. The search direction may be upward. Further, the blood flow part D can be extracted by using the ultrasonic Doppler method, and the two edge points 84 and 86 are specified based on such image processing, and the center point O is specified as the intermediate point. It is also possible to do. It is also possible to specify a blood flow part by binarization processing or the like without using Doppler information. Such automation can greatly reduce the burden on the user, and is particularly effective in group screening.

  FIG. 8 shows a block diagram of an ultrasonic diagnostic apparatus having a function of calculating the index value described above.

  The probe 180 is connected to the main body via a cable, and the probe 180 has a 1D array transducer in this embodiment. The 1D array transducer is formed by arranging a plurality of vibrating elements in a linear shape or an arc shape, and an ultrasonic beam is formed by them. The ultrasonic beam is scanned electronically. Electronic linear scanning and electronic sector scanning are known as such scanning methods. In this embodiment, an arc-shaped array transducer is used, and so-called convex scanning is performed. Incidentally, a single probe 180 is used, and the same probe is contacted stepwise with respect to a plurality of contact positions.

  The transmission / reception unit 182 functions as a transmission beamformer and a reception beamformer. At the time of transmission, the transmission / reception unit 182 supplies a plurality of transmission signals to the array transducer in parallel. As a result, a transmission beam is formed in the probe 180. The reflected wave from the living body is received by the probe 180, whereby a plurality of received signals are output to the transmission / reception unit 182. The transmission / reception unit 182 performs phasing addition processing on a plurality of reception signals at the time of such reception, and thereby outputs beam data as reception signals after phasing addition. The beam data is given to the signal processing unit 184. The signal processing unit 184 includes a logarithmic converter, a detector, and the like.

  The beam data after the signal processing is sent to the image forming unit 186. The image forming unit 186 is configured by a digital scan converter. It has a coordinate conversion function and an interpolation processing function. A B-mode black and white tomographic image is formed by a plurality of beam data. The image data is sent to the display processing unit 188. A tomographic image is displayed on the display unit 192.

  The measurement unit 190 is a module that performs automatic distance measurement, or a module that performs distance calculation based on a manually input position. The control unit 194 performs operation control of each configuration shown in FIG. The control unit 194 includes a CPU and an operation program. The input unit 196 includes an operation panel, which specifically includes a keyboard and a trackball. The user can specify a position using the input unit 196.

  FIG. 9 shows the operation of the apparatus shown in FIG. 8, and particularly shows the operation when calculating the index value.

  In a state where the living body is lying on its back on the bed, a holding device is installed on the abdomen. In S101, the probe is set at the A position. Here, the A position is, for example, the center position. In S102, the blood vessel center point and the boundary point are input by the user on the tomographic image obtained by the probe installed as described above. Prior to that, the posture of the probe is adjusted by the user so that a desired cross section is drawn. It corresponds to the setting of the central measuring line. The holding device is made of a soft material so that such a tilting motion, that is, a rolling motion is allowed.

  When the distance measurement is completed at the central position, the probe is set to the B position in S103, the posture and position of the probe are adjusted in S104, and the blood vessel center and the boundary point are set by the user on the B-mode tomographic image. It is specified. In this way, the second distance is observed. Similarly, in S105, the probe is set at the C position. In S106, the position and orientation of the probe are adjusted, and the blood vessel center point and boundary point are designated by the user on the ultrasonic image. As a result, the third distance is recognized.

  In S107, an index value that is highly correlated with the visceral fat mass is calculated based on the three distances and two predetermined angles. It corresponds to the estimation of visceral fat mass. In S108, such an index value is displayed. Rather than simply measuring the abdominal circumference in mass screening, it is more useful for diagnosis or evaluation of metabolic syndrome by obtaining the visceral fat presence area in the abdominal cavity as a two-dimensional shape using ultrasonic diagnosis as described above. It is possible to obtain a simple index value. In order to further increase the correlation between the index value and the visceral fat mass, it is desirable to apply a correction value based on gender, physique, and other information in diagnosis. Such a correction value is obtained by an empirical rule or an experimental rule.

  Next, the holding tool used for the measurement of the index value as described above will be described in detail with reference to FIGS. However, such a holding device can be used in applications other than the measurement described above.

  FIG. 10 shows a main configuration of the holding device 100. Reference numeral 100A represents a main body. The main body portion 100 </ b> A has a base 102, and three holding portions 104, 106, and 108 are provided on the base 102. Each holding portion 104, 106, 108 has a hollow portion 104A, 106A, 108A, respectively, into which a probe is inserted and held gently. The horizontal cross-sectional shapes of the hollow portions 104A, 106A, and 108A are unchanged in the vertical direction, but a shape that matches the shape of the probe may be adopted.

  The main body 100A is made of a soft material such as rubber, and the belt 110 connected to the main body 100A is also made of rubber or the like. However, in the case where the abdominal circumference is measured using the belt part 110, it is desirable that it is made of a non-stretchable material. By providing the belt part 110, the main body part 100A can be fixed in a state of surrounding the abdomen, and it becomes easy to stabilize the holding state of the probe. It is easy to define a Cartesian coordinate system based on the subject. In addition, when such a holding device 100 is used, the probe can be moved along with the surface movement of the living body even in the case of breathing, which can reduce problems such as measurement misalignment, and can further improve measurement reproducibility. It becomes possible to improve.

  In measuring the above-described index value, since three probe positions are determined, the main body portion 100A shown in FIG. 10 includes three holding portions 104, 106, and 108. The central holding portion 104 stands vertically, that is, has a vertical posture extending in the Z direction. On the other hand, two other holding portions 106 and 108 are provided with a predetermined angle, specifically, an inclination angle of 40 degrees. They are inclined on the YZ plane. Since the main body 100A itself is made of a soft material, the probe inserted in each holding portion can be tilted. However, the direction in which movement is possible is movement in the YZ plane, and movement of the probe in other directions is limited. As a result, the lower aorta can be easily searched, and the three scanning planes can be easily crossed accurately on the lower aorta. Incidentally, the code | symbol 112 represents the navel marker, The protrusion part is match | combined with the position of a navel. Thereby, the reproducibility of measurement and the goodness of ultrasonic propagation can be ensured.

  FIG. 11 shows a cross section of the main body 100A. As described above, the three holding portions 104, 106, and 108 are radially arranged as hollow bodies, and the angle θ1 is 40 degrees, for example, and the angle θ2 is also 40 degrees, for example. However, a smaller angle may be used at this stage so that such an angle is realized at the time of mounting. The central holding portion 104 stands vertically. The hollow interiors 104A, 106A, and 108A have a shape that encloses the outside of the probe. When the hollow interiors 104A, 106A, and 108A are held, the probe can be tilted by the freedom of movement in the hollow interior and the elasticity of the body. However, the probe does not easily fall off the holding part. Incidentally, reference numeral 114A represents an upper opening, reference numeral 114B represents a lower opening, similarly reference numeral 116A represents an upper opening, and reference numeral 116B represents a lower opening. Reference numeral 118A represents an upper opening, and reference numeral 118B represents a lower opening. In a state where the probe is set, it is desirable that the wave transmitting / receiving surface, specifically, the surface of the acoustic lens is in close contact with the surface of the body. Shaped acoustic coupling material is used. The main body 100A may be made of a transparent material to ensure visibility.

  FIG. 12 conceptually shows the entire holding device 100. As described above, the holding device 100 includes the main body portion 100A and the belt portion 110 connected to both ends thereof, and the belt portion 110 is wound around the body of the living body. The belt part 110 itself may be extendable and contractible, or may be provided with a mechanism capable of adjusting its length as indicated by reference numeral 120, for example. Further, a scale may be provided on the belt portion 110 so that the abdominal circumference can be measured when adjusting the length. The main body 110A is provided with protruding markers 112 on both sides of the one side and the other side, and such a marker 112 is aligned with the position of the navel regardless of the orientation of the main body 100A. It is possible to prevent problems such as re-installation. By adopting the navel marker 112, the probe contact position can always be shifted from the center of the living body to one side by a predetermined distance, and it is possible to achieve both good propagation path formation and measurement reproducibility. Such a position corresponds to the upper part of the lower aorta, and vertical positioning can be performed simultaneously.

  The holding device shown in FIGS. 10 to 12 can be easily set in a state where a plurality of scanning planes intersect with a reference portion having a deep part in the living body. It can be generally used when measurement is required. The degree of elasticity and holding action may be adjusted according to the application. If such a holding device is used, the doctor can easily complete the positioning of the probe by simply inserting the probe into the holding part in order in the group examination, so that the burden can be greatly reduced. In addition, the reproducibility of measurement can be made very good, so that the efficiency of mass screening can be increased.

  In this embodiment, the index value is measured in a state where the living body is in the horizontal direction. However, the index value may be measured using a similar holding device in the standing state.

  10 living body, 20 visceral fat area, 22 inferior aorta, 26 holding device, a, b, c distance.

Claims (7)

A wave transmitting / receiving unit that is in contact with a living body and transmits / receives an ultrasonic wave to output a reception signal;
Image forming means for forming an ultrasonic image based on the received signal;
Using a plurality of ultrasonic images including a plurality of measurement paths set radially on the cross section of the living body, a predetermined boundary located in the shallow part and a reference part located in the deep part on each measurement path A distance measuring means for measuring the distance to the surface;
Index value calculation means for calculating an index value that is correlated with visceral fat mass based on a geometric relationship between the plurality of measurement paths and a plurality of distances measured on the plurality of measurement paths;
Output means for outputting the index value;
An ultrasonic diagnostic system comprising: The system of claim 1, wherein
The reference site is a blood vessel;
Each ultrasonic image corresponding to each measurement path is displayed as a tomographic image,
A distance between the blood vessel and the predetermined boundary surface is measured on each tomographic image.
An ultrasonic diagnostic system characterized by that. The system of claim 2, wherein
The ultrasonic diagnostic system, wherein the blood vessel is a pulsating lower aorta. The system of claim 3, wherein
The ultrasound diagnostic system, wherein the plurality of tomographic images correspond to a plurality of scanning planes orthogonal to a cross section of the living body and crossing each other on the lower aorta. The system of claim 4, wherein
The ultrasonic diagnostic system, wherein a central scanning plane is formed at a position avoiding the navel among the plurality of scanning planes. The system of claim 5, wherein
The plurality of scanning planes include a central scanning plane, a right scanning plane, and a left scanning plane,
The ultrasonic diagnostic system according to claim 1, wherein the right scanning plane and the left scanning plane are set with substantially the same inclination angle to the left and right with respect to the central scanning plane. The system according to any one of claims 1 to 5,
The plurality of measurement paths include a central path, a right path, and a left path,
The index value calculation means includes
Based on the distance on the central route, the distance on the right route, and the right angle between the central route and the right route, the right side of the right portion sandwiched between the central route and the right route Means for determining the partial area;
Based on the distance on the central path, the distance on the left path, and the left angle between the central path and the left path, the left side of the left portion sandwiched between the central path and the left path Means for determining the partial area;
Means for calculating the index value using at least the right side area and the left side area;
An ultrasonic diagnostic system comprising: