JP2016043128A - Ultrasonic diagnostic apparatus and control program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To generate and display treatment support data effective for cautery treatment.SOLUTION: An ultrasonic diagnostic apparatus 100 comprises: an image data generation part 5 which generates ultrasonic image data on the basis of a reception signal obtained with ultrasonic transmission and reception to/from a patient; a reference image data generation part 11 which generates reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data by using reference image information on the patient previously collected by a separately-installed medical image information collection apparatus; a cautery region detection part 6 which detects a cautery region indicated in the second ultrasonic image data on the basis of the first ultrasonic image data before cautery treatment and the second ultrasonic image data after cautery treatment generated by the image data generation part 5; a support data generation part 13 which generates treatment support data by overlapping the region information on the cautery region on the reference image data; and a display part 14 which displays the treatment support data.SELECTED DRAWING: Figure 1

Description

  Embodiments of the present invention provide 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 a control program.

  The ultrasonic diagnostic apparatus radiates an ultrasonic pulse generated from a vibration element built in an ultrasonic probe into a patient's body, and receives an ultrasonic reflected wave caused by a difference in acoustic impedance of a living tissue by the vibration element. It collects various biological information. Recent ultrasonic diagnostic apparatus capable of electronically controlling the transmission / reception direction and focal point of ultrasonic waves by controlling the delay time of drive signals supplied to a plurality of vibration elements and reception signals obtained from the vibration elements. Since real-time image data can be easily observed with a simple operation by simply bringing the tip of the ultrasonic probe into contact with the body surface, it is widely used for morphological diagnosis and functional diagnosis of living organs.

  In addition, minimally invasive inspection methods and treatment methods using catheters and puncture needles, etc., have been developed under the observation of ultrasonic image data displayed in real time. For example, drug administration and cell / By performing puncture for the purpose of extracting a tissue under observation of two-dimensional ultrasonic image data or three-dimensional ultrasonic image data, safety and efficiency in examinations and treatments can be dramatically improved.

  Furthermore, in recent years, a method of inserting a puncture needle into a site to be treated such as a tumor and ablating with microwaves or radio waves emitted from the tip of the puncture needle has been performed. So-called radiofrequency ablation (RFA), which coagulates the target site, is an effective means for treating liver tumors and the like because it can easily and reliably control the local ablation area. It's getting on.

  When such inspection and treatment using a puncture needle are performed under observation of ultrasonic image data, the puncture needle is attached to a puncture adapter provided integrally with an ultrasonic probe, and the puncture displayed along with the treatment target site The insertion is performed while confirming the tip position of the needle based on the ultrasonic image data of the needle. In addition, a puncture marker indicating the insertion direction of the puncture needle is generated based on position information obtained by a position detector provided on the puncture needle or the ultrasonic probe, and is superimposed on the ultrasonic image data of the treatment target site and displayed. This makes it possible to insert a puncture needle more accurately.

  On the other hand, treatment using a puncture needle, such as radiofrequency ablation therapy, is usually performed under the guidance of ultrasound image data that is easy to display in real time, but the spatial resolution and contrast resolution of ultrasound image data are determined by X-ray CT. Since it is inferior to image data and MRI image data, it is often difficult to grasp the presence and shape of a tumor, and it takes a lot of time to determine the insertion direction and the 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 and orientation of the ultrasound probe, etc. X-ray CT image data and MRI image data of a cross section corresponding to the above-mentioned scanning cross section generated based on the ultrasonic image data collected on the scanning cross section in the patient body uniquely determined by the above-described three-dimensional image information ( Hereinafter, a method of comparing and displaying (referred to as reference image data) has been proposed.

JP 2002-112998 A

  According to the method described in Patent Document 1 and the like described above, the position and shape of the tumor region before treatment can be accurately captured by observing the reference image data with excellent 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 the ablation treatment, the region in which the tissue state has changed due to radiofrequency ablation therapy or the like (hereinafter referred to as the following) In this case, it is impossible to obtain various information effective for ablation treatment including the information of the ablation area from the above-described reference image data.

  The present invention has been made in view of the above-described problems, and an object of the present invention is to provide a region (cautery) in which treatment has been performed using ultrasonic image data collected in parallel with cauterization treatment using a puncture needle. A section corresponding to the scanning section of the ultrasonic image data collected using another medical image diagnostic apparatus (hereinafter referred to as a medical image information collecting apparatus). It is an object of the present invention to provide an ultrasonic diagnostic apparatus and a control program capable of accurately determining whether or not the ablation treatment is appropriate by displaying the reference image data in a superimposed manner.

  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 that supports ablation treatment using a puncture needle, and transmits and receives ultrasonic waves to a patient. The ultrasonic image data using image data generating means for generating ultrasonic image data based on the received signal obtained by the above and the patient's reference image information collected in advance by a medical image information collecting apparatus installed separately Reference image data generation means for generating reference image data of a cross section corresponding to the scanned cross section, first ultrasonic image data before cauterization treatment generated by the image data generation means, and second superposition after cauterization treatment Ablation area detection means for detecting the ablation area indicated in the second ultrasonic image data based on the sonic image data; and the ablation area in the reference image data. And support data generating means for generating the therapeutic assistance data by superimposing the band information, it is characterized in that a display means for displaying the therapeutic assistance data.

1 is a block diagram showing the overall configuration of an ultrasonic diagnostic apparatus in the present embodiment. The block diagram which shows the specific structure of the transmission / reception part and reception signal processing part with which the ultrasound diagnosing device of this embodiment is provided. The block diagram which shows the specific structure of the ablation area detection part with which the ultrasound diagnosing device of this embodiment is provided. The figure which shows the specific example of the 1st treatment assistance data aiming at the correct insertion of the RFA puncture needle produced | generated in the assistance data generation part of this embodiment. The figure which shows the specific example of the 2nd treatment assistance data for the purpose of the exact quality determination of the ablation treatment using the RFA puncture needle produced | generated in the assistance data generation part of this embodiment. The figure for demonstrating the specific example of the RFA puncture needle used for the ablation 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 assistance data aiming at the correct insertion of the RFA puncture needle produced | generated in the assistance data production | generation part of this embodiment. The figure which shows the modification of the 2nd treatment assistance data aiming at the exact quality determination of the cauterization 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 according to 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 region in a patient 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 MPR cross section) corresponding to a scanning cross section of ultrasonic image data from information (volume data), and this reference image The first region for accurate insertion of the RFA puncture needle by superimposing the region information of the tumor detected using the data on the first ultrasound image data before the cauterization treatment collected in the above-described scanning section. Generate treatment support data.

  Next, a subtraction process between the second ultrasound image data and the first ultrasound image data collected during the ablation treatment performed while observing the first treatment support data described above or when the ablation treatment is completed. By superimposing the information on the ablation area detected by the above-mentioned reference image data, second treatment support data for the purpose of accurately judging the quality of the ablation treatment using the RFA puncture needle is generated.

(Device configuration and functions)
The configuration and functions of the ultrasonic diagnostic apparatus according to this embodiment will be described with reference to FIGS. FIG. 1 is a block diagram showing an overall configuration of the ultrasonic diagnostic apparatus, and FIG. 2 is a block diagram showing a specific configuration of a transmission / reception unit and a received signal processing unit included in the ultrasonic diagnostic apparatus. FIG. 3 is a block diagram showing a specific configuration of the ablation area detection unit provided in the above-described ultrasonic diagnostic apparatus.

  The ultrasonic diagnostic apparatus 100 of the present embodiment shown in FIG. 1 transmits ultrasonic waves (ultrasonic pulses) to a desired scanning section in a patient before or after ablation treatment using an RFA puncture needle 150 or during ablation treatment. The ultrasonic probe 2 having a plurality of vibration elements that convert received ultrasonic waves (ultrasound reflected waves) obtained from the scanning section by the transmitted ultrasonic waves into electrical reception signals, and the scanning A transmission / reception unit 3 for supplying a driving signal for radiating transmission ultrasonic waves in a predetermined direction of the cross section to the above-described vibrating elements, and phasing and adding reception signals of a plurality of channels obtained from these vibrating elements; A reception signal processing unit 4 that performs signal processing on the reception signal after phase addition to generate B-mode data as ultrasonic data, and a two-dimensional ultrasonic signal based on the above-described B-mode data obtained in units of ultrasonic transmission and reception directions. sound An image data generation unit 5 that generates image data, ultrasound image data before the ablation treatment (first ultrasound image data), and ultrasound image data during or after the ablation treatment (second ultrasound image data) ) Based on the ablation area detection unit 6 for detecting the ablation area for the tumor area indicated in the ultrasound image data, the position signal of the ultrasound probe 2 supplied from the probe position sensor 21, and the ultrasound probe A position information detector 7 for detecting position information of the ultrasonic probe 2 and the RFA puncture needle 150 based on a position signal of the RFA puncture needle 150 supplied from a puncture needle position sensor 22 mounted on a puncture adapter (not shown) of FIG. Based on the position information of the ultrasonic probe 2 supplied from the position information detection unit 7 (center position / inclination angle of the ultrasonic probe 2, the arrangement direction of the vibration elements, etc.). MPR cross-section setting unit 8 for setting an MPR (multi-planar-reconstruction) cross-section corresponding to the above-described scanning cross-section, and position information of RFA puncture needle 150 supplied from position information detection unit 7 (position of RFA puncture needle 150) And an insertion angle estimation unit 9 for estimating the insertion direction of the RFA puncture needle 150 in the body of the patient based on the angle of inclination and the like.

  The ultrasonic diagnostic apparatus 100 includes a tumor region of the patient collected in advance using a medical image information collecting apparatus having excellent spatial resolution and contrast resolution such as an X-ray CT apparatus and an MRI apparatus installed separately. A reference image information storage unit 10 in which dimensional reference image information (volume data) is stored, and a reference image corresponding to the MPR section described above from the three-dimensional reference image information stored in the reference image information storage unit 10 A reference image data generation unit 11 that generates two-dimensional reference image data corresponding to a scanning section of ultrasonic transmission / reception by extracting information, and a tumor region detection that detects a tumor region of the patient indicated in the reference image data Unit 12 and first treatment support data in which a puncture marker indicating the insertion direction of the RFA puncture needle 150, tumor region information, and the like are superimposed on the first ultrasonic image data. A support data generation unit 13 that generates second treatment support data in which information about the ablation area is superimposed on the 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, and the like, a transmission delay time for the transmission / reception unit 3, and A scanning control unit 16 that controls the ultrasonic transmission / reception direction by setting a reception delay time and a system control unit 17 that comprehensively controls each of the above-described units are provided.

  The ultrasonic probe 2 has N vibration elements (not shown) at the distal end portion that comes into contact with the patient's body surface, and these vibration elements are input / output of the transmission / reception unit 3 via an N channel multi-core cable (not shown). Connected to the terminal. The above-described vibration element included in the ultrasonic probe 2 is an electroacoustic transducer, which converts a drive signal (electric pulse) into transmission ultrasonic waves (ultrasonic pulses) at the time of transmission and receives ultrasonic waves (ultrasonic reflected waves) at the time of reception. Has a function of converting the signal into an electrical reception signal.

  A puncture adapter (not shown) that sets the insertion direction of the RFA puncture needle 150 used for ablation treatment and slidably holds the RFA puncture needle 150 in the insertion direction on the wall surface of the ultrasonic probe 2; A puncture needle position sensor 22 that generates a position signal of the RFA puncture needle 150 and a probe position sensor 21 that generates a position signal of the ultrasonic probe 2 are provided.

  The ultrasonic probe includes sector scan support, linear scan support, convex scan support, and the like. A medical worker who operates the ultrasonic diagnostic apparatus 100 (hereinafter referred to as an operator) uses various ultrasonic probes. An ultrasonic probe suitable for the ablation treatment can be arbitrarily selected from among them. In this embodiment, the ultrasonic probe 2 for sector scanning in which N vibration elements are provided at the distal end thereof is used. The case where it is used will be described.

  Next, the transmission / reception unit 3 shown in FIG. 2 is driven to radiate transmission ultrasonic waves corresponding to, for example, the B-mode inspection in the ultrasonic transmission / reception direction Θp (Θp = θ1 to θP) set in the patient. A transmission unit 31 that supplies signals to the vibration element of the ultrasonic probe 2 and a reception unit 32 that performs phasing addition of reception signals of a plurality of channels obtained from these vibration elements. The transmission unit 31 includes a rate pulse generator. 311, a transmission delay circuit 312 and a drive circuit 313.

  The rate pulse generator 311 generates a rate pulse for determining a repetition period of transmission ultrasonic waves radiated into the body by dividing the reference signal supplied from the system control unit 17, and transmits the obtained rate pulse. This is supplied to the delay circuit 312. The transmission delay circuit 312 includes the same number of independent delay circuits as Nt transmission vibration elements selected in advance from the N vibration elements included in the ultrasonic probe 2, and is supplied from the scanning control unit 16. In order to obtain a narrow beam width in transmission according to the delay time control signal, the transmission ultrasonic wave is radiated with respect to the focusing delay time for focusing the transmission ultrasonic wave to a predetermined depth and the ultrasonic transmission / reception direction Θp. A deflection delay time is provided to the 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, the above-described focusing delay time and deflection use are performed. A drive signal having a predetermined shape having a delay time is generated.

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

  The reception delay circuit 323 converges the reception ultrasonic wave reflected from a predetermined depth in the patient body according to the delay time control signal supplied from the scanning control unit 16 and the ultrasonic transmission / reception direction Θp (Θp = θ1 to A deflection delay time for setting a strong reception directivity with respect to θP) is given to each of the reception signals composed of the Nr channel output from the A / D converter 322, and the adder 324 includes the reception delay circuit 323. The output Nr channel received signals are added and combined. 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 Θp.

  On the other hand, the received signal processing unit 4 includes an envelope detector 411 that performs envelope detection on the received signal after phasing addition output from the adder 324 of the receiving unit 32, and a logarithmic conversion process on the received signal after envelope detection. Is provided with a logarithmic converter 412 for generating 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 ultrasonic image data based on the B-mode data generated by the reception signal processing unit 4, for example, an ultrasonic data storage unit (not shown) An arithmetic processing unit including a DSC (digital scan converter), a DSP (digital signal processor), and the like is included.

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

  Next, when the ablation region detection unit 6 performs the ablation treatment on the tumor region of the patient using the PFA puncture needle 150, the first ultrasound image data collected for the tumor region before the ablation treatment. Of the ablation treatment by the PFA puncture needle 150 based on the pixel value of the second ultrasound image data collected for the tumor region during or after the ablation treatment and after the ablation treatment (cauterization region) For example, as shown in FIG. 3, the image data storage unit 61, the subtraction processing unit 62, and the contour extraction unit 63 are provided.

  The image data storage unit 61 of the ablation region detection unit 6 stores one piece of first ultrasound image data generated by the image data generation unit 5 based on a reception signal obtained by ultrasonic transmission / reception with respect to the tumor region before the ablation treatment. The part is saved. On the other hand, the subtraction processing unit 62 directly receives the second ultrasonic image data generated by the image data generation unit 5 based on the reception signal obtained by ultrasonic transmission / reception with respect to the tumor region during or after the cauterization treatment. Then, a subtraction process is performed between the pixel value of the second ultrasonic image data and the pixel value of the first ultrasonic 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 a predetermined threshold β1, and further extracts the ablation region by extracting the contour. Contour data is generated. That is, by comparing the first ultrasonic image data collected before the cauterization treatment with the second ultrasonic image data collected during the cauterization treatment or immediately after the cauterization treatment, the acoustic characteristics of the tissue are obtained by cauterization. It is possible to detect a significantly changed portion as an ablation region.

  Returning 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 is composed of a plurality provided inside or around the ultrasonic probe 2. Based on the position signal supplied from the probe position sensor 21, position information (such as the center position / tilt angle of the ultrasonic probe 2 and the arrangement direction of the vibration elements) of the ultrasonic probe 2 disposed on the patient body surface is detected.

  Similarly, the puncture needle position detection unit supplies a position signal supplied from a puncture needle position sensor 22 included in a puncture adapter (not shown) of the ultrasonic probe 2 or an RFA puncture needle 150 slidably attached to the puncture adapter. The position information (RFA puncture needle 150 position, inclination angle, etc.) 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 an ultrasonic sensor or a magnetic sensor as a position sensor is suitable. It is. The probe position detection unit of the position information detection unit 7 using a magnetic sensor detects, for example, a transmitter (magnetization generation unit) that generates magnetism as described in JP 2000-5168 A, and the like. A position information calculation unit (not shown) that calculates position information of the ultrasonic probe 2 by processing position signals supplied from the plurality of magnetic sensors (probe position sensors 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 attached to the surface of the casing of the ultrasonic diagnostic apparatus 100 adjacent to the ultrasonic probe 2. Be placed. Then, the position information calculation unit described above calculates the position information of the ultrasonic 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 or direction of a scanning cross-section in which 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 an MPR section corresponding to the scanning section is set. That is, the cross-section setting for the three-dimensional reference image information when the reference image data in the same cross section as the ultrasonic image data of the desired scanning cross-section collected by ultrasonic transmission / reception is generated using the pre-collected three-dimensional reference image information Is performed based on the above-described MPR cross section.

  On the other hand, the insertion direction estimation unit 9 is 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 via the system control unit 17, and the RFA puncture needle in the body of the patient. 150 insertion directions are estimated.

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

  The reference image data generation unit 11 has a function of generating two-dimensional reference image data based on reference image information of a 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, the reference image data generation unit 11 first receives MPR cross-section position information set by the MPR cross-section setting unit 8 based on the position information of the ultrasonic probe 2. Next, reference image information having the same position information as the MPR cross-section position information is extracted from the three-dimensional reference image information stored in advance in the reference image information storage unit 10, thereby collecting ultrasonic image data. Two-dimensional reference image data in a cross section corresponding to the current scan cross section is generated, and the obtained reference image data is stored in its own image data storage unit.

  The tumor region detection unit 12 uses the two-dimensional reference image data generated by the above-described reference image data generation unit 11 based on the three-dimensional reference image information collected by the medical image information collection device to determine the tumor region of the patient. For example, a pixel value comparison unit and a contour extraction unit (not shown) are provided.

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

  And the outline extraction part of the tumor area | region detection part 12 produces | generates the outline data of a tumor area | region by carrying out the connection process of the several adjacent pixel extracted by the above-mentioned pixel value comparison part.

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

  Further, the support data generation unit 13 detects the ablation area based on the first ultrasound image data before the ablation treatment generated by the image data generation unit 5 and the second ultrasound image data during or after the ablation treatment. A second purpose of accurate judgment of ablation treatment using the RFA puncture needle 150 is performed by superimposing the information on the ablation area detected by the unit 6 on the 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 region of the patient, the tumor region detection unit 12 extracts from the three-dimensional reference image information including the tumor region stored in advance in the reference image information storage unit 10. The above-described tumor region 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 scanning cross section of the ultrasonic image data, and the contour data of the tumor region is generated. . The support data generation unit 13 adds the above-described tumor region contour data and the RFA puncture to each of the first ultrasonic image data generated by the image data generation unit 5 in time series in the ultrasonic transmission / reception in the scanning section described above. First treatment support data is generated by superimposing the puncture marker of the needle 150.

  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 a tumor At. 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 a tumor detected by the tumor region detection unit 12 using the reference image data Ira is shown in the right region (b). The first ultrasonic image data Iua on which the contour data (region 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 each image data.

  On the other hand, when the ablation treatment is performed using the RFA puncture needle 150 inserted into the tumor region, or when the ablation treatment for the tumor region is completed, the ablation region detection unit 6 has its own image data storage unit. The ablation area is detected based on the first ultrasonic image data before the ablation treatment read out from 61 and the second ultrasound image data during or after the ablation treatment, and contour data of the ablation area is generated. Then, the support data generation unit 13 generates second treatment support data by superimposing the contour data of the ablation area on the 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, the left region (a) of the second treatment support data has an ablation region detection unit. 6 shows reference image data Irb in which the outline data (region information) Da of the ablation area detected by the subtraction process between the first ultrasound image data and the second ultrasound image data is superimposed on the puncture marker Br described above. In the right area (b), the second ultrasound image data Iub in which the contour data Ct of the tumor At and the puncture marker Bu are superimposed is shown.

  In FIG. 4, the case where the contour data Ct of the tumor At is superimposed on the first ultrasonic image data Iua constituting the first treatment support data is described, but the same applies to the reference image data Ira. The contour data Ct may be added. Similarly, in FIG. 5, the case where the outline data Ca of the ablation area Aa is superimposed on the reference image data Irb constituting the second treatment support data has been described, but the second ultrasonic image data Iub 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). The display data generation unit is the first treatment support data generated by the support data generation unit 13 before the cauterization treatment. In addition, the second treatment support data generated during or after the cauterization treatment is converted into a predetermined display format, and the data conversion unit generates D / A conversion or television for the obtained display data. Performs conversion processing such as format conversion and displays it 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, ultrasonic transmission / reception conditions and image data generation conditions, Setting of treatment support data generation conditions, selection of examination mode, setting of threshold values β1 and β2, input of various instruction signals, and the like are performed.

  Next, the scanning control unit 16 includes a delay time control unit (not shown), and the delay time control unit supervises a scanning section including a tumor region of the patient according to a scanning instruction signal supplied from the system control unit 17. A delay time control signal for transmitting and receiving sound waves 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 and an input information storage unit (not shown), and the above-described various information input / selected / set by 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 comprehensively controlling each unit included in the ultrasonic diagnostic apparatus 100 using the above-described various information, and generates ultrasonic image data in a desired scanning section. Then, the RFA puncture needle 150 is used 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 above-described ultrasonic image data. 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 handpiece 151 having a hollow structure that is percutaneously inserted toward a tumor region that is a treatment target site of the patient, and the handpiece 151. A plurality of deployment needles 152 that are inserted into the tumor region in a state of being housed in the central portion of the tumor and deployed so as to surround the tumor region from the distal end portion thereof, and connected to each of the deployment needles 152, and an RFA treatment (not shown) A lead wire 153 that supplies an alternating current of a predetermined frequency (for example, 500 KHz) from the drive circuit of the apparatus is provided. The deployment needle 152 driven by the above-described alternating current irradiates a radio wave of the same frequency from the distal end portion and performs ablation treatment on the tumor region.

  For example, when the distal end portion of the handpiece 151 inserted into the patient body reaches the rear of the tumor region, the deployment needle 152 is pushed out from the distal end portion and disposed (deployed) around the tumor region. In this case, as shown in FIG. 6B, the deployment needle 152 is deployed along a spherical surface 110 having a deployment diameter D of 2 cm to 3 cm, for example, and in ablation therapy using an RFA puncture needle, An RFA puncture needle having a deployment diameter suitable for the tumor region is selected from various RFA puncture needles having different deployment diameters. In FIG. 6, the RFA puncture needle 150 having four deployment needles 152 is shown, but an RFA puncture needle 150 having eight to ten deployment needles is used in normal cauterization treatment.

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

  Prior to the ultrasound transmission / reception with respect to the patient, the reference image information storage unit 10 of the ultrasound diagnostic apparatus 100 is collected in advance by a medical image information collection apparatus such as an X-ray CT apparatus or an MRI apparatus installed separately, or has a large capacity. The patient's three-dimensional reference image information (volume data) and its position information supplied via the storage medium are stored in its own image information storage unit (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 a predetermined position supplied from the position information detection unit 7 via the system control unit 17, and receives this position information and the above-described position information. Coordinate conversion is performed on the three-dimensional reference image information so that the position information read together with the three-dimensional reference image information from the image information storage unit corresponds. Then, the three-dimensional reference image information associated with the ultrasonic probe 2 by this coordinate conversion process and the position information thereof are stored again in the above-described image information storage unit (step S2 in FIG. 7).

  When the association between the 3D reference image information and the ultrasound probe 2 is completed, the operator of the ultrasound diagnostic apparatus 100 uses the input unit 15 to input patient information, ultrasound transmission / reception conditions, and treatment support data generation conditions. , Setting the examination mode (B mode examination), setting the threshold value β1 and the threshold value β2, etc., and then moving the ultrasonic probe 2 in a state where ultrasonic transmission / reception is possible along the patient's body surface At this time, under the observation of the ultrasonic image data displayed on the display unit 14, the ultrasonic probe 2 is placed at a position suitable for rendering a tumor region (step S3 in FIG. 7).

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

  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 placed at a suitable position on the surface of the patient body in step S3 described above. The insertion direction estimation unit 9 is arranged on the body surface or in the vicinity thereof based on the positional information of the RFA puncture needle 150 supplied from the puncture needle position detection unit via the system control unit 17. The insertion direction in the body of the RFA puncture needle 150 is estimated (step S6 in FIG. 7).

  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. Then, the MPR section corresponding to the scanning section is set.

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

  Next, the pixel value comparison unit of the tumor region detection unit 12 compares the pixel value of the reference image data read from the image data storage unit of the reference image data generation unit 11 with a preset threshold value β2, and determines the normal tissue. A tumor region in the reference image data is detected by extracting pixels having pixel values that are significantly different from the threshold value β2 that is an average pixel value (step S8 in FIG. 7). And the outline extraction part of the tumor area | region detection part 12 produces | generates the outline data of a tumor area | region by carrying out the connection process of the several adjacent pixel which the above-mentioned pixel value comparison part extracted.

  On the other hand, the support data generation unit 13 receives ultrasonic image data (first ultrasonic image data) before the cauterization treatment generated by the image data generation unit 5 in time series, and receives the image of the reference image data generation unit 11. Tumor region information detected by the tumor region detection unit 12 using the reference image data read from the data storage unit (for example, contour data of the tumor region) 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 for the purpose of accurately inserting the RFA puncture needle 150 into the tumor region is generated. Then, the first treatment support data indicating the tumor region information and the puncture marker of the RFA puncture needle 150 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 observing the first treatment support data displayed on the display unit 14 determines the desired site of the tumor region and the RFA puncture needle 150 indicated in the first treatment support data. After confirming that the puncture marker intersects with the puncture marker, the RFA puncture needle 150 is punctured into the patient body along the puncture adapter of the ultrasonic probe 2 (step S10 in FIG. 7), and the distal end thereof is the tumor region. Is reached, the ablation treatment for the tumor region is started by switching the separately installed RFA treatment device to the operating state (step S11 in FIG. 7).

  If the ablation treatment for the tumor region is performed for a predetermined time, the ablation treatment is temporarily interrupted by switching the above-described RFA treatment device to the non-operation state, and then the tumor ablated by the same procedure as in the above-described step 4 Ultrasonic transmission / reception is performed with respect to the scanning section in the patient body including the region, and ultrasonic image data (second ultrasonic image data) after the cauterization treatment is generated in time series (step S12 in FIG. 7).

  Next, the ablation area detection unit 6 receives the above-described 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. A subtraction process is performed on the pixel values of the ultrasound image data (first ultrasound image data) before the ablation treatment read out from. Then, the ablation area is detected by comparing the difference value between the obtained pixel values and the predetermined threshold value β1 (step S13 in FIG. 7), and the outline data of the ablation area is extracted by extracting the outline of these areas. 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 the above-described step S7, and the ablation area detection unit 6 performs the first ultrasonic image data and the first ultrasonic image data. A puncture marker indicating the insertion direction of the RFA puncture needle 150 estimated by the insertion direction estimation unit 9 and information on the ablation area detected by the subtraction process with the ultrasonic image data of 2 (for example, contour data of the ablation area) By superimposing the reference image data on the above-described reference image data, second treatment support data for the purpose of accurately judging whether or not the ablation treatment is performed by the RFA puncture needle 150 is generated. Then, the second treatment support data indicating the information on the ablation area and the puncture marker of the RFA puncture needle 150 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 observing 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. However (step S15 in FIG. 7), if the cauterization treatment is insufficient, the procedure from step S10 to step S15 is repeated. On the other hand, if it is confirmed in step S15 described above that sufficient ablation treatment has been performed on the tumor region, the RFA puncture needle 150 is removed, and the ablation treatment for the patient is completed.

  According to the present embodiment described above, the tumor area of the patient is detected based on the 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. Then, by inserting the RFA puncture needle into the tumor region under the observation of the first treatment support data generated by superimposing the region information on the first ultrasonic image data before the cauterization treatment, It is possible to accurately insert the desired position.

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

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

  In particular, it is possible to detect with high accuracy an area whose characteristics have been changed by cauterization treatment by subtracting the pixel value of the first ultrasonic image data and the pixel value of the second ultrasonic image data.

  As mentioned above, although embodiment of this indication has been described, this indication is not limited to the above-mentioned embodiment, and it can change and carry out. For example, in the above-described embodiment, the case where the tumor region information (contour data) is superimposed on the first ultrasound image data constituting the first treatment support data has been described (see FIG. 5). Similar area information may be added to the image data. Similarly, the case where the information (contour data) of the ablation region is superimposed on the reference image data constituting the second treatment support data (see FIG. 6) has been described. However, similar area information may be added. Note that the area information in this case is not limited to the contour data.

  Moreover, although the tumor region detection part 12 in the above-mentioned embodiment described the case where a tumor region is detected by comparing all the pixel values which reference image data has with threshold value (beta) 2, it is not limited to this. For example, as shown in FIG. 8, reference image data existing inside a concentric circle having a radius Rr (for example, Rr <1.5 cm) centered on the distal end portion Pr of the RFA puncture needle 150 shown on the puncture marker Br. The region of the tumor At may be detected by comparing the pixel value of and the threshold value β2.

  Similarly, the ablation area detection unit 6 detects the ablation area by subtracting all the pixel values included in the first ultrasound image data and all the pixel values included in the second ultrasound 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 with the radius Ru centered on the distal end Pu of the RFA puncture needle 150 shown on the puncture marker Bu. The ablation area Aa may be detected by performing a subtraction process on the pixel value of the second ultrasonic image data. Further, the above calculation may be performed with the rough center portion of the tumor At as the center instead of the distal end portion Pr or the distal end portion Pu of the RFA puncture needle 150 described above.

  Thus, by limiting the processing range of the pixel value to the periphery of the RFA puncture needle tip, it is possible to shorten the time required for the comparison processing of the pixel value and the threshold value β2 or the subtraction processing between the pixel values. In addition, since the influence of noise and the like generated outside the tumor region is reduced, the tumor region and the ablation region 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, and the reference image data or ultrasonic image data showing the RFA puncture needle 150 is used. On the other hand, the operator may specify using the input device of the input unit 15.

  Further, in the above-described embodiment, the case where the ablation treatment is performed on the tumor region using the RFA puncture needle corresponding to the so-called radiofrequency ablation therapy in which the treatment target site is coagulated by radiating radio waves has been described. It is not limited to this, and ablation treatment using other types of puncture needles may be used.

  On the other hand, the ultrasonic data generated in the reception signal processing unit 4 of the above-described embodiment is not limited to B-mode data, and may be other ultrasonic 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 having different inspection modes. .

  Each unit included in the ultrasonic diagnostic apparatus 100 of the present embodiment can be realized by using, for example, a computer including a CPU, a RAM, a magnetic storage device, an input device, a display device, and the like 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 computer to execute a predetermined control program. In this case, the above-described control program may be installed in advance in the computer, or may be stored in a computer-readable storage medium or installed in the computer of the control program distributed via the network. .

  Although several embodiments of the present invention have been described above, these embodiments are presented as examples and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and equivalents thereof.

DESCRIPTION OF SYMBOLS 2 ... Ultrasonic probe 21 ... Probe position sensor 22 ... Puncture needle position sensor 3 ... Transmission / 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 section setting unit 9 ... Insertion direction estimation unit 10 ... Reference image information storage unit 11 ... Reference image data generation unit 12 ... Tumor region detection unit 13 ... Support data generation unit 14 ... Display unit 15 ... Input unit 16 ... Scanning control unit 17 ... System control unit 150 ... RFA puncture needle 100 ... Ultrasonic diagnostic apparatus

Claims (11)

An ultrasonic diagnostic apparatus for displaying treatment support data for supporting ablation treatment using a puncture needle,
Image data generating means for generating ultrasonic image data based on a reception signal obtained by ultrasonic transmission / reception for a patient;
Reference image data generation means for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using the reference image information of the patient collected in advance by a medical image information collecting apparatus installed separately;
Based on the first ultrasound image data before the ablation treatment and the second ultrasound image data after the ablation treatment generated by the image data generation means, the ablation area indicated in the second ultrasound image data is obtained. Ablation area detection means for detecting,
Support data generating means for generating the treatment support data by superimposing region information 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 region detection unit detects the ablation region by a subtraction process between the first ultrasound image data and the second ultrasound image data.   The ablation area 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 area is detected.   Contour extraction means for extracting the contour of the ablation region as the region information based on a difference value between the first ultrasound image data and the second ultrasound image data obtained by the subtraction process, The ultrasonic diagnosis 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. apparatus.   The reference image data generation unit is adapted to the ultrasonic image data by extracting reference image information of a cross section corresponding to the scanning cross section from the three-dimensional reference image information collected in advance by the medical image information collecting apparatus. The ultrasonic diagnostic apparatus according to claim 1, wherein the reference image data is generated. An ultrasonic diagnostic apparatus for displaying treatment support data for supporting ablation treatment using a puncture needle,
Image data generating means for generating ultrasonic image data before cauterization treatment based on a reception signal obtained by ultrasonic transmission / reception for a patient;
Reference image data generation means for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using the reference image information of the patient collected in advance by a medical image information collecting apparatus installed separately;
A tumor region detecting means for detecting a tumor region of the patient based on the reference image data;
Support data generating means for generating treatment support data by superimposing region information of the tumor region on the ultrasound image data;
An ultrasonic diagnostic apparatus comprising: display means for displaying the treatment support data.   The ultrasonic diagnostic apparatus according to claim 6, wherein the tumor region detection unit detects the tumor region by comparing a pixel value of the reference image data with a predetermined threshold value.   The tumor region detection means detects the tumor region based on the reference image data within a predetermined range centering on the tip of the puncture needle inserted into the patient's body or the center of the tumor region. The ultrasonic diagnostic apparatus according to claim 6.   It comprises a puncture direction estimating means for estimating a puncture direction of the puncture needle, and the support data generating means superimposes region information of the tumor region and a puncture marker indicating the insertion direction on the ultrasound image data. The ultrasonic diagnostic apparatus according to claim 6, wherein the treatment support data is generated by: For ultrasonic diagnostic equipment that displays treatment support data that supports ablation treatment using a puncture needle,
An image data generation function for generating ultrasonic image data based on a reception signal obtained by ultrasonic transmission / reception for a patient;
A reference image data generation function for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using the reference image information of the patient collected in advance by a medical image information collecting apparatus installed separately;
Based on the first ultrasound image data before the ablation treatment and the second ultrasound image data after the ablation treatment generated by the image data generation means, the ablation area indicated in the second ultrasound image data is obtained. Ablation area detection function to detect,
A support data generation function for generating the treatment support data by superimposing region information of the ablation region on the reference image data;
A control program for executing a display function for displaying the treatment support data. For ultrasonic diagnostic equipment that displays treatment support data that supports ablation treatment using a puncture needle,
An image data generation function for generating ultrasonic image data before ablation treatment based on a reception signal obtained by ultrasonic transmission / reception for a patient;
A reference image data generation function for generating reference image data of a cross section corresponding to a scanning cross section of the ultrasonic image data using the reference image information of the patient collected in advance by a medical image information collecting apparatus installed separately;
A tumor region detection function for detecting a tumor region of the patient based on the reference image data;
A support data generation function for generating the treatment support data by superimposing region information of the tumor region on the ultrasound image data;
A control program for executing a display function for displaying the treatment support data.

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